Attachment_27_-_Contractor_Request_to_use_Prohibited_Material.pdf

PM AAA

Contractor Request for Use of Prohibited Materials

AAA-FRM-02002 v1.0 Page 1 of 4

1. General Information

Contractor:

Date of Request:

Technical Point of Contact:

Name:

Phone:

Email:

Address:

Vehicle(s):

Contract Number:

PM AAA Prohibited material for which waiver is requested:

2. Explanation of Use

Instructions: Provide a description of the parts/processes where the prohibited material will be used. Identify all components/parts which will contain the prohibited materials upon vehicle delivery including quantities of these parts. Identify whether or not the material will be required for operation or maintenance (including during vehicle rebuild). A separate spreadsheet may be attached listing the specific parts/processes, if needed. See Enclosure 1 for listing of minimum information required.

3. Health Hazard

Instructions: Provide an explanation of any health hazards associated with the use or presence of the prohibited material. Include likely routes of exposure to both the operator and the maintainer. Identify if any Personal Protective Equipment (PPE) that would be required as a result of using this material. Include the type of PPE and under what circumstances it would be required (manufacturing, operation, maintenance, disposal, etc.).

AAA-FRM-02002 v1.0 Page 2 of 4

4. Analysis of Alternatives

Instructions: Identify all alternative material that was considered in lieu of the prohibited material. If the alternative is only for specific applications, identify what type of parts it is a potential alternative for. Include explanation (e.g., Trade Study or BCA) as to why each cannot be implemented.

5. Technical Justification

Instructions: Provide technical justification for the use of prohibited material. Explain why it is necessary and why it cannot be eliminated.

6. Program Risk

Instructions: Describe the program risk(s) (cost, schedule, and performance) associated with denial of this request by the Government.

7. Get-Well Plan

Instructions: Identify the parts where an alternative may be integrated at a later date.

Provide a get-well plan explaining how this will be accomplished. Also, indicate which parts you will not be able to eliminate and provide a brief explanation.

AAA-FRM-02002 v1.0 Page 3 of 4

The following Sections will be filled in by the Government

8. Environment, Safety, and Occupational Health Working Group (ESOH WG)

Evaluation/Recommendation

Instructions: Government ESOH WG will provide an evaluation of the above information and a recommendation regarding approval/disapproval of the prohibited material request.

Date

Chairman, ESOH WG

9. Concurrence

I concur that use of the prohibited material as described above is acceptable and justified:

Lead Engineer, Assistant Program Manager, Engineering

Produce Support Manager,

10. Approval

Upon the basis of the findings above, I hereby determine that the use of the prohibited material in the parts identified in Sections 1 through 7 is acceptable and justified.

Program Manager, Advanced Amphibious Assault

AAA-FRM-02002 v1.0 Page 4 of 4

ENCLOSURE 1:

Minimum information required in a spreadsheet for Item 2, Explanation of Use:

a) Contractor

b) Contract Number

c) Prohibited Hazardous Material

d) Hazard Tracking Number

e) Part or Process Number

f) Part or Process Description

g) Where Used

h) WBS Element Number Affected

i) Hazardous Material Quantity per Part

j) Hazardous Material Quantity per Vehicle

k) Is the material required for maintenance? (yes or no)

l) Is the material required for vehicle operation? (yes or no)

m) Additional information you want the Government to know.