TGI_3819P59301A01_c0v0.pdf

PDF 5 MB Posted Aug 28, 2025

Attached to: USS BLUE RIDGE 5C1 DSRA TYCOM 5
Solicitation number: N6264925RA054
Issued by: Department of the Navy Naval Supply Systems Command

About this file

Written by GovTribe AI · Aug 28, 2025

This document is a Task Group Instruction (TGI) for replacing Collecting, Holding, and Transfer (CHT) piping on the USS Blue Ridge (LCC-19). The work involves replacing CHT piping in multiple locations, including the Crew Living Space, Passage, Storeroom, and A/C Machinery Room, with copper-nickel 70-30 Class 200 piping in 4-inch and 5-inch sizes. The project is scheduled to begin on 7/21/2026 and complete by 11/21/2027, with a contractor (KTR) responsible for removing existing piping, fabricating and installing new piping, conducting hydrostatic tests, and applying insulation.

The detailed material list includes various pipe tubes, elbows, tees, flanges, sleeves, and insulation materials, primarily from K-Flex and specified to MIL standards. The instruction notes potential asbestos and lead hazards and requires compliance with specific testing and installation procedures. SRF-JRMC will provide government-furnished services including crane rigging, utility services, safety inspections, and quality assurance inspections. The project is categorized as a Class P-2 piping job with Cleanliness Level III for the piping system and equipment.

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Other files

File	Type	Posted
Exhibit (A) BLR_5C1_TYCOM5 CDRL_r.pdf	PDF	Sep 25, 2025
N6264925RA0540003.pdf	PDF	Sep 25, 2025
N6264925RA0540002.pdf	PDF	Aug 28, 2025
BLR_5C1_TYCOM5 CDRL.pdf	PDF	Aug 28, 2025
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TGI_3819P59301T01_c0v0.pdf	PDF	Aug 28, 2025
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TGI_3819P52808T01_c0v0.pdf	PDF	Aug 28, 2025
TGI_3819P51413T01_c0v0.pdf	PDF	Aug 28, 2025
TGI_3819P52806A01_c0v0.pdf	PDF	Aug 28, 2025
TGI_3819P123ADA01_c0v0.pdf	PDF	Aug 28, 2025
TGI_3819P52806_T01_c0v0.pdf	PDF	Aug 28, 2025
TGI_3819P14218A01_c0v0.pdf	PDF	Aug 28, 2025
N6264925RA054 Amendment 0001.pdf	PDF	Jun 18, 2025
Attachment VIII Source of Repair Instruction.pdf	PDF	May 30, 2025
2.01 N6264925RA054 Solicitation.pdf	PDF	May 30, 2025
Attachment VI Quality Assurance Surveillance Plan (QASP).pdf	PDF	May 30, 2025
Attachment III GFP_List_V3 TYCOM5.xlsx	XLSX spreadsheet	May 30, 2025
Attachment VII Warranty Tracking Information.pdf	PDF	May 30, 2025
Attachment V Contract data.pdf	PDF	May 30, 2025
Attachment II Proposal Sheet Generator v1.2.xlsx	XLSX spreadsheet	May 30, 2025
Attachment IV-3 Request for Information Form (SAMPLE).docx	DOCX document	May 30, 2025
Exhibit (A) CDRL BLR_5C1_TYCOM5.pdf	PDF	May 30, 2025

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FOUO

WebAIM Short Form TASK GROUP INSTRUCTION

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

WORK CERTIFICATION SIGNATURES: DLs

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

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

FOUO Pg 1 of 8

ER013511 * ER013501

PREPARING ACTIVITY: STATUS: APP WORKING STATUS:

PREPARED BY: CODE: PHONE: DATE:

INOMATA, YOSHIYUKI 234 3152434536 21-NOV-2024

APPROVED BY: CODE: PHONE: DATE:

SHINMEI, HIDEKUNI 234 3152432371 21-NOV-2024

CONCURRED BY: CODE: PHONE: DATE:

REASON FOR WORK/NEED FOR CHANGE:

JCN:

ER01-3501 * ER01-3511

SPECIAL REQUIREMENTS:

CU PHASE DESCRIPTION:

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

YAGINUMA, TAKEHIDE

JOB SUMMARY ID: TOT MAN HR.: TOT DUR: TOT JML COST: PLANNING ACCEPTANCE:

593A1101

1. SCOPE/PURPOSE:

1.1 Title: Replacement of Collecting, Holding, and Transfer (CHT) Piping; accomplish

1.2 Location of Work:

1.2.1 Crew Living Space (5-40-01-L)

1.2.2 Passage (6-61-2-L)

1.2.3 Storeroom (6-52-4-A)

1.2.4 A/C Machinery Room No. One (7-40-0-E)

1.3 Identification:

1.3.1 Quantity (One Lot), CHT Piping located in 1.2.1

TGI Short Form

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 2 of 8

CU PHASE DESCRIPTION (Cont.)

Size: 4 Inch IPS (4.500 Inch OD x 0.109 Inch WT) Material: Cu-Ni 70-30, CL 200 Specification: MIL-T-16420 Remarks: See Sheet 5 of Ref. No. 3, Sheet 4 (PART PLAN 5th DK) of Ref. No. 4, Sheet 5 (Zone 42-F) of Ref. No. 5 and

Sketch Enclosure-01 for details.

1.3.1.1 Quantity (55 FT), Pipe Lagging

Pipe Size: 4 Inch IPS Insulation: EB-4013 Lagging: MIL-C-20079, Type I, Class 3

1.3.2 Quantity (One Lot), CHT Piping located in 1.2.2 and 1.2.3 Size: 5 Inch IPS (5.563 Inch OD x 0.125 Inch WT)

4 Inch IPS (4.500 Inch OD x 0.109 Inch WT) Material: Cu-Ni 70-30, CL 200 Specification: MIL-T-16420 Remarks: See Sheet 2 (Zone 6-D) and Sheet 3 (ELEVATION VIEW 10C) of Ref. No. 6, Sheet One (Zone 5-B) of Ref. No.

7, and 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. PROCEDURE:

2.1 Remove existing, fabricate and install each new CHT piping listed in 1.3.1 and 1.3.2, using Ref. No. 3 through Ref. No. 7, Enclosure-01 and Enclosure-02 for guidance.

2.1.1 Accomplish the requirements of 009-09 of Ref. No. One for the certification process.

2.1.2 Accomplish the requirements of 009-12 of Ref. No. One, including Table One, Column(s) A, Lines One through 10.

2.1.3 Accomplish the requirements of 009-12 of Ref. No. One, including Table 2, Column(s) A, Lines One through 7.

2.1.4 Accomplish the requirements of 009-71 of Ref. No. One for hydrostatic test, using clean, fresh water at 60 PSIG, for each new and disturbed CHT piping systems listed in 1.3.1.

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

2.1.5 Accomplish the requirements of 009-71 of Ref. No. One for hydrostatic test, using clean, fresh water at 50 PSIG, for each new and disturbed CHT piping systems listed in 1.3.2.

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 3 of 8

CU PHASE DESCRIPTION (Cont.)

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

2.2 Accomplish the requirements of 009-11 of Ref. No. One for installation each new insulation and lagging listed in 1.3.1.1, using Ref. No. 3 through Ref. No. 5 for guidance.

2.3 Accomplish the requirements of 009-32 of Ref. No. One for each new and disturbed surface.

2.4 Notes:

2.4.1 Planner: Code 234 Y. Inomata, 080-9350-1347

Planner: Code 234 O. Mitsui, 243-0976 Planner: Code 231B H. Tanaka, 243-4491

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

2.4.3 JCN ER01-3501 and ER01-3511 are related to this TGI.

2.5 Government Furnished Material (GFM):

2.5.1 SRF-JRMC will provide GFM listed in the Material List.

2.6 SRF-JRMC will provide the following service work: (TGI No. 3819P59301S02).

2.6.1 [C740] Crane and crane rigging service.

2.6.2 [X99E] Utility service, electrical.

2.6.3 [X99M] Utility service, including low pressure air supply, water supply, and steam supply.

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

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

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

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 4 of 8

OTHER SPECIAL REQUIREMENTS:

CLASS P-2 PIPING.

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL III.

Ref.

No.

Document/Drawing Number DOCUMENT/DRAWING TITLE REV

CHG

NO.

CPY

REQ PARAGRAPH SECT PG CHPT

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

3 PDD 505-ELM-

120250

REPLT OF CHT PUMP NO.1 &

2 SUCT & DISCH PP

- Y 1,3, 4 DWG 528-4346220 CHT PIPING SYSTEM

SUCTION & DISCHARGE TKS

#1,2,3 & 4

C Y 4

5 DWG 505-5341776 MODIFICATIONS TO

COLLECTING, HOLDING AND

TRANSFER SYS UPGARDE

G Y 5

6 DWG 528-4346215 COLLECTION HOLDING &

TRANSFER SYSTEM PIPING

ARRANGMENT FR 52-76 1ST

PLTF

B Y ALL

7 DWG 528-4346273 PLUMBING DRAINS $

COLLECTING, HOLDING &

TRANSFER SYSTEM DIAG-

PLANS 5TH DK & BL

- Y 1

TASK NAME / TASK DESCRIPTION

SHOP/

TSD TS

CREW

# MHRS RWRK

. N

MATERIAL LIST

ITEM

NO.

REF

NO.

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING NUMBER DOCUMENT/DRAWING TITLE

REV

ICN: 3819P59301 KEY OP: A01

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 5 of 8

MATERIAL LIST

ITEM

NO.

REF

NO.

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

001 M TUBE,MET, 4"IPS, 70-30, #200

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4710 006048328 NA 4 N 42955264 20/FT

002 M TUBE,MET, 4"IPS, 70-30, #200

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4710 006048328 NA 4 N 42955263 20/FT

003 M TUBE,MET, 4"IPS, 70-30, #200

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4710 006048328 NA 4 N 42955262 20/FT

004 M TUBE,MET, 4"IPS, 70-30, #200

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4710 006048328 NA 4 N 42955261 20/FT

005 M ELBOW,PI, 4"IPS, 70-30,

90DEG, BW, LR

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 014283175 NA 4 N 42955258 4/EA

006 M ELBOW,TU, 4"IPS, 70-30,

45DEG, BW

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 007254005 NA 4 N 42955256 8/EA

007 M TEE,PIPE, 4"IPS, 70-30, BW

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 014397295 NA 4 N 42955255 1/EA

008 M ELBOW 90, 4"IPS, BW,, ELBOW

90, 4"IPS, BW, SR, 70/30,

200PSI

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 LL4462310 NA 4 N 42957580 2/EA

009 M BACKING RING. 4"IPS,

BACKING RING. 4"IPS, CNA

70/30, 200PSIG

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 LL4358122 NA 4 N 42957578 32/EA

010 M SLEEVE, 4"IPS, BW, SLEEVE,

4"IPS, BUTT WELD, CU-NI 70-

30, 200PSI, DWG: 810-1385880

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 4730 LL4462305 NA 4 N 42957579 10/EA

011 M TUBE,METALLIC, 5" IPS, CU-NI

70-30, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 006048366 NA 4 N 43035063 15/FT

012 M TUBE,METALLIC, 4" IPS, CU-NI

70-30, CL200

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4710 006048328 NA 4 N 43035066 5/FT

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 6 of 8

MATERIAL LIST

ITEM

NO.

REF

NO.

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

013 M LATERAL, LATERAL. BUTT

WELD, SIZE: 5" X 5" X 4"IPS,

MATL: CU-NI 70/30,

PRESSURE: 200 PIS, DWG:

810-1385880, SPEC: MIL-C-

15726.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL9311056 NA 4 N 43247477 1/EA

014 M FLANGE,PIPE, 5" IPS, CU-NI

70-30, SW, 150PSI

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 014635647 NA 4 N 43035064 1/EA

015 M ELBOW 45DEG, ELBOW

45DEG, BUTT WELD, SIZE:

5"IPS, MATL: CU-NI 70/30,

PRESSURE: 200PSI, DWG: 810-

1385880, PREMIER COPPER P/N:

87104650.

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4462316 NA 4 N 43247466 2/EA

016 M ELBOW,TUBE, ELBOW 45, 4"

IPS, CU-NI 70-30, BW

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 007254005 NA 4 N 43035067 1/EA

017 M BACKING, BACKING RING,

5"IPS, CU-NI 70/30, 200PSIG,

MIL-STD-22

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4480106 NA 4 N 43037407 7/EA

018 M BACKING, 4" IPS, CU-NI 70-30,

200PSIG

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4358122 NA 4 N 43037404 4/EA

019 M SLEEVE,, 4" IPS, CU-NI 70-30,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4462305 NA 4 N 43037405 1/EA

020 M SLEEVE,, 5" IPS, CU-NI 70-30,

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 4730 LL4462306 NA 4 N 43037406 1/EA

400 M ADHESIVE, ORDERED FOR

KTR

ORIG:C234 Y.INOMATA, 243-

9B 8040 008419773 NA 4 Y 42955265 7/PT

401 M ADHESIVE, ORDERED FOR

KTR

ORIG:C234 Y.INOMATA, 243-

9B 8040 002738708 NA 4 Y 42955266 7/GL

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 7 of 8

MATERIAL LIST

ITEM

NO.

REF

NO.

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

402 M INSULATION, PIPE,

INSULATION, PIPE,BRAND: K-

FLEX ECO,SPECIFICATION

COMPLIANCE: EB 4013,FOR

SIZE: 4" IPS,SIZE: 4-1/2" ID X

3/4" THK X 6 FT LG,UI: EA/6

FT(ONE CONTINUOUS

LENGTH REQUIRED),MATL:

NON-HALOGEN,

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 5970 LL9607848 NA 4 N 42957583 12/EA

403 M INSULATION, FLAT SHT,

INSULATION, FLAT

SHEET,BRAND: K-FLEX

ECO,SPECIFICATION

COMPLIANCE: EB 4013,SIZE:

36" W X 48" L X 3/4" THK,MATL:

NON-HALOGEN,

ORDERED FOR KTR

ORIG:C234 Y.INOMATA, 243-

9B 5640 LL9607854 NA 4 N 42957584 1/SH

404 M ADHESIVE, ADHESIVE FOR

INSULATION SLEEVING

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 8040 008419773 NA 4 Y 43035069 4/PT

405 M ADHESIVE, ADHESIVE FOR

CLOTH

ORDERED FOR KTR

ORIG:C234 O.MITSUI 243-0976

9B 8040 002738708 NA 4 Y 43035070 2/GL

406 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 4" IPS,

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

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

**GSA ADVANTAGE

AVAILABLE**

3EA/BOX. *MUST BE ORDERED

IN MULTIPLES OF 3EA*

*MSM AVAILABLE*

9B 5970 LL9607848 NA 4 N 43037408 3/EA

26-NOV-2024 1416

20.14.15.2.9020 (September 2024) (Continued) ICN: 3819P59301 KeyOp: A01

COMPONENT NAME: TYPE: PHASE: REPEAT: CHG/VER:TGI NO: CHT PPG AY A 0 0/0

SHIP/HULL NO: SHIP/HULL NAME: PROJECT: SYSTEM: PLANT ID: CASREP CAT:

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE: *F/O - REPLACE CHT PP IN 5-40-01-L AND 6-61-2-L

FOUO Pg 8 of 8

MATERIAL LIST

ITEM

NO.

REF

NO.

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

407 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 43037409 4/EA

408 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 8" IPS,

SIZE: 8-5/8" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

1EA/BOX.

*MSM AVAILABLE*

9B 5640 LL9607851 NA 4 N 43037410 2/EA

ATTACHMENT LIST

TITLE FILE NAME SAVED DATE

ENCLOSURE-01 3819P59301A01-Sketch-1.pdf 06-NOV-2024 0000 ENCLOSURE-02 3819P59301A01-Sketch-2.pdf 06-NOV-2024 0000 ENCLOSURE-03 3819P59301A01-QA28.docx 20-NOV-2024 0000

Yoshiyuki.Inomata.ja Text Box

SKETCH

3819P59301A01 ENCLOSURE-01 SHEET 1 OF 2

Yoshiyuki.Inomata.ja_1 Polygonal Line

Yoshiyuki.Inomata.ja_2 Polygonal Line

Yoshiyuki.Inomata.ja_3 Text Box

Yoshiyuki.Inomata.ja_4 Text Box

CREW LIVING SPACE (5-40-01-L)

Yoshiyuki.Inomata.ja_5 Text Box

REPLACE RED MARKED AREA OF CHT PP

Yoshiyuki.Inomata.ja_6 Callout

CONTINUED FROM SHEET 2

Yoshiyuki.Inomata.ja_7

SKETCH

3819P59301A01 ENCLOSURE-01 SHEET 2 OF 2

Yoshiyuki.Inomata.ja_8 Line

Yoshiyuki.Inomata.ja_9 Line

Yoshiyuki.Inomata.ja_10 Line

Yoshiyuki.Inomata.ja_11 Line

Yoshiyuki.Inomata.ja_12 Callout

CONTINUED TO SHEET ONE

Yoshiyuki.Inomata.ja_13

REPLACE RED MARKED AREA OF CHT PP

3819P59301A01

SKETCH

ENCLOSURE-02 Sheet 1 of 1

REPLACE RED MARKED CHT PIPING

Location: Passage (6-61-2-L)

Valve 6-62-2

Location: Storeroom (6-52-4-A)

Remove yellow marked branch piping due to not shown on DWG: 528-4346215 Rev. B

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P59301A01 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 ER01-3501 KTR N/A CHT 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. LAR-XXXXX/LCC19/12L056

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): ______________________

T Y

) PARAGRAPH

DESCRIBING

VALVE POSITION

AND POINT OF

ENTRY

REF

LTR

GAGE

USED

(LTR

FROM

BLK 7)

REQUIRED

MEDIUM

USED

PRESSURE

ACTUAL

MINIMUM

DURATION

ALLOWED

LEAKAGE

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 2.1.4 for 1.3.1 A,B Clean Fresh Water 60 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

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P59301A01 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 ER01-3511 KTR N/A CHT 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 505-4610903 Rev. 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): ______________________

T Y

) 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 2.1.5 for 1.3.2 A,B Clean Fresh Water 50 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

File details come from the government source that posted it. Updated Aug 28, 2025.