FLORENCE FINCH FM200 and Galley Hood SOW.pdf

Statement of Work (SOW) For CGC FLORENCE FINCH’s FM200 and Galley Hood Inspections

1. Background and Current Observed Issues CGC FLORENCE FINCH is requesting inspection and testing for the installed fire suppression systems in accordance with standard maintenance procedures.

2. REFERENCES

CG MPC R-A-8843, R-102 GALLEY FIRE SUPPRESSION SYSTEM OPERATION TEST/CHECK

CG MPC N30050.D, GALLEY HOOD CONTR FIRE SYS

CG MPC N31015.D FM-200 FIRE PROT SYS (HULLS 33-ON)

3. REQUIREMENTS

Contractor must submit a resume that includes the performance of fire suppression system maintenance aboard CG assets. Performance of work aboard FLORENCE FINCH must be IAW the attached MPC’s R-A-8843, N30050.D and N31015.D.

4. PERIOD OF PERFORMANCE

The window of availability for the required services is 22 Jun 2026 to 29 July 2026. All work must be finalized prior to the end of this window. The Contractor shall contact the Cutter POC upon contract award and no later than 5 calendar days prior to the start of the availability window to finalize the exact dates and duration of the service visit. Vendor shall state in their proposal the amount of time the job is expected to take.

5. PLACE OF PERFORMANCE

CGC FLORENCE FINCH

37573 HIGHWAY 30

ASTORIA OR 97103

USA

Cutter Point of Contact:

MKC Matthew Schmader

PH: (503) 490-8028

Email: Matthew.j.Schmader@uscg.mil

Contracting Officer Technical Representative (COR):

CWO Brandon Triepke

PH: (585) 360-7516

Email: Brandon.m.Triepke2@uscg.mil mailto:Matthew.j.Schmader@uscg.mil mailto:Brandon.m.Triepke2@uscg.mil

U.S. COAST GUARD

COMPUTERIZED MAINTENANCE SYSTEM

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1 R-102 GALLEY FIRE SUPPRESSION SYSTEM OPERATION TEST/CHECK

SYSTEM:

N3 Firefighting system-General

SUBSYSTEM:

N-300 Firefighting systems-General

COMPONENT:

Extinguishing System, P/N: R-102-1T-02, CAGE: 03670, NIIN: 013699819

PERIODICITY EVENT:

NONE

NUMBER OF COMPONENTS:

TASK HOURS:

8.0

PERSONNEL:

1 Contractor

1 DC

1 MK

LOCATION:

Galley

SOURCE DOCUMENTS:

TP 3924-555-A, R-102 Restaurant Fire Suppression System TP 4563B-555-A, Fire Suppression System-Model R-102 TP 7427-651-A, R-102 Restaurant Fire Suppression System TP 8057-555-A, Range Hood Fire Fighting System R-102-1T-4N-6F

Distribution Statement D: Distribution authorized to the DHS/CG/DoD and their contractors Administrative/Operational use, 08/08/19. Other requests shall be referred to the appropriate asset product line.

WARNING: This document contains technical data whose export is restricted by the Arms Export-Control Act (Title 22, U.S.C., Sec 2751, et. seq.) or the Export Administration Act of 1979, as amended, Title 50, U.S.C. App 2401 et. seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5200.22-M, National Industrial Security Program Operating Manual, Section 5-705 or DoD 5200.1-R, Information Security Program Regulation, Chapter VI, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

http://osc-s-lim-ap106.osc.uscg.mil:8888/webcenter/content/conn/WCC1/path/i/Surface/TECH_PUB/3924/3924_555_A.pdf http://osc-s-lim-ap106.osc.uscg.mil:8888/webcenter/content/conn/WCC1/path/i/Surface/TECH_PUB/4563B/4563B_555_A.pdf http://osc-s-lim-ap106.osc.uscg.mil:8888/webcenter/content/conn/WCC1/path/i/Surface/TECH_PUB/7427/7427_651_A.pdf http://osc-s-lim-ap106.osc.uscg.mil:8888/webcenter/content/conn/WCC1/path/i/Surface/TECH_PUB/8057/8057_555_A.pdf

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1 R-102 GALLEY FIRE SUPPRESSION SYSTEM OPERATION TEST/CHECK

REFERENCES:

COMDTINST 9077.1 (series) Equipment Lockout / Tags-Plus Instruction

MPC R-C-8845

MPC R-S-8844

TOOLS/TESTEQUIPMENT:

Cap, Compressed Gas Cylinder, P/N: 77251, CAGE: 03670, NIIN: 014754221 Guard, Mechanical Drive, P/N: 14985, CAGE: 03670, NIIN: 0014408430 Lever, Manual Control, P/N: 14995, CAGE: 03670, NIIN: 014408437 Test Link, Fire, P/N: 15751, CAGE: 03670, NIIN: 012381593

EXPENDABLES:

Cap-Plug, Protective, Dust and Moisture Seal, P/N: 77695, CAGE: 03670, NIIN: 014408427 Link, Fusible, Fire (360 Deg F), P/N: 415745, CAGE: 03670, NIIN: 012422955

CONSUMABLES:

Cover, Pull Station, P/N: 434618, CAGE: 03670, NIIN: 016780181 (If required) Foam Liquid, Fire Extinguishing (3 Gal), P/N: 79372, CAGE: 03670, NIIN: 014408428 (If required) Gasket, P/N: 181, CAGE: 03670, NIIN: 004052608 (If required) Nonmetallic Rod, P/N: 24915, CAGE: 03670, NIIN: 014932964 (If required) O-Ring, P/N: 56909, CAGE: 03670, NIIN: 012768430 (If required) Plug, Expansion, P/N: 416974, CAGE: 03670, NIIN: N/A (If required) Silicone Compound, P/N: AS8660 8OZTU, CAGE: 81343, NIIN: 008807616 Switch, Sensitive, P/N: 423878, CAGE: 03670, NIIN: 014932959 (If required) Towel, Machinery Wiping, P/N: CJ99300, CAGE: 7J789, NIIN: 006342408

A PRELIMINARY STEPS

WARNING

VARIOUS STEPS IN THIS PROCEDURE EMPLOY ITEMS ON

THE HAZARDOUS MATERIALS LIST. BEFORE EXECUTING

THIS MPC, REFER TO THE APPLICABLE MSDS/SDS FOR

FULL SAFETY AND HANDLING PROCEDURES.

NOTE: This MPC should be completed by Coast guard personnel who have knowledge of this system or be contracted out. If contrac-tor performs maintenance on this system, ensure they are an autho-rized marine fire extinguishing system inspector. If contracted, ship's force personnel SHALL observe maintenance. Contractor will pro-vide tools, expendables, and consumables.

1. Notify all cognizant personnel before maintenance is started.

2. Ensure this MPC can be accomplished without disrupting system operations.

3. Obtain permission from Engineering Officer (EO) and Engineering Officer of the Watch (EOW), prior to conducting maintenance.

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WARNING

ENSURE EQUIPMENT IS PROPERLY TAGGED OUT. FAILURE

TO COMPLY MAY RESULT IN SERIOUS PERSONAL INJURY

OR DEATH.

4. Complete Red Danger Tag(s) IAW COMDTINST 9077.1 (series).

5. Attach Red Danger Tags to the following:

a. Circuit breaker for galley appliance protected by R-102 system.

b. R-102 system remote pull stations.

c. R-102 system control box.

WARNING

USE APPROPRIATE EYE OR FACE PROTECTION WHEN

EXPOSED TO EYE OR FACE HAZARDS FROM FLYING

PARTICLES, MOLTEN METAL, LIQUID CHEMICALS, ACIDS

OR CAUSTIC LIQUIDS, CHEMICAL GASES OR VAPORS,

COMPRESSED AIR OR POTENTIALLY INJURIOUS LIGHT

RADIATION.

6. Disarm R-102 galley fire suppression.

a. Remove the enclosure cover from the Ansul Automan regulated release assembly.

b. Insert the mechanical drive guard (lock bar), P/N: 14985, into the cocked regulator mechanism, (Refer to Figure 1).

(1) Slide the lock bar forward to engage.

c. Unscrew charging cartridge clockwise from regulated release assembly, (Refer to Figure 2).

(1) Install compressed gas cylinder cap (shipping cap), P/N: 77251, on cartridge.

(2) Set aside good cartridge in safe location.

B INSPECT R-102 SYSTEM

1. Inspect cartridge receiver gasket.

a. Remove gasket from cartridge receiver in regulated release mechanism.

b. Clean gasket with machinery wiping towel (rag), P/N: CJ99300.

c. Check gasket for damage or elasticity.

d. Replace gasket, P/N: 181, (If required).

WARNING

AVOID EYE CONTACT AND INGESTION WITH SILICONE

COMPOUND. FAILURE TO COMPLY MAY RESULT IN

PERSONAL INJURY.

e. Apply light coat of silicon compound, P/N: AS8660 8OZTU, to gasket.

f. Install gasket into cartridge receiver.

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CAUTION

CARTRIDGE SHALL REMAIN OUT OF RECEIVER AT THIS

TIME. IF CARTRIDGE IS INSTALLED, SYSTEMWILL ACTIVATE

DURING FOLLOWING TESTS.

NOTE: The date code is a two or three letter/number code stamped into the side of the actuation regulator. The UL listing and first letter code will determine how it is read.

2. Check the date code and UL listing stamped into the regulator body, (Refer to Figure 3 and Table 1).

3. Test regulator, if date code is 12 years or older, (Refer to MPC R-C-8845).

4. Inspect agent tank.

a. Remove agent tank.

(1) Disconnect expellant gas hose from tank adaptor assembly, (Refer to Figure 4).

(2) Disconnect distribution piping union at tank adaptor outlet.

(3) Lift agent tank from enclosure.

b. Check agent tank for manufacture date stamped on the tank nameplate or hydrostatic test label.

(1) Test agent tank, if manufacture date or hydrostatic date is 12 years or more, (Refer to MPC

R-C-8845).

c. Remove the tank adaptor assembly from the agent tank, (Refer to Figure 5).

WARNING

AVOID EYE CONTACT, SKIN CONTACT, INHALATION, AND

INGESTION WITH EXTINGUISHING AGENT. USE OF PROPER

PERSONAL PROTECTIVE EQUIPMENT RECOMMENDED.

WASH EXPOSED SKIN THOROUGHLY AFTER HANDLING.

FAILURE TO COMPLY MAY RESULT IN PERSONAL INJURY.

NOTE: Agent level of Ansulex low pH liquid fire suppressant should be 1-1 1/8 inch below the fill opening.

d. Check agent level in the tank.

CAUTION

DURING FILLING, THE AGENT TEMPERATURE SHOULD

BE 60-80°F. DO NOT FILL WITH COLD AGENT. DO NOT

OVER-FILL. OVERFILLING MAY RESULT IN AGENT ENTER-

ING GAS HOSE AND REGULATOR POTENTIALLY CAUSING

SYSTEM MALFUCTION.

(1) Add fire extinguishing foam liquid, P/N: 79372, to the agent tank, (If required).

(a) Ensure stored suppressant has been brought to room temperature prior to use.

e. Inspect threads on the tank adaptor for damage.

(1) Replace tank adaptor, (Refer to MPC R-C-8845), (If required).

f. Inspect threads on the tank collar for damage.

(1) Replace tank, (Refer to MPC R-C-8845), (If required).

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5. Inspect the tank adaptor.

a. Inspect o-ring.

(1) Remove o-ring from tank adaptor.

(2) Wipe o-ring with rag.

(3) Check o-ring for damage.

(a) Replace o-ring, P/N: 56909, (If required).

WARNING

AVOID EYE CONTACT AND INGESTION WITH SILICONE

COMPOUND. FAILURE TO COMPLY MAY RESULT IN

PERSONAL INJURY.

(4) Apply thin coat of silicone compound to o-ring.

(5) Install o-ring on tank adaptor.

b. Inspect vent plug.

(1) Remove vent plug from tank adaptor.

(2) Wipe plug with rag.

(3) Inspect vent plug for corrosion or damage.

(a) Replace vent plug, P/N: 74247, (If required).

(4) Install vent plug into tank adaptor.

c. Ensure expansion plug (bursting disc), P/N: 416974, is in place, silver side up.

(1) Replace bursting disc, (If required).

d. Install tank adaptor onto agent tank.

NOTE: There is no torque value required, do not over tighten.

(1) Tighten tank adaptor by hand.

6. Install filled agent tank assembly into enclosure.

a. Connect distribution piping union to tank adaptor outlet.

b. Connect expellant gas hose to tank adaptor assembly.

7. Inspect discharge nozzles, (Refer to Figure 6).

a. Remove blow-off cap from nozzle and discard.

b. Ensure nozzles are clean and free of cooking grease build-up.

8. Verify agent distribution piping is not obstructed.

NOTE: Nitrogen may be used as an alternate to low pressure dry air.

a. Blow low pressure dry air through the piping.

(1) Verify dry air is flowing through the piping and out of each nozzle.

WARNING

AVOID EYE CONTACT AND INGESTION WITH SILICONE

COMPOUND. FAILURE TO COMPLY MAY RESULT IN

PERSONAL INJURY.

b. Apply thin coat of silicone compound, to nozzle orifice.

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c. Install new dust and moisture seal protective cap-plug (blow-off cap), P/N: 77695, (Refer to Figure 7).

C TEST R-102 SYSTEM

1. Test manual actuation.

a. Remove lock bar from the cocked regulator mechanism, (Refer to Figure 1).

(1) Slide the lock bar back then remove.

b. Operate remote manual pull station.

(1) Remove break rod from the pull station, (Refer to Figure 8).

NOTE: Take care in removing the break rod from the pull station side shields while rotating the break rod/pull knob assembly.

(a) Insert small screwdriver into slot at bottom of pull knob.

(b) Push in slightly on screwdriver.

(c) Turn pull knob clockwise.

(d) Remove break rod from pull knob.

(2) Check nonmetallic rod (break rod) for damage.

(a) Replace break rod, P/N: 24915, (If required).

(3) Pull ring handle on pull station.

(4) Check pull station cover for damage or wear.

(a) Replace pull station cover, P/N: 434618, if cable has worn a groove in the cover as deep as the diameter of the cable.

c. Reset pull station, (Refer to Figure 9).

(1) Insert break rod into pull knob.

(2) Push pull knob into faceplate.

(3) Turn pull knob counterclockwise until the break rod and pull knob snap in place.

d. Ensure regulated release mechanism has actuated, (Refer to Figure 10).

e. Cock the regulated release mechanism using the mechanical control lever (cocking lever), P/N:

14995, (Refer to Figure 11).

f. Test electrical switches, (Refer to Figure 10).

(1) Press the lever of each switch up.

(a) Verify that a click was heard.

(2) Pull ring handle on pull station again, to trip system.

(3) Press the lever of each switch up.

(a) Verify that no click was heard.

g. Replace switch, P/N: 423878, if improper function is noted.

2. Cock the regulated release mechanism using the cocking lever.

3. Test automatic actuation.

a. Raise tension lever to “UP” position, (Refer to Figure 12).

b. Remove one of the old fusible links.

c. Install test link, P/N: 15751, in its place, (Refer to Figure 13).

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d. Lower tension lever to “DOWN” position, (Refer to Figure 14).

e. Cut test link using wire cutter.

f. Raise tension lever to “UP” position.

g. Remove used test link.

h. Remove all old fusible links.

(1) Discard old fusible links.

i. Install new fusible links.

(1) Ensure fusible link, P/N: 415745, is rated at 360 degree Fahrenheit.

j. Lower tension lever to “DOWN” position.

4. Cock the regulated release mechanism using the cocking lever.

5. Insert the lock bar into the cocked regulator mechanism, (Refer to Figure 1).

a. Slide the lock bar back then remove.

6. Install agent tank assembly into enclosure.

a. Place agent tank into enclosure.

b. Connect distribution piping union to tank adaptor outlet.

c. Connect expellant gas hose to tank adaptor assembly.

7. Check cartridge, (Refer to MPC R-S-8844).

8. Ensure regulated release mechanism is cocked.

9. Ensure lock bar is installed.

a. Slide the lock bar forward to engage.

10. Install cartridge into cartridge receiver counterclockwise, (Refer to Figure 15).

NOTE: There is no torque value required, do not over tighten.

a. Tighten by hand.

11. Remove lock bar.

12. Install enclosure cover.

D FINAL STEPS

1. Remove Red Danger Tag IAW COMDTINST 9077.1 (series).

2. Restore equipment to the normal status.

3. Notify EO, EPO, or Supervisor of any discrepancies, repairs, or future actions.

4. Ensure HAZMAT created or used during the MPC is properly stored, segregate or disposed of IAW all applicable local, state, and federal regulations prior to completion of this procedure.

5. Record maintenance action.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document. Page 7 of 20 http://osc-s-lim-ap106.osc.uscg.mil:8888/webcenter/content/conn/WCC1/path/i/Surface/MPC/DC_R-S-8844.pdf https://cg.portal.uscg.mil/sites/externaldata/Directives/CI_9077_1D.pdf

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UL 541L UL 74FF UL 74FF

Month* Year* Year* Month* Month* Year*

Jan A 1981 K 2005 E Jan A Jan A 2011 T

Feb B 1982 L 2006 F Feb B Feb B 2012 U1

Mar C 1983 M 2007 G Mar C Mar C 2013 U2

Apr D 1984 N 2008 H Apr D Apr D 2014 U3

May E 1985 P 2009 I May E May E 2015 U4

Jun F 1986 R 2010 J Jun F Jun F 2016 U5

Jul G 1987 S 2011 K Jul G Jul G 2017 U6

Aug H 1988 T Aug H Aug H 2018 U7

Sep J 1989 U Sep I Sep J 2019 U8

Oct K 1990 V Oct J Oct K 2020 U9

Nov L 1991 W Nov K Nov L 2021 V1

Dec M 1992 Y Dec L Dec M 2022 V2

1993 Z *STAMPED YEAR 1ST, MONTH 2ND

**STAMPED “I” FOR SEPTEMBER

2023 V3

1994 A 2024 V4

1995 B 2025 V5

1996 C *STAMPED MONTH 1ST,

YEAR 2ND

1997 D

1998 E

1999 F

2000 G

2001 H

2002 J

2003 K

2004 L

2005 M

*STAMPEDMONTH 1ST, YEAR 2ND

MANUFACTURE DATE CODE

Table 1

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INSTALLATION OF LOCK BAR

Figure 1

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CARTRIDGE REMOVAL

Figure 2

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LOCATION OF DATE CODE AND UL LISTING

Figure 3

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AGENT TANK REMOVAL

Figure 4

TANK ADAPTOR

Figure 5

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NOZZLE LAYOUT

Figure 6

RUBBER NOZZLE CAP

Figure 7

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REMOVING BREAK ROD FROM PULL STATION

Figure 8

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INSTALLING BREAK ROD IN PULL STATION

Figure 9

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REGULATED RELEASE MECHANISM

Figure 10

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RECOCKING SYSTEM

Figure 11

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TENSION LEVER DISENGAGED

Figure 12

FIRE TEST LINK

Figure 13

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TENSION LEVER ENGAGED

Figure 14

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CARTRIDGE INSTALLATION

Figure 15

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WPC-154

N30050.D

REV'D 09/15/20

ASSET NUMBER OPERATING ACTIVITY MAINTENANCE ACCOMPLISHED MAINTENANCE DUE

DATE ASSET HOURS DATE ASSET HOURS

MO DAY YEAR MO DAY YEAR

ZULU DATE ZULU TIME

MO DAY YEAR

ITEM 1

DUE

CMS CODE ACTION DESCRIPTION CEINUM

N30050 INSPECT GALLEY HOOD CONTR FIRE SYS P3-B000-001

SCHEDULED UNSCHEDULED

DISCREPANCIES FOUND: NO_____ YES_____

MAN HOURS: MK___.___DC___.___EM___.___ET___.___IT___.___GM___.___BM___.___FN___.___SN___.___ME___.___OTHER___.___

IF DISCREPANCIES ARE FOUND REMARKS ARE REQUIRED

TECHNICIAN'S

SIGNATURE

TECHNICIAN'S

ID

* ASTERISK INDICATES QA REQUIRED QA

REFERENCES:

DWG 154-WPC-555-301, Fixed Fire Extinguishing System Diagram DWG 154B-WPC-555-301, Fixed Fire Extinguishing System Diagram DWG 154-WPC-640-201, Living Compartments and Arrangements DWG 154B-WPC-640-201, Living Compartment and Arrangements

MPC R-A-8843

TP 8057-651-A, Ranger Hood Fire Fighting System-Model R-102-1T-4N-6F

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Distribution Statement D: Distribution authorized to the DHS/CG/DoD and their contractors Administrative/Operational use, 08/25/20. Other requests shall be referred to the appropriate asset product line.

WARNING: This document contains technical data whose export is restricted by the Arms Export-Control Act (Title 22, U.S.C., Sec 2751, et. seq.) or the Export Administration Act of 1979, as amended, Title 50, U.S.C. App 2401 et. seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5200.22-M, National Industrial Security Program Operating Manual, Section 5-705 or DoD 5200.1-R, Information Security Program Regulation, Chapter VI, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

PRIVACY ACT STATEMENT

Authority: 44 U.S.C. 3101; 44 U.S.C. 3534; 5 U.S.C. §552a (e)(3); and Executive Order 9397.

Purpose: To account for scheduled and unscheduled maintenance performed on CG aircraft and surface assets.

Routine Uses: Authorized CG personnel will use this information to document scheduled and unscheduled maintenance, man-hours expended, and the technician respon-sible for tasks performed on CG aircraft and surface assets. Any external disclosures of data within this record will be made in accordance with DHS/ALL-004, General Information Technology Access Account Records, 77 Federal Register 70792, November 27, 2012.

Disclosure: Furnishing your Tech ID is voluntary; however, the inability to collect this information could result in untimely or incomplete Asset Computerized Maintenance System reports or the inability for the CG to make informed decisions regarding manpower analysis.

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ASSET NUMBER OPERATING ACTIVITY MAINTENANCE ACCOMPLISHED MAINTENANCE DUE

DATE ASSET HOURS DATE ASSET HOURS

MO DAY YEAR MO DAY YEAR

MPC IS A COMBINATION OF R-102 SYSTEM TEST, GALLEY HOOD PIPING IN-

SPECT, AND FUSIBLE LINK REPLACE.

EPOS SHALL SUBMIT SERVICE REQUEST THROUGH THEIR SECTOR EO TO

THE SFLC ASSET MANAGER INBOX 60 DAYS PRIOR TO REQUIRED DUE DATE

FOR ANNUAL INSPECTION.

COMPLETE AND SUBMIT SURFACE ASSET SERVICES FORM 2455.

http://10.38.65.78/SFLCFormsLibrary/FormDoc.ashx?FormID=5

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MK BM

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

DC IT

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

EM FN

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

ET SN

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

GM OTHER

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

NAME: ____________________________TECH ID/TH: _______/_____ NAME: ____________________________TECH ID/TH: _______/_____

PRIVACY ACT STATEMENT

Authority: 44 U.S.C. 3101; 44 U.S.C. 3534; 5 U.S.C. §552a (e)(3); and Executive Order 9397.

Purpose: To account for scheduled and unscheduled maintenance performed on CG aircraft and surface assets.

Routine Uses: Authorized CG personnel will use this information to document scheduled and unscheduled maintenance, man-hours expended, and the technician respon-sible for tasks performed on CG aircraft and surface assets. Any external disclosures of data within this record will be made in accordance with DHS/ALL-004, General Information Technology Access Account Records, 77 Federal Register 70792, November 27, 2012.

Disclosure: Furnishing your Tech ID is voluntary; however, the inability to collect this information could result in untimely or incomplete Asset Computerized Maintenance System reports or the inability for the CG to make informed decisions regarding manpower analysis.

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REV'D 09/15/20

Services Request Form Unit:_______________ POC:_________________ Hull:_______________ Date:_________________

Phone Number:______________

Description of Services Requested:

Completed by Sector:

Company Name:

Address:

Date Scheduled:

Required Date of Completion:

Phone #:

Priority: EO Signature:

Completed by Product Line:(Description of work to be accomplished, attach sketch or standard boat repair):

Product Line Signature:

Remarks:

SCHR Entry is required: □ Supplier of services is PL approved:

Supplier of services is not approved, PL Designee or PL representative will be on site when repairs are effected.

SFLC Form 2455

RESET

FORM

PRINT

FORM

Revised 04Nov09

SURFACE ASSET SERVICES REQUEST FORM 2455

DESTRUCTION NOTICE - Destroy by any method that the document. Page 4 of 4

DATE ASSET HOURS DATE ASSET HOURS

ZULU DATE ZULU TIME

REVIEWED

BY

LOG YN DATA

ENTRY

COMPLETED

MO DAY YEAR MO DAY YEAR

ASSET NUMBER OPERATING ACTIVITY MAINTENANCE ACCOMPLISHED MAINTENANCE DUE

MO DAY YEAR

ITEM 1

DUE

CMS CODE ACTION DESCRIPTION CEINUM

SCHEDULED UNSCHEDULED

REMARKS: _________________________________________________________________________________________

TECHNICIAN’S

SIGNATURE _________________________________________________________

TECHNICIAN’S

ID _________________________________________________________

* ASTERISK INDICATES QA REQUIRED

REFERENCES:

MAN HOURS: MK __.__ DC __.__ EM __.__ ET __.__ IT __.__ GM __.__ BM __.__ FN __.__ SN __.__ ME __.__ OTHER __.__

U.S. COAST GUARD

COMPUTERIZED MAINTENANCE SYSTEM

Distribution Statement D: Distribution authorized to the DHS/CG/DoD and their contractors Administrative/Operational use, 00/00/00. Other requests shall be referred to the appropriate asset product line.

WARNING: This document contains technical data whose export is restricted by the Arms Export-Control Act (Title 22, U.S.C., Sec 2751, et. seq.) or the Export Administration Act of 1979, as amend-ed, Title 50, U.S.C. App 2401 et. seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5200.22-M, National Industrial Security Program Operating Manual, Section 5-705 or DoD 5200.1-R, Information Security Program Regulation, Chapter VI, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

PRIVACY ACT STATEMENT

Authority: 44 U.S.C. 3101; 44 U.S.C. 3534; 5 U.S.C. §552a (e)(3); and Executive Order 9397.

Purpose: To account for scheduled and unscheduled maintenance performed on CG aircraft and surface assets.

Routine Uses: Authorized CG personnel will use this information to document scheduled and unscheduled maintenance, man-hours expended, and the technician responsible for tasks performed on CG aircraft and surface assets. Any external disclosures of data within this record will be made in accordance with DHS/ALL-004, General Information Technology Access Account Records, 77 Federal Register 70792, November 27, 2012.Disclosure: Furnishing your Tech ID is voluntary; however, the inability to collect this information could result in untimely or incomplete Asset Computerized Maintenance System reports or the inability for the CG to make informed decisions regarding manpower analysis.

WPC-154

N31015.D

REV’D 10/31/24

TP 8011-436-A, Fire/Gas Detection and Control System-Model PRO-2000X2S TP 8095A FM-200, Design, Installation, Operation and Service Manual TP 8303 FM-200 Beta/Gamma Fire Protection System Installation, Operation & Service Manual

N31015 TEST FM-200 FIRE PROT SYS (HULLS 33-ON) P3-B000-001

IF DISCREPANCIES ARE FOUND REMARKS ARE REQUIRED

DISCREPENCIES FOUND: Yes No

MK BM

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

DC IT

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

EM FN

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

ET SN

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

GM OTHER

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

NAME TECH ID/TH: NAME TECH ID/TH:

PRIVACY ACT STATEMENT

Authority: 44 U.S.C. 3101; 44 U.S.C. 3534; 5 U.S.C. §552a (e)(3); and Executive Order 9397.

Purpose: To account for scheduled and unscheduled maintenance performed on CG aircraft and surface assets.

Routine Uses: Authorized CG personnel will use this information to document scheduled and unscheduled maintenance, man-hours expended, and the technician responsible for tasks performed on CG aircraft and surface assets. Any external disclosures of data within this record will be made in accordance with DHS/ALL-004, General Information Technology Access Account Records, 77 Federal Register 70792, November 27, 2012.

Disclosure: Furnishing your Tech ID is voluntary; however, the inability to collect this information could result in untimely or incomplete Asset Computerized Maintenance System reports or the inability for the CG to make informed decisions regarding manpower analysis.

WPC-154

N31015.D

REV’D 10/31/24

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1 FM-200 FIRE PROTECTION SYSTEM (HULLS 33-ON) TEST

REFERENCES:

COMDTINST 9077.1 (series) Equipment Lockout/Tags- Plus Instruction

MPC N31018.0

MPC N31019.0

TOOLS/TEST EQUIPMENT:

M7 Responder SCBA Assembly, P/N: 10102292, CAGE: 55799, NIIN: 015876781

Stopwatch, P/N: MIL-S-14823, CAGE: 81349, NIIN: 001260286 (Or equivalent)

EXPENDABLES:

NONE

CONSUMABLES:

Break Glass, P/N: 313020, CAGE: 0KDP7, NIIN: N/A (If required)

Break Glass, P/N: 928103, CAGE: 0KDP7, NIIN: N/A (If required)

Seal, Antipilferage, P/N: PTS, CAGE: 62757, NIIN: 012420583 (Or equivalent)

A PRELIMINARY STEPS

NOTE: This MPC is completed by a Depot repair activity or requires Depot level assistance.

1. Contact the Product Line to schedule Depot level work.

2. Ensure that the area is safe for maintenance.

NOTE: This MPC should be completed by an original equipment manufacturers (OEM) authorized fire extinguishing system inspector. Ship’s force personnel shall observe maintenance.

Inspector will provide tools, expendables, and consumables.

3. Notify the Engineer Petty Officer (EPO) that testing of the fire protection system will commence.

4. Ensure that the following are available and established while prior to performing maintenance on the fire protection system:

a. Firefighting team.

b. Fire watch.

c. Rescue team.

d. CPR - qualified personnel.

5. Announce to the crew that the fire protection system will be disabled while performing maintenance.

https://uscg.sharepoint-mil.us/:b:/r/sites/USCGReferences/directives/Directives/CI_9077_1D.pdf?csf=1&web=1&e=ZkCwhY

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6. Perform FM-200 fire protection system pressure check, (Comply with MPC N31018.0).

7. Inspect the FM-200 fire protection system, (Comply with MPC N31019.0).

8. Install FM-200 fire protection system warning signs on all accesses to FM-200 fire protected spaces, (Refer to Figure 1).

CAUTION

TESTING OF FM-200 FIRE SUPPRESSION SYSTEM

PRESSURE SWITCHES WILL INITIATE AN AUTOMATIC

SHUTDOWN OF MAIN ENGINES, SHIPS GENERATORS,

INTAKE BLOWERS, AND THE ACTIVATION OF RED

WARNING STROBE LIGHTING.

9. Close the following damage control and engine room doors, hatches, and fixtures:

a. Engine room doors.

b. Engine room emergency escape hatches.

c. Engine room intake dampers.

d. Engine room natural exhaust ventilation covers.

10. Assemble the rescue team.

a. Assign a minimum of two rescue personnel.

(1) Designate one rescuer per two maintenance personnel.

(2) Provide a self-contained breathing apparatus (SCBA), P/N: 10102292, to each designated rescuer.

(a) Review SCBA operating procedures, to include the buddy system.

b. Establish communications from one rescue person to a manned watch station, (i.e., quarterdeck or bridge).

c. Check that CPR-qualified personnel are readily available and on standby.

11. Conduct a safety briefing for all involved personnel.

a. Discuss the following hazards that are involved while working with the FM-200 fire protection system:

(1) Discuss how the FM-200 system could be accidentally discharged.

(2) Discuss where the FM-200 might migrate after discharge, (visualize the dispersion of FM-200 as if it were water).

(3) Discuss the actions to be taken by maintenance, rescue, and other affected personnel should an accidental discharge occur.

b. Define all egress paths from the affected spaces to well-ventilated areas that are not susceptible to the effects of the FM-200 gas.

c. Discuss the following when demonstrating proper egress:

(1) Discuss holding open inward-swinging doors in the egress route by a positive means, (i.e., such as a C-clamp).

(2) Discuss which access openings in the egress route should remain open throughout the procedure and how they should be secured.

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(3) Check that the appropriate entries are made in the damage control closure log.

(4) Check that all escape paths are free of any obstructions.

d. Perform a walk-through with all maintenance personnel of the egress route to the safe area(s).

e. Check that warning signs and/or guards are at all areas that could be affected by FM-200 gas hazards and migration zones to ensure all non-maintenance personnel are safe and clear of the area.

f. Evacuate all personnel not involved in FM-200 system maintenance from the protected spaces, work areas, and all possible gas migration zones prior to performing maintenance.

g. Position assigned rescue personnel and discuss the following duties:

(1) Monitor conditions in the area of the FM-200 system while avoiding the likely path of heavy FM- 200 gas migration in the event of FM-200 discharge.

(2) Maintain a count of maintenance personnel working on the FM-200 fire protection system.

(3) Conduct a communications check with the continually manned watch station, (i.e., bridge or quarterdeck).

WARNING

ENSURE EQUIPMENT IS PROPERLY TAGGED OUT. FAILURE

TO COMPLY MAY RESULT IN SERIOUS PERSONAL INJURY

OR DEATH.

12. Complete Equipment Lockout/Tags-Plus Process IAW COMDTINST 9077.1 (series).

a. Attach Red Danger Tags to all FM-200 fire protection system actuation stations.

B TEST

WARNING

INHALATION OF HIGH FM-200 CONCENTRATIONS

OF 10% OR MORE MAY CAUSE HEADACHE,

DISORIENTATION, VERTIGO, SWEATING, NUMBNESS,

LOSS OF LIMB CONTROL, MENTAL CONFUSION, LOSS OF

CONSCIOUSNESS IN AS LITTLE AS 16 SECONDS; CARDIAC

ARREST WITHIN SECONDS OF UNCONSCIOUSNESS;

PERMANENT BRAIN DAMAGE IN 3 TO 5 MINUTES; DEATH,

UNLESS EFFECTIVE CPR IS INITIATED WITHIN FIRST

MINUTES OF CARDIAC ARREST.

NOTE: The following procedures will be performed by an OEM certified fire suppression system contractor. Unit personnel will observe maintenance for proper completion and safety.

1. Disconnect the lever/pressure operated control head from the primary FM-200 cylinder(s).

a. Loosen the swivel nut on the control head from the FM-200 CYLINDER valve actuation port, (Refer to Figure 2).

b. Remove the control head from FM-200 CYLINDER valve, leaving the tubing attached to the control head.

https://uscg.sharepoint-mil.us/:b:/r/sites/USCGReferences/directives/Directives/CI_9077_1D.pdf?csf=1&web=1&e=ZkCwhY

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NOTE: Each FM-200 cylinder is factory equipped with a safety cap installed on the valve outlet, and securely chained to the valve to prevent loss. This device is a safety feature and will provide controlled safe discharge when installed if the cylinder is actuated accidentally.

c. Loosen swivel nut on the discharge hose.

d. Remove the discharge hose from the FM-200 CYLINDER valve outlet port.

e. Install the safety cap on the FM-200 CYLINDER valve outlet port, (Refer to Figure 3).

2. Disconnect the lever operated control head from the time delay override and the reserve FM-200 cylinder(s).

3. Start the ship’s service diesel generator(s) (SSDG) and main diesel engine(s) (MDE), IAW ship’s procedure, to be tripped by the FM-200 fire protection system during maintenance test.

4. Energize the engine room intake fans IAW ship’s procedure.

5. Activate the FM-200 fire protection system from each remote pull box station.

a. Activate the REMOTE STANDARD/WATERTIGHT switch(es).

(1) Remove the tamper/safety glass from the REMOTE switch(es).

(a) Open the watertight cover using the cover handle, (for watertight actuator only).

(b) Remove the screws from the glass retainer.

(c) Remove the glass retainer.

(d) Remove the remote pull box actuator tamper/safety glass carefully.

(e) Check the integrity of the tamper/safety glass.

1) Replace REMOTE switch actuator tamper/safety glass, P/N: 928103 (standard) or P/N:

313020 (watertight), if needed.

(f) Place the remote pull box actuator tamper/safety glass in a secure location to prevent damage.

1) Repeat Steps 1 B 5.a.(1) through 1 B 5.a.(1)(f) for any remaining remote standard/ watertight pull box station(s).

(2) Assign one person to activate the FM-200 fire protection system at the REMOTE switch.

(3) Assign a second person to observe the lever/pressure operated control head pin for the primary FM-200 cylinder.

(4) Activate the REMOTE STANDARD/WATERTIGHT switch actuator.

(5) Measure the time from actuation to when lever/pressure operated control head stem for the primary FM-200 cylinder extends.

(a) Start stopwatch, P/N: MIL-S-14823.

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(b) Stop stopwatch when cylinder control head stem is extended.

1) Notate actuation time on system inspection tag.

NOTE: The tolerance for FM-200 fire protection system time delay is -0 to +12 seconds.

(6) Notify EPO if measured time is outside of tolerance.

(7) Check that the following has occurred:

(a) Shutdown of MDEs and SSDGs.

(b) Red warning strobe is operating.

(c) Engine room intake fans have shut down.

(d) Siren cylinder has discharged, and that the siren is heard.

b. Repeat Steps 1 B 5.a.(3) through 1 B 5.a.(7)(d) from each remote actuation station.

6. Test the lever operated control heads manually from the following locations:

a. Remote actuation stations.

b. Time delay override.

c. Reserve FM-200 cylinder.

(1) Pull the safety pull pin.

(2) Move the lever to the “OPEN” position.

(3) Check that the lever operated control head stem extends.

(4) Exercise the lever several times.

(5) Reset the lever operated control head.

(a) Move the lever to the “CLOSED” position.

(b) Ensure the lever operated control head stem is in the “SET” position.

(c) Insert the safety pull pin.

(d) Attach a seal, P/N: PTS, around the safety pull pin.

1) Repeat Steps 1 B 6.c.(5)(a) through 1 B 6.c.(5)(d). for each location listed in Steps 1 B 6.a. through 1 B 6.c.

7. Install the lever operated control head onto the time delay.

8. Place the control head in the “SET” position.

9. Connect the lever operated control head onto the reserve FM-200 cylinder(s).

10. Connect the lever/pressure operated control head onto the primary FM-200 cylinder(s).

11. Recertify system if applicable.

a. Provide tags for each cylinder and recertification letter including noting of any deficiencies found.

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C FINAL STEPS

1. Secure back-up firefighting capabilities and fire watch.

2. Notify all cognizant personnel that maintenance is complete.

3. Remove all warning signs.

4. Notify the ship’s force that maintenance is complete.

5. Reconnect necessary Operating Components and Remove Lockout/Tags-plus Material and Hardware IAW COMDTINST 9077.1 (series).

6. Restore equipment to its normal condition of readiness.

7. Notify EPO of discrepancies, repairs, or further action upon completion of maintenance.

8. Record any maintenance action by completing appropriate sign off and adding pertinent remarks.

https://uscg.sharepoint-mil.us/:b:/r/sites/USCGReferences/directives/Directives/CI_9077_1D.pdf?csf=1&web=1&e=ZkCwhY

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FM-200 FIRE PROTECTION COMPARTMENT WARNING SIGN

Figure 1

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ELECTRIC CONTROL HEAD

Figure 2

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FM-200 CYLINDER DETAILS

Figure 3