MDR Report 4S24.pdf

6830 1ABC EXHIBIT A

SYSTEM/ITEM ARGON, TECH.

ITEM NO

CATEGORY

CONTRACTOR

CONTRACT

PAGE

(ADP DD FORM 1423(MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

PRINTED 03/15/2021

CONTRACT DATA REQUIREMENTS LIST

01 SEQ NO A001

02 DATA DESC MATERIAL SAFETY DATA SHEETS

03 SUBTITLE

04 DID NUMBER FED-STD-313

05 CONTRACT REF PARA. C.3.1

06 TECH OFFICE 106

07 DD 250 REQ DD

08 APP CODE

10 FREQUENCY 1-TIME

11 AS OF DATE

12 DATE 1ST SUBM WITH MATERIAL

13 DATE SUB SUBM

14 DISTRIBUTION 106.1,

15 TOTAL 3

16 REMARKS MATERIAL SAFETY DATA SHEETS ARE REQUIRED. VENDOR TO COMPLETE ONLY

THOSE PORTIONS THAT ARE APPLICABLE. HAZARDOUS ELEMENTS OR COMPOUNDS

MAY BE IDENTIFIED BY FORMULA NUMBER OR TRADENAME (SEE 20.4 OF FED-STD

313C). MATERIAL SAFETY DATA SHEETS ARE TO BE IDENTIFIED BY STOCK NUMBER AS

ASSIGNED BY PNS.

SEQ. NO. A001

PREPARED BY

APPROVED BY

DATE

DATE

DD FORM 1423

09 IAC INPUT

/1 0

6830 1ABC EXHIBIT A

SYSTEM/ITEM ARGON,TECH.

ITEM NO

CATEGORY

CONTRACTOR

CONTRACT

PAGE

(ADP DD FORM 1423(MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

PRINTED 03/15/2021

CONTRACT DATA REQUIREMENTS LIST

01 SEQ NO A002

02 DATA DESC CERTIFICATION/DATA REPORT

03 SUBTITLE CERTIFICATION OF ANALYSIS

04 DID NUMBER DI-MISC-80678

05 CONTRACT REF PARA. C.3.2

06 TECH OFFICE 136.2

07 DD 250 REQ DD

08 APP CODE

10 FREQUENCY 1-TIME

11 AS OF DATE

12 DATE 1ST SUBM PRIOR TO DELIVERY

13 DATE SUB SUBM

14 DISTRIBUTION 133.2, 501.3 VIA MAIL (NO DD250 REQ)

15 TOTAL 3

16 REMARKS PARAGRAPH 10.3 OF DI-MISC-80678 IS DELETED. TECHNICAL CONTENT IN

ACCORDANCE WITH MIL-A-18455C. COA TO BE FORWARDED TO PNS DISTRIBUTION

FACILITY (B337) VIA EMAIL PRIOR TO DELIVERY.DELIVERY WILL BE AUTHORIZED UPON

SATISFACTORY RECEIPT INSPECTION OF COA.

SEQ. NO. A002

PREPARED BY

APPROVED BY

DATE

DATE

DD FORM 1423

09 IAC INPUT

/2 0

CONTRACT

PRINTED 03/15/2021 ATTACHMENT PAGE

6830 1ABC

C DESCRIPTION/SPECIFICATIONS

C.1 PROVIDE ARGON IN ACCORDANCE WITH MIL-A-18455C, DATED 23DEC1986, SECTION 6.2

C.2 CYLINDERS ARE TO BE RENTED FROM THE CONTRACTOR.

C.3 DATA REQUIREMENTS:

C.3.1 SAFETY DATA SHEETS, SEE EXHIBIT A, SEQUENCE A001

C.3.2 CERT.OF ANALYSIS, SEE EXHIBIT A, SEQUENCE A002

C.3.3 CERTIFICATION MUST INDICATE THE NUMBER OF DEWARS;

LOT NUMBER; ANALYTICAL RESULTS FOR EACH DEWAR/SERIAL

NUMBER; AND A SENTENCE STATING THAT THE DEWARS WERE

PROCESSED AND FILLED IN ACCORDANCE WITH MIL-A-18455C.

C.3.4 EACH DEWAR TO HAVE A PERFORATED THREE SECTION TAG ATTACHED

DENOTING: FULL/IN USE/EMPTY. TAG TO HAVE PERFORATED LINES

BETWEEN EACH STATEMENT.

D PRESERVATION/PACKAGING/PACKING

D.1 BULK ARGON TO BE SUPPLIED IN 5850 CUBIC FOOT DEWARS WITH WHEELS,

CONTRACTOR OWNED.

D.2 D10 HAZARDOUS MATERIAL

D.3 PACKING SLIP/INVOICE SHALL INCLUDE DEWAR SERIAL NUMBER AND LOT NUMBER. PACKING SLIP/INVOICE SHALL BE DELIVERED TO DISTRIBUTION FACILITY (PNS B337) FOR VERIFICATION PRIOR TO

DELIVERING DEWARS TO END USERS.

E INSPECTION ACCEPTANCE

E.1 INSPECTION AT DESTINATION SHALL CONSIST OF REVIEW OF CERTIFICATE OF ANALYSIS, TO BE

PROVIDED IN ACCORDANCE WITH EXHIBIT A, SEQ A002

ITEM NO.

STOCK NUMBER

6830-LL-DM1-0882

SPECIAL CHARACTERISTICS

UNIT OF ISSUE IS A 5850 CF DEWAR TANK

FORM: LIQUID

ITEM NAME ARGON, TECHNICAL, 99.98% BY VOLUME

SECTION B

H SPECIAL PROVISIONS

H.1 H12 HAZARDOUS MATERIAL IDENTIFICATION & MATERIAL SAFETY DATA

K Section

L Section

M Section

SMIC

6Y