Attachment 7 -Exhibit C (DD 1423 CDRL).pdf

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

REQUIRED

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final Reg Repro

16. REMARKS

15. TOTAL

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

TBD A MISC

INDUSTRIAL PLANT EQUIPMENT (IPE) MACHINE COOLANT N4215826RX60284 TBD

A001 CERTIFICATION DATA REPORT CLEAN-OUT DATA SHEET

DI-MISC-82386 PWS Paragraph 6.5.3 NNSY C900F

LT

D (SEE BLK 16)

WEEKLY SEE BLK 16

N/A SEE BLK 16 N/A

NNSY C900F 0 1 0

0 1 0

LAUTURE.MARC.ED

OUARD.1242617831

Digitally signed by

LAUTURE.MARC.EDOUARD.1242

617831 Date: 2026.03.19 09:10:54 -04'00'

RIGGINS.REBEK

AH.R.1108966021

Digitally signed by

RIGGINS.REBEKAH.R.110896602

Date: 2026.03.19 10:01:35 -04'00'

BLOCK 4: THE SUBMISSION OF THIS DATA SHEET IS ACCEPTABLE IN THE

CONTRACTOR'S FORMAT. ADDITIONAL FORMAT INSTRUCTIONS AND

GUIDANCE CAN BE OBTAINED REFERENCING DI-MISC-81423A (FACILITIES

MAINTENANCE REPORT). TAILORING GUIDANCE AS FOLLOWS:

CLEAN-OUT DATA SHEET SHALL CONTAIN A MINIMUM OF THE

FOLLOWING:

• IDENTIFICATION OF PERSONNEL PERFORMING WORK

• DOD ASSET NUMBER

• DATE SERVICE WAS ACCOMPLISHED

• WHETHER TRAMP OIL WAS REMOVED AND APPROXIMATE QUANTITY

• INITIAL REFRACTOMETER READING

• WHETHER WATER OR CONCENTRATE WAS ADDED IN ORDER TO

ACHIEVE DESIRED COOLANT CONCENTRATION

• FINAL REFRACTOMETER READING

• NUMBER OF MECHANICAL MAN-HOURS

• NUMBER OF TOTAL MAN-HOURS

• SERVICE REPRESENTATIVE SIGNATURE WHO PERFORMED WORK

NOTE: CONTRACTOR SHALL ENSURE THE MONITORING RESULTS LISTED

IN THE DATA SHEET ARE ATTACHED TO EACH MACHINE FOR INSPECTION

PURPOSES.

BLK 9: DISTRIBUTION STATEMENT D DISTRIBUTION AUTHORIZED TO THE

DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY

(CRITICAL TECHNOLOGY) (18 MARCH 2026). OTHER REQUESTS SHALL BE

REFERRED TO POC AT NORFOLK NAVAL SHIPYARD, PORTSMOUTH, VA.

BLK 11: CONTRACT AWARD DATE.

BLK 12: THE CONTRACTOR SHALL SUBMIT A CLEAN-OUT DATA SHEET

WITHIN 10 DAYS AFTER EACH EVENT FOR ALL CONTINUAL MAINTENANCE

OF MACHINE COOLANT ON ANY EQUIPMENT LISTED IN APPENDIX A OF

THE PWS.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA EMAIL

IN A DOWNLOADABLE MICROSOFT OFFICE ACCEPTABLE FORMAT THAT

WILL BE WRITE-PROTECTED OR PDF FORMAT. THE CONTRACTOR SHALL

CALL THE APPROPRIATE GOVERNMENT ORGANIZATIONAL ENTITIES TO

ENSURE RECEIPT OF THE REPORT.

TECHNICAL POC: TO BE DETERMINED AT AWARD

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

REQUIRED

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final Reg Repro

16. REMARKS

15. TOTAL

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

TBD A NDTI

INDUSTRIAL PLANT EQUIPMENT (IPE) MACHINE COOLANT N4215826RX60284 TBD

A002 TEST/ INSPECTION REPORT COOLANT SAMPLE LABORATORY ANALYSIS

DI-NDTI-80809 PWS Paragraph 6.7.4 NNSY C900F

LT

D (SEE BLK 16)

BI-WEEKLY SEE BLK 16

N/A SEE BLK 16 N/A

NNSY C900F 0 1 0

0 1 0

LAUTURE.MARC.ED

OUARD.1242617831

Digitally signed by

LAUTURE.MARC.EDOUARD.1242

617831 Date: 2026.03.19 09:10:17 -04'00'

RIGGINS.REBEK

AH.R.1108966021

Digitally signed by

RIGGINS.REBEKAH.R.110896602

Date: 2026.03.19 10:02:32 -04'00'

BLOCK 4: THE SUBMISSION OF THIS DATA SHEET IS ACCEPTABLE IN

THE CONTRACTOR'S FORMAT. TAILORING GUIDANCE AS FOLLOWS:

• CUSTOMER

• NID#

• PRODUCT

• DATE CHARGED

• CAPACITY

• RECOMMENDED CONTRACTION %

• DATE SAMPLE TAKEN

• DATE SAMPLE RECEIVED

• ACTUAL CONCENTRATION

• pH LEVEL

• TRAMP OIL

• BACTERIA LEVEL

• FUNGI LEVEL

• RUNNING CHARGE OF CONTRACTION & pH LEVEL

• RECOMMENDATIONS

NOTE: LABORATORY ANALYSIS IS ONLY REQUIRED IF HOLCUT 795

COOLANT IS NOT UTILIZED.

BLK 9: DISTRIBUTION STATEMENT D DISTRIBUTION AUTHORIZED TO

THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY

(CRITICAL TECHNOLOGY) (18 MARCH 2026). OTHER REQUESTS SHALL

BE REFERRED TO POC AT NORFOLK NAVAL SHIPYARD,

PORTSMOUTH, VA.

BLK 11: CONTRACT AWARD DATE.

BLK 12: THE CONTRACTOR SHALL SUBMIT ANALYSIS WITHIN 10 DAYS

AFTER EACH EVENT FOR ALL CONTINUAL MAINTENANCE OF MACHINE

COOLANT ON ANY EQUIPMENT LISTED IN APPENDIX A OF THE PWS.

BLK 14: DATA SUBMISSION SHALL BE SUBMITTED TO ALL POCs VIA

EMAIL IN A DOWNLOADABLE MICROSOFT OFFICE ACCEPTABLE

FORMAT THAT WILL BE WRITE-PROTECTED OR PDF FORMAT. THE

CONTRACTOR SHALL CALL THE APPROPRIATE GOVERNMENT

ORGANIZATIONAL ENTITIES TO ENSURE RECEIPT OF THE REPORT.

TECHNICAL POC: TO BE DETERMINED AT AWARD

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