J-7_MSC_Drydock_Eval_Form.doc

Ship name:

USS MT WHITNEY

PART A (to be completed by MSC), also see WI 0901

PART B (to be completed by ALL shipyards)

Drydock Certification / Classification Info

Provide date in English and Metric Units:

Drydock Characteristics

Breadth, molded MnDk Breadth, molded Wtr Line ft – ft -in in

Length, overall ft-in m

Breadth ft-in m

Maximum drydock lift capability

LT

MT

Maximum entry draft rating:

LT

MT

Water depths around dock ft-in m area and approaches, tidal conditions, Anticipated Arrival Draft and any unusual conditions for entering/

leaving the drydock.

Depth Over Floor ft-in m

Positioning Clearances

Depth Over Blocks ft-in m

Depth Over Sill ft-in m

Loading Pressures

Max Side Block loading

Max Keel Block Loading Psi Psi

Max Block Loading Capability

Block Capability

LT/ft2

LT/m2

Keel & Side Block Information

Cap material

Construction

Cap thickness (min)

Cap Material

Side blocks (e.g., shaped, wedged, etc.)

Cap Thickness in cm

Block Age

Hardwood:

White Oak, California Laurel, Oregon Myrtle, Iron bark, Height ft-in m

Blue Gum, American Rock Elm or Preserved Red Oak.

Width ft-in m

Softwood:

Douglas Fir, Tamarack, Long Leaf Pine or Hemlock

Length ft-in m

Minimum Available Services

AC volts

Electrical power number of phases

AC volts

VAC

amperage (total)

number of phases frequency

amperage (total) amps number of lines frequency

Hz number of lines

Ground connections number 2 total

Ground connections cable size, each

cable size, each cir mils

Sewage connections pipe size inch ips capacity gals per day pipe size inch ips cm gal/day ltr/day

number of connections

Fire Main connection size inch ips number of connections pressure psig connection size inch ips cm gals per min psig kg/m2 gpm ltr/min

Aux Seawater psig

Aux Seawater gals per min psig kg/m2 gpm ltr/min

Fresh Water psig

Fresh Water

LT per day psig kg/m2 gpm ltr/min

Compressed Air psig

Compressed Air cu ft per min psig kg/m2 cfm ltr/min

Shore Steam psig

Shore Steam lbs per hour psig kg/m2 lb/hr kg/hr

High Pressure Water Wash pressure psig

High Pressure Water Wash pressure psig kg per sq cm

Safety Response Plans Required

Safety Response Plans Available (circle correct answer)

x No

FORMCHECKBOX

x No

FORMCHECKBOX

FORMCHECKBOX

No x

FORMCHECKBOX

No x

PART C (to be completed by Shipyard if drydock is not certified by IACS or under MIL STD 1625C)

Dockmaster info

Contractor name

Dockmaster name

Certifying Agency

Certificate No.

Years experience

Drydock Insurance Info

No FORMCHECKBOX

Insurer

Policy No.

Amount Insured

Date of expiration

PART D (to be completed by ALL Shipyards)

1 .

The Offeror shall provide a list of the vessels (and their principal characteristics) drydocked in this drydock over the past 2 years. (Attach a separate page)

2 .

The Offeror shall describe the nature and cause of accidents experienced by the shipyard in drydocking operations over the past 5 years. The Offeror shall describe corrective action taken or practices implemented to prevent recurrence of accident. (Attach a separate page) I hereby certify that the above information is true and accurate.

Name and Title of Shipyard Official

Signature of Shipyard Official

Date