Exhibit_A_CDRL_A006.doc

PRIVATE

CONTRACT DATA REQUIREMENTS LISTPRIVATE

(1 Data Items)

Form Approved

OMB No. 0704-788

Public reporting burden for this collection of information is estimated to average 440 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, including suggestions for reducing this burden, to Department of Defense, Washington 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 Contract Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

X006

B. EXHIBIT

A

C. CATEGORY:

TDP _________ _________

TM __________________OTHER ADM/MGMT

D. SYSTEM/ITEM

AIRCRAFT MAINTENANCE SERVICES

E. CONTRACT/PR NO.

N00421-13-R-0069

F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Industrial Hygiene Survey

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

PBSOW Table B

6. REQUIRING OFFICE

PHSF MO, COR

DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

Draft

Final

A

Reg

Repro

Blocks 12 & 13: Within 60 days of contract award and Biennially thereafter.

Contractor Format, Government Approved Electronically.

GIO

15. TOTAL

G. PREPARED BY

H. DATE

17 December 2012

I. APPROVED BY

J. DATE

17 December 2012

DD FORM 1423-2, JUN 90

Previous editions are obsolete Page 1 of 1 Pages

Exhibit B