C04.0 CDRLs & DIDs.pdf

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DATA ITEM DESCRIPTION

Title: WORK COMPLETION CERTIFICATION CERTIFICATE

Number: DI-MGMT-82061

AMSC Number: N9710

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

GIDEP Applicable: No

Project Number: MGMT-2016-048

Use/Relationship: This DID will certify that all contracted work has been performed and completed.

This DID contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

Requirements:

Format. The report shall be similar to that of Attachment A.

Content. The report shall contain all the information specified in Attachment A:

Source: https://assist.dla.mil -- Downloaded: 2017-02-01T16:32Z Check the source to verify that this is the current version before use.

DI-MGMT-82061

DI-MGMT-82061

End of DI-MGMT-82061

Title: QUALTIY MANAGEMENT SYSTEM (QMS)

Number: DI-MGMT-82184 Approval Date: 20180418

AMSC Number: N9901 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Preparing Activity: SH Project Number: MGMT-2018-014

Use/Relationship: The Quality Management System (QMS) provides the roadmap for the complete QMS to be implemented.

This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

1. Format. The QMS shall be in contractor’s format.

2. Content. The QMS shall contain the following the parts:

2.1 Subpart 1. CTTR QMS Quality Manual. This part shall include a QMS Quality Manual that is based on the existing QMS Manual and is in accordance with ISO 9001:2015. It shall also contain the following:

a. A description of the QMS

b. Proposed changes

c. Revisions

d. Updates and

e. Any changes than enhance the existing QMS Manual

f. History of revisions

2.2 Subpart 2. Plan of Action and Milestones (POA&M) Timetable. This part shall contain the following:

a. Details for the completion of all documents that are needed to implement the updated

QMS and proposed changes.

b. A timetable for the development and implementation of all plans, procedures, work

Instructions, Job Qualification Standards (JQSs), Tier IV, and records to be added or modified.

c. It shall also specify the following:

1. The document names, document number, site, and estimated dates of completion.

2. The timeline by quarters and the documents scheduled for development, verification, validation, and completion during each quarter.

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DI-MGMT-82184

3. Completion of all documents by the end of the first year of the contract.

4. Actual completion date

End of DI-MGMT-82184

Source: https://assist.dla.mil -- Downloaded: 2019-02-28T18:19Z

Title: ACCEPTANCE TEST REPORT (ATR) Number: DI-QCIC-81891 Approval Date: 20130118 AMSC Number: N9313 Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: AS/PMA251 Applicable Forms: N/A

Use/relationship:

The ATR contains the results of the qualification tests performed by the contractor to demonstrate that the system conforms to the performance specifications, work authorization document, or contract requirements.

This Data Item Description (DID) contains format, content, and intended use information for the data product resulting from the work task described in the Statement of Work (SOW).

1. Format. Contractor’s format is acceptable.

2. Content. The ATR shall contain the following:

a. Test article identification and full description of test specimens utilized, including any deviations for the configuration specified in the applicable test plan.

b. Date and location of test or evaluation.

c. The operator who conducted the test.

d. Results obtained, including specific identification and discussion of objectives demonstrated satisfactorily and those not demonstrated satisfactorily.

e. Contractor’s conclusions, corrective action anticipated, recommendation to correct. deficiencies, and suggested improvements based on evaluation of the test.

f. All analysis and supporting data.

g. All data sheets.

3. End of DI-QCIC-81891.

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Title: CONTRACTOR HAZARDOUS MATERIAL INVENTORY REPORT

Number: DI-ENVR-82091 Approval Date: 20161208

AMSC Number: N9751 Limitation: N /A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: ENVR-2017-001

Applicable Forms: PSNS&IMF form 5090/132

Use/Relationship: Contractor Hazardous Material Inventory Report will be used to identify hazardous materials needing for approval by the government for use on the Naval Installation.

by the discrete task requirement as delineated in the contract.

1. Format. The Hazardous Material Inventory Report shall be presented on PSNS&IMF form

5090/132 in this DID.

2. Content. The report shall contain all of the information specified in PSNS&IMF 5090/132.

End of DI-ENVR-82091

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DI-ENVR-82091

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI)

Ref: NAVSEA Standard Items 009-97 and 009-02 NWRMC Local Standard Item 099-04NW

Document No.

CONTRACTOR – INITIAL REQUEST1 (Before moving any hazmat onto this Federal facility) **Refer to instructions on last page**

PRIME CONTRACTOR (KTR) (POC) SUB-CONTRACTOR (If Applicable) PRIME KTR CERTIFICATION SIGNATURE (sign or submit electronically) Print & sign

PHONE

Mr KTR NA Signature on File 555-232-2222

CONTRACT NUMBER PROJECT NAME2 WORKSITE LOCATION3 PROJECT EXECUTION START

DATE

PROJECTED

END5

N4523A-12-D-0003 USS Michigan Dry Dock 2 12/14/2015 04/03/2016

ENVIRONMENTAL, SAFETY, AND HEALTH (ESH) GOVERNMENT REPRESENTATIVE

CONTRACT OFFICE AGENCY (i.e., C/400, AIT)

ESH GOVERNMENT REPRESENTATIVE NAME PHONE FAX SUBMITTAL

DATE C/400/106.2 ESH SBS 360-535-2222

CODE 106.31 HAZARDOUS MATERIAL PROCESS MANAGEMENT BRANCH

106.31 NAME & INITIALS RECEIPT DATE REVIEW DATE

Trade Name6

Name on product & MSDS must match

For kits, list kit name, then list kit components individually

Manufacturer7

Name on product & MSDS must match

Process Code Number8

Use provided flow chart

Container Size & Type9

Enter size

SHIPYARD MSDS

Number10 (As assigned by Code 106.31)

SHIPYARD Assigned Stock Number (Assigned by Code 106.31)

Speclt SSPR 6PK Marking Fluorescent Green Spray Paint, #1989830

Rust-Oleum Corp. ID0507 11 oz AER See Attached SDS

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI) CODE 106.31 Document No. Page 2 of 2

CONTRACTOR – INITIAL REQUEST (Before moving any hazmat onto this Federal facility)

Trade Name6

Name on product & MSDS must match

For kits, list kit name, then list kit components individually

Manufacturer7

Name on product & MSDS must match

Process Code Number8

Use provided flow chart

Container Size & Type9

Enter size

SHIPYARD MSDS Number10 (As assigned by Code 106.31)

SHIPYARD Assigned Stock

( assigned by Code 106.31)

PSNS & IMF 5090/132 (Rev. 04-13)

INSTRUCTIONS

Contractor: Fill out each section under the heading “CONTRACTOR” per the following instructions and footnotes. List all hazardous material (HM) that you, as the contractor, anticipate transporting from offsite onto the Federal property located at the Bremerton Naval Complex (BNC). Do not list HM obtained inside the BNC that has been labeled with the facility’s salmon colored supplemental barcode label. Use as many additional sheets as necessary to include all HM that you anticipate transporting onsite. Provide the most current MSDS for each product listed in the CHMI. If you are using a “Non-Road” engine do not forget to submit an O&M plan to Code 106.31 Air Department. For all marine coatings, provide a Volatile Organic Compound (VOC) certification sheet for each batch. If you have a Marine Coating that is

General Use and the VOC’s are above 340g/l you must submit separate paperwork to Code 106.31 Air department. All HM must be approved by the Code 106.31 before bringing material onsite. Low Use

Exempt materials may also be processed on this form. Upon completion of all Contractors required items submit the completed CHMI form to your Government Environmental, Safety, and Health representative.

* Prime Contractor Certification Statement: I hereby certify that the submitted information contained in the attached document(s) is true, complete and accurate, and all material listed has been approved by

Code 106.31.

Designated Government Environmental, Safety, and Health Representative: Complete Designated Government ESH section. Submit completed CHMI to Code 106.31 for review and approval.

FOOTNOTES

This is for the initial request. Use the Receipt & Monthly Usage Form to report monthly HM usage by the 5 th calendar day of the following month. Negative usage reports are required. If no usage, enter 0 in applicable field or leave blank and submit report.

Identify Project (e.g. – ship hull number or name, etc).

Identify Worksite Location (e.g. – Hull number, bldg. 431 5th floor, Dry

Dock 2, Pier D, etc).

The date that the contractor is to start work on the project.

The planned (best estimation) completion date for work on the project.

Provide a separate line for each product and/or container size that will be used. When reporting kits, list each component on separate lines. If part numbers are included in the Trade Name block, it will be helpful in processing the CHMI faster.

Reference example below.

Trade Name Manuf acturer

Container

Size & Type

MSDS

Stock

Buff Base Part

A PPG 0.8 gal CN

Converter Part

B PPG 0.2 gal CN

Welding electrodes 7018 ESAB 10lb

Table 1 – Container Type

Descripti on

Aeros ol Can

Ba g

Bottle Bo x

Cartri dge

Can Contain er

Cylind er

Drum

Code AER BG BT B

X

CA CN CO CY DR

Descripti on

Each Jar Package Ki t

Rod Spool Tank Tube

Code EA JR PG K

T

RD SP TK TU

Manufacturer, product name on container and company name must all match.

To determine the proper Process Code Number use the attached Hazardous Material Process Code Selection Flow Chart.

Report container size(s) in quantifiable units (e.g., weight or volume) such as a 3 lb. jar or a 16 fl oz bottle. For compressed gas cylinders, report the quantity of gas in cubic feet or units such as pounds (e.g., 150 cu-ft or 100 lb cylinder). For bulk material (e.g., diesel fuel) or material without a specific container size (e.g., welding rod or wire), use the units in which the material is commonly sold to consumers (e.g., use gallon for diesel fuel or pound for welding rod or wire). For kits, list both the kit size and each individual component size. Reference Footnote 6 for reporting kits. See Table 1 for the applicable container type. Enter container type code.

Provide the Shipyard approved Material Safety Data Sheet (MSDS) number (if known) or include a MSDS for each product (Code

400 projects only). Sending a Technical Data Sheet with the MSDS will be helpful in processing the CHMI faster. When sending an MSDS ensure that it is no older than 5 years old, the MSDS must be a representative of the material being used.

For Usage remember you are reporting for the size requested and it is listed on the form. When reporting round up to the nearest tenth, use percentages (i.e. do not use: 3 gal of a 10 gal container, use: .3

When Reporting Partial Usage, Use Decimals to Represent the Fraction of Container Used.

EXAMPLE:

Use 0.8 to indicate 3/4 usage of a container

Do Not Enter as Lbs, Gallons, Ounces etc.

Round Up to Nearest Tenth.

Use 0.3 to indicate 1/4 usage of a container Use 0.8 to indicate 3/4 usage of a container

PSNS 5090/132 (Rev. 04-13)

Title: CONDITION FOUND REPORT

Number: DI-MGMT-81648 Approval Date: 20040809 AMSC Number: N7531 Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: N PEO SHIPS-FL32 Applicable Forms: N/A

Use/Relationship: The Condition Found Report identifies needed repairs and recommends corrective action for work discovered during the contract performance period which are not covered by the work specifications.

This DID contains the format, content, and intended use information for the data product resulting from the work task described in the contract.

Requirements:

1. Reference documents. N/A.

2. Format. The report shall be in contractor’s format.

3. Content. The report shall be serialized by CFR Number, and shall include the following:

a. Contract number, ship and hull number

b. Work Item Number to which the CFR relates

c. Date work requirement was discovered

d. Clear description of the work requirement

e. Specific location of the work requirement

f. Recommendation for corrective action

3.1 Recommendation for appropriate/best time to accomplish (i.e. during current availability with or without schedule change, future CNO or Continuous Maintenance Availability), and supporting rationale for the recommendation (such as cost efficiencies, availability of work force, availability of material, premium expenditures, etc.).

3.2 Cost and time estimates and the time frame for which it is valid, including:

a. Class “C” cost estimates. For work requirements which could be estimated within five working days, a class “F” estimate (+/-40%) identifying any potential impact which may affect the current schedule shall be included. The Class “F” estimate shall also contain the date on which a class “C” estimate will be provided.

b. Estimated Premium/Acceleration Costs, including premium costs for; material, subcontractors, man-hours, rework and any additional costs to on going work resulting from inclusion of the CFR work requirement.

c. Identification of related changes, if any, to the internal milestones and production and contract completion dates shall be included. When no changes were required a statement to that fact shall also be included

4. Media. The electronic media requirements shall be as specified in the contract on the DD 1423 CDRL.

5. End of DI-MGMT-81648

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DATA ITEM DESCRIPTION

Title: Work Completion Certification Certificate

Number: DI-MGMT-82050 Approval Date: 20160705

AMSC Number: N9679 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2016-043

Use/relationship: This DID will certify that all contracted work has been performed and completed.

by the specific and discrete task requirement as delineated in the contract.

1. Format. The report shall be similar to that of Sample Figure 1.

2. Content. The report shall contain all the information specified in Sample Figure 1.

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DI-MGMT-82050

DI-MGMT-82050

End of DI-MGMT-82050