Attch 3 CDRL A027 Test Insp Rpt Draft.pdf

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PREVIOUS EDITION MAY BE USED.

DD FORM 1423, FEB 2024

Page of (Updated 20250617)

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of (Updated 20250617)

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES Draft Final Reg Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 delivering such data item to the Government.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785 DD Form 1423, "Contract Data Requirements List"

Blk 11: Recurring Excel spreadsheet: 0; Individual inspection and certification reports: N/A.

Blk 12: Recurring Excel spreadsheet: 90 DAC; Individual inspection and certification reports: seven business days after completion of testing/inspection/certification.

Blk 13: Recurring Excel spreadsheet: 15 DARP; Individual inspection and certification reports: N/A

Blk 14a: Recurring Excel spreadsheet: Electronic format ONLY shall be delivered to the SLD 30/PM via email SLD30.PM.FRAME@spaceforce.mil and appropriate stakeholders. Individual inspection and certification reports: Submit report to SLD 30/PM and the Facility Manager responsible for the tested, inspected and certified property or equipment.

Recurring Excel spreadsheet:

Provide the following under separate tabs. Spreadsheet should not contain any locked cells

1. Roofs This section should capture the annual inspection details for roofs. The data fields should include:

• Facility Number: Identifier for the facility.

• Description: Type of roof.

• Additional Detail: Specifics of the roof material.

• Test Name: The name of the test performed.

• Evaluation Date: The date the evaluation was conducted.

• DCR Rating: The Direct Condition Rating given after the evaluation.

• Next Evaluation Date: The date for the next scheduled evaluation.

• Notes: Any relevant observations or comments.

2. Pressure Vessels This section will detail the inspections of pressure vessels. The required fields are:

• Facility Number: Identifier for the facility.

• Location: The location of the pressure vessel.

• PV #: The pressure vessel identification number.

• Item Description: A description of the pressure vessel.

• Inspection: The type of inspection performed.

• Rating: The result of the inspection.

• Inspection Date: Date of the last inspection.

• Next Inspection Date: Date of the next scheduled inspection.

• Specific ISI Tasks: Any specific in-service inspection tasks.

• Unique ISI Last Performed: The date the last unique ISI was performed.

• RV Calibration Required?: Whether relief valve calibration is required.

• RV Calibration Date: Date of the last relief valve calibration.

• Next RV Calibration Date: Date for the next relief valve calibration.

• PG Calibration Required?: Whether pressure gauge calibration is required.

• PG Calibration Date: Date of the last pressure gauge calibration.

• Next PG Calibration Date: Date for the next pressure gauge calibration.

• Last Certification Date: The date of the last certification.

• Next Certification Date: The date of the next certification.

• Rejectable Items: A list of items that are rejectable.

• Inspection Notes: Any notes from the inspection.

16. REMARKS: 3. Cranes & Hoists This section will cover the certification and testing of cranes and hoists. The fields should be:

• Facility Number: Identifier for the facility.

• Description: A description of the crane or hoist.

• Criticality: Whether the equipment is critical.

• Status (A/I/R): The status of the equipment (Active/Inactive/Removed).

• Location: The location of the equipment.

• Unit: The unit number.

• Equipment Number: The equipment identification number.

• Annual Certification Date: The date of the last annual certification.

• Pass/Fail: The result of the certification.

• Annual Certification Next Due: The date for the next annual certification.

• Non-Crit 4-Year Load Test Last Perf: Date of the last 4-year load test for non-critical equipment.

• Non-Crit 4-Year Load Test Next Due: Date for the next 4-year load test.

• Manufacturer/Model/SN#/Capacity: Details of the equipment.

• Crane Type: The type of crane.

• Build Date: The date the equipment was built.

• Notes: Any relevant notes.

4. Elevators This section is for detailing the inspections and testing of elevators. The necessary fields are:

• Facility Number: Identifier for the facility.

• Description: A description of the elevator.

• Type: The type of elevator.

• Status (A/I/R): The status of the elevator.

• Location: The location of the elevator.

• Capacity (LBS): The capacity of the elevator in pounds.

• Equipment Number: The equipment identification number.

• Annual Certification Date: The date of the last annual certification.

• CAT 3 Test Last Perf: Date of the last Category 3 test.

• CAT 3 Test Next Due: Date for the next Category 3 test.

• CAT 5 Test Last Perf: Date of the last Category 5 test.

• CAT 5 Test Next Due: Date for the next Category 5 test.

• Manufacturer/Model/SN#/Capacity: Details of the elevator.

• Notes: Any relevant notes.

5. Towers This section covers the periodic condition assessment inspections required for all towers. The necessary fields are:

The required fields for the routine report are:

• Facility Number/Tower ID: The unique facility or tower identifier.

• Structure Details: Location, height, structure type (e.g., guyed, self-supporting, monopole), and risk category.

• Inspection Date: The date the physical inspection was completed.

• Next Inspection Date: The date for the next scheduled inspection.

• Structural Assessment: A detailed description of the condition of structural members, including legs, diagonals, girts, welds, bolts, guy wires, guy hardware, and foundations.

• Appurtenance Assessment: A description of the condition of ancillary equipment, including ladders, safety climbs, platforms, sector frames, and antenna mounts.

16. REMARKS: 6. Lightning Protection and Grounding Systems This section will cover the inspection and testing of lightning protection systems (LPS) and facility grounding systems. Reports shall be in accordance with NFPA 780 and AFMAN 32-1065.

The required fields are:

• Facility Number: The facility identifier for the protected structure.

• Inspection Date: The date the inspection and testing were performed.

• Next Inspection Date: The date for the next scheduled inspection.

• Visual Inspection Summary: A description of the condition of air terminals, conductors, bonds, and surge protective devices.

• Continuity Test Results: A log of the electrical continuity measurements for all primary conductors.

• Ground Resistance Test Results: A log of the ground resistance readings for the system in accordance with the testing methods and locations specified in AFMAN 32-1065, Table A2.1, including a site diagram identifying all test locations.

• Deficiency List: A list of all findings that are not compliant with the referenced standards, with recommended corrective actions.

• Notes: Any relevant observations.

Individual inspection and certification reports:

Provide the actual detailed test, inspection, or certification report. Results shall explicitly state regulatory deficiencies.