TGI_3819P52802A01_c0v0.pdf

FOUO

FOUO: Public availability to be determined under 5 USC 552

TASK GROUP INSTRUCTION

AIM REV 20.11.4.0 (OCTOBER 2020)

TGI COMPONENT NAME: TYPE: PHASE: REPEAT: CHANGE:

NO.: PLMB WS DRN PP AY A 0 0

SHIP/HULL NO.: SHIP/HULL NAME: SYSTEM: PROJ/WO NO: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE:

*F/O - REPLACE PLMB DRN AND GRAY WTR DRAIN PIPING

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

OKUTO MITSUI 234. 315-243-0976 21-NOV-2024

APPROVED BY: CODE PHONE DATE

YOSHIYUKI INOMATA 234. 315-243-4536 21-NOV-2024

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

REASON FOR WORK/NEED FOR CHANGE:

CHANGE INSTRUCTIONS:

SPECIAL REQUIREMENTS:

CLASS P-2 PIPING.

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL III.

This work affects a fire zone boundary. Fabrication and/or staging of a non-flammable closure is required.

WORK CERTIFICATION SIGNATURES

COMPLETION OF WORK REVIEW: BADGE NO.: SHOP/CODE: PHONE: DATE:

ACCEPTANCE OF COMPLETED WORK

PHYSICAL INSPECTION PHYSICAL INSPECTION COMPLETED: BADGE NO.: SHOP/CODE: PHONE: DATE:

REQUIRED:☐YES ☒NO

RECORDS REVIEW: BADGE NO.: SHOP/CODE: PHONE: DATE:

TGI NO.: PLMB WS DRN PP AY A 0

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SHIP: LCC-19 CHG/VER: 0/0

LIST OF EFFECTIVE PAGES

SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO.

1-6 Sketch (1-6)

J1-2 QA28

(1-2)

M1-6 Engrg Inst (1)

1. SCOPE/PURPOSE

1.1 Title: Plumbing Drain Piping and Gray Water Drain System Piping; replace

1.2 Location of Work:

1.2.1 Wordroom Scullery (3-34-2-Q)

1.2.2 Cleaning Gear Locker (4-36-2-A)

1.2.3 Galley (4-52-0-Q)

1.2.4 Passage (4-52-2-L)

1.2.5 Accommodation Ladder Space (4-64-4-Q)

1.2.6 CPO WR, WC, SH and DECONTN STA (4-74-2-L)

1.2.7 Crew Lounge (5-35-2-L)

1.2.8 Passage (5-37-2-L)

1.2.9 Crew Living Space (5-52-0-L)

1.2.10 Crew WR, WC, SH & DECONTN STA (5-58-1-L)

1.2.11 CPO Living Space (5-68-2-L)

1.2.12 UPC (6-30-4-Q)

1.2.13 EIC (6-72-2-Q)

1.2.14 Dry Provisions Storeroom (7-64-0-A)

1.2.15 Chemical Waste Drain Holding Tank (7-67-0-W)

1.3 Identification:

1.3.1 Quantity (One AY), Plumbing Drain Piping located in 1.2.7 and 1.2.12 Size: 3 Inch IPS (3.500 Inch OD X 0.095 Inch WT) (Cu-Ni 90-10)

3 Inch IPS (3.500 Inch OD X 0.065 Inch WT) (Copper) Material: Copper (Existing) / Cu-Ni 90-10 (New) Specification: WW-T-797 / MIL-T-16420 CL 200

JCN: ER01-3504

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SHIP: LCC-19 CHG/VER: 0/0

Remarks: See Sheet One (Zone 4-B and 4-D) of 2.3, Sheet One (Zone 4-D and 8-D) of 2.4 and Sheet One of Sketch Enclosure-02 for details.

1.3.1.1 Quantity (One EA), Deck Penetration Sleeve

Size: 3 Inch IPS Material: Carbon Steel Specification: ASTM-A500

DWG: 545-2492627

1.3.2 Quantity (One AY), Plumbing Drain Piping located in 1.2.7 Size: 2 Inch IPS (2.375 Inch OD X 0.083 Inch WT) Material: Cu-Ni 90-10 Specification: MIL-T-16420 CL 200

JCN: ER01-3505

Remarks: See Sheet One (Zone 4-D) of 2.3, Sheet One (Zone 3-D) of 2.4 and Sheet 2 of Sketch Enclosure-02 for detail.

1.3.3 Quantity (One AY), Gray Water Drain System Piping located in 1.2.14 Size: 2 Inch IPS (2.375 Inch OD X 0.154 Inch WT)

1-1/2 Inch IPS (1.900 Inch OD X 0.145 Inch WT) Material: CRES 316/316L Specification: MIL-P-24691/3

JCN: ER01-3509

Remarks: See Sheet 3 (Zone 19-E and ELEVATION 23-B) of 2.6, Sheet 3 (Zone 20-E) of 2.8 and Sheet 3 of

Sketch Enclosure-02 for details.

1.3.4 Quantity (One AY), Plumbing Drain Piping located in 1.2.11 and 1.2.13 Size: 3 Inch IPS (3.500 Inch OD X 0.095 Inch WT) (Cu-Ni 90-10)

3 Inch IPS (3.500 Inch OD X 0.065 Inch WT) (Copper) 2 Inch IPS (2.375 Inch OD X 0.083 Inch WT) (Cu-Ni 90-10)

Material: Copper (Existing) / Cu-Ni 90-10 (New) Specification: WW-T-797 / MIL-T-16420 CL 200

JCN: ER01-3513

Remarks: See Sheet One (Zone 6-D) of 2.10, Sheet 2 (Zone 8-D) of 2.11, Sheet One (Zone 8-G and

SECTION 5-A) of 2.12 and Sheet 4 of Sketch Enclosure-02 for details.

1.3.4.1 Quantity (One EA), Deck Penetration Sleeve

Size: 3 Inch IPS Material: Carbon Steel Specification: ASTM-A500

DWG: 545-2492627

1.3.5 Quantity (One AY), Plumbing Drain Piping located in 1.2.9 Size: 3 Inch IPS (3.500 Inch OD X 0.095 Inch WT) (Cu-Ni 90-10)

3 Inch IPS (3.500 Inch OD X 0.065 Inch WT) (Copper) 1-1/2 Inch IPS (1.900 Inch OD X 0.072 Inch WT) (Cu-Ni 90-10) 1-1/2 Inch IPS (1.900 Inch OD X 0.065 Inch WT) (Copper)

Material: Copper (Existing) / Cu-Ni 90-10 (New) Specification: WW-T-797 / MIL-T-16420 CL 200

JCN: ER01-3514

Remarks: See Sheet One (Zone 3-C, D) of 2.10 and Sheet 5 of Sketch Enclosure-02 for details.

1.3.6 Quantity (One AY), Plumbing Vent Piping located in 1.2.10 Size: 2-1/2 Inch IPS (2.875 Inch OD X 0.083 Inch WT) (Cu-Ni 90-10)

2-1/2 Inch IPS (2.875 Inch OD X 0.203 Inch WT) (Steel Galvanized) Material: Cu-Ni 90-10 / Steel Galvanized

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SHIP: LCC-19 CHG/VER: 0/0

Specification: MIL-T-16420 CL 200 / ASTM-A53

JCN: ER01-3527

Remarks: See Sheet One (Zone 4-A) of 2.10, Engrg Inst Enclosure-01 and Sheet 6 of Sketch Enclosure-02 for details.

1.4 Security Classification: None.

1.5 Initial Condition:

1.5.1 Potential Asbestos Hazard.

1.5.2 Potential Lead Hazard.

1.6 Contractor work start date: 7/21/2026

1.7 Contractor work completion date: 11/21/2027

2. REFERENCES:

REF.

NO.

DOCUMENT

/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV CHG

NO.

COPY

REQ’D

(Y/N)

SOURCE

DOC

(Y/N)

PARA SEC PG CHP

1 NSI FY-25 NAVSEA Standard Items - ORG N 2 LI FY-25 Local Standard Items - ORG N

3 DWG 528-

4346273

PLUMBING DRAINS $

COLLECTING, HOLDING &

TRANSFER SYSTEM DIAG-

PLANS 5TH DK & BL

- Y 1

4 DWG 505-

2492260

PLMB DRAINS - FR30 - 52 5TH DK

& BEL PLAN

F Y 1

5 DWG 545-

2492627

WELDED BHD OR DK SLEEVES

FOR IPS PIPING

C Y 1

6 DWG 505-

6905010

CONTAMINATED DRAIN SYS,

DECK DRAIN MODS INCID TO

SHIPALT 1181D

- Y 3

7 DWG 508-

8274295

SCD LCC-2975 GRAY WATER

TANK PUMP PP MODS

- Y 3

8 DWG 508-

8274296

SECONDARY DRAINAGE

SYSTEM - SEC DR PP MODS

GRAY WTR DR TK

- Y 3

9 DWG 508-

8274297

GRAY WTR DRN TK PP DIAG - Y 2

10 DWG 505-

2492262

PLMB DRAINS-FR 52-76 PLAN

5TH DE & BEL

L Y 1

11 DWG 528-

4346215

COLLECTION HOLDING &

TRANSFER SYSTEM PIPING

ARRANGMENT FR 52-76 1ST

PLTF

B Y 2

12 DWG 510-

5591096

ACC. LADDER WELL DRAIN A Y 1

13 DWG 104-

2491047

5TH DK PLTG STEM - FR 51 1/2 H Y 1

14 DWG 104-

2491048

5th Deck PLTG FR51-1/2 - FR102- 1/4

M Y 1

15 MIL MIL-

STD-1627

Bending of Pipe or Tube for Ship Piping Systems

C N

3. APPENDICES:

3.1. Appendix “J” TGI Job Summary Information Sheet

3.2. Appendix "M" TGI Material List

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SHIP: LCC-19 CHG/VER: 0/0

3.3. Appendix “D” Deficiency Form

4. GENERAL REQUIREMENTS:

4.1 Not Applicable.

5. PROCEDURE:

5.1 Remove existing, fabricate and install each new plumbing drain piping and gray water drain system piping listed in 1.3.1 through 1.3.6 in accordance with Enclosure-01, using 2.3 through 2.14 and Enclosure-02 for guidance.

5.1.1 Bend each new piping in accordance with 2.15.

5.1.2 Accomplish the requirements of 009-12 of 2.1, including Table One, Column(s) A, Lines One through 10.

5.1.3 Accomplish the requirements of 009-12 of 2.1, including Table 2, Column(s) A, Lines One through 7.

5.1.4 Accomplish the requirements of 009-71 of 2.1 for hydrostatic test, using clean, fresh water at 50 PSIG, for each new and disturbed plumbing drain piping systems.

5.1.4.1 Document shop hydrostatic test results on QA Form 28 Enclosure-03-1.

5.1.5 Accomplish the requirements of 009-71 of 2.1 for hydrostatic test, using clean, fresh water at 203 PSIG, for each new and disturbed gray water drain piping systems.

5.1.5.1 Document shop hydrostatic test results on QA Form 28 Enclosure-03-2.

5.1.6 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of each deck sleeve.

Allowable leakage: None.

5.1.7 Accomplish flow check of each new plumbing drain piping listed in 1.3.1, 1.3.2, 1.3.4, and 1.3.5 using clean, fresh water. Allowable external leakage: None.

(V)(G) “FLOW CHECK”

5.2 Accomplish the requirements of 009-32 of 2.1 for each new and disturbed surface.

5.3 Notes:

5.3.1 Planner: Code 234, O. Mitsui 070-7787-2048

Planner: Code 231B, T. Takeishi 243-6704 Planner: Code 233, M. Takemura 080-9350-1458

5.3.2 Work Integration Manager (WIM): Code 333 T. Yaginuma, 080-5419-0598

5.3.3 Opening, initial cleaning, and closing of chemical waste drain holding tank (7-67-0-W) will be covered by TGI No. 3819P12354A01 (F/O TGI).

5.3.4 Work per this instruction involves cutting an access (or removal of a door) through a fire zone bulkhead, through the hull of the ship above the turn of the bilge, through ventilation components (ducting, plenums, etc.), or through any air-tight, fume-tight or watertight bulkheads normally used to control air flow in the event of a shipboard fire. A nonflammable closure is required in accordance with COMNAVSEASYSCOM MSG R 261400Z JUL 12. The closure, if not continuously in use, shall be staged near the access, readily visible and accessible, so that any emergency responder can install the closure to affect proper air flow onboard the ship.

5.3.5 JCNs ER01-3504, ER01-3505, ER01-3509, ER01-3513, ER01-3514, and ER01-3527 are related to this TGI.

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SHIP: LCC-19 CHG/VER: 0/0

5.4 Government Furnished Material (GFM):

5.4.1 SRF-JRMC will provide GFM listed in Appendix “M”.

5.5 SRF-JRMC will provide the following Service Work: (TGI No. 3819P52802S02).

5.5.1 [C740] Crane and crane rigging service.

5.5.2 [X99E] Utility Service, electrical.

5.5.3 [X99M] Utility Service, including low pressure air supply, water supply, and steam supply.

5.5.4 [C106.1] Safety inspection for SRF-JRMC employees.

5.5.5 [C106.2] Gas free inspection for SRF-JRMC employees.

5.5.6 [C133] QA inspection for (G) symbol(s).

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J-1

SHIP: LCC-19 CHG/VER: 0/0

APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

SYSTEM: PLANT NO.: COMPONENT NAME: TYPE: PHASE: REPEAT: CU PH

VERSION:

CASREP

CAT:

PLMB WS DRN PP AY A 0 0

CU PHASE TITLE:

*F/O - REPLACE PLMB DRN AND GRAY WTR DRAIN PIPING

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

PLMB DR 5-68-2-L PP PLMB VNT 5-58-1-L PP PLMB WS 7-64-0-A PP PLMB DR 5-52-0-L

PP PLMB DR 5-35-2-L PP PLMB DR 6-72-2-Q PP PLMB DR 6-30-4-Q PP

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P52802A01-Engrg Inst.pdf) saved on 16-NOV-2024 0000.

2. ENCLOSURE-02 (3819P52802A01-Sketch.pdf) saved on 20-NOV-2024 0000.

3. ENCLOSURE-03 (3819P52802A01-QA28.docx) saved on 19-NOV-2024 0000.

ZONE MANAGER: ZONE: COMPARTMENT: LEVEL: FRAME: SIDE:

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P52802 A01

TOTAL MAT’L COST TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to replace plumbing drain piping and gray water drain system piping.

Location of Work:

Wordroom Scullery (3-34-2-Q) Cleaning Gear Locker (4-36-2-A) Galley (4-52-0-Q) Passage (4-52-2-L) Accommodation Ladder Space (4-64-4-Q) CPO WR, WC, SH and DECONTN STA (4-74-2-L) Crew Lounge (5-35-2-L) Passage (5-37-2-L) Crew Living Space (5-52-0-L) Crew WR, WC, SH & DECONTN STA (5-58-1-L) CPO Living Space (5-68-2-L)

UPC (6-30-4-Q)

EIC (6-72-2-Q)

Dry Provisions Storeroom (7-64-0-A) Chemical Waste Drain Holding Tank (7-67-0-W)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

22 KE PC

22 KE PC

22 MQ CS

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J-2

SHIP: LCC-19 CHG/VER: 0/0

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

Deck Covering Work CFM: $ 3,826.44 for deck covering material, paints, thinners, sampler/analyze asbestos and lead, and misc such as covering material and other consumable.

22 MQ CS 0 0 0

Steet Metal Work CFM: $ 200 for rivet and misc such as other consumable.

22 MQ CS 0 0 0

Insulation Work CFM: $ 707.31 for insulation, tape, adhesive, sampler/analyze asbestos, and misc such as other consumable.

22 MQ CS 0 0 0

Electrical Work CFM: $70 for fastener, cable band and other consumable materials.

22 MQ CS 0 0 0

Process Funding Document. 10 CT OM 1 1 0

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M-1

SHIP: LCC-19 CHG/VER: 0/0

APPENDIX “M”

TGI MATERIAL LIST

SYSTEM: PLANT NO.: COMPONENT NAME: TYPE: PHASE: REPEAT: CU PH

VERSION:

CASREP

CAT:

PLMB WS DRN PP AY A 0 0

CU PHASE TITLE:

*F/O - REPLACE PLMB DRN AND GRAY WTR DRAIN PIPING

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

3819P52802 A01

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

001 M TUBE,METALLIC, 3" IPS, CU-NI

90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

3B 4710 006047978 NA 4 N 43055148 20/FT

002 M TUBE,METALLIC, 3" IPS, CU-NI

90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

3B 4710 006047978 NA 4 N 43055149 20/FT

003 M TUBE,METALLIC, 3" IPS, CU-NI

90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

3B 4710 006047978 NA 4 N 43055152 20/FT

004 M COUPLING,TUBE, 3" IPS, CU-NI

90-10, BW, PG=2EA

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007225473 NA 4 N 43055147 5/PG

005 M BACKING,, 3" IPS, CU-NI 90-10,

200PSIG

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4558783 NA 4 N 43057404 30/EA

006 M ELBOW,PIPE, ELBOW 45, 3"

IPS, CU-NI 90-10, BW

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 005423335 NA 4 N 43055096 8/EA

NOTES:

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M-2

SHIP: LCC-19 CHG/VER: 0/0

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

007 M PIPE,METALLIC, ORDERED

FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 010259582 NA 4 N 43055140 2/FT

008 M ELBOW 90, ELBOW 90, 3"IPS,

BW, SR, 90/10, 200PSI

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4462378 NA 4 N 43057400 1/EA

009 M LATERAL, 3"IPS, BW,,

LATERAL, BUTT WELD, SIZE:

3"IPS, MATLE: CU-NI 90/10,

PRESSURE: 200PSI, DWG: 810-

1385880.

PREMIER COPPER P/N:

88140500.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4462421 NA 4 N 43247467 1/EA

010 M TUBE,METALLIC, 2" IPS, CU-NI

90-10, CL200

ORDERED FOR X56P

ORIG:C234 O.MITSUI 243-0976

3B 4710 002898006 NA 4 N 43055097 25/FT

011 M COUPLING,TUBE, 2" IPS, CU-NI

90-10, BW

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 005423290 NA 4 N 43055145 2/EA

012 M BACKING, 2" IPS, CU-NI 90-10,

200PSIG

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4558779 NA 4 N 43057402 11/EA

013 M ELBOW 45, 2-1/2" IPS, CU-NI

90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4462384 NA 4 N 43137403 3/EA

013 M ELBOW,TUBE, ELBOW 45, 2"

IPS, CU-NI 90-10, BW

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007203959 NA 4 N 43055099 3/EA

014 M ELBOW,TUBE, ELBOW 90, 2"

IPS, CU-NI 90-10, BW, LR,

200PSI

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007256990 NA 4 N 43055143 1/EA

015 M PIPE,METALLIC, PIPE, METAL,

SIZE: 1-1/2"IPS (1.900"OD X

0.145"THK), MATL: CRES 316,

SHEDULE 40, MIL-P-24691/3

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 002777868 NA 4 N 43055133 15/FT

016 M PIPE,METALLIC, PIPE METAL,

2"IPS, CRES 316L, SCHEDULE

40, SEAMLESS, ASTM A312,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 016027048 NA 4 N 43135003 15/FT

016 M PIPE,METALLIC, PIPE, METAL,

SIZE: 2"IPS (1.900"OD X

0.154"THK), MATL: CRES 316,

SHEDULE 40, MIL-P-24691/3

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 002777869 NA 4 N 43055130 15/FT

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M-3

SHIP: LCC-19 CHG/VER: 0/0

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

017 M ELBOW,PIPE, ELBOW 90, SIZE;

2"IPS, SOCKET WELD,CRES

316L, CLASS 3000, ASME-

B16.11

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 016110284 NA 4 N 43055106 3/EA

018 M ELBOW 90, ELBOW 90, SIZE; 1-

1/2"IPS, SOCKET WELD,

CRES 316L, ASTM-A182,

3000 PSI,

ASME-B16.11

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4946805 NA 4 N 43057410 3/EA

019 M FLANGE C, 2"IPS,,

FLANGE,COMMERCIAL, SLIP-

ON, FLAT FACE,

SIZE: 2" IPS,

MATL: CRES 316,

PRESSURE: 150PSI,

SPEC: ASME B16.5,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9311057 NA 4 N 43247479 1/EA

020 M FLANGE C, 1-1/2"IPS,, FLANGE,

SLIP-ON, FLAT FACE, 150 PSI,

SPEC: ASME B16.5,

SIZE: 1-1/2" IPS,

MATL: CRES 316L,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4892641 NA 4 N 43247440 3/EA

021 M COUPLING, REDUCER,

SOCKET WELDING,

SIZE: 2" IPS X 1-1/2" IPS,

PRESSURE: 3000PSI,

MATL: ASTM A128, CRES 316,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9308479 NA 4 N 43247470 1/EA

022 M TEE, 1-1/2"IPS, SW, , TEE,

SIZE; 1-1/2"IPS, SOCKET

WELDING,

CRES 316, ASTM A182,

3000 PSIG, ASME B16.11

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9305016 NA 4 N 43247447 1/EA

023 M BACKING RING, 1-1/2",

BACKING RING 1-1/2" IPS, 3/4"

WIDTH, SCH 40, CRES 316L,

MIL-STD-22D

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9308623 NA 4 N 43117465 1/EA

024 M VALVE,BALL, ORDERED FOR

KTR

ORIG:C234 O.MITSUI 243-0976

3B 4820 012183307 NA 4 N 43055112 1/EA

025 M VALVE,BALL, ORDERED FOR

KTR

ORIG:C234 O.MITSUI 243-0976

3B 4820 013326818 NA 4 N 43055115 1/EA

026 M GASKET, BLUE GARD 3200

ORDERED FOR KTR

9B 5330 015446752 NA 4 N 43055119 1/SH

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M-4

SHIP: LCC-19 CHG/VER: 0/0

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

027 M TEE,TUBE, 3" IPS, CU-NI 90-10,

BW, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007225483 NA 4 N 43055121 1/EA

028 M TEE, TEE, REDUCING, BUTT

WELD, SIZE: 3" X 3" X 1-

1/2"IPS, MATL: CU-NI 90/10,

PRESSURE: 200 PSI, DWG:

810-1385880, PREMIER COPPER P/N:

88121497.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9311058 NA 4 N 43247481 1/EA

029 M TUBE,METALLIC, 1-1/2" IPS,

CU-NI 90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

3B 4710 002898005 NA 4 N 43055102 15/FT

030 M COUPLING,TUBE, 1-1/2" IPS,

CU-NI 90-10, BW, FV=5EA

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007225467 NA 4 N 43055141 1/FV

031 M BACKING, 1-1/2" IPS, CU-NI 90-

10, 200PSIG

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4558777 NA 4 N 43057401 6/EA

032 M LATERAL, LATERAL. BUTT

WELD, SIZE: 3" X 3" X 2"IPS,

MATL: CU-NI 90/10,

PRESSURE: 200 PIS, DWG:

810-1385880, SPEC: MIL-C-

15726.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9311055 NA 4 N 43247476 1/EA

033 M PIPE,METALLIC, 2-1/2" IPS,

GALV STEEL, SCH 40

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 002775467 NA 4 N 43055126 2/FT

034 M TUBE,METALLIC, 2-1/2" IPS,

CU-NI 90-10, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

3B 4710 002898007 NA 4 N 43055107 2/FT

035 M ELBOW,PIPE, ELBOW 90, 2-1/2"

IPS, SW, CU-NI 90-10

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 014637046 NA 4 N 43055123 1/EA

036 M BACKING RING, BACKING

RING, SIZE: 2-1/2"IPS, 1"WIDE,

MATL: CARBON STEEL, SCH

40, MIL-STD-22D.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9304380 NA 4 N 43247448 1/EA

037 M BACKING, 2-1/2" IPS, CU-NI 90-

10, 200PSIG

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9C 4730 LL4558781 NA 4 N 43057403 1/EA

038 M FLANGE,PIPE, 2" IPS, CU-NI

90-10, SW, 150PSI

ORDERED FOR KTR

9B 4730 014645353 NA 4 N 43055125 1/EA

FOUO

M-5

SHIP: LCC-19 CHG/VER: 0/0

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

039 M DECK SLEEVE, SLEEVE,

WELDED BULKHEAD OR DECK

SLLEVES, FOR PIPING 3"IPS,

SIZE: 4.000 INCH OD X 0.245

INCH THK X 4.010 ICH ID, IAW:

AGC19 WELDED BHD OR DK

SLEEVES FOR IPS PIPING 545-

2492627, TYPE D , ASTM A500,

GRADE A, CARBON STEEL.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9309208 NA 4 N 43257431 2/EA

040 M FLANGE, NAVY, FLANGE,

NAVY, SOCKET WELD,

SIZE: 2"IPS,

MATL: CU-NI 70/30,

PRESURE: 150PSI,

DWG: 810-4715319, FIG 2-A,

ITEM NO 21,

PREMIER COPPER P/N:

22122400

NSN: 4730-01-463-5603 (PQDR:

N62758-24-0022 SUBMITTED)

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4462164 NA 4 N 43257427 1/EA

400 M ADHESIVE, ADHESIVE FOR

INSULATION SLEEVING

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 8040 008419773 NA 4 Y 43055235 10/PT

401 M ADHESIVE, ADHESIVE FOR

CLOTH

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 8040 002738708 NA 4 Y 43055236 6/GL

402 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 2-1/8" OD TUBE,

SIZE: 2-1/8" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

**GSA ADVANTAGE ITEM**

10EA/BOX. *MUST BE

ORDERED IN MULTIPLES OF

10EA*

*MSM AVAILABLE*

9B 5970 LL9607843 NA 4 N 43057414 10/EA

403 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 2" IPS,

SIZE: 2-3/8" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

**GSA ADVANTAGE ITEM**

*MUST BE ORDERED IN

MULTIPLES OF 8EA*

*MSM AVAILABLE*

9B 5970 LL9607844 NA 4 N 43057415 16/EA

FOUO

M-6

SHIP: LCC-19 CHG/VER: 0/0

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

404 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 3" IPS,

SIZE: 3-1/2"ID X 3/4" THK X 6 FT

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

DO NOT CROSS NSN: 5640-01-

607-0098(SIMC: X3),

**GSA ADVANTAGE ITEM**

*MUST BE ORDERED IN

MULTIPLES OF 5EA*

9B 5970 LL9607846 NA 4 N 43057416 15/EA

405 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR 5" IPS,

SIZE: 5-1/2" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

2EA/BOX. *MUST BE ORDERED

IN MULTIPLES OF 2EA*

*MSM AVAILABLE*

9B 5640 LL9607849 NA 4 N 43057417 2/EA

FOUO: Public availability to be determined under 5 USC 552 SHEET_____OF_____

☐ NUCLEAR APPENDIX "D"

DEFICIENCY FORM

☐ NON-NUCLEAR

1. SHIP/HULL NO.: 2a. DL or DR No.

(Circle One)

2b. REVISION: 3a. COMPONENT NAME: 3b. TYPE: 3c. PHASE: 3d. REPEAT:

LCC-19 PLMB WS DRN PP AY A 0

4a. ICN: 4b. KEY OP: 5. LOC SPACE/LVL: FRAME: P/S/C: 6. CAUSED BY:

3819P52802 A01

7. DESCRIPTION:

8. ORIGINATOR: NAME: BADGE: SHOP/CODE: DATE: PHONE NO.:

9. CORRECTIVE ACTION:

10. EVALUATOR: NAME: BADGE: SHOP/CODE: DATE: PHONE NO.:

FOR NON-NUCLEAR USE ONLY

11. RFD/RFW REQ’D ☐ LAR REQ'D ☐

ILS MOD REQ’D ☐

SRD/PLAN REV REQ'D ☐

DWG NO.: _____________________ S/A NO.: ___________________

12. ISOLATION SIGN: BADGE: SHOP/CODE: DATE: PHONE NO.:

SATISFACTORY:

13. SUBSAFE OQE RECORD? SIGN: BADGE: SHOP/CODE: DATE: PHONE NO.

YES ☐ NO ☐

14. CORRECTIVE ACTION SIGN: BADGE: SHOP/CODE: DATE: PHONE NO.

COMPLETE:

15. INSPECTION REQ’D? INSPECTION COMPLETE/SIGN: BADGE: SHOP/CODE: DATE: PHONE NO.

_________:YES ☐ NO ☐

16. RECORDS REVIEW SIGN: BADGE: SHOP/CODE: DATE: PHONE NO.

COMPLETE (DR ONLY)

DL’s ISSUED

(DR ONLY)

FOUO: Public availability to be determined under 5 USC 552 SHEET_____OF_____

☐ NUCLEAR Deficiency Form Continuation Sheet ☐ NON-NUCLEAR

1. SHIP/HULL NO.: 2a. DL or DR No.

(Circle One) 2b. REVISION: 3a. COMPONENT NAME: 3b. TYPE: 3c. PHASE: 3d. REPEAT:

LCC-19 PLMB WS DRN PP AY A 0

3819P52802A01 ENGRG INST

ENCLOSURE-01

SHEET 1 OF 1

LIST OF MATERIAL

PC NO. DESCRIPTION QTY PP CL MATL SPEC NSN REMARKS

P-1 TUBE, 2-1/2 IPS, 2.875 OD X 0.203 WT 1’ P-2 GALV

STEEL ASTM A53 4710-00-277-5467 SCHEDULE 40.

P-2 TUBE, 2-1/2 IPS, 2.875 OD X 0.083 WT 1’ P-2 CNA

90-10

MIL-T-

16420

4710-00-

289-8007 TY 1, CLASS 200#.

F-1 ELBOW 90º, 2-1/2 IPS, SR, SWLDG 1 P-2 CNA

90-10

MIL-C-

24679

4730-01- 463-7046

PREMIER P/N

99101450 OR EQ.

F-2 BACKING RING, 2-1/2 IPS, 1"WIDE, SCH 40 1 P-2 STEEL MIL-STD-

22D -

W&O SPLY P/N

549985-2-1/2” IPS

OR EQ.

F-3 BACKING RING, 2-1/2 IPS 1 P-2 CNA

90-10

MIL-STD-

22D - PERMIER P/N

BR910450 OR EQ.

3819P52802A01

SKETCH

ENCLOSURE-02 Sheet 1 of 6

Location: Crew Lounge (5-35-2-L)

REPLACE RED MARKED PLUMBING DRAIN

PIPING LISTED IN 1.3.1 WITH NEW ONE

Location: UPC (6-30-4-Q)

ENCLOSURE-02 Sheet 2 of 6

Location: Crew Lounge (5-35-2-L)

REPLACE RED MARKED PLUMBING DRAIN

PIPING LISTED IN 1.3.2 WITH NEW ONE

Remove cleaning cap due to not shown on

DWG: 505-2492260

Rev. F

ENCLOSURE-02 Sheet 3 of 6

Location: Dry Provisions Storeroom (7-64-0-A)

REPLACE RED MARKED GRAY WATER DRAIN

PIPING LISTED IN 1.3.3 WITH NEW ONE

ENCLOSURE-02 Sheet 4 of 6

Location: CPO Living Space (5-68-2-L)

REPLACE RED MARKED PLUMBING DRAIN

PIPING LISTED IN 1.3.4 WITH NEW ONE

Location: EIC (6-72-2-Q)

ENCLOSURE-02 Sheet 5 of 6

Location: Crew Living Space (5-52-0-L)

REPLACE RED MARKED PLUMBING DRAIN

PIPING LISTED IN 1.3.5 WITH NEW ONE

P5

A0

SK

ET

CH

EN

CL

O

SU

RE

-0

Sh ee t 6 o f 6

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P52802A01 ENCLOSURE-03-1 TOTAL 2

SHOP TEST RECORD Page 1 of 1

QA FORM 28 Planning must fill in blocks identified by a prior to issuing

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC SER NO. 5. SYSTEM/COMPONENT/ROTATABLE POOL SER NO.

USS BLUE RIDGE LCC19 SEE REMARKS KTR N/A PLUMBING DRAIN PIPING

6. REFERENCES: TEST REF (E.G., MS, TECH MAN) & OTHER REFS (E.G., VLV DWG) 7. TEST GAGE RANGE /INSTRUMENT USED SERIAL NO. CAL DUE DATE 8. RELIEF VLV SET POINT

A. S9086-RK-STM-010/CH-505 Rev. 6

B.

C.

D.

9. TEST REQUIREMENTS & RESULTS

TEST TYPE KEY H = STRENGTH AND POROSITY/ELEVATED PRESSURE TEST J = MECHANICAL JOINT TIGHTNESS ST = SEAT TIGHTNESS OP = OPERATIONAL O = OTHER

(SPECIFY): ______________________

TE

ST

T Y

PE

(S

EE

K

EY

) PARAGRAPH

DESCRIBING

VALVE POSITION

AND POINT OF

ENTRY

REF

LTR

GAGE

USED

(LTR

FROM

BLK 7)

REQUIRED

MEDIUM

MEDIU

M USED

PRESSURE

ACTUAL

MINIMUM

DURATION

ALLOWED

LEAKAGE

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.1.4 for 1.3.1 A Clean Fresh Water 50 PSIG 30 minutes None

H 5.1.4 for 1.3.2 A Clean Fresh Water 50 PSIG 30 minutes None

H 5.1.4 for 1.3.4 A Clean Fresh Water 50 PSIG 30 minutes None

H 5.1.4 for 1.3.5 A Clean Fresh Water 50 PSIG 30 minutes None

H 5.1.4 for 1.3.6 A Clean Fresh Water 50 PSIG 30 minutes None

10. REMARKS. (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA)

JCNs: ER01-3504, ER01-3505, ER01-3513, ER01-3514 and ER01-3527

11. QA INSPECTOR/SHOP SUPERVISOR SIGNATURE/BADGE NO. (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

DATE 12. QAS SIGNATURE/BADGE NO. (RECORD HAS BEEN REVIEWED FOR

COMPLETENESS)

DATE

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P52802A01 ENCLOSURE-03-2 TOTAL 2

SHOP TEST RECORD Page 1 of 1

QA FORM 28 Planning must fill in blocks identified by a prior to issuing

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC SER NO. 5. SYSTEM/COMPONENT/ROTATABLE POOL SER NO.

USS BLUE RIDGE LCC19 ER01-3509 KTR N/A GRAY WATER DRAIN SYSTEM PIPING

6. REFERENCES: TEST REF (E.G., MS, TECH MAN) & OTHER REFS (E.G., VLV DWG) 7. TEST GAGE RANGE /INSTRUMENT USED SERIAL NO. CAL DUE DATE 8. RELIEF VLV SET POINT

A. S9086-RK-STM-010/CH-505 Rev. 6

B. DWG 505-6905010 Rev. -

C.

D.

9. TEST REQUIREMENTS & RESULTS

TEST TYPE KEY H = STRENGTH AND POROSITY/ELEVATED PRESSURE TEST J = MECHANICAL JOINT TIGHTNESS ST = SEAT TIGHTNESS OP = OPERATIONAL O = OTHER

(SPECIFY): ______________________

TE

ST

T Y

PE

(S

EE

K

EY

) PARAGRAPH

DESCRIBING

VALVE POSITION

AND POINT OF

ENTRY

REF

LTR

GAGE

USED

(LTR

FROM

BLK 7)

USED

MINIMUM

ALLOWED

LEAKAGE

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.1.5 A,B Clean Fresh Water

203 PSIG 30 minutes None

10. REMARKS. (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA)

11. QA INSPECTOR/SHOP SUPERVISOR SIGNATURE/BADGE NO. (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

DATE 12. QAS SIGNATURE/BADGE NO. (RECORD HAS BEEN REVIEWED FOR

COMPLETENESS)

DATE