7349B165_CDRL_form_DD1423_-_DID_80678_-_Mil-S-24093A.doc
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| 7349B168_CDRL_form_DD1423_-_DID_80678_-_Mil-S-24093A_(1).doc | DOC document | |
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CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
OMB No. 0704-188
Public reporting burden for collection of information is estimated to average 110 hours per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to Government issuing Contracting Officer for the Contract Officer for the Contract/PR No. listed in block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
TDP ______
TM ______
OTHER _CERT. DATA _
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
#1 WATERBORNE SHAFTS
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A0001 |
| CERTIFICATION / DATA REPORT |
| CERTIFICATE OF COMPLIANCE |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
DI-MISC-80678
NNSY CODE 266
| 7. DO 258 REQ |
| 9. DIST STATEMENT |
REQUIRED
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| 1 TIME |
| WITH MATERIAL |
b. COPIES
8. APP CODE
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
| a. ADDRESSEE |
| Draft |
| Final |
| Reg |
| Repro |
| 16. REMARKS |
| NNSY 266 |
| 1 |
| 0 |
Certificate of Compliance:
The Contractor shall prepare and submit a Certificate of Compliance certifying that the items/components furnished under this contract comply with the requirements of the procurement document, including any/all invoked specifications and drawings, and meets specifications requiring Certification.
One copy shall be supplied to Code 266, zachary.d.webster@navy.mil One copy shall be shipped with forgings.
CODE 135.24
(FOR FILE)
| 1 |
| 0 |
15. TOTAL
| 2 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Lisa Froze |
| 14 DEC 2017 |
| Zachary D. Webster |
| 15 Dec. 2017 |
DD Form 1423-1, JUN. 90
Previous editions are obsolete
Page _1_ of __1_
1007/183
S/N 0102-LF-010-5500
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
OMB No. 0704-188
Public reporting burden for collection of information is estimated to average 110 hours per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to Government issuing Contracting Officer for the Contract Officer for the Contract/PR No. listed in block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
TDP ______
OTHER _CERT. DATA _
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
#1 WATERBORNE SHAFTS
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A0002 |
| CERTIFICATION / DATA REPORT |
| CHEMICAL AND MECHANICAL |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
DI-MISC-80678
NNSY CODE 266
| 7. DO 258 REQ |
| 9. DIST STATEMENT |
REQUIRED
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
| 1 TIME |
| WITH MATERIAL |
b. COPIES
8. APP CODE
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
| a. ADDRESSEE |
| Draft |
| Final |
| Reg |
| Repro |
| 16. REMARKS |
| NNSY 266 |
| 1 |
| 0 |
Chemical and Mechanical Certification
The Contractor shall prepare and submit Chemical and Mechanical Analysis certifying that the parts listed and items/components furnished under this contract comply with the requirements of the procurement document, including any/all invoked specifications and drawings, including MIL-S-24093A (latest rev.), section 3.3 Table I and section 3.4 Table II.
One copy shall be supplied to Code 266, zachary.d.webster@navy.mil One copy shall be shipped with forgings.
CODE 135.24
(FOR FILE)
| 1 |
| 0 |
15. TOTAL
| 2 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Lisa Froze |
| 14 Dec. 2017 |
| Zachary D. Webster |
| 15 Dec. 2017 |
S/N 0102-LF-010-5500
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
OMB No. 0704-188
Public reporting burden for collection of information is estimated to average 110 hours per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to Government issuing Contracting Officer for the Contract Officer for the Contract/PR No. listed in block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
TDP ______
OTHER _CERT. DATA _
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
#1 WATERBORNE SHAFTS
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A0003 |
| CERTIFICATION / DATA REPORT |
| ULTRASONIC TESTING |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
DI-MISC-80678
NNSY CODE 266
| 7. DO 258 REQ |
| 9. DIST STATEMENT |
REQUIRED
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
| 1 TIME |
| WITH MATRIAL |
b. COPIES
8. APP CODE
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
| a. ADDRESSEE |
| Draft |
| Final |
| Reg |
| Repro |
| 16. REMARKS |
| NNSY 266 |
| 1 |
| 0 |
All Nondestructive Tests (NDT) shall meet the requirements of
NAVSEA Tech Manual S094-AS-GIB-010-271 (latest) for forgings.
Ultrasonic Testing
Records of ultrasonic inspection shall contain the following:
a. Description and unique identification.
b. Approved procedure identification.
c. Instrument manufacturer, model number, and serial number.
d. Transducer size and type.
e. Search beam angle.
f. Test frequency.
g. Couplant.
h. Calibration standard number.
i. Acceptance standard used.
j. Date of inspection.
k. Signature(s) of inspector(s).
l. Disposition (accept/reject) of the item inspected.
One copy shall be supplied to Code 266, zachary.d.webster@navy.mil One copy shall be shipped with forgings.
CODE 135.24
(FOR FILE)
| 1 |
| 0 |
15. TOTAL
| 2 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Lisa Froze |
| 14 Dec. 2017 |
| Zachary D. Webster |
| 15 Dec. 2017 |
S/N 0102-LF-010-5500
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
OMB No. 0704-188
Public reporting burden for collection of information is estimated to average 110 hours per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to Government issuing Contracting Officer for the Contract Officer for the Contract/PR No. listed in block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
TDP ______
OTHER _CERT. DATA _
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
#1 WATERBORNE SHAFTS
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A0004 |
| CERTIFICATION / DATA REPORT |
| MAGNETIC PARTICLE TEST |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
DI-MISC-80678
NNSY CODE 266
| 7. DO 258 REQ |
| 9. DIST STATEMENT |
REQUIRED
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
| 1 TIME |
| WITH MATERIAL |
b. COPIES
8. APP CODE
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
| a. ADDRESSEE |
| Draft |
| Final |
| Reg |
| Repro |
| 16. REMARKS |
| NNSY 266 |
| 1 |
| 0 |
All Nondestructive Tests (NDT) shall meet the requirements of
NAVSEA Tech Manual S094-AS-GIB-010-271 (latest) for forgings.
Magnetic Particle Testing
Records of magnetic particle inspections shall contain the following:
a. Description and unique identification of item inspected.
b. Approved procedure identification.
c. Instrument manufacturer and model number, or unique equipment identification (yokes excluded).
d. Acceptance standard used.
e. Date of inspection.
f. Signature(s) of inspector(s).
g. Disposition (accept/reject) of the item inspected.
One copy shall be supplied to Code 266, zachary.d.webster@navy.mil One copy shall be shipped with forgings.
CODE 135.24
(FOR FILE)
| 1 |
| 0 |
15. TOTAL
| 2 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Lisa Froze |
| 14 Dec. 2017 |
| Zachary D. Webster |
| 15 Dec. 2017 |
S/N 0102-LF-010-5500
LEAD DOC. 7349 B165
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