DI-PSSS-81535A.pdf

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Attached to
F108 Module 8 Combustion Diffuser Nozzle (CDN) Case Federal contract opportunity
Solicitation number
FA8122-19-R-0011
Issued by
Department of the Air Force Materiel Command

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Deficiency Report

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Text version

DATA ITEM DESCRIPTION

Title: DEFICIENCY REPORT (DR)

Number: DI-PSSS-81535A Approved Date: 20160524 AMSC Number: F9660 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: AF 11 (AFLCMC/EZSC) Project Number: PSSS-2016-013 Applicable Forms: N/A

Use/Relationship: The Deficiency Report (DR) provides complete and accurate deficiency identification on government furnished material (GFM) in repair contracts by contractors to the Government. This information is used by the Government to identify necessary corrective action in accordance with T.O. 00-35D-54, USAF Deficiency Reporting, Investigation, and Resolution.

(Copies of this document are available online at http://www.tinker.af.mil/technicalorders/.)

a. This Data Item Description (DID) contains the format, content, and intended use information for the data deliverable resulting from the work task described in the solicitation.

b. This DID is applicable when contractors are responsible for maintaining custodial records for government property being repaired.

c. This DID interrelates with DI-MGMT-80258, Material Improvement Project (MIP) Report.

(Copies of this document are available online at http://quicksearch.dla.mil.)

d. This DID supersedes DI-ALSS-81535.

Requirements:

1. Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2. Format. The Contractor format is acceptable.

3. Content. The Deficiency Report content shall be as described in Table I.

DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited.

Source: https://assist.dla.mil -- Downloaded: 2016-06-27T19:20Z Check the source to verify that this is the current version before use.

http://www.tinker.af.mil/technicalorders/ http://quicksearch.dla.mil/

DI-PSSS-81535A

TABLE I. Deficiency report content.

1. From: Address of Originating Activity

2. To: Office of Primary Responsibility (OPR) for the equipment. Refer to D043 or D086 for guidance.

Subject First Part as applicable:

a. Category I Deficiency Report (CAT I DR)

b. Category II Deficiency Report (CAT II DR)

c. Report Control Number (RCN): An RCN consists of three parts. The first part will be the DoD Activity Address Code (DoDAAC).

The second part will be the last two digits of the calendar year.

The third part will be a 4-digit sequence number that is locally assigned.

3. Description of Deficiency:

Describe in detail what is wrong, the circumstances prior to the difficulty, probable cause, any action taken, and recommendations. Attach copy of supporting documents. Continue on separate sheet if necessary. Ensure that the description answers the questions listed in the instructions on the back of this form

4. Date of Deficiency: Year, month, day deficiency was discovered.

5. National Stock

Number (NSN) NSN and applicable Material Management Aggregation Code (MMAC) of item (see D043 and D086).

6. Nomenclature Noun of item for which report is submitted. Software DRs shall provide nomenclature of programmable hardware.

7. Operating Time at Failure

Hours, cycles, days, miles rounds or others

8. Deficient Item Part Number

Complete Manufacturer part number. If Computer Identification Number (CPIN) is associated with a computer program it shall also be provided.

9a. Manufacturer’s CAGE Code

Unique code assigned to suppliers of government or defense agencies.

9b. Manufacturer/Shipper/ City/State

Complete address of manufacturer or shipper.

10. Quantity Number received, inspected, deficient, and in stock.

11. Serial, lot or batch number Complete item serial number.

12a. Item new, repaired or overhauled

Use one to identify item as appropriate.

12b. Date Manufacturer, Repaired or Overhauled

Year/Month/Day

12c. Last Repair Facility CAGE/DoDAAC/Address

Check the source to verify that this is the current version before use.

DI-PSSS-81535A

13a. Contract Number Obtain contract number from records service tag, manufacturer/container label, etc. Contract number is critical to processing reports.

13b. Requisition/Document Number

Obtain from tags/labels on item packaging.

13c. Purchase Order Number.

The Purchase Order Number associated with the defective part. This can usually be found on the attached shipping document.

14. Government Furnished Material (GFM)

Yes/No/Unknown

15a. Item Under Warranty Yes/No/Unknown 15b. Warranty Expiration

Date Provide if known.

16. End Item Enter the applicable Equipment Item Code (EIC), Work Unit Code (WUC), or Table of Authorized Material Control Number (TAMCN) for the deficient material.

17. Next Higher Assembly a. NSN – National Stock Number associated with the next higher assembly.

b. NOMENCLATURE – Item name of the next higher assembly.

c. PART NUMBER – Part number assigned to the next higher assembly.

d. SERIAL NUMBER – Serial number from the next higher assembly.

18. End Item a. NSN – National Stock Number associated with the end item.

b. NOMENCLATURE – Name of the end item.

c. TYPE/MODEL – Type or model assigned to the end item configuration.

d. SERIAL NUMBER – Serial number from the end item equipment or system.

19. Current Disposition of Deficient Item

Holding/Disposed or Destroyed/Repaired/Other

20. Location of Deficient Material

Enter the name and location or supply activity that is currently holding the exhibit/deficient material.

End of DI-PSSS-81535A.

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