D_21169981- HYDROSTATIC TEST REPORT.pdf

PDF 456 KB Posted

Attached to
HOSE ASSEMBLY Federal contract opportunity
Solicitation number
SPMYM222Q1833
Issued by
Defense Logistics Agency Land and Maritime

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21169981- Material Spec Sheet.pdf PDF
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Text version

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188 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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302.

Please DO NOT RETURN your form to either of these address. 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 NDTI

D. SYSTEM/ITEM

E. CONTRACT/PR NO. F. CONTRACTOR

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

TEST/INSPECTION REPORT

3. SUBTITLE

HYDROSTATIC TEST REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16*

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

A. ADDRESSEE

Final

Draft Reg Repr o 16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 5/9/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

PSNS.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document no: 2116-9981

ATAT

N4523A 0 1 0

TOTAL 0 1 0

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

/s/ Grace Booker 5/9/2022 /s/ Malvin Doinog 5/9/2022

DD Form 1423-1, JUN 90 Page 1 of 2 Page(s)

S/N 0102-LF-010-5600

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

0002AD D

D001

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