Exhibit_D_Appendix_D-8_SDDR_Form_2178.pdf

Form 2178

Conduct of Engineering Subcontractor Deviation Disposition Request

By N3B upon receipt: SDDR No.: SDDR-__ __ __ __ __ __ Date Received: ____________________

Instructions to Subcontractor:

1. Notify N3B Subcontract Technical Representative (STR), or N3B Subcontract Administrator (SA) if no STR, within 5 working days after identification or detection of proposed deviation.

2. Instructions on reverse provide additional direction for completing and processing this form.

3. Attach additional supporting information whenever necessary.

4. Submit completed form by email to STR, or SA if no STR, as soon as possible.

5. Copy of completed form will be returned to Subcontractor after N3B evaluation and disposition.

Form available from N3B Document Control. Email to

1.0 SUBCONTRACTOR’S REQUEST FOR DEVIATION FROM CONTRACTUAL REQUIREMENTS

1.1 Subcontractor’s Document No.: 1.2 Date Submitted:

1.3 Subcontractor Information (Name, Address, Point of Contact, and Telephone Number)

1.4 Subcontractor Order Number: Subcontractor Item No: Item Name:

1.5 N3B Subcontract No.: N3b Subcontract Administrator N3B Subcontract Technical Representative:

1.6 Date Deviation Detected: Detection Method:

1.7 Previous SDDR submittals for same or similar issue:

1.8 N3B STR or SA Notified:

1.9 Description:

1.10 Cost Impact of proposed disposition: 1.11 Schedule Impact of proposed disposition:

1.12 Proposed Action and Technical Justification:

1.13 Associated Subcontractor Document Change(s):

1.14 Subcontractor’s Authorized Representative: (Name, Title, Telephone Number, and Date)

Form 2178 (10/11)

RFP-0000476

2.0 N3B EVALUATION AND DISPOSITION

2.1 Project ID: Project Title:

2.2 Affected SSC Management Level: ML-1 ML-2 ML-3 ML-4

2.3 Affected SSC Functional Classification SC SS DID NS

2.4 Proposed Action Accepted Rejected

2.5 LANL Actions:

USQD/ USID Required USQD/USID No.: Other Subcontractors Affected Yes No Drawing Change LANL Subcontractor Price Adjustment Yes No Specification Change LANL Subcontractor Baseline Change Yes No Other:

2.6 Disposition Statement:

2.7 Technical Subject Matter Expert (TSME): (Name, Z Number, Organization, Signature and Date)

2.8 Design Authority Representative (DAR): (Name, Z Number, Organization, Signature and Date)

2.9 Quality Subject Matter Expert (QSME): (Name, Z Number, Organization, Signature and Date)

2.10 Project Engineer: (Name, Z Number, Organization, Signature and Date)

2.11 Subcontract Technical Representative (STR): (Name, Z Number, Organization, Signature and Date)

2.12 N3B Subcontract Administrator: (Name, Z Number, Organization, Signature and Date)

Instructions (N3B need not include in permanent record)

1. This form is primarily associated with N3B LANL Engineering Standards Manual Chapter 1 Section Z10 Attachment F, Specifications; plus N3B P840-1 Quality

Assurance for Procurements and N3B P850.2, Subcontract Technical Representative Procedure.

2. Reference to the SDDR form is made in Subcontract Exhibit D for construction / fabrication projects and procurements of engineered or custom (not off the shelf) structures, systems, components or technically oriented services.

3. Subcontractors should use this form to:

a. Notify N3B when the Subcontractor wants to propose changes to the subcontract unanticipated at time of award

b. Notify N3B when a manufactured product does not meet subcontract requirements and to document the Subcontractor’s proposed action together with their technical justification.

c. Notify N3B upon failure to meet requirements of Design Agency reviewed Subcontractor submittal documents.

d. Receive N3B disposition of the SDDR.

4. Submittal of SDDRs from lower-tier subcontractors shall be through the Subcontractor.

5. The SDDR is not a vehicle for addressing Requests for Information (RFI), Field Change Notices (FCNs), Field Change Requests (FCRs), or Design Revision Notices (DRNs).

6. N3B engineering actions and disposition statements do not relieve the Subcontractor from responsibility for the accuracy, adequacy, or suitability of the item being provided as defined in the subcontract, nor does it constitute a waiver of the terms of the subcontract.

7. Prior to approving any SDDR, N3B will consider whether:

a. There is a significant advantage to N3B in terms of cost/ schedule or item performance.

b. The deviation will adversely affect important properties or functions of the item or the service.

Field-by-Field Instructions for Subcontractor

Field Subcontractor Entry

1.1 Enter your document number by which you track

your documentation. If none, enter N/A.

1.2 Enter the date on which you submit the SDDR to

N3B.

1.3 Enter your organization name, address, point of

contact name, and telephone number.

1.4 Enter your order number if applicable

Enter your item number as applicable from the drawing, catalog, internal specification, etc.

Enter supplied item or service name or description.

1.5 Enter N3B subcontract number.

Enter N3B Subcontract Administrator's name.

Enter N3B Subcontract Technical Representative's name.

1.6 Enter the date deviation detected.

Enter the method used to detect deviation (e.g., NDT, visual, dimensional check, software error report, etc.)

1.7 List previously submitted SDDRs including dates

for same or similar deviations.

1.8 Date and method (fax, letter, e-mail, etc.) used to

notify N3B STR or SA.

1.9 Describe the characteristics and define the extent

of the out-of-specification condition for each identified item or service affected. Include quantities and serial, lot, batch, heat or other numbers as appropriate. Identify the location of the deviating characteristics by drawing coordinates or specific location, as applicable.

Attach reproducible-quality drawings, sketches, photographs, etc. as necessary.

When proposing a change in either Subcontractor

Field Subcontractor Entry or N3B documents, describe the change.

Completely identify the documents including title or subject, date and revision, and where appropriate, attach a copy of the areas in question.

1.10 Enter cost impact in US dollars to the Subcontract

that would result from the proposed changes.

1.11 Enter schedule impact in weeks to the Subcontract

that would result from the proposed changes.

1.12 Describe the proposed disposition and provide

technical (and, where appropriate, cost/schedule) justification for N3B evaluation. Attach legible and reproducible quality copies of supporting documentation. Submit a detailed repair procedure or reference the procedure previously submitted for use in similar situations for deviations correctable by repair.

1.13 Identify the nature of changes that may be needed

on associated documents (e.g. drawings, specifications, procedures, installation instructions, testing instructions, etc.)

1.14 The Subcontractor’s Authorized Representative

enters his or her name, title, telephone number, and date.

Submit completed form to N3B STR or N3B SA if no STR.

Also, Subcontractor shall include a copy of the completed SDDR form in the quality verification documents to which the SDDR applies.

STR, OR SUBCONTRACT ADMINISTRATOR IF NO STR

Upon receipt, log SDDR information and obtain SDDR number from Conduct of Engineering’s SharePoint site http://coe.lanl.gov/xprg/default.aspx (username is Z No.; password is WIN account password).

Enter number at top of SDDR page 1 along with date received.

Forward the form and any supporting documentation to the N3B Project Engineer for engineering evaluation and disposition (construction/fabrication projects) with copy to Subcontract Administrator (or STR depending on who receives original SDDR). If PE is unknown, forward to the Technical Subject Matter Expert (TSME). If all of the above are unknown, forward to Requestor.

If Subcontractor withdraws request, cancel number on website above.

LANL Project Engineer or TSME

Prior to approving any SDDR, it is imperative to consult with the Engineer of Record /Design Agency for technical evaluation and disposition. Also, consider whether:

There is a significant advantage to N3B in terms of cost/ schedule or item performance.

The deviation will adversely affect important properties or functions of the item or the service.

The SDDR is not a vehicle for granting variances from LANL institutional documents; if SDDR disposition requires variance from an institutional document then LANL engineering must follow the variance process of the appropriate institutional document (e.g., Engineering Standards). Generally, an SDDR may be used to document disposition of nonconformances in lieu of a nonconformance report (NCR) for a given procurement prior to receipt by LANL; however, once item or service is delivered, nonconformances require an NCR.

LANL EVALUATION AND DISPOSITION

LANL Project Engineer or the TSME, when appropriate, are responsible for completing this section unless noted otherwise.

Field No. Entry Information

2.1 Enter the project identification number and the

project title, if applicable

2.2 Check the appropriate box for management level

of the affected item.

2.3 For nuclear facilities, check the functional

classification box for the affected item. For nonnuclear facilities, check “NS” box.

2.4 Check the disposition box

2.5 LANL Actions:

Check all applicable boxes to define LANL actions.

Price adjustment requires procurement document (Purchase Order) change.

When disposition is “Use-As-Is”, “Repair”, or Modify LANL Requirements in Hazard Category 2 & 3 nuclear facility or in high hazard nonnuclear facility, then USQD/ USID by a LANL Qualified Evaluator (QEV) is required.

Field No. Entry Information

2.6 Provide appropriate justification for LANL actions

checked in Field 2.5. When changes to N3B drawings, specifications, requisitions, or other N3B documents are involved, each document is identified and the change is described in sufficient detail so that the Subcontract Administrator can use the description as the basis for a subcontract modification, if appropriate.

If other suppliers are affected indicate who they are and the document that initiated resolution of that involvement.

Also identify “Other” follow up actions such as the need for additional calculations, drawings or sketches, receipt inspections, etc.

2.7 Technical Subject Matter Expert (TSME) enters

name, Z number, organization, signature, and date.

TSME may be a LANL subject matter expert or the Design Agency subject matter expert on the item being procured.

TSME signature is always required and signifies thorough review of technical, cost, and schedule impacts of the SDDR.

2.8 Design Authority Representative (DAR) enters

name, Z number, organization, signature, and date.

DAR is always a LANL person. DAR signature is always required and signifies thorough review of safety basis, environmental safety and health, regulatory, and LANL institutional requirements impact of the SDDR.

2.9 Quality Subject Matter Expert (QSME) enters

name, Z number, organization, signature, and date.

QSME signature is required for ML-1, ML-2, and ML-3 procurements and signifies thorough review of QA requirements impact on the SDDR.

2.10 Project Engineer enters name, Z number, organization, signature, and date.

Project Engineer signature is required for construction projects and signifies that appropriate LANL and Design Agency personnel have evaluated the SDDR and changes to affected engineering documents shall be implemented.

2.11 Subcontract Technical Representative (STR)

enters name, Z number, organization, signature and date.

Completed form is then forwarded to the Subcontract Administrator for further action as appropriate.

2.12 Subcontract Administrator sends a copy of the

completed form to the Subcontractor together with a proposed Subcontract modification, if appropriate.

Form 2178 (10/11) http://coe.lanl.gov/xprg/default.aspx