CDRLS Automated De-Paint Systems Maintenance.pdf

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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

data_item: A001 title: Project Planning Chart sub: Project Planning Report auth: DI-MGMT-80507C ref: Para 4.2 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ONE/P asof: Block 16 firstsub: Block 16 subsub: N/A addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-MGMT-80507C as follows: Contractor format is Acceptable. Delete: 3.18 and 3.19

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(11)(12) Delivery NLT 30 days after contract award

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date: 17 Jan 2023 app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A002 title: Database Design Description sub: Database Design Description auth: DI-IPSC-81437 ref: Para 4.4.3.1 req_ofc: 309 MXSG/OBC dd250: LT appcode: NA dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-IPSC-81437 as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery:Within ten (10) days of any changes, upgrades, or repairs.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided to each addressee in block 16 on a compact disc or thumb drive. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: IPSC system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A003 title: Computer Software Product End Items sub: Computer Software Product End Items auth: DI-AVCS-80700A ref: Para 4.4.4 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-AVCS-80700A as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery within ten (10) business days of any changes, upgrades, or repairs, or within twenty (20) business days of being requested.

(14) One (1) copy of each submittal shall be provided to each addressee in block 16 on a compact disc or thumb drive. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: AVCS system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A004 title: Commissioning Plan (CxP) sub: Commissioning Plan (CxP) auth: DI-SESS-82197 ref: Para 4.5.1 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: N/A addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-SESS-82197 as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery:no later than ten (10) business days after the completion of repairs.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TDB exhibit: A xtdp: Off xtm: Off othercat: SESS system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A005 title: COMMERCIAL OFF-THE-SHELF (COTS) MANUALS AND ASSOCIATED SUPPLEMENTAL DATA sub:

auth: DI-TMSS-80527D ref: Para 4.7 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery: within thirty (30) days of any changes, upgrades, or repairs

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided to each addressee in block 16 on a compact disc or thumb drive. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: TMSS system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A006 title: CONDITION FOUND REPORT sub: CONDITION FOUND REPORT auth: DI-MGMT-81648A ref: Para 5.2, 6.3 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: Block 16 draft1:

reg1: 3 repro1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-MGMT-81648A as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery: As found, before unscheduled maintenance can proceed.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A007 title: Status Report sub: Status Report auth: DI-MGMT-80368A ref: Para 6.4, 9.2, 9.3, 13.3.1.7 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: Block 16 asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-MGMT-80368A as follows: Contractor format is Acceptable. Appendix A shall include a list of all employees that have completed required security training as per PWS section 13.3.1 to include course name and completion date.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(10)(11)(12)(13) Delivery: Reports shall be delivered on a monthly basis after award of the contract during the initial first year period of performance (PoP) and then on a quarterly bases for each subsequent option year PoP.

or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A008 title: QUALITY ASSURANCE PROGAM PLAN (QAPP) sub: QUALITY ASSURANCE PROGAM auth: DI-QCIC-81794A ref: Para 12.1 req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: N/A addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-MGMT-80507C as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(11)(12) Delivery NLT 30 days after contract award

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group: NSP total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: QCIC system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A009 title: ENVIRONMENTAL, SAFETY, AND OCCUPATIONAL HEALTH (ESOH) PLAN sub: Safety Plan auth: DI-SAFT-82313 ref: Appendix C req_ofc: 309 MXSG/OBC dd250: LT appcode: N/A dist: D freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: N/A addressee1: Block 16 draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: (4) Tailoring to DI-MGMT-80507C as follows: Contractor format is Acceptable.

(9) DISTRIBUTION STATEMENT D: Authorized to Department of Defense and U.S.

DoD contractors for Administrative or Operational Use Only. Other requests for this document shall be referred to 309 MXSG/OBC, Hill AFB, Utah.

(11)(12) Delivery NLT 15 days after contract award or reconstruction of the document.

(14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format. Addressees:

Brian Opheikens

309 MXSG/MXDSA

brian.opheikens@us.af.mil 801-777-4405

Andrew Orme

309 AMXG/EN

andrew.orme@us.af.mil 801-586-3170

Russell Carpenter

309 MXSG/MXDEZ

russell.carpenter.2@us.af.mil 801-777-0877 group:

total_price:

prep_name: Rand Bagley line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: SAFT system: Automated De-Paint Systems Maintenance ctr_no: TBD contr: South West Research Institute remarksb:

Page2:

Reset:

prep_date:

app_by: Brian Opheikens app_date:

Page:

of_pages:

app: Adobe Professional 8.0