J-11_Dry_Dock_Evaluation_Form.pdf

Attachment J – 11

MSC DRYDOCK EVALUATION FORM

Ship name: USNS SIOUX Hull No: T-ATF 171

PART A (to be completed by MSC) PART B (to be completed by ALL shipyards) Drydock Certification / Classification Info

Shipyard name

Drydock No.

Drydock Type Graving Floating Marine Railway

I

Certified? Yes No

Certifying / Classifying Agency

Certificate No.

Date of expiration

Ship Characteristics English measure Metric measure Provide date in English and Metric Units:

Length, overall ft - in 0.0 m Drydock Characteristics Breadth, molded ft - in 0.0 m Length, overall ft-in m Draft, light load line ft - 0 in 0.0 m Breadth ft-in m Gross Tonnage (U. S.) Tons MT Displacement, Full Load LT MT Maximum drydock lift capability LT MT

Minimum Displacement/Draft Displacement LT MT Draft - forward ft - in m Maximum entry draft rating: LT MT Draft – aft ft - in m Max stern trim for graving dock ft - in m Water depths around dock ft-in m area and approaches, tidal conditions, Anticipated Arrival Draft and any unusual conditions for entering/ Draft - forward ft - 0 in m leaving the drydock.

Draft - aft ft - 0 in m Depth Over Floor ft-in m Positioning Clearances Depth Over Blocks ft-in m Bottom: keel to drydock floor ft - 0 in m Depth Over Sill ft-in m Side: hull to drydock wall ft - 0 in m Depth Over KEEL ft-in m

Loading Pressures Max block loading Tons Per square ft. per sq mtr Note: All blocks to be positioned under longitudinal strength members and transverse bulkheads.

ATTACHMENT J - 11

Max Block Loading Capability Blocking Requirements Block Capability LT/ft2 LT/m2 Construction Hard

Wood Keel & Side Block Information

Cap material Soft Wood

Construction

Cap thickness (min) 2 Cap Material Side blocks (e.g., shaped, wedged, etc.) Shape d 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

MSC DRYDOCK EVALUATION FORM (cont’d)

PART A (to be completed by MSC) PART B (to be completed by ALL shipyards) Provide data in English and Metric units Minimum Required Services Electrical power Minimum Available Services AC volts 450 VAC Electrical power number of phases 3 AC volts VAC amperage (total) 2400 Amps number of phases frequency 60 Hz amperage (total) amps number of lines 6 frequency Hz number of lines Ground connections number 2 Ground connections cable size, each 500,000 cir mils number cable size, each cir mils Sewage connections number 1 Sewage connections pipe size 2 1/2 inch ips number capacity 1,000 gals per day 3,785 liters per day pipe size inch ips cm capacity gal/day ltr/day Fire Main number of connections 2 Fire Main connection size 2 1/2 inch ips number of connections pressure 125 Psig 8.8 kg per sq cm connection size inch ips cm capacity 1,000 gals per min 3,785 liters per min pressure psig kg/m2 capacity gpm ltr/min Aux Seawater pressure 100 Psig 7.0 kg per sq cm Aux Seawater capacity 600 gals per min 2,271 liters per min pressure psig kg/m2 capacity gpm ltr/min Fresh Water pressure 60 Psig 4.2 kg per sq cm Fresh Water capacity 100 gals per min 378 liters per min pressure psig kg/m2 capacity gpm ltr/min

Compressed Air pressure 125 Psig 8.8 kg per sq cm Compressed Air capacity 200 cu ft per min 5664 liters per min pressure psig kg/m2 capacity cfm ltr/min Shore Steam pressure 100 psig 7.0 kg per sq cm Shore Steam capacity 6,000 lbs per hour 2,722 kg per hour pressure psig kg/m2 capacity lb/hr kg/hr High Pressure Water Wash pressure 3,000 psig 211 kg per sq cm High Pressure Water Wash pressure psig kg per sq cm

Safety Response Plans Required Safety Response Plans Available (circle correct answer)

Firefighting Yes X No Firefighting Yes No Flooding (accidental) Yes X No Flooding (accidental) Yes No Earthquake Yes No X Earthquake Yes No Typhoon Yes No X Typhoon Yes No

MSC DRYDOCK EVALUATION FORM (cont’d)

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 Is Drydock insured? Yes No Insurer Policy No.

Amount Insured Date of expiration

MSC SHIP REPAIR FACILITY SURVEY

NOTE: If survey form has been previously submitted, then enter changes only.

Commander (Code M-4E3) Military Sealift Command Washington, DC 20390

SHIPYARD AND ADDRESS SHIPYARD DATA

Telephone No:

Telex No:

Date Found:

BUILDING WAYS (M. I. W.)

NO. LAUNCHING DIMENSIONS MAXIMUM SHIP

SIZE

OF (check one) (ton 2,240 lbs)

WAY

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

[ ] END LENGTH: LENGTH:

[ ] SIDE

[ ] BASIN WIDTH: WIDTH:

[ ] SLAB

DEPTH: DEPTH:

LENGTH OF LAUNCHING RUN DEPTH OF RUN AT M.L.W.

DEPTH OF WATER

OVER

WAY END

AT DROP

OFF

NO.

CRANES SERVING WAY

TYPE

LIFT CAPACITY

(std. tons)

CERTIFICATION DATE &

CERTIFIED BY WHOM

TIDAL RANGE (DIFF. OF M.L. M.H) IS FIRE PROTECTION AVAILABLE

ON BUILDING WAY?

YES NO

IS SNUBBING NECESSARY?

YES NO

MSC SHIP REPAIR FACILITY SURVEY (continued) SHIPYARD:

BERTHS OF SHIPS (Piers, Wharves, Bulkheads, etc.) DRY DOCKS (means high water)

TYPE

LENGTH

(actual & usable)

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

ACT:

USE:

WATER DEPTH

(M. L. W.)

IN-

BOARD

OUT-

BOARD

HEIGHT

OF

DOCK

(M.L.W.)

USE

REPAIR/

OUTFIT-

ING

SERVICES AVAILABLE

(Use abbreviation of service below)

DOCK

MATERIAL TYPE

Floating--(FD) Graving--(GD) Marine Railway (MR)

DRY DOCKS (continued)

DOCK

MAXIMUM SHIP SIZE

ACCOMMODATED

LENGTH OA-BEAM

LENGTH

at coping (GD), at keel blocks OVERALL on cradle (MR), on PONTOON

(FD)

CLEAR WIDTH

at top cradle (MR), at keel at top inboard block wing wall (FD, GD) height

DEPTH/DRAFT

OVER OVER OVER

SILL FLOOR KEEL

(GD)

BLOCKS

LIFTING CAPACITY

(ton 2,240)

DATE CERTIFIED, CERTIFIED BY WHOM, &

DATE CERTIFICATION EXPIRES

LEGEND (abbreviation of services) Fresh Water --- F.W. - G.P.M. - P.S.I. Steam --- S - P/HR - P.S.I. Electric Power --- E - V - AC - AMP Fire Protection --- FP - G.P.M. - P.S.I.

Salt Water ----- S.W. - G.P.M. - P.S.I Air ------ A - C.F.M. - P.S.I. Electric Power --- E - V- DC - AMP Sanitary Sewer --SS - YES - NO

BERTHING, SHOP OR YARD CRANES; STATIONARY, RAIL, MOBILE, OR BRIDGE (3 tons or over)

NAVIGATIONAL RESTRICTIONS (indicate at M.L.W.)

MINIMUM CHANNEL (depth width) MINIMUM HORIZONTAL AND VERTICAL BRIDGE CLEARANCES

DISTANCE TO NEAREST DISTANCE TO NEAREST

AIRPORT RAILROAD CONNECTION (identify)

LIST ANY OTHER RESTRICTIONS (include projects under construction which will after navigational restrictions)

MAX REACH HEIGHT OF HOOK

NO TYPE CAPACITY MAX SPAN CAPACITY BOOM HEIGHT ABOVE BASE HEIGHT OF HOOK AREA SERVICE DATE CERTIFIED, CERTIFIED BY WHOM & (STD TONS) (BRIDGE) AT REACH LENGT HINGE ABOUT REACH (BRIDGE) DATE CERTIFICATION EXPIRES

SHIPYARD:

MSC SHIP FACILITY SURVEY (continued)

PRINCIPAL SHOPS AND BUILDINGS

STORAGE SPACE FOR COMPONENTS AND MATERIALS

(LIST DIMENSIONS FOR EACH AREA, PLUS TYPE MATERIAL STORED)

NAME OF SHOP

OR BUILDING

FABRICATING

PLATE

SHEET METAL

SUBASSEMBLY

WOOD WORKING

BOAT ASSEMBLY

OR MOLDING

BOILER

MACHINE

ELECTRICAL

ELECTRONIC

PIPE

FOUNDRY

RIGGER

DIMENSIONS OF

SHOP OR BUILDING

LARGEST EXIT

WIDTH HEIGHT

ALL OTHER SHOPS

(LIST NAMES AND DIMENSIONS)

RAW STEEL STORAGE (SQ. FT.) ___________________________________________________________

WELDING AND ASSEMBLY (SQ. FT.) _______________________________________________________

LIST TYPES OF WORK NORMALLY SUBCONTRACTED

ACREAGE LEGALLY CONTROLLED

IN USE DEVELOPED TOTAL

EXISTING LOCAL ORDINANCES LIMITING PRODUCTIVE USE

LIMITATION IMPOSED BY PROPERTY ZONING CLASSIFICATION

SHIPYARD:

MSC SHIP REPAIR FACILITY SURVEY (continued)

LIST ANY EQUIPMENT OR CAPABILITY NOT OTHERWISE DESCRIBED IN THIS FORM

EMPLOYMENT

MANAGEMENT, ADMINISTRATION

PROFESSIONAL ENGINEERING

PRODUCTION SKILLED

PRODUCTION UNSKILLED

NONPRODUCTION

TOTAL:

CURRENT

CURRENT

SHIFTS

POTENTIAL MAXIMUM

MAXIMUM

NORMAL

NORMAL

REQUIRED SUBMITTALS TO ACCOMPANY THIS FORM:

1. PLOT PLAN OF YARD.

2. CERTIFIED DEPTH OF WATER PLOT

3. FOR EACH SHOP LISTED ON SHEET 4, A LIST OF MACHINE TOOLS AND

EQUIPMENT WHICH INDICATES THE CAPACITIES OF THE SHOP.

4. A GENERAL STATEMENT (INCLUE, NAME OF SHIP, DATES, AND

DOLLAR AMONT OF JOB) OF SHIP REPAPIR WORK WHICH HAS BEEN

ACCOMPLISHED BY THE APPLICANT.

5. LISTING OF OFFICIALS AND THE QUALIFICATIONS OF EACH FOR SHIP

REPAIR (INCLUDE AS A MINIMUM JOBS HELD, YEARS, HELD, ONE

LINE

6. IF FACILITIES ARE LOCATED AT MORE THAN ONE LOCATION THEN

LIST EACH FACILITY AND ITS LOCATION.

7. POINT OF CONTACT FOR INFORMATION SUBMITTED IN THIS FORM

(NAME/TITLE/PHONE NUMBER).

ARE YOU CERTIFIED AS A SMALL BUSINESS? YES NO

NAME AND TITLE OF SENIOR SURVEYOR SIGNATURE DATE SIGNED

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