N00253-16-T-0166-DD1423.pdf

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items)

Form Approved OMB No. 0704-0188

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 the 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 DC, Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302 and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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:

0003 A TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

MK 50 BOILER DISPOSAL N00253-16-T-0166

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A001 CERTIFICATE OF DISPOSAL/RECYCLE COD/COR D

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

N/A HAZMAT DISPOSAL NAVSEA NUWC KYPT C/421 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION NSP

DD 1 TIME N/A b. COPIES

8. APP CODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

120 DAYS ADC N/A Drafts Reg Repro

16.

REMARKS:

IN ACCORDANCE WTH STATEMENT OF WORK PARAGRAPH 3.13:

CERTIFICATE OF DISPOSAL (COD) OR CERTIFICATE OF RECYLE (COR)TO BE

PROVIDED AS PROOF OF DESTRUCTION OR DEMILITARIZATION.

THE CONTRACTOR MUST SUBMIT THE COD OR COR WITH THE INVOICE

SUBMITTED IN WIDE AREA WORKFLOW (WAWF).

AT A MINIMUM, THE COD/COR MUST CONTAIN:

A. NAME OF THE TREATMENT FACILITY

B. EPA IDENTIFICATION NUMBER OF TREATMENT/DISPOSAL FACILITY

C. ADDRESS OF TREATMENT/DISPOSAL FACILITY

D. METHOD OF DISPOSAL/TREATMENT

E. DATE BOILERS/HARDWARE WERE RECEIVED AT THE FACILITY

F. DATE BOILERS/HARDWARE WERE DISPOSED/TREATED

NUWC KYPT C/42

0 0 0

0 0

15. TOTAL 0 1 1

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A002 HAZARDOUS WASTE MANIFEST

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

N/A NAVSEA NUWC KYPT C/421 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD 1 TIME N/A b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

A 120 DAYS ADC N/A Drafts Reg Repro

16.

REMARKS:

CONTRACTOR TO PROVIDE A COPY OF THE FULLY EXECUTED UNIFORM

HAZARDOUS WASTE MANIFEST, TO BE SUBMITTED WITH THE INVOICE IN

WAWF.

WAWF

TOTAL 1

G. PREPARED BY:

HANS TORRANCE

H. DATE

11/25/15

I. APPROVED BY

J. DATE

DD Form 1423-2, JUN 90 1059/183

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