TGI_3819P52601_A01_c1v1.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.: SCD 11176K DD AY A 0 1

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

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE:

*(RE) F/O - SCD 11176K ACCOMPLISH MODIFICATION OF FORECASTLE DECK DRN AND PIPING

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

HIRONARI ITO 234. 315-243-4534 30-MAY-2024

APPROVED BY: CODE PHONE DATE

HIDEKUNI SHINMEI 234. 315-243-4534 30-MAY-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:

Correct the column of the requirements of 009-12.

CHANGE INSTRUCTIONS:

CH1: Revise the column of the requirements 009-12 on paragraph 5.1.6.1 from “E” to “D”. (06/05/2024)

SPECIAL REQUIREMENTS:

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL III.

CLASS P-2 PIPING.

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.: SCD 11176K DD AY A 0

FOUO

SHIP: LCC-19 CHG/VER: 1/1

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 QA20

(2)

J1-2 QA28

(1)

M1-2 Map (1- 2)

1. SCOPE/PURPOSE

1.1 Title: SCD 11176K, Modification of Forecastle Deck Drain and Piping; accomplish

1.2 Location of Work:

1.2.1 Anchor and Line Handling Space (2-F-0-Q)

1.2.2 C7F 1st Division Office (2-14-6-Q)

1.2.3 Supplementary Plot (2-14-5-Q)

1.2.4 Windlass Room (3-8-0-Q)

1.2.5 Stateroom (3-14-2-L)

1.2.6 Sail Loft (3-14-1-Q)

1.2.7 CMAA Office (4-12-2-Q)

1.2.8 Training Officer Office (4-12-3-Q)

1.2.9 Freeboard Weather, Frames between 12 and 13, Port and Starboard (Stbd)

1.3 Identification:

1.3.1 Quantity (One Lot), Forecastle Deck Drain and Piping with Associated Fittings Remarks: See 2.3 for detail.

1.3.1.1 Quantity (2 EA), Forecastle Deck Drain Overboard Discharge Valve Size: 4.00 Inch IPS Type: Scupper, Flanged Valve No.: 4-12-2-W and 4-13-1-W

1.3.2 Quantity (One Lot), Structural Member in 2-F-0-Q, 2-14-5-Q, 3-8-0-Q, and 3-14-1-Q

1.3.2.1 Quantity (One EA), Deck Plate, Second Deck Plating, Frames between 13 and 15, Stbd

Material: OS, MIL-S-22698 GR-A, 10.2 LBs Plate Remarks: See Sheet 3 of 2.11 for detail

1.3.2.2 Quantity (One EA), Bulkhead Plate, Transverse Bulkhead Plating, Frame 14, Stbd

Material: OS, MIL-S-22698 GR-A, 10.2 LBs Plate Remarks: See Section 4-A of 2.11 for detail

FOUO

SHIP: LCC-19 CHG/VER: 1/1

1.3.2.3 Quantity (One EA), Bracket on Transverse Bulkhead Plating, Frame 14, Stbd

Material: OS, MIL-S-22698 GR-A, 4 Inches x 1/4 Inch Thickness Flat Bar Remarks: See Section 4-A of 2.11 for detail

1.3.2.4 Quantity (2 EA), Vertical Stiffener on Transverse Bulkhead Plating, Frame 14, Stbd

Material: OS, MIL-S-22698 GR-A, 6 Inches x 3.06 Inches x 5.9 LBs T Remarks: See Elevation 4-B of 2.11 for detail

1.3.2.5 Quantity (2 EA), Deck Pad on Second Deck Plating, Frames between 14 and 15, Stbd

Material: OS, MIL-S-22698 GR-A, 15.3 LBs Plate Remarks: See Sheet 3 of 2.11 for detail

1.3.2.6 Quantity (One EA), Deck Plate, Second Deck Plating, Frames between 13 and 14, Port

Material: OS, MIL-S-22698 GR-A, 10.2 LBs Plate Remarks: See Plan 5-A of 2.11 for detail

1.3.2.7 Quantity (One EA), Bulkhead Plate, Transverse Bulkhead Plating, Frame 14, Port

Material: OS, MIL-S-22698 GR-A, 12.75 LBs Plate Remarks: See Section 5-B of 2.11 for detail

1.4 Security Classification:

1.4.1 Spaces - 1.2.3

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 505-

8506468

DECK DRAIN MODS IMPROVED

FORECASTLE DRAINAGE 2ND

DK - 4TH DK, FR 12-15

A Y AL

L

4 DWG 100-

2491002

SHELL PLATING & STRINGERS

STEM-FR 51-1/2 ABV 4TH DK

E Y AL

L

5 DWG 810-

4714432

STD Pipe Hangers Fabrication

DETS & INSTL

L N

6 DWG 106-

2491056

2ND DK PLTG STEM - FR 52 M Y AL

L

FOUO

SHIP: LCC-19 CHG/VER: 1/1

REF.

NO.

DOCUMENT

/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV CHG

NO.

COPY

REQ’D

(Y/N)

SOURCE

DOC

(Y/N)

PARA SEC PG CHP

7 DWG 105-

2491053

3RD DK PLTG STEM - FR 52 M Y AL

L

8 DWG 505-

2424406

PP SLEEVES STRL PEN (S-3-11) B N

9 DWG 803-

1385866

PENETRATION BULKHEAD &

DECK

E N

10 MIL MIL-

STD-1627

Bending of Pipe or Tube for Ship Piping Systems

C N

11 PDD 106-

ELM-240219

PATCHES FOR DECK DR MODS

INCIDENTAL TO SCD 11176

- Y AL

L

3. APPENDICES:

3.1. Appendix “J” TGI Job Summary Information Sheet

3.2. Appendix "M" TGI Material List

3.3. Appendix “D” Deficiency Form

4. GENERAL REQUIREMENTS:

4.1 Not Applicable.

5. PROCEDURE:

5.1 Accomplish modification of forecastle deck drain and piping listed in 1.3.1 in accordance with 2.3, using 2.4 through 2.9 for guidance.

5.1.1 Accomplish the requirements of 009-95 of 2.1 for installation of new cap (F14 shown on 2.3).

5.1.2 Bend each new pipe in accordance with 2.10.

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

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

5.1.5 Accomplish the requirements of 009-71 of 2.1 for hydrostatic test, using clean, fresh water at 50 PSIG, for new and disturbed forecastle deck drain and piping.

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

5.1.6 Accomplish clad weld of penetration sleeve on shell plating in accordance with 2.3.

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

5.1.6.2 Accomplish nondestructive testing in accordance with Line 10.

5.1.6.3 Accomplish the requirements of 099-911YO of 2.2, using QA Form 20 Enclosure-02-1 and Enclosure-02-2.

Each joint identification number must be in accordance with Mapping Plan Enclosure-01.

5.1.6.4 Accomplish the requirements of 009-09 of 2.1 for welding procedure of each joint shown on Mapping Plan Enclosure-01.

FOUO

SHIP: LCC-19 CHG/VER: 1/1

5.1.7 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of each deck drain and penetration sleeve. Allowable leakage: None.

5.1.8 Cycle the valve from fully closed to fully open to fully closed 4 times. Allowable binding: None.

(V) “VALVE CYCLING”

5.1.9 Accomplish flow check of forecastle deck drain and piping listed in 1.3.1, using clean, fresh water. Allowable external leakage: None.

(V)(G) “FLOW CHECK”

5.2 Remove existing, fabricate and install new each structural member listed in 1.3.2 in accordance with 2.11.

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

5.2.1.1 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of each deck plate, bulkhead plate listed in 1.3.2.1, 1.3.2.2, 1.3.2.6, and 1.3.2.7. Allowable leakage: None.

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

5.4 Notes:

5.4.1 Planner: Code 234 H. Ito, 243-4534

Planner: Code 231B H. Tanaka, 243-4491

5.4.2 All material listed in 2.3 will be provided as kitted material by Puget Sound Naval Shipyard (PSNS).

5.4.3 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.

5.4.4 Preservation work for new and disturbed exterior surface of freeboard will be covered by ICN 3819P11001

(KTR TGI).

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

5.4.6 JCN EXSA-ZBV7 is related to this TGI.

5.5 Government Furnished Material (GFM)

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

5.6 SRF-JRMC will provide the following service work: (TGI No. 3819P52601S02).

5.6.1 [C740] Crane and crane rigger service.

5.6.2 [X99E] Utility service, electrical.

5.6.3 [X99M] Utilities service, including low pressure air supply, water supply, and steam supply.

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

FOUO

SHIP: LCC-19 CHG/VER: 1/1

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

5.6.6 [C133] QA inspection for (G) Symbol(s).

5.6.7 [C135] QA inspection for (G) Symbol(s).

FOUO

J-1

SHIP: LCC-19 CHG/VER: 1/1

APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

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

VERSION:

CASREP

CAT:

SCD 11176K DD AY A 0 1

CU PHASE TITLE:

*(RE) F/O - SCD 11176K ACCOMPLISH MODIFICATION OF FORECASTLE DECK DRN AND PIPING

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

DK DRN 4-12-3-Q PP DK DRN 3-8-0-Q PP DK DRN 4-12-2-Q PP DK DRN 2-F-0-Q

PP DK DRN 3-14-2-L PP CMPT 4-12-3-Q MS CMPT 3-14-1-Q MS CMPT 4-12-2-Q

MS CMPT 2-F-0-Q MS CMPT 3-14-2-L MSCMPT 2-14-5-Q MS CMPT 3-8-0-Q MS

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P52601-Map.pdf) saved on 25-MAY-2024 0000.

2. ENCLOSURE-02 (3819P52601A01-QA20.docx) saved on 25-MAY-2024 0000.

3. ENCLOSURE-03 (3819P152601A01-QA28.docx) saved on 28-MAY-2024 0000.

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

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P52601 A01

TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to accomplish modification of deck drain and piping.

Location of Work:

Anchor and Line Handling Space (2-F-0-Q) C7F 1st Division Office (2-14-6-Q) Supplementary Plot (2-14-5-Q) Windlass Room (3-8-0-Q) Stateroom (3-14-2-L) Sail Loft (3-14-1-Q) CMAA Office (4-12-2-Q) Training Officer Office (4-12-3-Q) Freeboard Weather, Frames between 12 and 13, Port and Starboard

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.1 PFTR HRs, RGRS HRs, SFTR HRs , SMTL HRs , WELD

HRs, IMCH HRs, OMCH HRs, PNTR HRs, INSL HRs, QA HRs

22 KE PC

5.2 SFTR HRs, STML HRs, WELD HRs, INSL HRs, CARP HRs, PNTR HRs, RGRS HRs, QA HRs

22 KE PC

5.3 PNTR HRs, QA HRs 22 KE PC

Piping Work CFM for PT inspection cost, analysis and bulk sample cost for asbestos, sample cost for lead, air compressor rental cost, fuel oil cost, welding rod, paint, firewatch cost and MISC such as gas cylinder, plastic sheet, covering material, plastic bag, coverall, argon gas and consumable material.

22 MQ CS

FOUO

J-2

SHIP: LCC-19 CHG/VER: 1/1

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

Structure Work CFM for all paints, thinner, grits including disposal cost, deck covering material, firewatch cost, air compressor rental cost and fuel oil cost for air hose test, sampler/analysis cost for asbestos/lead, and misc such as electrode, gases, temporary covering and closure material, and other consumable.

22 MQ CS

Process Funding Document. 10 CT OM

FOUO

M-1

SHIP: LCC-19 CHG/VER: 1/1

APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

SCD 11176K DD AY A 0 1

CU PHASE TITLE:

*(RE) F/O - SCD 11176K ACCOMPLISH MODIFICATION OF FORECASTLE DECK DRN AND PIPING

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

3819P52601 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

100 M PLATE,ME, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

5 FT X 3 FT X 1 PM

9B 9515 001533184 NA 4 N 41415012 15/SF

101 M PLATE,ME, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

2 FT X 2 FT X 1 PM

9B 9515 001533217 NA 4 N 41415013 4/SF

102 M PLATE,ME, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

2 FT X 2 FT X 1 PM

9B 9515 001533223 NA 4 N 41415014 4/SF

103 M BEAM,STRUCTURAL, ORDER

FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 9520 002780938 NA 4 N 41415001 10/FT

104 M INSULATI, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9Q 5640 008096312 NA 4 N 41415015 25/EA

105 M INSULATI, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9Q 5640 008096315 NA 4 N 41415016 15/EA

106 M SOUND CO, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9Q 5640 007565866 NA 4 N 41415017 15/EA

NOTES:

FOUO

M-2

SHIP: LCC-19 CHG/VER: 1/1

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

107 M TAPE,TEX, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 8315 002671632 NA 4 N 41415018 3/RO

108 M TAPE,TEX, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 8315 002671633 NA 4 N 41415019 3/RO

109 M ADHESIVE, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 8040 002738708 NA 4 Y 41415021 3/GL

110 M CAP,SNAP, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 5325 007377648 NA 4 N 41415020

100/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 SCD 11176K DD AY A 0

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

3819P52601 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 SCD 11176K DD AY A 0

MAPPING PLAN

ENCLOSURE-01 SHEET 1 OF 23819P52601A01

PLAN VEW

4TH DK, FR 12 - 15, PORT

DETAIL 1-A HJ-1

SEE DETAIL 1-A

CMAA OFFICE

4-12-2-Q

MAPPING PLAN

ENCLOSURE-01 SHEET 2 OF 23819P52601A01

TRAINING OFFICER OFFICE

4-12-3-Q

SEE DETAIL 2-A

PLAN VEW

4TH DK, FR 12 - 15, STBD

DETAIL 2-A HJ-2

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P52601A01 ENCLOSURE-02-1 TOTAL 2

WELDING IN PROCESS CONTROL/NONDESTRUCTIVE TEST RECORD

QA FORM 20 (FRONT)

When the form is used for production welding, the blocks marked with a must be completed by the planner. 1. PAGE 1 OF 2

2. SHIP USS BLUE RIDGE

HULL NO. LCC-19

3. JCN

EXSA-ZBV7

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

18 MAY 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

SHELL PLTG

9. DWG NO.

505-8506468 REV. A

10. CWP STEP NO.

5.1.6.3

11. JOINT ID

HJ-1

12. JOINT DESIGN

CLAD WELD

13. INST LOCATION: [ ] STBD

COMPT: [ ] C/L

FR: [ ] PORT

14. WELDED LOCATION:

[ ] SHOP

[ ] FIELD

BASE MATERIAL DATA

15. COMP DATA 16. MATERIAL 17. SIZE 18. THICKNESS 19. MATL SPEC 20. MIC NO.

COMPONENT A:

COMPONENT B:

21. [ ] SEAL RING

[ ] BACK RING/STRIP

22. MATERIAL 23. SIZE 24. THICKNESS 25. MATL SPEC 26. MIC NO.

WELDING MATERIAL SPECIFICATIONS AND DATA

27. TYPE OF FILLER(S) 28. SIZE 29. MATL 30. MIL-SPEC 31. MIC NO.

WELD HISTORY

32. WELDING

STANDARD:

MIL-STD-1689A

33. WELDING

PROCEDURE:

34. DATA SHEET 35. POSITION: [ ] VERT [ ] FLAT [ ] FIXED [ ] 45 DEG

[ ] HORZ [ ] OVHD [ ] ROLLED

36. ACCESSIBILITY:

[ ] 12”OR LESS

[ ] UNRESTRICTED

37. PREHEAT TEMP 38. PREHEAT METHOD 39. POST HEAT. START TIME:

TEMP REQD: STOP TIME:

40. PURGE

GAS:

41. FLOW RATE 42. SHIELD GAS 43. FLOW RATE 44. CUP SIZE 45. TUNGSTEN SIZE

46. WELD LAYER 47. PROCESS 48. QUAL EXP DATE 49. AMPS 50. INTERPASS TEMP 51. WELDER SIGNATURE 52. DATE

53. INSPECTION DATA CONTAINED ON REVERSE OF THIS PAGE

REMARKS:

94. FINAL DISPOSITION:

[ ] ACCEPT

[ ] REJECT

95. NDT SUPERVISOR DATE

THE PERSON DESIGNATED TO SIGN FOR AN ACTION VERIFIES, BASED ON PERSONAL

OBSERVATION OR CERTIFIED RECORDS, AND CERTIFIES BY THEIR SIGNATURE THAT

THE ACTION HAS BEEN PERFORMED IN ACCORDANCE WITH THE SPECIFIED

REQUIREMENTS.

3819P52601A01 ENCLOSURE-02-1 TOTAL 2

WELDING IN PROCESS CONTROL/NONDESTRUCTIVE TEST RECORD

QA FORM 20 (BACK) PAGE 2 OF 2

NDT INSPECTION DATA

54. INSPECTION STANDARD 55. WELD CLASS 56. ACCEPTANCE STANDARD 57. ACCEPT CLASS

58. WELD PREP 59. INSP METHOD 60. ACCEPT/REJECT 61. NDT INSPECTOR SIGNATURE 62. DATE

COMPONENT A [ ] ACCEPT [ ] REJECT

COMPONENT B [ ] ACCEPT [ ] REJECT

63. JOINT FITUP [ ] ACCEPT [ ] REJECT

64. INSP LAYER 65. INSP METHOD 66. INSP PROC NO 67. ACCEPT/REJECT 68. NDT INSPECTOR SIGNATURE 69. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

70. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

71. Repair Method: Excavation: L W D

72. INSP LAYER 73. INSP METHOD 74. INSP PROC NO. 75. ACCEPT/REJECT 76. NDT INSPECTOR SIGNATURE 77. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

78. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

79. Repair Method: Excavation: L W D

80. INSP LAYER 81. INSP METHOD 82. INSP PROC NO. 83. ACCEPT/REJECT 84. NDT INSPECTOR SIGNATURE 85. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

86. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

87. Repair Method: Excavation: L W D

88. INSP LAYER 89. INSP METHOD 90. INSP PROC NO. 91. ACCEPT/REJECT 92. NDT INSPECTOR SIGNATURE 93. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

53. REMARKS (Continued):

THE PERSON DESIGNATED TO SIGN FOR AN ACTION VERIFIES, BASED ON PERSONAL

OBSERVATION OR CERTIFIED RECORDS, AND CERTIFIES BY THEIR SIGNATURE THAT

3819P52601A01 ENCLOSURE-02-2 TOTAL 2

WELDING IN PROCESS CONTROL/NONDESTRUCTIVE TEST RECORD

QA FORM 20 (FRONT)

When the form is used for production welding, the blocks marked with a must be completed by the planner. 1. PAGE 1 OF 2

2. SHIP USS BLUE RIDGE

HULL NO. LCC-19

3. JCN

EXSA-ZBV7

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

18 MAY 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

SHELL PLTG

9. DWG NO.

505-8506468 REV. A

10. CWP STEP NO.

5.1.6.3

11. JOINT ID

HJ-2

12. JOINT DESIGN

CLAD WELD

13. INST LOCATION: [ ] STBD

COMPT: [ ] C/L

FR: [ ] PORT

14. WELDED LOCATION:

[ ] SHOP

[ ] FIELD

BASE MATERIAL DATA

15. COMP DATA 16. MATERIAL 17. SIZE 18. THICKNESS 19. MATL SPEC 20. MIC NO.

COMPONENT A:

COMPONENT B:

21. [ ] SEAL RING

[ ] BACK RING/STRIP

22. MATERIAL 23. SIZE 24. THICKNESS 25. MATL SPEC 26. MIC NO.

WELDING MATERIAL SPECIFICATIONS AND DATA

27. TYPE OF FILLER(S) 28. SIZE 29. MATL 30. MIL-SPEC 31. MIC NO.

WELD HISTORY

32. WELDING

STANDARD:

MIL-STD-1689A

33. WELDING

PROCEDURE:

34. DATA SHEET 35. POSITION: [ ] VERT [ ] FLAT [ ] FIXED [ ] 45 DEG

[ ] HORZ [ ] OVHD [ ] ROLLED

36. ACCESSIBILITY:

[ ] 12”OR LESS

[ ] UNRESTRICTED

37. PREHEAT TEMP 38. PREHEAT METHOD 39. POST HEAT. START TIME:

TEMP REQD: STOP TIME:

40. PURGE

GAS:

41. FLOW RATE 42. SHIELD GAS 43. FLOW RATE 44. CUP SIZE 45. TUNGSTEN SIZE

46. WELD LAYER 47. PROCESS 48. QUAL EXP DATE 49. AMPS 50. INTERPASS TEMP 51. WELDER SIGNATURE 52. DATE

53. INSPECTION DATA CONTAINED ON REVERSE OF THIS PAGE

REMARKS:

94. FINAL DISPOSITION:

[ ] ACCEPT

[ ] REJECT

95. NDT SUPERVISOR DATE

THE PERSON DESIGNATED TO SIGN FOR AN ACTION VERIFIES, BASED ON PERSONAL

OBSERVATION OR CERTIFIED RECORDS, AND CERTIFIES BY THEIR SIGNATURE THAT

3819P52601A01 ENCLOSURE-02-2 TOTAL 2

WELDING IN PROCESS CONTROL/NONDESTRUCTIVE TEST RECORD

QA FORM 20 (BACK) PAGE 2 OF 2

NDT INSPECTION DATA

54. INSPECTION STANDARD 55. WELD CLASS 56. ACCEPTANCE STANDARD 57. ACCEPT CLASS

58. WELD PREP 59. INSP METHOD 60. ACCEPT/REJECT 61. NDT INSPECTOR SIGNATURE 62. DATE

COMPONENT A [ ] ACCEPT [ ] REJECT

COMPONENT B [ ] ACCEPT [ ] REJECT

63. JOINT FITUP [ ] ACCEPT [ ] REJECT

64. INSP LAYER 65. INSP METHOD 66. INSP PROC NO 67. ACCEPT/REJECT 68. NDT INSPECTOR SIGNATURE 69. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

70. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

71. Repair Method: Excavation: L W D

72. INSP LAYER 73. INSP METHOD 74. INSP PROC NO. 75. ACCEPT/REJECT 76. NDT INSPECTOR SIGNATURE 77. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

78. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

79. Repair Method: Excavation: L W D

80. INSP LAYER 81. INSP METHOD 82. INSP PROC NO. 83. ACCEPT/REJECT 84. NDT INSPECTOR SIGNATURE 85. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

86. NDT INSPECTION DATA REPAIR NO._____ Defect: L W D

87. Repair Method: Excavation: L W D

88. INSP LAYER 89. INSP METHOD 90. INSP PROC NO. 91. ACCEPT/REJECT 92. NDT INSPECTOR SIGNATURE 93. DATE

[ ] ACCEPT [ ] REJECT

[ ] ACCEPT [ ] REJECT

53. REMARKS (Continued):

THE PERSON DESIGNATED TO SIGN FOR AN ACTION VERIFIES, BASED ON PERSONAL

OBSERVATION OR CERTIFIED RECORDS, AND CERTIFIES BY THEIR SIGNATURE THAT

3819P52601A01 ENCLOSURE-03-1 TOTAL 1

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 EXSA-ZBV7 KTR N/A Deck 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. .

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

MEDIUM

USED

REQUIRED

PRESSURE

ACTUAL

PRESSURE

MINIMUM

DURATION

ACTUAL

DURATION

ALLOWED

LEAKAGE

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.1.5 A 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