1.06_CDRLS_N3598A24NA058.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO.

B.EXHIBIT

C.CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM

2E-1377-01-300-3579-MT99

E.CONTRACT/PR NO.

F.CONTRACTOR

1.DATA ITEM NO.

A001

2.TITLE OF DATA ITEM

Test Procedure

3.SUBTITLE

17.PRICE

GROUP

4.AUTHORITY (Data Acquisition Document No.) 5.CONTRACT REFERENCE

6.REQUIRING OFFICE 18.ESTIMATED

TOTAL PRICE

DI-NDTI-80603 ALL DRAWINGS NSWC Indian Head EOD Tech Division

7.DD250 REQ

LT

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

ONE TIME

12.DATE OF FIRST

SUBMISSION

14.DISTRIBUTION

D

60 DAC

a. ADDRESSEE

b. COPIES

8.ADP CODE

A

11.AS OF

DATE

13.DATE OF SUBSEQUENT

Draft

Final

Reg Repro

16.REMARKS SEE BLOCK 16 0 1 0

THE PLAN IS TO SPECIFY PROCESS CONTROL INSTRUCTIONS AND INSPECTION

PROCEDURES NEEDED TO ENSURE PRODUCT CONFORMANCE TO DRAWINGS,

SPECIFICATIONS, AND CONTRACT REQUIREMENTS IAW ANSI/ASQC Q9000-2000 OR

EQUIVALENT. THE PLAN IS TO INCLUDE FIRST ARTICLE AND PRODUCTION LOT

QUALITY CONFORMANCE INSPECTION PROCEDURES IAW DI-NDTI-80603A ALONG

WITH ALL APPLICABLE DATA ENTRY SHEETS TO BE USED TO DOCUMENT PROCESS

INSPECTIONS.

BLK 14: DISTRIBUTION ADDRESS

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A151

4. NUWC-Indian Head E24JC See section H for distribution POC’s and their emails.

15.TOTAL 0 1 0

G. PREPARED BY:

Robert Kovach

H. DATE

4 September 24

I. APPROVED BY:

Lisa Hardman

J. DATE

4 September 24

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 7 Pages

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

D. SYSTEM/ITEM

A002

2.TITLE OF DATA ITEM

Test/Inspection Report

3.SUBTITLE

Pre-Production & Production Test

DI-NDTI-80809 ALL DRAWINGS NSWC Indian Head EOD Tech Division

7.DD250 REQ

SS

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

PER LOT

SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8.ADP CODE

16.REMARKS SEE BLOCK 16 0 1 0

THE REPORT IS TO VERIFY BOTH FIRST ARTICLE AND PRODUCTION LOT CONFORMANCE TO THE

APPLICABLE DRAWINGS, SPECIFICATIONS, AND CONTRACT REQUIREMENTS. THE REPORT

CONSISTS OF THE PLAN (A001) CONTAINING ALL REQUIRED INSPECTION

RESULTS DOCUMENTED ON THE PLAN’S DATA ENTRY SHEETS. IN ADDITION, THE

REPORT IS TO INCLUDE MATERIAL CERTIFICATIONS AND ALL OTHER PERTINENT

OBJECTIVE QUALITY EVIDENCE. DCMC REVIEWIS REQUIRED PRIOR TO SUBMITTAL

TO NUWC DIVISION KEYPORT. THE REPORT MUST BE APPROVED BY NAVSEA

KEYPORT BEFORE FINAL ACCEPTANCE OF THIS LOT IN WAWF.

BLK 12: DATE OF PRE-PRODUCTION TEST REPORT SUBMISSION – NLT 15 DAYS

AFTER FIRST ARTICLE TEST COMPLETION.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 15 DAYS AFTER LOT

ACCEPTANCE TESTING OF SECOND LOT AND BEYOND.

3. NAVSUP ALC, Code A151

Robert Kovach

H. DATE

4 September 24

I. APPROVED BY:

Lisa Hardman

4 September 24

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 7 Pages

(2 Data Items)

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

D. SYSTEM/ITEM

A003

2.TITLE OF DATA ITEM

Engineering Change Proposal (ECP)

17.PRICE GROUP

DI-CMAN-80639C Section C NSWC Indian Head EOD Tech Division

REQUIRED

10.FREQUENCY 12.DATE OF FIRST

ASREQ ASREQ

a. ADDRESSEE

11.AS OF DATE

When Revised Reg Repro 16.REMARKS See Block 16 0 1 1 An Engineering Change Proposal (ECP) provides the documentation in which the engineering change is described. It includes change impacts to systems, configuration items and other associated configuration documentation affected by the proposed change.

1. NUWC-Indian Head E24JC

15.TOTAL 1 1

A004

2.TITLE OF DATA ITEM

Request for Deviation (RFD)

4.AUTHORITY (Data Acquisition Document No.)

DI-CMAN-80640C

5.CONTRACT REFERENCE

Section C

6.REQUIRING OFFICE

NSWC Indian Head EOD Tech Division

18.ESTIMATED

TOTAL

PRICE

7.DD 250 REQ

LT

9.DIST STATEMET

REQUIRED

10.FREQUENCY

ASREQ

ASREQ

14 DISTRIBUTION

A

11.AS OF DATE

When Revised

Reg Repro 16.REMARKS See Block 16 0 1 1 A Request for Deviation describes a proposed departure from (a non-conformance with) the contractually-specified configuration documentation for a specific number of units or for a specified period of time.

1. NUWC-Indian Head E24JC

15.TOTAL 1 1

G.PREPARED BY H.DATE I.APPROVED BY J.DATE

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

D. SYSTEM/ITEM

A005

2.TITLE OF DATA ITEM

Ammo Data Card (ADC)

DI-MISC-80043B Section C NUWC DIV KEYPORT CODE 423

SD

REQUIRED

10.FREQUENCY

PER LOT

PER LOT

a. ADDRESSEE

PER LOT Reg Repro

16.REMARKS SEE BLOCK 16 0 1 0

BLK 4: DATA CARD SHALL BE PREPARED IN ACCORDANCE WITH MIL-STD-1168,

AS CHANGED BY ADL EXCEPTIONS AND THE CONTRACT DOCUMENT LIST BY

ACCESSING THE WORLDWIDE AMMUNITION-DATA REPOSITORY (WARP) WHICH IS

LOCATED: https://mhpwarp.redstone.army.mil. AN ACCESS REQUEST FORM

MUST BE COMPLETED BEFORE WARP CAN BE ACCESSED. QUESTIONS SPECIFIC TO

WARP SHOULD BE ADDRESSED TO ONE OF THE RESPECTIVE POCs AS LISTED ON

THE WEBSITE.

BLK 10,12,13: DATA CARDS PROVIDED TO NAVSEA PMS-404 AND THOSE SENT

WITH SHIPMENTS SHALL BE HARDCOPY PRINTOUTS GENEREATED WITH THE WARP

PROGRAM AND SHALL BE SIGNED AND DATED BY THE GOVERNMENT INSPECTOR.

NAVSEA PMS-404 SUBMISSIONS SHALL ALSO INCLUDE HARDCOPY PRINTOUT OF

SAMPLES CARDS (SEE MIL-STD-1168, PARA 4.3.1.4)

3. NAVSUP ALC, Code A151

4. NUWC-Keyport Code N321

Robert Kovach 4 September 24 Lisa Hardman 4 September 24

DD Form 1423-2, AUG 96 PREVIOUS EDITION MAY BE USED Page 3 of 7 Pages

Robert Kovach

H. DATE

4 September 2024

I. APPROVED BY:

Lisa Hardman

J. DATE

4 September

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 7 Pages

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

D. SYSTEM/ITEM

A006

2.TITLE OF DATA ITEM

Failure Analysis/Corrective Action Report

DID-80255 Section E NSWC Indian Head EOD Tech Division

REQUIRED

10.FREQUENCY

SEE BLOCK 16

12.DATE OF FIRST

SEE BLOCK 16 Reg Repro

16.REMARKS SEE BLOCK 16 0 1 0

BLK 5: INCLUDE AND TAKE ACTION ON SECTION I IF FAT IS REQUIRED.

BLK 10: FREQUENCY - IS DETERMINED BY NUMBER OF FAT/LAT FAILURES.

BLK 12: DATE OF FIRST SUBMISSION – NLT AN INTERIM REPORT IS DUE NLT

10 DAYS AFTER NOTIFICATION OF LOT FAILURE. A FINAL REPORT IS DUE 30

DAYS AFTER NOTIFICATION OF LOT FAILURE.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 10 DAYS AFTER FAT

COMPLETION OF SECOND FAILED LOT AND BEYOND.

3. NAVSUP ALC, Code A151

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO. B.EXHIBIT

D. SYSTEM/ITEM

1. DATA ITEM NO.

A007

2.TITLE OF DATA ITEM

Production Line Of Balance Status

3.SUBTITLE

Production Progress Report

4. AUTHORITY (Data Acquisition Document No.) 5.CONTRACT REFERENCE 6.REQUIRING OFFICE 18.ESTIMATED

DI-MGMT-80034 See Block 16 NSWC Indian Head EOD Tech Division

9.DIST STATEMENT

AS REQUIRED

10.FREQUEN

CY

MTHLY

N/A

16.REMARKS See Block 16 0 1 1 (Block 5) Contractor shall submit a monthly progress report (DD Form 375) describing the contractor's current progress in a graphic form by comparison of planned objectives for flow of materials and Components into manufacturer of end items as related to delivery requirements.

(Block 12) Date for First Submission: 30 days after start of production.

Report shall be submitted to:

COMMANDING OFFICER

(Block 16) Date of Subsequent Submission: Subsequent reports to be submitted no later than the 5th day of the month (for the month proceeding). Local DCASMA verification required on all Status reports.

3. NAVSUP ALC, Code A151

15.TOTAL 0 1 1

G. PREPARED BY

Robert Kovach

H. DATE

4 September 2024

I.APPROVED BY

Lisa Hardman

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page

Robert Kovach

H. DATE

4 September 2024

I. APPROVED BY:

Lisa Hardman

4 September 2024

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 7 Pages

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER X

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

RADIOGRAPHIC TEST TECHNIQUE

3. SUBTITLE

X-RAY TECH, FILM & INSPECTION

REPORT

4. AUTHORITY (Data Acquisition Document No.)

SEE BLOCK 16

5. CONTRACT REFERENCE

SEE BLOCK 16

6. REQUIRING OFFICE

NSWC Indian Head EOD Tech Division

7. DD 250 REQ

SS

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE 13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

Block 4 Authority - Section E - Inspection and Acceptance paragraph 5.a.

Block 5 Contract Reference - Section E - Inspection and Acceptance paragraph

5.a. ASTM E1742 Section 6.

Block 9. - DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology) (Date of Contract Award). Other requests shall be referred to (NSWC IHEODTD

Code E26).

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 (Title 50, U.S.C., App. 2401 et seq.), as amended.

Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Block 10 Frequency - ONE /R with sample plate film. Block 12 Date of First Submission -

With sample plate film.

Block 13 Date of Subsequent Submission - Section E - Inspection and Acceptance paragraph 12.

X-Rays must be reviewed by Indian Head EOD Tech Division before LAT testing can be conducted.

Block 14. Distribution Addresses

1. NUWC-Indian Head E24JC

Cognizant DCMA (Indicated in Block 6 of SF26) LT with report only.

SEE BLOCK 16 0 1 1

15. TOTAL 0 1 1

G. PREPARED BY

Robert Kovach

H. DATE

I. APPROVED BY

Lisa Hardman

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 7 of 7 Pages