Exhibit_J-2_DIDs.pdf

DATA ITEM DESCRIPTION

Title: CONTRACTOR HAZARDOUS MATERIAL INVENTORY REPORT

Number: DI-ENVR-82091 Approval Date: 20161208

AMSC Number: N9751 Limitation: N /A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: ENVR-2017-001

Applicable Forms: PSNS&IMF form 5090/132

Use/Relationship: Contractor Hazardous Material Inventory Report will be used to identify hazardous materials needing for approval by the government for use on the Naval Installation.

This DID contains the format and content preparation instructions for the data product generated by the discrete task requirement as delineated in the contract.

Requirements:

1. Format. The Hazardous Material Inventory Report shall be presented on PSNS&IMF form

5090/132 in this DID.

2. Content. The report shall contain all of the information specified in PSNS&IMF 5090/132.

End of DI-ENVR-82091

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DI-ENVR-82091

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI)

Ref: NAVSEA Standard Items 009-97 and 009-02 NWRMC Local Standard Item 099-04NW

Document No.

CONTRACTOR – INITIAL REQUEST1 (Before moving any hazmat onto this Federal facility) **Refer to instructions on last page**

PRIME CONTRACTOR (KTR) (POC) SUB-CONTRACTOR (If Applicable) PRIME KTR CERTIFICATION SIGNATURE (sign or submit electronically) Print & sign

PHONE

Mr KTR NA Signature on File 555-232-2222

CONTRACT NUMBER PROJECT NAME2 WORKSITE LOCATION3 PROJECT EXECUTION START

DATE

PROJECTED

END5

N4523A-12-D-0003 USS Michigan Dry Dock 2 12/14/2015 04/03/2016

ENVIRONMENTAL, SAFETY, AND HEALTH (ESH) GOVERNMENT REPRESENTATIVE

CONTRACT OFFICE AGENCY (i.e., C/400, AIT)

ESH GOVERNMENT REPRESENTATIVE NAME PHONE FAX SUBMITTAL

DATE C/400/106.2 ESH SBS 360-535-2222

CODE 106.31 HAZARDOUS MATERIAL PROCESS MANAGEMENT BRANCH

106.31 NAME & INITIALS RECEIPT DATE REVIEW DATE

Trade Name6

Name on product & MSDS must match

For kits, list kit name, then list kit components individually

Manufacturer7

Name on product & MSDS must match

Process Code Number8

Use provided flow chart

Container Size & Type9

Enter size

SHIPYARD MSDS

Number10 (As assigned by Code 106.31)

SHIPYARD Assigned Stock Number (Assigned by Code 106.31)

Speclt SSPR 6PK Marking Fluorescent Green Spray Paint, #1989830

Rust-Oleum Corp. ID0507 11 oz AER See Attached SDS

CONTRACTOR HAZARDOUS MATERIAL INVENTORY (CHMI) CODE 106.31 Document No. Page 2 of 2

CONTRACTOR – INITIAL REQUEST (Before moving any hazmat onto this Federal facility)

Trade Name6

Name on product & MSDS must match

For kits, list kit name, then list kit components individually

Manufacturer7

Name on product & MSDS must match

Process Code Number8

Use provided flow chart

Container Size & Type9

Enter size

SHIPYARD MSDS Number10 (As assigned by Code 106.31)

SHIPYARD Assigned Stock Number ( assigned by Code 106.31)

PSNS & IMF 5090/132 (Rev. 04-13)

INSTRUCTIONS

Contractor: Fill out each section under the heading “CONTRACTOR” per the following instructions and footnotes. List all hazardous material (HM) that you, as the contractor, anticipate transporting from offsite onto the Federal property located at the Bremerton Naval Complex (BNC). Do not list HM obtained inside the BNC that has been labeled with the facility’s salmon colored supplemental barcode label. Use as many additional sheets as necessary to include all HM that you anticipate transporting onsite. Provide the most current MSDS for each product listed in the CHMI. If you are using a “Non-Road” engine do not forget to submit an O&M plan to Code 106.31 Air Department. For all marine coatings, provide a Volatile Organic Compound (VOC) certification sheet for each batch. If you have a Marine Coating that is

General Use and the VOC’s are above 340g/l you must submit separate paperwork to Code 106.31 Air department. All HM must be approved by the Code 106.31 before bringing material onsite. Low Use

Exempt materials may also be processed on this form. Upon completion of all Contractors required items submit the completed CHMI form to your Government Environmental, Safety, and Health representative.

* Prime Contractor Certification Statement: I hereby certify that the submitted information contained in the attached document(s) is true, complete and accurate, and all material listed has been approved by

Code 106.31.

Designated Government Environmental, Safety, and Health Representative: Complete Designated Government ESH section. Submit completed CHMI to Code 106.31 for review and approval.

FOOTNOTES

This is for the initial request. Use the Receipt & Monthly Usage Form to report monthly HM usage by the 5 th calendar day of the following month. Negative usage reports are required. If no usage, enter 0 in applicable field or leave blank and submit report.

Identify Project (e.g. – ship hull number or name, etc).

Identify Worksite Location (e.g. – Hull number, bldg. 431 5th floor, Dry

Dock 2, Pier D, etc).

The date that the contractor is to start work on the project.

The planned (best estimation) completion date for work on the project.

Provide a separate line for each product and/or container size that will be used. When reporting kits, list each component on separate lines. If part numbers are included in the Trade Name block, it will be helpful in processing the CHMI faster.

Reference example below.

Trade Name Manuf acturer

Container

Size & Type

MSDS

Stock

Number

Buff Base Part

A PPG 0.8 gal CN

Converter Part

B PPG 0.2 gal CN

Welding electrodes 7018 ESAB 10lb

Table 1 – Container Type

Descripti on

Aeros ol Can

Ba g

Bottle Bo x

Cartri dge

Can Contain er

Cylind er

Drum

Code AER BG BT B

X

CA CN CO CY DR

Descripti on

Each Jar Package Ki t

Rod Spool Tank Tube

Code EA JR PG K

T

RD SP TK TU

Manufacturer, product name on container and company name must all match.

To determine the proper Process Code Number use the attached Hazardous Material Process Code Selection Flow Chart.

Report container size(s) in quantifiable units (e.g., weight or volume) such as a 3 lb. jar or a 16 fl oz bottle. For compressed gas cylinders, report the quantity of gas in cubic feet or units such as pounds (e.g., 150 cu-ft or 100 lb cylinder). For bulk material (e.g., diesel fuel) or material without a specific container size (e.g., welding rod or wire), use the units in which the material is commonly sold to consumers (e.g., use gallon for diesel fuel or pound for welding rod or wire). For kits, list both the kit size and each individual component size. Reference Footnote 6 for reporting kits. See Table 1 for the applicable container type. Enter container type code.

Provide the Shipyard approved Material Safety Data Sheet (MSDS) number (if known) or include a MSDS for each product (Code

400 projects only). Sending a Technical Data Sheet with the MSDS will be helpful in processing the CHMI faster. When sending an MSDS ensure that it is no older than 5 years old, the MSDS must be a representative of the material being used.

For Usage remember you are reporting for the size requested and it is listed on the form. When reporting round up to the nearest tenth, use percentages (i.e. do not use: 3 gal of a 10 gal container, use: .3

When Reporting Partial Usage, Use Decimals to Represent the Fraction of Container Used.

EXAMPLE:

Use 0.8 to indicate 3/4 usage of a container

Do Not Enter as Lbs, Gallons, Ounces etc.

Round Up to Nearest Tenth.

Use 0.3 to indicate 1/4 usage of a container Use 0.8 to indicate 3/4 usage of a container

PSNS 5090/132 (Rev. 04-13)

Title: EXTREMELY HAZARDOUS SUBSTANCES (EHS) REPORT

Number: DI-ENVR-82152 AMSC Number: N9853 DTIC Applicable: No Preparing Activity: SH Applicable Forms: N/A

Approval Date: 20170823 Limitation: N/A GIDEP Applicable: No Project Number: ENVR-2017-008

Use/Relationship: This DID is used to obtain information of each Extremely Hazardous Substances (EHS) brought aboard Government facilities.

This DID contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

Requirements:

Format. The report shall be in the contractor’s format.

Content. The report shall include the following information:

a. Name and hull number of ship

b. Contract number and job order

c. Work Item

d. Work specification paragraph numbers

e. Standard item paragraph number

f. Safety Data Sheet (SDS) of each EHS brought aboard the Government facility

g. Quantities of all chemical products containing EHS brought aboard the Government facility

End of DI-ENVR-82152

Title: OPTION 1, 2, & 3 COATING THINNING CERTIFICATION REPORT

Number: DI-ENVR-82153

AMSC Number: N9854

Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20170823

Limitation: No

Project Number: ENVR-2017-010

Use/Relationship: This DID is used to obtain and track emission data and certification of each preservation coating to be thinned upon option 1, 2 and 3 thinning requirements.

by the specific and discrete task requirements as specified in NAVSEA Standard Item 009-97, Shipbuilding and Ship Repair Operations National Emission Standard for Hazardous Air

Pollutants (NESHAPS) for Surface Coating Information.

by the specific and discrete task requirement as delineated in the contract.

The reference document cited in this DID can be obtained as specified in the contract.

Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revision, shall be specified in contract.

Format. The report shall be in the format similar to that of Attachment A of NAVSEA Standard

Item 009-97, Shipbuilding and Ship Repair Operations National Emission Standard for

Hazardous Air Pollutants (NESHAPS) for Surface Coating Information.

Content. The report shall contain all of the information specified in Attachment A of NAVSEA

Standard Item 009-97, Shipbuilding and Ship Repair Operations National Emission Standard for

Hazardous Air Pollutants (NESHAPS) for Surface Coating Information; and shall also contain the following:

Name and hull number of ship

Contract number and job order

Work Item

Work item paragraph number(s)

Standard item paragraph number(s)

End of DI-ENVR-82153

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Title: COATING USAGE AND THINNING REPORT

Number: DI-ENVR-82154 AMSC Number: N9855 DTIC Applicable: No Preparing Activity: SH Applicable Forms: N/A

Approval Date: 20170823 Limitation: N/A

Project Number: ENVR-2017-011

Use/Relationship: This DID will be used to obtain usage and surface coating thinning data to administer and track hazardous air pollutants.

This DID contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

The reference document cited in this DID can be obtained as specified in the contract.

Requirements:

Format. The report shall be in the contractor's format.

Content The report shall contain the following information:

Name and hull number of ship

Contract number and job order

Work item number

Paragraph numbers including standard item paragraph number

Volume and type of each coating used the previous month

Volume and type of thinner used the previous month

Calculations used to determine the maximum allowable thinning ration for each coating thinned the previous month

End of DI-ENVR-82154

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Title: Status Report

Number: DI-MGMT-80368A Approval Date: 30 OCT 2006 AMSC Number: 7619 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: NS/DA02 Applicable Forms: N/A

Use/relationship:

The Status Report documents the status of contractor effort towards achieving contract objectives. It identifies accomplishments to date and difficulties encountered, and compare the status achieved to planned goals and the resources expended. It is used by the Government to monitor and evaluate contractor performance.

This Data Item Description (DID) contains format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

It is not intended that all requirements herein should be applied to every program.

Portions of the DID are subject to tailoring by deletion depending on the specific status reporting requirements of the project.

This DID is related to DI-FNCL-80331, Funds and Man-Hour Expenditure Report which can be used in conjunction with this report if paragraph 3.2.3 below is deleted.

This DID supersede DI-MGMT-80368.

1. Reference documents. None.

2. Format. The Status Report shall be in contractor format.

2.1 Identification. The data indicated below shall be contained on a title page or on the first page of the report.

a. Title/identification of the system/component/program/project.

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DI-MGMT-80368A

b. Type of report (e.g., monthly, interim, final).

c. Period covered by the report.

d. Contract number.

e. Preparing activity or contractor’s title.

f. Security classification, when required.

g. Distribution Statement.

2.2 Page size. The report shall be on 8 ½ by 11 inch (metric A4) paper.

3. Content. The report shall contain the following:

3.1 Summary. The summary shall include a brief statement of the overall project status , covering the accomplished technical activities and development, objectives of efforts, summary results of efforts, identification of major problems/deficiencies with impact, and recommended solutions.

3.2 Body of report. The Status Report shall contain the following items, where applicable:

3.2.1 Milestone/task status. The status of each milestone/task as defined by the statement of work or contract, as applicable:

a. A statement as to whether or not the program/project/task is on schedule; if not, the effort planned to meet the schedule shall be indicated. Include an overall status of each milestone, task, or unit of work. Include update schedule sheets, milestone charts, or task synopsis sheets identifying phase of task and percentage of completion of each task, technical instruction, or order.

b. A comparison of achieved end-product performance capabilities projected against contract baseline values, requirements, or allocations.

c. Effort expended on each task to date, and a brief description of technical developments and accomplishments.

d. Key dates in any testing program and description of tests performed and significant test results. If applicable, a description of the amount and type of down time on the equipment or system under test.

e. A list of all designs completed and a brief description of each item. For designs in process, provide estimated dates for design and drawing completion.

f. A narrative of outstanding problems existing as of the previous status report, and their resolution status. 2

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lorraine.henry Highlight lorraine.henry Highlight

DI-MGMT-80368A

g. New problem areas encountered or anticipated, their effect on the overall work effort/project and steps being taken to remedy problem situations.

h. Significant results of conferences, trips, or directives for the Contracting officer’s representatives.

i. Any other information which may cause significant changes in the program schedule.

3.2.2 Future plans. Summary of future plans, recommendations and proposals both for the next reporting period and for any long term plans.

3.2.3 Itemized man-hours and costs. Itemized man-hour and cost expenditure incurred for the reporting period by category and task, total contractual expenditures, and funds remaining as of the reporting date.

3.2.4 Contract deliveries status. The status of each deliverable end item, including data deliverables, as required by the contract. Provide item and contract identification, shipping/transmittal data, acceptance status, security classification, and schedule due date information.

3.2.5 Report preparer. Name of person(s) preparing report and telephone number(s).

3.3 Appendices. Appendices where applicable, for tables, references, charts, or other descriptive material. Each appendix shall be identified and referenced in the appropriate area of the report.

4. END OF DI-MGMT-80368A

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lorraine.henry Highlight

DATA ITEM DESCRIPTIOtIJ I

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RSPORT , PRODUCTION OR DELIVERY PROBLEM(S) DI-tKM~- al178

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3.1 The report is used to inform the procuring activity of crises which have developad, or are developing, emd which have the potsmtial to stop, interrupt or severely impact the production or delivery of contract end itsma.

(continued on page 2)

5.OFFICEOP Pai66enYFfEFwJslelu’Tv(em 6b.GIDEP R5WIRE0

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7.1 This data item description (DID) contains the format-and content prapsration instructions for the data prodnct generated by the specific sad discrete task requirsmemt sc delineated in the contract.

7.2 This DID is applicable to the acquisition of both hardvare and software systama, aubsystams, components and sqnipmant. It mey be applied to sny contract covering the acquisition of enpplies/sertices, the delivery of which, if stopped

(continwl Oa page 2) “VPROVAL UMITAIION 98. APPLICABLEFORME 9h AMECNUMBER i PREPaaAnori INSTRUCTION

10.1 FormSt. The report shell ha in contractor format.

10.2 Content. The report still confein the following:

10.2.1

10.2.2

Idamtificatioa. Tbe first page of the ieport shall contain the following:

n. Identification of the system/eampanemt/program/project/hull/ectivity involved.

b. Contract f7umber.

c. Preparing activity.

d. 8srial/idantific.stion mnmbar (assignsd by the preparin8 activity), and the date.

e. “’Securityclassification, when required.

Sady of Report. The report shall “contain .Scamplete, but concise, explemation as to the nature and cause of the crisis or problsm snd the current or potential In addition, impact on contract end itsm production, delivery, cost or sckdding.

the report ehall include the following as applicable snd appropriate:

(continued on page 2) i rIIETRISmON 57ATEMEW

Distribution Statement A: Approved for public release; distribution is 1imited.

i Form 1S60.JIJNSS m.iau ddo s am 017s01em PAGE ~ Or ~ PAGEs <m ,,m. .-.301-$ 641 lr— .nna,n-,w/cc,.,..,..“ICI,..,,, -’”- ‘---

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DI-MGNT- 81178 “

I

Block 3, DESCRIPTION/PORPOSE (centirmed)

3.2. !ixamplesof such crises are: accidents, strikes, %bkontracto’r” “or vendor difficulties or slippage, shortage of material, transportation tie-ups, or othez petential kttlenecks which may impact ceatract snd item production or delivery. . .

Bliick7, APPLIcATION/I NTERRSMTIONSRIP (continued) or interrupted, will adversely effect e military program, project or operation, or the constnction, conversion, overhaul, alteration or maintenance of military ships, systems or equipment.

Block 10, PREPARATION INSTRUCTIONS (centinued) a.

b.

c.

d.

e.

10.2.3 the re

Action(.s) Taken. Describe contractor action(s) taken to remedy the crisis or problem. If no contractor action has been taken, provide a brief explanation.

Action(s) Required. Clearly indicate the action(s) required, the date by which the action is required, and tbe respa-ibl~ party. e.g., contractor, procurina activity, other agency or actznty. ● Revised Data. Revised/updated product ion, delivery, cost or scheduling data should be provided, if available.

Contractor Recommendations. Delineate contractor recommendation(s), if any, to solve the turrent crisis or problcm, to prevent a recurrence, or for procuring activity follow-up.

Appandicss. Tables, references, cherts or other descriptive material or informctiun that vill clarify the crisis or probl~m, or that will support tbe rationale for contractor recomrnmdations, if any, should be prnvided as appendices. Each appendix shall be identified and referenced in the expropriate area of tbe repnrt.

RnDort Preparer. Name and telephone number of the person(s) preparing port.

page 2 of 2 pages

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Title: Government Furnished Material Condition Found Report

Number: DI-MGMT-82048 Approval Date: 20160705

AMSC Number: N9677 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Preparing Activity: SH Project Number: MGMT-2016-040

Applicable Forms: N/A

Use/Relationship: This DID will be used to identify Government Furnished Material (GFM), Government Furnished Information (GFI), and Condition Found Reports (CFR).

1. Format. The report shall be in the contractor’s format.

2. Content. The report shall contain the following information:

2.1 Government Furnished Material (GFM) not received (if applicable):

a. Work Item number

b. Work Item paragraph

c. Material description

d. Expected delivery date

e. Required delivery date

f. Action proposed to resolve

2.2 Government Furnished Information (GFI) that is overdue or deficient:

b. Deficiency description

c. Proposed action

2.3 Contractor Conditions Found that are overdue:

b. Expected submission date

c. Deficiency and condition reports for which Government response is outstanding

End of DI-MGMT-82048

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Title: Contractor Furnished Material (CFM) Report

Number: DI-MGMT-82049 Approval Date: 20160705

AMSC Number: N9678 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Preparing Activity: SH Project Number: MGMT-2016-041

Use/Relationship: This DID will be used to identify Contractor Furnished Material (CFM) to accomplish the Work Items that are not already on hand.

a. Contract number

b. Contractor’s purchase order number

c. Description of material

d. Quantity ordered

e. Date scheduled to be ordered

f. Date ordered

g. Date required to meet production schedule

h. Proposed receipt date

i. A summary listing any problem areas

j. Date submitted to the SUPERVISOR

k. Alteration number

l. Drawing and piece number

m. Date received

n. Work Item number

End of DI-MGMT-82049

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End of DI-MGMT-82051

Title: REQUEST FOR TECHNICAL DEVIATION OF SHIPYARD STANDARD WORK

ITEM REQUIREMENT(S)

Number: DI-MGMT-82051 Approval Date: 20160712

AMSC Number: N9681 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: SH Project Number: MGMT-2016-038

Use/relationship: This DID will identify the required information needed to obtain authorization to deviate from the references of any work item.

This DID contains the format content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

a. Ship’s Name/Hull Number

b. Contractor/Subcontractor

c. Name of deviation requestor

d. Identification as an existing condition and result of repair

e. Duration of repair with and without the deviation

f. System, component as indicated in the applicable selected record drawing

g. Location by compartment, frame and deck

h. Description of the deviation and degree of non-compliance

i. Document deviated from

j. Technical justification for the deviation

k. Alteration number if applicable

l. Date supervisor response is needed by

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Title: ENVIRONMENTAL COMPLIANCE REPORT

Number: DI-MGMT-82052 Approval Date: 20160712

AMSC Number: N9682 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: SH Project Number: MGMT-2016-039

Use/relationship: This DID will report the material usage at Naval Facilities to identify that the

Contractor is operating in compliance with environmental law.

This DID contains the format content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

2. Content. The report shall include the following items based upon category of the material:

2.1 Paint, solvent, adhesive, and nonskid usage records shall include the following:

a. Product manufacturer, identification and color

b. Net daily paint usage in gallons, paint application method (airless spray, HVLP, brush/ roller) per paint type,

c. Amount of paint disposed as hazardous waste

d. Density of mixed paint

e. Net daily onsite solvent usage in gallons used for equipment cleaning and surface preparation

f. Net amount of adhesives in unit of measure (ounces, quart, gallons or pound)

g. Product material safety data sheet (MSDS)

h. Technical data sheet

i. VOC certification for paint and nonskid product

j. Government site location

k. Applicable local Air Pollution Control District (APCD) permit number

l. Date, and ship’s name

2.2 The report shall include the abrasive blast grit materials used and shall specify the following:

a. Manufacturer of abrasive blast grit and MSDS

b. Abrasive blast grit usage certification

c. Amount and hourly usage of the abrasive blast grit

d. Permit associated with the abrasive blasting equipment

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DI-MGMT-82052

2.3 The report shall include welding operation information and shall specify the following:

a. Welding rod manufacturer

b. Specific product used in welding application

c. MSDS

d. Usage in pounds

e. Type of welding application

2.4 The report shall identify the portable internal combustion (IC) engine greater than 50

Brake horsepower operation information and shall also include:

a. Amount of fuel used in gallons and the hours of operation

b. IC engine permit number and site location

End of DI-MGMT-82052

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Title: Contractor’s Competent Person Training and Qualification Report

Number: DI-MGMT-82058

AMSC Number: N9707

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-045

Use/Relationship: This DID will document all personnel, including subcontractors, assigned to

Certify Spaces for entry on a nuclear vessel certifying that proper training has been received prior to start of work.

Format. The report shall be in the contractor’s format.

Content. The report shall include a Title page specifying the following information:

a. Ship’s name/hull number

b. Title

c. Program name

d. Contractor’s name and address

e. Contract number

f. CDRL exhibit number

g. Revision level

h. Approval/submission

i. Date

j. Data item author

k. Review/Approval record

l. Signature

The report shall contain and discuss the following information:

Purpose

References

The report shall include a copy of the employee’s initial and annual update training Competent

Person Certificate of Completion, if applicable.

End of DI-MGMT-82058

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Title: CONTRACTOR’S FIREWATCH TRAINING PROGRAM

Number: DI-MGMT-82059

AMSC Number: N9708

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-046

Use/Relationship: This DID will document that all personnel, including subcontractors, assigned to perform work on a nuclear vessel have been trained prior to start of work.

Content. The plan shall include a Title page specifying the following information:

a. Ship’s name/hull number

b. Title

c. Program name

d. Contractor’s name and address

e. Contract number

f. CDRL exhibit number

g. Revision level

h. Approval/submission

i. Date

j. Data item author

k. Review/Approval record

l. Signature

The program shall contain the following information:

Purpose

References

Procedure for training each employee

Record of training for each employee

End of DI-MGMT-82059

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Title: SHIPBOARD INTERFERENCES FOR REMOVED AND INSTALL REPORT

Number: DI-MGMT-82060

AMSC Number: N9709

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-047

Use/Relationship: This DID will document that the contractor has removed and reinstalled interferences which are within the scope of work.

Content. The report shall contain the following:

Location/Space

Item description (e.g. , piping size, valve number, cable identification, gage number, etc)

System

Previously damaged and deteriorated interferences

Interferences removed/installed.

End of DI-MGMT-82060

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Title: COMPARTMENT INSPECTION REPORT

Number: DI-MGMT-82063

AMSC Number: N9712

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-050

Use/Relationship: This DID will be used to provide results of each compartment inspection, including discrepancies found, and provides objective quality evidence (OQE) for the work accomplished within the compartment.

Content. The report shall contain the following information:

Name and hull number of ship

Job Order

Work Item

Paragraph numbers including standard item paragraph number

Compartment (number and name)

Date of inspection

List of discrepancies and the identity of the Contractor responsibility and Government responsibility

Signature of Contractor representative

Signature of SUPERVISOR

Signature of Commanding Officer’s designated representative

End of DI-MGMT-82063

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Title: CRITICALLY COATED SURFACES REPORT

Number: DI-MGMT-82066

AMSC Number: N9715

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-053

Use/Relationship: This DID will provide the Government with auditable coating records of in process and final results for any critically coating application.

References. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

Content. The report shall contain a Title page containing the following information:

a. Title

b. CDRL exhibit number

c. Approval/submission

d. Date

e. Program name

f. Contract number

g. Contractor’s name and address

h. Data item author

i. Signature

j. Approval record

The Report shall contain all the information required by Standard Item 009-32.

End of DI-MGMT-82066

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Title: HEAVY WEATHER PLAN

Number: DI-MGMT-82069

AMSC Number: N9718

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-056

Use/Relationship: This DID will be used to ensure contractor designated responsibility and implements procedures for prevention of damage to naval ships, craft, barges, and lighters due to heavy weather.

Format. The plan shall be in the contractor’s format.

Content. The plan shall contain specific responsibilities and detailed actions to be taken during heavy weather conditions, and shall also contain the following information:

Steps to be taken to remove or secure staging items or equipment on desks of ships, craft, barges, and lighters, pier or dry dock, including cranes that could become wind-borne.

Steps to be taken for protection of ships, craft, barges, and lighters from damage from other floating equipment, such as barges, doughnuts, work floats, and other ships, craft, barges, and lighters.

Provisions to be taken for protections of government equipment and material in custody of the contractor from damage by pier side flooding.

Provisions to be taken for removal of temporary hoses, welding lines, air lines, oxygen/acetylene lines, etc., extending through watertight closures.

Provisions to be taken for security, emergency fire and flooding protections, emergency shipboard dewatering and fire main capability, emergency shipboard electrical generation, and emergency shipboard communications.

Provisions to be taken for access to the ship for personnel and emergency equipment during and immediately following the storm consistent with prudent safety precautions.

Steps to ensure that all hull/deck openings are made watertight.

Steps to be taken to secure floating piers during high winds/high tides.

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DI-MGMT-82069

The name and telephone number (business and residential) of the private contractor’s single point of contact with the authority to commit the contractor to take necessary actions as requested by the SUPERVISOR.

End of DI-MGMT-82069

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Title: LIST OF SUBCONTRACTORS REPORT

Number: DI-MGMT-82070

AMSC Number: N9719

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-057

Use/Relationship: This DID will be used to identify a complete list of all subcontractors hired by the contractor.

Format. The plan shall be in the contractor’s format.

Content. The plan shall contain the following information:

List of all subcontractors performing work aboard Naval Facilities and Vessels.

Identity of each company name and any work to be completed by the Work Item number.

End of DI-MGMT-82070

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Title: INCIDENT REPORT

Number: DI-MGMT-82071

AMSC Number: N9720

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-058

Use/Relationship: This DID will be used to describe each accident, electrical shock, and fire that requires medical treatment.

This DID contains the format and content preparation instructions for the data product generated by the discrete task requirement as delineated in the contract.

Format. The report shall be similar to that of Figure 1.

Content. The report shall contain all the information contained in Figure 1.

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DI-MGMT-82071

Figure 1

INCIDENT REPORT

Report #

INITIAL REPORT REQUESTED UPDATE FINAL REPORT

TYPE OF INCIDENT:

NAME(S) OF INJURED (if applicable):

INCIDENT DATE: TIME: COMPANY:

SUPERVISOR:

LOCATION OF INCIDENT: TYPE OF INJURY OR FIRE:

CAUSE OF INCIDENT: EQUIPMENT INVOLVED:

WORK ITEM NUMBER: CONTRACT NUMBER:

WITNESS AND/OR INDIVIDUALS INVOLVED

NAME(S) DEPT. COMPANY

DESCRIPTION OF INCIDENT

INVESTIGATED BY (NAME): TITLE:

SIGNATURE OF INVESTIGATOR: DATE:

DISPOSITION OF INJURED (if applicable)

IMMEDIATE CORRECTIVE ACTION

FIGURE 1 (continued)

LONG TERM CORRECTIVE ACTION

INVESTIGATED BY (NAME): TITLE:

SIGNATURE OF INVESTIGATOR: DATE:

INCIDENT REPORT

Report #

ROOT CAUSE ANALYSIS

FIGURE 1 (continued) Incident Report Instructions

REPORT NUMBER- Unique tracking number created by contractor

TYPE OF INCIDENT- Injury, fire or near miss

NAME(S) OF INJURED- Self Explanatory

INCIDENT DATE: - Self Explanatory

TIME: - Self Explanatory

COMPANY: - Prime and subcontractors involved

SUPERVISOR – Supervisor of employee(s) involved

LOCATION OF INCIDENT: - Base/Yard, Ship name and hull number, space number and compartment name TYPE OF

INJURY OR FIRE – i.e. broken arm, laceration to head or Class A, B, C fires, smoldering

CAUSE OF INJURY – i.e. Equipment failure, PPE, process

EQUIPMENT INVOLVED – Equipment working on and equipment being used to cause incident WORK

ITEM NUMBER – Work Item being accomplished when incident occurred

CONTRACT NUMBER: - Contract Number assigned by government agency i.e. RMC, Alteration Installation Team

(AIT) Sponsor.

WITNESS AND/OR INDIVIDUALS INVOLVED – Name, company of witnesses and or individuals involved with the incident.

DESCRIPTON OF INCIDENT OR NEAR MISS – Short description of events leading up to incident and extent of injuries and or damage to equipment.

DISPOSITION OF INJURED – i.e. Transported to hospital via ambulance or POV, transported to clinic, released from hospital, name of hospital or clinic, limited duty or loss time (if known).

IMMEDIATE CORRECTIVE ACTION – i.e. Scene/space secured, ship notified (who and when), RMC notified (who and when) clean-up of blood, equipment secured fire debris cleaned up.

INVESTIGATED BY – Self Explanatory.

TITLE – Self Explanatory.

SIGNATURE OF INVESTIGATOR – Self Explanatory.

DATE – Self Explanatory.

LONG TERM CORRECTIVE ACTION – What action(s) were taken so that incident does not reoccur, i.e. training, safety stand down or process/policy change?

ROOT CAUSE ANALYSIS – Process by which you will identify the cause or contributing factors of the incident.

Note: Attach additional information as necessary.

End of DI-MGMT-82071

Title: FACT FINDING REPORT

Number: DI-MGMT-82086 Approval Date: 20161208

AMSC Number: N9746 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-006

Use/Relationship: This DID will capture relevant facts regarding an unplanned event and will document the severity level of problems associated with the unplanned event.

by the specific requirement delineated in the contract.

1. Format. The report shall be in a format similar to that of Figures 1, 2 and 3.

2. Content The report shall contain tall of the information specified in Figures 1, 2 and 3 and shall contain the following information:

a. Chronological statement of relevant facts

b. Working copy of cause and Corrective Action Form(s)

c. Any other document(s) used during the Fact Finding Investigation

d. The identity of the senior manager who performed the review

e. Complete chronological statement of relevant facts from the unplanned event

f. Any other document(s) used during the Fact Finding Investigation (e.g.

Independent Statements from individual(s), appropriate references, technical work documents)

g. A copy of critique meeting attendance from if a critique meeting was held

h. Identity of any similar unplanned event(s)

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DI-MGMT-82086

Figure 1

Preliminary Report

Final Report

FACT FINDING REPORT FORM

SENIOR MANAGER REVIEW: CONFIDENTIAL

ACTIVITY RESPONSIBLE FOR INVESTIGATION OF UNPLANNED EVENT:

CRITIQUE DATE/TIME (indicate "report only" if no critique held):

REPORT SERIAL NUMBER: DATE REPORT ISSUED:

DATE/TIME OF ACTUAL UNPLANNED EVENT:

DATE/TIME WHEN UNPLANNED EVENT WAS DISCOVERED:

LOCATION OF UNPLANNED EVENT (i.e. building /facility, room/space):

TITLE (based on the most obvious problem):

SEVERITY LEVEL ASSIGNED:

DESCRIPTION OF THE UNPLANNED EVENT:

IMMEDIATE CORRECTIVE ACTIONS TAKEN:

PREVIOUS SIMILAR UNPLANNED EVENT ( s) : YES NO , IF YES, LI ST SERIAL NUMBER ( s)

PROCEDURE NUMBER: STEP BEING WORKED:

DISCOVERED BY: PHONE#:

CHAIRPERSON: PHONE #:

ORGAN IZATION (S) RESPONSIBLE FOR IDENTIFIED PROBLEMS OR ASSIGNED ACTIONS/OPEN ITEMS

ORG:______ ORG:_______ ORG:______ ORG:______ ORG:_______ ORG:

CHAIRPERSON/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE SIGNATURES

SUPERVISOR/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE:

CONCURRENCE BY/DATE

Figure 2

CRITIQUE MEETING ATTENDANCE SHEET FORM

REPORT SERIAL NUMBER: DATE/TIME:

PRINT NAME ORGANIZATION/SHOP PHONE #

Figure 3

CAUSE AND CORRECTIVE ACTION FORM

REPORT SERIAL NUMBER: EVENT SEVERITY LEVEL: MANAGER/TECHNICAL CODE:

DATE ISSUED:

This form contains the problem descriptions that were identified as being partially or wholly the responsibility of . As the manager, you are responsible to follow up and take the appropriate actions to correct the listed problems.

PROBLEM # PROBLEM SEVERITY LEVEL

DESCRIPTION:

CAUSE:

SHORT-TERM CORRECTIVE ACTIONS:

ESTIMATED COMPLETION DATE: ____________ ACTUAL COMPLETION DATE:

LONG-TERM CORRECTIVE ACTIONS:

ESTIMATED COMPLETION DATE: ACTUAL COMPLETION DATE:

ACTION ASSIGNMENT SIGNATURES

CRITIQUE CHAIRPERSON DATE:

(Prime contractor)

SUPERVISOR REPRESENTATIVE: DATE:

RESPONSIBLE ORGANIZATION: DATE:

ACTION COMPLETION/ACCEPTANCE SIGNATURES

RESPONSIBLE ORGANIZATION:

PRIME CONTRACTOR ACCEPTANCE:

SUPERVISOR REPRESENTATIVE: DATE:

End of DI-MGMT-82086

Title: Hazardous Waste Report

Number: DI-MGMT-82129 Approval Date: 20170608

AMSC Number: N9814 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-026

Use/Relationship: The Hazardous Waste Report will identify type, amount, and disposal cost of hazardous waste removed during the period of performance. It will provide the Government with evidence of proper hazardous waste disposal.

1. Format. The Report shall be in contractor’s format.

2. Content. The report shall contain:

2.1. Name, title, description, and quantity of each item.

2.2. Analysis used to identify the hazardous waste.

2.3. Copies of paid invoices and receipts for the disposal of hazardous wastes.

End of DI-MGMT-82129

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Title: PURCHASE ORDER (PO)

Number: DI-MISC-81616 Approval Date: 20010801 AMSC Number: N7446 Limitation:

DTIC Applicable: GIDEP Applicable:

Office of Primary Responsibility: N/PMS377 Applicable Forms: N/A

Use/Relationship: To allow the Government to effectively monitor procurement of Contractor-furnished equipment requiring repair parts support and allowance list development.

a. This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task required as delineated in the contract.

1. Format. The Purchase Order (PO) and Purchase Order Index shall be in the contractor’s format.

2. Content. The POs shall include the following:

a. Vendor Name

b. Address of Vendor

c. Location of Material

d. Time of Completion

e. Applicable specifications and drawings

f. All tests and inspections required

g. PO Number

h. PO Date

i. Design code designator

j. Drawing and Piece Number

k. Federal Supply Code of Manufacturer’s (FSCM) five digit number

l. Quantity Ordered

m. Original PO Number on reissued POs

2.1. The Purchase Orders shall contain an Index. The Index shall be in alpha-numeric sequence and shall include the following information:

DISTRIBUTION STATEMENT A: APPROVED FOR PUBLIC RELEASE;

DISTRIBUTION IS UNLIMITED.

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a. Purchase Order (PO) Number

b. Identification of all PO line items, by noun description and equipment functional description (EFD)

c. Contractor’s design code designation, drawing number, and piece number

d. PO issue date

e. Vendor’s Name and Federal Supply Code of Manufacturer’s (FSCM) five digit number

f. Quantity ordered per line item

g. Provisioning and technical documentation control number for all line items requiring repair and replacement parts

h. Logistics Support Analysis Control Number (LSACN)

i. Applicable Mil-Spec

j. APL Number

2.1.2 The PO Index shall include all cancelled purchase orders and POs superseded by a vendor change.

2.1.3 The PO Index shall list all PO changes below the PO to which they apply and shall include all updated information.

End of DI-MISC-81616.

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Title: NON-DESTRUCTIVE TESTING TRAINING PROGRAM

Number: DI-NDTI-81936 Approval Date: 20130827

AMSC Number: N9421 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: AS/AIR 4.8.8.8

Use/relationship: American Society for Nondestructive Testing (ASNT) TC1A establishes the requirements for a written practice to describe the training program for qualifying Non-

Destructive Training (NDT) personnel.

This DID contains the format, content, and intended use information for the data product resulting from the work task described in the contract Statement of Work (SOW).

1. Reference Documents. ASNT TC-1A.

2. Format. Contractor format.

3. Content.

3.1. Title Page, containing the following:

a. Title/identification of the system/component/program/project.

b. Title of CDRL and CDRL number

c. Contract number.

d. Preparing activity or contractor’s title.

e. Security classification, when required.

f. Distribution Statement.

3.2. Table of Contents

3.3 Content. As a minimum, the supplier shall have in place a compliant Non-Destructive

Testing program in accordance with ASNT TC-1A. Accordingly, specific objective evidence shall be provided to demonstrate compliance.

3.3.1 NDT Training Program Written Practice: The supplier shall have a documented written practice for his/her Non-destructive Testing activities in accordance with ASNT-TC-1A.

The supplier shall provide evidence that the training program is properly established by way of submitting a copy of the program or making reference to the same via a statement of compliance including, if applicable, where the program exists within their quality program and/or operating procedures (i.e. excerpt from a Table of Contents; cover page of the program document, reference to a procedure number, etc).

3.3.2 Level III Examiner: When NAVSEA S9074-AQ-GIB-010/248 is specified, the supplier shall have under their employ a Level III examiner available to approve the Welding

Training program. If a Level III examiner is not directly employed by the supplier, the use of an

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DI-NDTI-81936

accredited sub-contractor is permissible. The supplier shall provide evidence that this requirement has been met by providing a copy of the Level III examiner’s credentials.

4. End of DI-NDTI-81936.

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Title: Quality Program Plan (QPP)

Number: DI-QCIC-81722 Approval Date: 29 NOV 2006 AMSC Number: 7676 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: NS/I5223 Applicable Forms: N/A

Use/Relationship:

The Quality Program Plan (QPP) describes the methodology that will be used to meet the quality requirements needed for the specific program. The object of the plan is to define and document what, where, and how to procure, fabricate, assemble, inspect, test and deliver only units and other end products that conform to quality standards. The QPP should start with the contractor’s standard quality system and detail changes to that. The QPP shall be used to verify attainability of contract objectives in the area of producing reliable, quality products. This DID is applicable to development, low rate initial production and full rate production efforts.

a. This DID contains the format and content preparation instructions for the data product generated by the specific requirement delineated in the contract and International Organization for Standardization (ISO) 9001, Quality Management Systems – Requirements (Entire Document).

b. The prime contractor is required to include information from significant suppliers (eg, PWAs) or teammates regarding their standard quality system requirements and any deviations specific to this program.

1. Reference Documents: The applicable issue of the documents herein, including, their approval dates and the dates of any applicable amendments, notices, and revisions, shall be as cited in the current issue of the DODISS at the time of the solicitation; or, for non DODISS-listed documents, as stated herein. International Organization for Standardization (ISO) 9001 Quality Management Systems – Requirements, current edition, is available at International Organization for Standardization website http://www.iso.org/iso/en/ISOOnline.frontpage.

2. Format: Contractor format is acceptable using 8 ½ x 11 in. paper.

3. Content:

3.1 The data item shall have a Title page containing the following information as a minimum:

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DI-QCIC-81722

3.1.1 Title

3.1.2 CDRL exhibit number

3.1.3 Revision level

3.1.4 Approval/submission

3.1.5 Date

3.1.6 Program name

3.1.7 Contract number

3.1.8 Contractor’s name and address

3.1.9 Data item author

3.1.10 Signature

3.1.11 Approval record

3.2 The data item shall have a table of contents if the length of the document warrants.

3.3 The data item shall have a revision status log page which includes the various revision levels, dates, and summary description of the changes made.

3.4 The QPP shall reference any Industry standard for which the contractor has a current certification. The plan shall reference the contractor’s current Quality Manual, number or identification, and date. The plan shall then detail any changes, deletions or additions to the contractor’s standard requirements, and shall delineate the specific Industry workmanship standards and levels for soldering, printed wiring assembly, etc, that are to be applied to the program. The government shall concur in use of any standard repair procedures and conditions for use on the program.

3.5 The QPP shall include an organizational chart identifying the Product Assurance (PA) organization, names and titles of key PA personnel assigned to the program, and how the PA organization relates to the corporate structure.

3.6 The QPP shall include a proposed end item product flow including test & inspection points. The plan shall briefly address the following topics if different from or not included in the quality manual: quality audit frequency, depth, and independence; process certification and control of automated processes; “cannot duplicate” (CND) and nonconforming material processes; incoming inspection/test, certified supplier program and parts control; and any unique requirements for the program.

4. END OF DI-QCIC-81722

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Title: Operating, Support, Health, and Safety (OSH&S) Hazard

Analysis Report

Number: DI-SAFT-81841 Approval Date: 20111108

AMSC Number: N9216 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: SH/PMS394

Use/Relationship:

The Operating, Support, Health, and Safety Hazard Analysis

Report (OSH&S) Report are used to systematically identify and evaluate health hazards, evaluate proposed hazardous materials, and propose measures to eliminate or control these hazards through engineering design changes or protective measures to reduce the risk to an acceptable level.

This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirements as delineated in the contract.

Requirements:

1. Format. The OSH&S report shall be in the contractor’s format.

2. Content. The report shall contain a title page…