CDRL A001 Initial Inspection Form- GDLd.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved

(1 Data Item) 0MB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the lime 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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 ii does not display a currently valid 0MB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the ContracVPR No. listed in Block E.

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

TDP TM OTHER ---

D. SYSTEM/ITEM

I

F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD250 REQ 9. DIST STATEMENT 10. FREQUENCY

REQUIRED

12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

b. COPIES 8.APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

SUBMISSION Draft Reg Repro

16. REMARKS

15. TOTAL

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

DD FORM 1423-1, AUG 96 (EG) PREVIOUS EDITION MAY BE USED. Page __ of __ Pages Designed using Perform Pro, WHS/DIOR, Aug 96

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

A001 Initial Machinery Inspection Form

CLIN 0001

SOW 3.a N32205 (MSC N441)

DD

N/A

See Block 16ASGEN

N/AN/A

XXXX

MSC_MHEOHE@US.NAVY.MIL

A

Material Handling Equipment

E. CONTRACT/PR NO.

N2185631534415

See Block 16

An Initial Machinery Inspection Form shall be completed in accordance with NAVSUP Publication 538 (6th Rev) Figure 8-12 and the applicable OEM Technical Manual for each unit serviced. The form shall identify the current machinery operational condition as well as status of all systems and safety devices.

The form shall be submitted via email within 5 days of machinery receipt.

Forms shall be submitted in an Adobe or Microsoft compatible format with the following file naming convention:

CDRL#_MSC Barcode_Date in YYYYMMDD format example: CDRLA001_23-02785_20230821

Submit all forms in accordance with Block 14a to MHE Type Desk at MSC_MHEOHE@US.NAVY.MIL

Distribution Statement not required

XX

NAVSUP PUBLICATION 538 SIXTH REVISION

SHIPBOARD UNIT □ SHOREBASED UNIT □ INSPECTION DATE

MAKE MHE TYPE BLADE LENGTH

MODEL MOTOR TYPE FUEL TYPE

YEAR TIRE TYPE HOUR METER READING

SERIAL NO. CAPACITY EQUIPMENT COST CODE

Item Inspection Point Accept Reject N/A

No.

1 Manufacturer's data/identification plate

2 Manufacturer's "STRUCTURALLY WEIGHT TESTED" marking (ammunition or shipboard handling)

3 Accredited laboratory certification plate (e.g., UL, FM)

4 Alphabetical designation (EE, DS, etc.)

5 Operational controls correctly labeled/marked

6 Battery identification plate or marking

7 Fuel type marking (e.g., DIESEL FUEL ONLY)

8 Warning decals and labels

9 Safe working load marking (sides and mast) (e.g., SWL 6000 LBS)

10 Vehicle weight marking (sides and mast) (e.g., VW 10,000 LBS)

11 Registration number (e.g., 13-20000)

12 SLEP data plate

13 "LEAD AND CHROMATE FREE PAINT" marking

14 "LIFT HERE" marking

15 "TIEDOWN" marking

16 Tire pressure marking (pneumatic only)

17 Fuel cap (color coded)

18 "SHIPBOARD USE APPROVED" marking

19 Blue diagonal striping (type EX only)

20 Instruction plates

21 Grease fittings (on components) fully filled and accessible

22 Correct fluid levels (brake, radiator, transmission, hydraulic, etc.)

23 Paint is smooth and adheres well

24 No evidence of loose, missing or broken hardware

25 No evidence of bent, cracked or worn accessories

26 No evidence of missing covers, panels, loose or poor fit

27 Overhead guard and load backrest (cargo guard) not damaged

MHE Inspection Form

Item

No.

NAVSUP PUBLICATION 538 SIXTH REVISION

Inspection Point Accept

Forks are straight within 1 % of length

Hydraulic cylinders: no weld cracks, leaks or other damage

Neoprene hydraulic lines: free of paint, routed correctly and secured

Towing devices, hitch pins, tow chains, etc. are attached

Battery cables: secure, no cuts/abrasions, and protected by non-conductive covers

Battery mounts and hold downs are secure

Wiring harness is correct with no frayed, brittle or crimped connections (soldered only)

Tires are correct type, size and thread (no delamination shall be accepted)

Wheel lugs are torqued as specified

Check mast rollers and locks

Fork heel pins and locks function

Lift chains and anchor pins are secure and functional

Operator pedals are equipped with rubber pads or non-slip coating

Operator restraint system/seat belt equipped and functional

Dash gauges are correct and marked

Key ignition switch (verify key numbers match contract numbers)

Start MHE and note any unusual noises

Weight gauge is legible and operable

Steering wheel is smooth and little free play

Verify all gauges function

Verify hourmeter operates properly

Verify horn operates

Verify back-up alarm operates

Verify all lights operate: brake, spot, battle/blackout, etc.

No evidence of steering play or loose suspension

Bring to full operating temperature (fuel power only) and check for leaks

Check for arcing and operation of contactors, traction, steer and hydraulic pump motors (electric MHE only)

Battery disconnect switch is operable

Check accelerator and inching/declutching pedal operation

Check brake operation

MHE Inspection Form (Continued)

Reject N/A

NAVSUP PUBLICATION 538 SIXTH REVISION

Item Inspection Point Accept

No.

58 Parking brake functions

59 Check emergency stop operation

60 Check for smoothness when raising mast to full height

61 Verify hose reel functions smoothly

62 Check tilt and side shift (rotation some models) operation and smoothness

63 Check acceleration (all forward and reverse gears)

64 Check braking (at speed) if smooth and straight

65 Check transmission (forward and reverse)

66 Clutch adjustment, engagement and operation

67 Check for exhaust leaks

68 Check applicable steering modes (2 wheel, 4 wheel, crab)

69 Verify the turning radius/tracking

70 For electric trucks, the presence of static conductive straps or tires

INSPECTION ACTIVITY INSPECTOR NAME

8-20

PRINT:

SIGNATURE:

MHE Inspection Form (Continued)

Reject N/A

DATE (MMDDYY)