J-4 MSC SHIP REPAIR FACILITY SURVEY.pdf

COMSCINST 4330.21C

Report Control Symbol: MSC 4330-4

MSC SHIP REPAIR FACILITY SURVEY

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

DATE:

To:

Commander (Code N4) Military Sealift Command Norfolk, VA 23511

SHIPYARD AND ADDRESS

SHIPYARD DATA

Telephone No:

Telex No:

Date Founded:

BUILDING WAYS (M. L. W.)

NO.

OF

WAY

LAUNCHING

(check one)

DIMENSIONS

MAXIMUM SHIP SIZE

(ton 2,240 lbs)

DEPTH OF WATER CRANES SERVING WAY

OVER

WAY END

AT DROP

OFF

NO.

TYPE

LIFT CAPACITY

(std. tons)

CERTIFICATION DATE &

CERTIFIED BY WHOM

END

SIDE

BASIN

SLAB

LENGTH:

WIDTH:

DEPTH:

LENGTH OF LAUNCHING RUN

DEPTH OF RUN AT M.L.W.

TIDAL RANGE (DIFF. OF M.L. - M.H.)

IS FIRE PROTECTION AVAILABLE

ON BUILDING WAY?

YES NO

IS SNUBBING NECESSARY?

YES NO

MSC FORM 4330/26 (12-83) SHEET 1 OF 5

MSC SHIP REPAIR FACILITY SURVEY (continued) SHIPYARD:

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

NO. TYPE

LENGTH

(actual & usable)

WATER DEPTH

(M. L. W.)

HEIGHT

OF

DOCK

(M. L. W.)

USE

REPAIR/

OUTFIT-

TING

SERVICES AVAILABLE

(use abbreviation of service below)

DOCK

NO.

MATERIAL TYPE

IN-

BOARD

OUT-

BOARD

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

ACT:

USE:

DRY DOCKS (continued)

DOCK

NO.

MAXIMUM SHIP SIZE

ACCOMMODATED

LENGTH OA-BEAM

LENGTH CLEAR WIDTH DEPTH/DRAFT

LIFTING CAPACITY

(ton 2,240)

DATE CERTIFIED, CERTIFIED BY WHOM, &

DATE CERTIFICATION EXPIRES OVERALL at coping (GD), a keel blocks on cradle (MR), on PONTOON

(FD)

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

OVER

SILL

(GD)

OVER

FLOOR

OVER

KEEL

BLOCKS

LEGEND (abbreviation of services)

Fresh Water --- F.W. - G.P.M. - P.S.I. Steam --- S - P/HR - P.S.I. Electric Power --- E - V - AC - AMP Fire Protection --- FP - G.P.M. - P.S.I.

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

MSC FORM 4330/26 (12-83) SHEET 2 OF 5

MSC SHIP REPAIR FACILITY SURVEY (continued)

SHIPYARD

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

NO TYPE CAPACITY

(STD TONS)

MAX REACH/

MAX SPAN

(BRIDGE)

CAPACITY AT

REACH

BOOM

LENGTH

HEIGHT

HINGE

HEIGHT OF HOOK

ABOVE BASE

AT OUT REACH

HEIGHT OF HOOK

(BRIDGE)

AREA SERVED DATE CERTIFIED, CERTIFIED BY WHOM &

DATE CERTIFICATION EXPIRES

NAVIGATIONAL RESTRICTIONS (indicate at M.L.W.) DISTANCE TO NEAREST

RAILROAD CONNECTION

DISTANCE TO NEAREST

AIRPORT (Identify)

MINIMUM CHANNEL (depth/width)

MINIMUM HORIZONTAL AND VERTICAL BRIDGE CLEARANCES

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

MSC FORM 4330/26 (12-83) SHEET 3 OF 5

PRINCIPAL SHOPS AND BUILDINGS

NAME OF SHOP

OR BUILDING

DIMENSIONS OF

SHOP OR BUILDING

LARGEST EXIT ALL OTHER SHOPS

(LIST NAMES AND DIMENSIONS)

STORAGE SPACE FOR COMPONENTS AND MATERIALS

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

WIDTH HEIGHT

FABRICATING

PLATE

SHEET METAL

SUBASSEMBLY

CARPENTER

WOOD WORKING

BOAT ASSEMBLY

OR MOLDING

BOILER

MACHINE

ELECTRICAL

ELECTRONIC

PIPE

FOUNDRY

RAW STEEL STORAGE (SQ. FT.) _________________________________________

WELDING AND ASSEMBLY (SQ. FT.) ______________________________________

RIGGER

LIST TYPES OF WORK NORMALLY SUBCONTRACTED

ACREAGE LEGALLY CONTROLLED

IN USE

DEVELOPED

TOTAL

EXISTING LOCAL ORDINANCES LIMITING PRODUCTIVE USE

LIMITATION IMPOSED BY PROPERTY ZONING CLASSIFICATION

MSC FORM 4330/26 (12-83) SHEET 4 OF 5

EMPLOYMENT CURRENT CURRENT

SHIFTS

POTENTIAL MAXIMUM MAXIMUM

SHIFTS

NORMAL NORMAL

SHIFTS

REQUIRED SUBMITTALS TO ACCOMPANY THIS FORM:

1. PLOT PLAN OF YARD.

2. CERTIFIED DEPTH OF WATER PLOT.

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

INDICATES THE CAPACITIES OF THE SHOP.

4. A GENERAL STATEMENT (INCLUDE, NAME OF SHIP, DATES, AND DOLLAR AMOUNT OF JOB)

OF SHIP REPAIR WORK WHICH HAS BEEN ACCOMPLISHED BY THE APPLICANT.

5. LISTING OF OFFICIALS AND THE QUALIFICATIONS OF EACH FOR SHIP REPAIR (INCLUDE AS

A MINIMUM JOBS HELD, YEARS HELD, ONE LINE DESCRIPTION OF DUTIES FOR EACH JOB).

6. IF FACILITIES ARE LOCATED AT MORE THAN ONE LOCATION THEN LIST EACH FACILITY AND

ITS LOCATION.

7. POINT OF CONTACT FOR INFORMATION SUBMITTED IN THIS FORM (NAME/TITLE/PHONE

NUMBER).

MANAGEMENT, ADMINISTRATION

PROFESSIONAL, ENGINEERING

PRODUCTION SKILLED

PRODUCTION UNSKILLED

NONPRODUCTION

TOTAL:

ARE YOU CERTIFIED AS A SMALL BUSINESS? YES NO

NAME AND TITLE OF SENIOR SURVEYOR

SIGNATURE

DATE SIGNED

MSC FORM 4330/26 (12-83) SHEET 5 OF 5