TGI_3819P13339A01_c0v0.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.: HATCH 3-101-2 AY A 0 0

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

LCC-19 USS BLUE RIDGE 19P

CU PHASE TITLE:

F/O - OVERHAUL WATERTIGHT HATCH 3-101-2 AND REPLACE LIFELINE/GUARDLINE ASSEMBLY

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

HIROYUKI TANAKA 231B 315-243-4491 02-AUG-2024

APPROVED BY: CODE PHONE DATE

RYOUTA TAKAGI 231B 315-243-4502 02-AUG-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:

CHANGE INSTRUCTIONS:

SPECIAL REQUIREMENTS:

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.: HATCH 3-101-2 AY A 0

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SHIP: LCC-19 CHG/VER: 0/0

LIST OF EFFECTIVE PAGES

SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO. SHT NO. CHG NO.

1-9 Map (1)

J1-2 QA17

(1-4) M1-6 Engrg Inst (1- 2)

1. SCOPE/PURPOSE

1.1 Title: Watertight Hatch 3-101-2 and Lifeline/Guardline Assembly; overhaul and replace

1.2 Location of Work:

1.2.1 Sponson, Third Deck Weather, Frame 101, Port

1.2.2 Sponson, Third Deck Weather, Frame 101, Starboard

1.2.3 SD Storeroom (4-98-10-Q)

1.2.4 3M Office (4-98-8-Q)

1.2.5 Crew Living Space (5-98-01-L)

1.2.6 Crew Washroom, Water Closet and Shower (5-98-2-L)

1.2.7 Crew Living Space (6-98-0-L)

1.2.8 Fire Room (8-76-0-E)

1.2.9 Engine Room (8-86-0-E)

1.2.10 Shaft Alley (9-98-0-Q)

1.3 Identification:

1.3.1 Quantity (One EA), Hatch, Watertight

Hatch No. : 3-101-2 Size: 36 Inches x 75 Inches Material: Steel Type: Ramped Low Profile, Individually Dogged, 12 Dogs

1.3.1.1 Quantity (12 EA), Wedge

Material: Bronze Casting, ASTM B148 Remarks: See Sheet 3 Detail 3-G of 2.5 for detail

1.3.2 Quantity (3 EA), Guard Rope for Watertight Hatch 3-101-2 (Existing)

Remarks: See Sheet 5-A Detail 5-U of 2.7 for detail

1.3.3 Quantity (4 EA), Portable Hatch Guard Stanchion of Existing Guard Rope listed in 1.3.2 (Existing)

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SHIP: LCC-19 CHG/VER: 0/0

Material: Steel Remarks: See Sheet 5 Detail 5-L and Sheet 5-A Assy 5-R of 2.7 for detail

1.3.4 Quantity (4 EA), Deck Socket with brackets for Portable Hatch Guard Stanchion listed in 1.3.3 (Existing)

Material:

Deck Socket: CRES Bracket: Steel Remarks: See Sheet 5 Detail 5-L and Detail 5-K of 2.7 for detail

1.3.5 Quantity (4 EA), Ramp Plate of Watertight Hatch 3-101-2 (Existing)

Material: OS, MIL-S-22698 GR-A, 10.2 LBs Plate Remarks: See Sheet 5 and Sheet 6 Detail 6-B of 2.6 for detail

1.3.6 Quantity (4 EA), Portable Hatch Guard Stanchion for Lifeline Assembly listed in 1.3.7 and Guardline Assembly listed in 1.3.8

Material: CRES 316L, ASTM A269, 2-1/2 Inches OD x 0.1875 Inch Thickness Tube Remarks: See 2.6 and 2.8 for detail

1.3.6.1 Quantity (18 EA), Staple

Material: CRES 316L, ASTM A276, 5/8 Inch Diameter Round Bar Remarks: See Mapping Plan Enclosure-02, 2.6, and Sheet 8 Detail 62-A and Detail 62-C of 2.8 for detail

1.3.6.2 Quantity (4 EA), Stanchion Base Fitting

Material: CRES 316L, ASTM A276 Remarks: See 2.6, and Sheet 7 Detail 53-E of 2.8 for detail

1.3.6.3 Quantity (4 EA), Stanchion Cap

Material: CRES 316L, ASTM A240, 10.2 LBs Plate Remarks: See 2.6, and 2.8 for detail

1.3.7 Quantity (6 AY), Kevlar Rope Lifeline Assembly for Watertight Hatch 3-101-2

Size: 1/2 Inch Diameter Material: Jacketed Aramid Type Rope Line No(s).: KL-1 through KL-6 Remarks: See Mapping Plan Enclosure-02, and Sheet 5 and Sheet 6 Elevation 6-A of 2.6, and Sheet 10 Detail

78-E of 2.8), and 2.9 for location and detail

1.3.8 Quantity (3 AY), Synthetic Rope Guardline Assembly for Watertight Hatch 3-101-2, including snap hook and shackle

Specification: MIL-R-30500 Material: Polyester Size: 5/8 Inch Diameter (2 Inches Circumference) Line No(s).: SG-1 through SG-3 Remarks: See Mapping Plan Enclosure-02, Sheet 5 of 2.6, and Sheet 10 Detail 74-C of 2.8 for location and detail

1.3.9 Quantity (4 EA), Ramp Plate of Watertight Hatch 3-101-2

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SHIP: LCC-19 CHG/VER: 0/0

Material: OS, MIL-S-22698 GR-A, 10.2 LBs Plate Remarks: See Sheet 5 and Sheet 6 Detail 6-B of 2.6 for detail

1.3.10 Quantity (4 EA), Flush Deck Socket for Portable Hatch Guard Stanchion listed in 1.3.6

Material: CRES 316L, ASTM A276 Remarks: See 2.6, and Sheet 7 Detail 52-C of 2.8 for detail

1.3.11 Quantity (4 EA), Flush Deck Plug for Flush Deck Socket listed in 1.3.10

Material: Brass Alloy, ASTM B21 Remarks: See 2.6, and Sheet 7 Detail 55-C of 2.8 for detail

1.3.12 Quantity (2 AY), Brace Rod Assembly

Remarks: See Sheet One of 2.10 for material, and Sheet One Detail 8-A and Detail 6-A of 2.11 for detail, and

2.12 for length

1.3.12.1 Quantity (4 EA), Toggle Eye Bolt with wire rope

Remarks: See Sheet One of 2.10 for material, and Sheet One Detail 8-A and Detail 6-B of 2.11 for detail

1.3.13 Quantity (4 EA), Label Plate, Watertight Hatch

1.3.13.1 Quantity (One EA), Label Plate, Exterior

Material: CRES, Type-II of 2.16 Inscription: 1st. Line: 3-101-2

2nd. Line: SD STOREROOM 3rd. Line: 4-98-10-Q

1.3.13.2 Quantity (One EA), Label Plate, Damage Control Closure Classification, Exterior

Material: CRES, Type-II of 2.16 Remarks: Figure-D of 2.16

1.3.13.3 Quantity (One EA), Label Plate, Interior

Material: Aluminum Alloy, Type-I of 2.16 Inscription: 1st. Line: 3-101-2

2nd. Line: WEATHER

1.3.13.4 Quantity (One EA), Label Plate, Damage Control Closure Classification, Interior

Material: Aluminum Alloy, Type-I of 2.16 Remarks: Figure-D of 2.16

1.4 Security Classification: None.

1.5 Initial Condition:

1.5.1 Potential Lead Hazard

1.5.2 Potential Asbestos Hazard

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SHIP: LCC-19 CHG/VER: 0/0

1.6 Contractor work start date:

1.7 Contractor work completion date:

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 123-

5593573

FLUSH HATCH MODS - Y 1,2

,3

4 DWG 122-

2491848

ACCOM LDR HATCHWAYS 3RD

DK

A Y 1,2 ,4

5 DWG 122-

2491843

HATCH COVER FOR W.T. TRUNK

NO.4-143-1-T

C Y 1,2 ,3

6 PDD 600-

ELM-230333

Replacement of Portable Lifeline Assy for Hatch (3-101-2)

- Y AL

L

7 DWG 600-

2491390

GUARD RAILS AROUND

HATCHES

M Y SE

E N

OT

E

8 DWG 804-

5184155

LIFERAILS, LIFELINES &

AWNING STANCHIONS (AL &

STL) DETAILS & L/M

A N

9 DWG 804-

5959308

LIFELINE SYSTEM, KEVLAR

ASSEMBLY AND TESTING

- N

10 DWG 803-

1624096

HATCH WTRTT FL & L PF

RAMPED, INDV DOGGED, 30X48 -

5PSI - ARR

F N

11 DWG 803-

1624106

HATCH WTRTT FL 8L PF

RAMPED, INDV DOGGED, HINGE,

BRACE & CATCH DETAILS

C N

12 DWG 805-

1624080

HATCH W T RAISED

(INDIVIDUALLY DOGGED) 36" X

72" WITHOUT SCUTTLE.

E N

13 MIL MIL-

STD-1689

Fabrication, Welding and Inspection of Ships Structure

A N

14 MIL MIL-

STD-2035

Nondestructive Testing Acceptable Criteria

A N

15 TM

SYSTEMS &

SPECIFICAT

IONS

SSPC Painting Manual Volume 2 - N

16 PDD 602-

ELM-150531

SRF-JRMC STD ELM LABEL

PLATE FOR CLOSURE

A 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:

1/12/2026

5/15/2027

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SHIP: LCC-19 CHG/VER: 0/0

5.1 Remove existing hatch panel of each hatch listed in 1.3.1 and wedge 1.3.1.1, using 2.3 through 2.5 for guidance.

5.1.1 Cut and remove existing hinge blades of the hatch in accordance with Enclosure-01.

5.1.1.1 Clean, prepare, and retain removed hinge blades for reinstallation.

5.1.2 Disassemble dog assembly.

5.1.2.1 Clean each part free of dirt, grease and foreign matter.

5.1.3 Remove existing gasket and label plate(s) of each hatch.

5.2 Remove each existing guard rope, portable hatch guard stanchion, deck socket, and ramp plate listed in 1.3.2 through 1.3.5 in accordance with 2.6, using 2.3 and 2.7 for guidance.

5.2.1 Drill hole(s) on the existing ramp for gas free inspection.

5.3 Fabricate each new wedge, portable hatch guard stanchion, lifeline assembly, guardline assembly, ramp plate, flush deck socket, flush deck plug, and brace rod assembly listed in 1.3.1.1, and 1.3.6 through 1.3.12 in accordance with 2.6, 2.8, General Note 2 of 2.9, 2.10 through 2.12, using 2.4 for guidance.

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

5.3.2 Accomplish a load test of each new top staple of each new staple listed in 1.3.6.1.

(I)(G) “LOAD TEST”

5.3.2.1 Test load must be 3,000 LBs (plus 150 LBs and minus 0 LBs).

5.3.2.2 Hold test load for 10 minutes.

5.3.2.3 No permanent deformation, cracks, separation or visible damage of top staples and portable stanchions is acceptable.

5.3.2.4 Document the test on QA Form 17 Enclosure-03-1.

5.3.3 Accomplish visual (VT) inspection of each new weld of each new staple listed in 1.3.6.1 in accordance with 2.8 and Paragraphs 6.4 and 7.2 of 2.13. The accept or reject criteria must be in accordance with 2.8 and Paragraph 4 Class 3 of 2.14.

(I)(G) “VT INSPECTION”

5.3.3.1 Document the VT inspection on QA Form 17 Enclosure-03-2.

5.3.4 Accomplish a load test of each new lifeline assembly listed in 1.3.7.

(I)(G) “LOAD TEST”

5.3.4.1 Test load must be 3,000 LBs (plus 150 LBs and minus 0 LBs).

5.3.4.2 Hold test load for 10 minutes.

5.3.4.3 No permanent deformation, cracks, separation, snapping, fraying or visible damage of kevlar rope lifeline assembly is acceptable. The both end ropes of the tested lifeline assembly still extend beyond grip cones.

5.3.4.4 Document the test on QA Form 17 Enclosure-03-3.

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SHIP: LCC-19 CHG/VER: 0/0

5.3.5 Accomplish a load test of each new guardline assembly listed in 1.3.8.

(I)(G) “LOAD TEST”

5.3.5.1 Test load must be 1,100 LBs (plus 55 LBs and minus 0 LBs).

5.3.5.2 Hold test load for 10 minutes.

5.3.5.3 No permanent deformation, cracks, snapping, fraying or visible damage of synthetic rope guardline assembly is acceptable.

5.3.5.4 Document the test on QA Form 17, Enclosure-03-4.

5.4 Install each new portable hatch guard station, lifeline assembly, guardline assembly, ramp plate, flush deck socket, flush deck plug, and brace rod assembly listed in 1.3.6 through 1.3.12 in accordance with 2.6, General Note 4 of 2.9, and 2.10 through 2.12, using 2.4 and 2.8 for guidance.

5.4.1 Drill hole(s) on existing ramp for gas free inspection.

5.4.2 Install each new toggle eye bolt listed in 1.3.12.1 in accordance with 2.10 and 2.11.

5.4.3 Accomplish build up weld of remaining hole(s) on the existing ramp.

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

5.4.5 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of the flush deck socket. Allowable leakage: None.

5.4.6 Accomplish a hammer test of the flush deck socket in accordance with 2.6.

5.5 Accomplish the requirements of 009-32 of 2.1, including Table 2, Line(s) 21, for exterior surfaces and Table 3, Line(s) 25, for interior surfaces of hatch panel of each hatch listed in 1.3.1, and Table 2, Line(s) 21, for exterior surface of ramp and knife edge angle of the hatch. Application of nonskid system must conform to MIL-PRF-24667, Type V, Composition G.

5.5.1 Near-white blast clean for each hatch panel, ramp and knife edge angle. Accomplish each requirement of Surface Preparation Specification SSPC-SP 10 of 2.15.

5.6 Prepare and align hatch panel of each hatch listed in 1.3.1 for reinstallation, using 2.3 through 2.5 for guidance.

5.6.1 Fabricate and install new gasket conforming to MIL-PRF-900.

5.7 Reinstall hatch panel of each hatch listed in 1.3.1, using 2.3 through 2.5 for guidance.

5.7.1 Install each new wedge listed in 1.3.1.1 in accordance with 2.4 and 2.5.

5.7.2 Reinstall hinge blades of the hatch in accordance with Enclosure-01.

5.7.3 Reassemble dog assembly.

5.7.3.1 Lubricate each dogging mechanisms.

5.7.4 Adjust each dogging mechanism for unobstructed operation and to obtain 100 percent centered contact with the imprint of chalk in the center three-fifths of the gasket.

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SHIP: LCC-19 CHG/VER: 0/0

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

5.8 Accomplish an operational test of each hatch listed in 1.3.1 to assure unobstructed operation. Allowable sticking or binding: None.

(V)(G) “OPERATION TEST”

5.9 Accomplish the requirements of 009-25 of 2.1 for a chalk test of each hatch listed in 1.3.1.

5.10 Accomplish the requirements of 009-25 of 2.1 for a water hose test of each hatch listed in 1.3.1. Allowable leakage: None.

5.11 Fabricate and install new each label plate listed in 1.3.13 in accordance with 2.16.

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

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

5.13 Notes:

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

Planner: Code 232 R. Toriumi, 080-9899-1237 Planner: Code 234 T. Kikuchi, 243-4506 Engineer: Code 250 M. Orishimo, 243-4330

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

5.13.3 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.

5.13.4 WPC will copy the following pages in reference.

REF. 2.7: Pages 3, 3-A, 4-A, 5, 5-A, and 6C

5.13.5 JCN DA02-9737 is related to this TGI.

5.14 Government Furnished Material (GFM):

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

5.15 SRF-JRMC will provide the following service work: (TGI No. 3819P13339S02).

5.16.1 [C740] Crane and crane rigging service.

5.16.2 [X99E] Utility service, electrical.

5.16.3 [X99M] Provide utility service, including water supply, steam supply, and low pressure air supply except onboard blasting work.

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

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

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SHIP: LCC-19 CHG/VER: 0/0

5.16.6 [C133] QA Inspection for (G) symbol(s).

5.16.7 [C135] QA inspection for (G) symbol(s).

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J-1

SHIP: LCC-19 CHG/VER: 0/0

APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

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

VERSION:

CASREP

CAT:

HATCH 3-101-2 AY A 0 0

CU PHASE TITLE:

F/O - OVERHAUL WATERTIGHT HATCH 3-101-2 AND REPLACE LIFELINE/GUARDLINE ASSEMBLY

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

CMPT 4-98-10-Q MS 3RD DECK WEA PORT MS HATCH 3-101-2 HA LIFE LINE 3RD DECK

RZ

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P13339A01-Engrg Inst.pdf) saved on 02-AUG-2024 0000.

2. ENCLOSURE-02 (3819P13339A01-Map.pdf) saved on 02-AUG-2024 0000.

3. ENCLOSURE-03 (3819P13339A01-QA17.docx) saved on 02-AUG-2024 0000.

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

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P13339 A01

TOTAL MAT’L COST TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to overhaul watertight hatch 3-101-2 and replace lifeline/guardline assembly.

Location of Work:

Sponson, Third Deck Weather, Frame 101, Port Sponson, Third Deck Weather, Frame 101, Starboard SD Storeroom (4-98-10-Q) 3M Office (4-98-8-Q) Crew Living Space (5-98-01-L) Crew Washroom, Water Closet and Shower (5-98-2-L) Crew Living Space (6-98-0-L) Fire Room (8-76-0-E) Engine Room (8-86-0-E) Shaft Alley (9-98-0-Q)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.1 SFTR HRs, WELD HRs, CARP HRs, PNTR HRs, RGRS

HRs, LBR HRs

22 KE PC

5.2 SFTR HRs, WELD HRs, OMCH HRs, BLRM HRs, PFTR

HRs, INSL HRs, PNTR HRs, RGRS HRs, QA HRs

22 KE PC

5.3 SFTR HRs, WELD HRs, IMCH HRs, RGRS HRs, QA HRs 22 KE PC

5.4 SFTR HRs, WELD HRs, PNTR HRs, RGRS HRs, QA HRs 22 KE PC

5.5 CARP HRs, PNTR HRs, QA HRs 22 KE PC

5.6 SFTR HRs 22 KE PC

5.7 SFTR HRs, WELD HRs, CARP HRs, RGRS HRs, QA HRs

22 KE PC

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J-2

SHIP: LCC-19 CHG/VER: 0/0

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.8 SFTR HRs 22 KE PC

5.9 SFTR HRs 22 KE PC

5.10 SFTR HRs 22 KE PC

5.11 SFTR HRs, WELD HRs, QA HRs 22 KE PC

5.12 PNTR HRs, QA HRs 22 KE PC

Structure Work CFM: $ for all paints, thinner, grits including disposal cost, label plate cost, firewatch cost, confined space watch cost, air compressor rental cost and fuel oil cost for air hose test, lead sampling/analysis cost, and misc such as electrode, gases, temporary covering and closure material, and other consumable.

22 MQ CS

Machinery Work CFM: $ for misc such as covering material, plastic sheet, tape, fastener, gasket, asbestos sampler cost and analysis cost for gasket, and any other consumable.

22 MQ CS

Piping Work CFM: $ for marine chemist, lead sampling cost, welding materials, gases, paint, fire watch cost, and other consumable.

22 MQ CS

Process Funding Document. 10 CT OM

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M-1

SHIP: LCC-19 CHG/VER: 0/0

APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

HATCH 3-101-2 AY A 0 0

CU PHASE TITLE:

F/O - OVERHAUL WATERTIGHT HATCH 3-101-2 AND REPLACE LIFELINE/GUARDLINE ASSEMBLY

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

3819P13339 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

001 M BAR, METAL, 5/8"DIA,, ORDER

FOR X11

ORIG: C231B, H.TANAKA, 243-

BAR, METAL, ROUND, 5/8"DIA,

CRES 316L, ANNEALED, ASTM

A276 CONDITION A, HOT

FINISHED.

10 FT CONTINUOUS LENGTH X

3 EA

9B 9510 LL9001746 NA 4 N 31897453 30/FT

002 M BAR, METAL, 3"DIA, 3, ORDER

FOR X31M

ORIG: C231B, H.TANAKA, 243-

BAR, METAL, ROUND, 3"DIA,

CRES 316L, ASTM A276,

CONDITION A.

10 FT CONTINUOUS LENGTH X

1 EA

9B 9510 LL9801233 NA 4 N 31887460 10/FT

NOTES:

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M-2

SHIP: LCC-19 CHG/VER: 0/0

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

003 M BAR, METAL, 3"DIA, 3, ORDER

FOR X11

ORIG: C231B, H.TANAKA, 243-

BAR, METAL, ROUND, 3"DIA,

CRES 316L, ASTM A276,

CONDITION A.

10 FT CONTINUOUS LENGTH X

1 EA

9B 9510 LL9801233 NA 4 N 31887461 10/FT

004 M PLATE,ME, ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 9515 002044622 NA 4 N 31885117 1/SF

005 M PLATE,ME, ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 9515 002336261 NA 4 N 31885119 1/PM

006 M TUBE,METAL,2-1/2"OD, TUBE,

METAL, SEAMLESS,

SPEC: ASTM A269 GR TP316

SIZE: 2-1/2" OD X 0.187" THK,

MATL: CRES 316L,

10 FT CONTINUOUS LENGTH X

2 EA

ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 4710 LL9307852 NA 4 N 31887430 20/FT

007 M BAR,METAL, ORDER FOR

X31M

ORIG: C231B, H.TANAKA, 243-

9B 9530 001671935 NA 4 N 31885100 2/FT

008 M BAR, METAL, 3"DIA, BAR,

METAL, ROUND, 3"DIA, CRES

316L, ASTM A276, CONDITION

A.

10 FT CONTINUOUS LENGTH X

1 EA

ORDER FOR X31M

ORIG: C231B, H.TANAKA, 243-

9B 9510 LL9801233 NA 4 N 31897432 10/FT

009 M BAR, METAL, 3"DIA, BAR,

METAL, ROUND, 3"DIA, CRES

316L, ASTM A276, CONDITION

A.

10 FT CONTINUOUS LENGTH X

1 EA

ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 9510 LL9801233 NA 4 N 31897431 10/FT

010 M GASKET, GASKET,

SPEC: MIL-PRF-900,

DUROMETER,: 45,

THK: 1/2",

WIDE: 1-1/2",

MATL: SYNTHETIC RUBBER.

REMARKS: 3/16" X 45

DEGREES CHAMFERED

CORNERS(3/16" X 45 DEG),

40 FEET CONTINUOUS

LENGTH X 1 EA

ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 5330 LL9301411 NA 4 N 31607411 40/FT

FOUO

M-3

SHIP: LCC-19 CHG/VER: 0/0

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

011 M BAR,METAL, ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

1 EA X 10 FT CONTINUES

LENGTH

BAR, MATAL, FLAT

SPEC: ASTM B148,

WIDE: 2",

THICKNESS: 1”,

MATL: ALUMINIUM BRONZE

C95200

9B 9510 LL9308642 NA 4 N 31847431 10/FT

012 M PIPE,METALLIC, ORIG: C231B,

H.TANAKA, 243-4491

ORDER FOR X11

9B 4710 002778705 NA 4 N 31885102 12/FT

013 M BAR, METAL, 1/4"DIA,, BAR,

METAL, ROUND, 1/4"DIA,

CARBON STEEL ,

ASTM A36.

ORIG: C231B, H.TANAKA, 243-

ORDER FOR X11

9B 9510 LL9301414 NA 4 N 31887426 10/FT

014 M TOGGLE EYE BOLT, TOGGLE

EYE BOLT, CONSISTS OF

CRES, EYE BOLT & NAVAL

BRASS RIVET & NAVAL BRASS

TOGGLE, USE FOR

WATERTIGHT HATCH, NAVSEA

DWG: 803-1624106 DETAIL 6-B,

PC-79, 80, 81. (REF: 803-

1624135 PC-24, 25 & 28).

ORIG: C231B, H.TANAKA, 243-

ORDER FOR X11

9B 5306 LL9306704 NA 4 N 31887431 4/EA

015 M PLATE,ME, ORIG: C231B,

H.TANAKA, 243-4491

ORDER FOR X11

9B 9515 002375333 NA 4 N 31885127 2/SF

016 M SHEET,METAL, ORDER FOR

X11

ORIG: C231B, H.TANAKA, 243-

9B 9515 002044595 NA 4 N 32165017 1/SH

017 M PIN, LOCK, PIN, LOCK, SIM TO

DRIV LOK HIGH-ALLOY,

SHEAR-PROOF PIN TYPE A

SS-312-2250

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5315 LL9301347 NA 4 N 31617494 14/EA

018 M PACKING PLUNGER, PACKING

PLUNGER, SIZE 0.248"DIA X 1-

1/2"OVERALL LG, CRES 304,

QQ-S-763 CL 304 COND A

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5330 LL9301348 NA 4 N 31617496 14/EA

FOUO

M-4

SHIP: LCC-19 CHG/VER: 0/0

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

019 M SCREW, CAP, SCREW, CAP,

SIZE 1/2"DIA X 4"LG, FILLISTER

HEAD, CRES, FF-S-85 STYLE

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5305 LL9301349 NA 4 N 31617498 14/EA

020 M SCREW, MACHINE, SCREW,

MACHINE, SIZE 1/2"-13UNC-2A

X 1"LG, SELF-LOCKING,

HEXAGON HEAD, SIMILAR TO

NYLOK #M38 WITH PELLET,

CRES

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5305 LL9301351 NA 4 N 31617500 28/EA

021 M SLEEVE BEARING, OIL IMPG,

SIZE 1-3/8"ID X 1-5/8"OD X 1-

1/8"LG, BRONZE, SIMILAR TO

BEEMER ENG CO STOCK LIST

#85

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 4730 LL9301352 NA 4 N 31617502 14/EA

022 M THRUST BEARING, SIZE 1-

3/8"ID X 1-15/16"OD X 1/8"THK,

OIL IMPG BRZ, SIM TO

BEEMER ENG CO STOCK LIST

#65

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 3120 LL9301354 NA 4 N 31617506 28/EA

023 M STRING, PACKING, SIZE

1/8"DIA X 5FT CONTINUOUS

LG, PLASTIC, MIL-P-17578

TYPE II

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5330 LL9301355 NA 4 N 31617508 5/FT

024 M SLEEVE BEARING, SIZE 1-

3/8"ID X 1-5/8"OD X 1-1/2"LG,

OIL IMPG BRZ, SIM TO

BEEMER ENG CO STOCK

LIST#85

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 4730 LL9301353 NA 4 N 31617504 14/EA

025 M SPRING, CATCH, PH BRONZE,

QQ-B-750, CMPOSISION A,

SPR OR ASTM B103, ALLOY

C51000, TEMPER H08

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5340 LL9301357 NA 4 N 31617512 14/EA

FOUO

M-5

SHIP: LCC-19 CHG/VER: 0/0

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

026 M SCREW, MACHINE, SIZE #10-

32UNF-3A X 5/16"LG, ROUND

HEAD, BRASS, FF-S-92 TY I

STYLE 1S

ORDER FOR X11

ORIG: C231B, H. TANAKA, 243-

9B 5305 LL9301358 NA 4 N 31617514 28/EA

027 M O-RING, ORDERD FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 5331 004440849 NA 4 N 31605025 14/EA

028 M PACKING, ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 5330 002629436 NA 4 Y 33175100 1/CN

029 M PACKING, ORDER FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 5330 002629436 NA 4 Y 31885134 1/CN

030 M PACKING MATERIAL, ORDER

FOR X11

ORIG: C231B, H.TANAKA, 243-

9B 5330 002629437 NA 4 Y 31885097 3/YD

100 M ANCHOR SHACKLE, ORDER

FOR KTR

ORIG: C231B, H.TANAKA, 243-

ANCHOR SHACKLE,BOLT PIN,

SPEC: RR-C-271, TYPE IVA,

GRADE A, CLASS 3,

SIZE: 3/8",

MATL CRES 316,

BIW CATALOG NO.02182-106,

DO NOT CROSS NSN: 4030-01-

463-6778, AAC-Y

9B 4030 LL9004302 NA 4 N 3/EA

101 M ROPE,FIBROUS, ORDER FOR

KTR

ORIG: C231B, H.TANAKA, 243-

9B 4020 013584655 NA 4 N 40/FT

102 M TURNBUCKLE, ORDER FOR

KTR

ORIG: C231B, H.TANAKA, 243-

9B 5340 012676232 NA 4 N 6/AY

103 M ROPE,3-STRAND TWISTE,

ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

ROPE, 3-STRAND TWISTED,

SIZE 5/8"DIA X 600FT/REEL,

2.0" CIRC, WHITE COLOR,

POLYESTER, AVE BREAK

STRENGTH 10537.

1RL=600FT, GSA ADVANTAGE

ITEM.

LL9004534 NA 4 N 1/RL

104 M SNAP HOOK, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 5340 014469461 NA 4 N 3/EA

105 M HOOK,SIS, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 4030 012676224 NA 4 N 6/AY

200 M GASKET,SPIRAL WOUND,

ORDERED FOR X37E

ORI: CODE 232 R. TORIUMI

080-9899-1237

TY-2, CL-C, 150 SERIES

10 INCH

9B 5330 014246787 NA 4 N 31715143 2/EA

FOUO

M-6

SHIP: LCC-19 CHG/VER: 0/0

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

201 M SHEET,NONMETALLIC,,

ORDERED FOR X37E

ORI: CODE 232 R. TORIUMI

080-9899-1237

GARLOCK STYLE 9900

1/16 THK 60X60

9B 9390 014653232 NA 4 N 31715141 1/SH

202 M COMPLETE KIT, GASKET,

ORDERED FOR X37E

ORI: CODE 232 R. TORIUMI

080-9899-1237

COMPLETE KIT, GASKET &

INSULATION,

1. FLANGE SIZE & PRESSURE

RATING : 8" IPS, 150#

2. FLANGE SPEC : ASME B16.5

3. GASKET : PGE, RAISED

FACE (TYPE-F)

4. SEAL TYPE FOR GASKET :

NITRILE

5. INSULATING WASHER

MATERIAL : G-10/DOUBLE

9B 5330 LL9306599 NA 4 N 31717484 1/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 HATCH 3-101-2 AY A 0

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

3819P13339 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 HATCH 3-101-2 AY A 0

SUBJECT: TEMPORARY REMOVAL OF HATCH {3-101-2)

ICN: 3819P13339

JCN: DA02-9737

ORIGINATOR: C250 M.ORISHIMO

DATE: 07/10/2024

REFERENCE:

(a)AGC19-122-2491848 11A11

, ACCOM LOR HATCHWAYS 3RD DK

NOTES:

1. THE PURPOSE OF THIS ENGINEERING INSTRUCTION IS TO PROVIDE A TEMPORARY REMOVAL PLAN

OF HATCH (3-101-2) OF USS BLUE RIDGE (LCC 19) .

2. REMOVAL NOTE: EXISTING HINGE BLADE SHALL BE REMOVED WITH SAME DIMENSIONS SHOWN ON

INSTALLATION PLANS AND REUSED.

3. WELDING FOR STEEL MATERIALS SHALL BE CONDUCTED IN ACCORDANCE WITH SRF-JRMC

PROCESS INSTRUCTION N0.100-2. VT INSPECTION SHALL BE REQUIRED TO WELD.

4. FOR INFORMATION OF HATCH NOT SHOWN ON THIS INSTRUCTION, SEE REF ( a).

ENGRG INST

SHEET 1 OF 2 3819P13339A01

Hiroyuki.Tanaka.ja Text Box

ENCLOSURE-01

3819P13339A01

Hiroyuki.Tanaka.ja_1 Text Box

ENCLOSURE-01

MAPPING PLAN

ENCLOSURE-02

SHEET 1 OF 13819P13339A01

PLAN VIEW

Staple (3EA) Top: ST‐1

Intermediate: ST‐2 Lower: ST‐3

Kevlar Rope Lifeline Assembly (3 AY) Top: KL‐1

Intermediate: KL‐2 Lower: KL‐3

Staple (3EA) Top: ST‐4

Intermediate: ST‐5 Lower: ST‐6

Staple (3EA) Top: ST‐7 Intermediate: ST‐8 Lower: ST‐9

Staple (3EA) Top: ST‐10

Intermediate: ST‐11 Lower: ST‐12

Staple (3EA) Top: ST‐13 Intermediate: ST‐14 Lower: ST‐15

Staple (3EA) Top: ST‐16

Intermediate: ST‐17 Lower: ST‐18

Kevlar Rope Lifeline Assembly (3 AY) Top: KL‐4

Intermediate: KL‐5 Lower: KL‐6

Synthetic Rope Guardline Assembly (3 AY) Top: SG‐1

Intermediate: SG‐2 Lower: SG‐3

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P13339A01 ENCLOSURE-03-1 TOTAL 4

TEST AND INSPECTION RECORD

QA FORM 17 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

USS BLUE RIDGE LCC-19 DA02-9737 KTR N/A Lifeline/Guardline Stanchion

6. REFERENCES (COMPONENT DETAIL/ASSEMBLY DRAWING AND REV)

A. JFMM Rev. D Chg-3 Vol IV Ch 13 B. Dwg 804-5184155 Rev. A C. ELM 600-230333 Rev. “-“

D. E. F.

7. PART DESCRIPTION/PIECE NO.: Staple on Lifeline/Guardline Stanchion, See Mapping Plan Enclosure-02

8. DESCRIPTION OF TEST AND/OR INSPECTION:

STATIC LOAD TEST FOR TOP STAPLE ON LIFELINE/GUARDLINE STANCHION

Total of 6 EA top staple(s) on lifeline/guardline assembly in accordance with Reference C.

1. Rig the load indicating device to the top staple using rigging gear equipment (shackles, wire rope and etc).

2. Observe the load indicating device and slowly apply a static test load of 3,000 (+150, -0) LBs perpendicular to stanchion. Hold for 10 minutes.

3. Slowly release the test load and visually inspect the tested staple on the stanchion to meet the following acceptance criteria.

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, separation or visible damage of staple and stanchion.

9. RESULTS:

Use Continuation Sheet-1.

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

12. RECORD HAS BEEN REVIEWED FOR COMPLETENESS

QA WCS SIGNATURE (QAO/QAS SIGNATURE FOR SUBSAFE/SOC/SFCC ONLY) DATE

3819P13339A01 ENCLOSURE-03-1 (Continuation Sheet-1) TOTAL 4

9. RESULTS (Continued):

TEST ITEM TEST LOAD TEST DURATION TEST RESULT

STAPLE No. ST-1 LBs Min SAT / UNSAT STAPLE No. ST-4 LBs Min SAT / UNSAT STAPLE No. ST-7 LBs Min SAT / UNSAT

STAPLE No. ST-10 LBs Min SAT / UNSAT STAPLE No. ST-13 LBs Min SAT / UNSAT STAPLE No. ST-16 LBs Min SAT / UNSAT

TEST LOAD: 3,000 (+150, -0) LBs / TEST DURATION: 10 MINUTES (References A, B and C)

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, separation or visible damage of staple and stanchion.

*TEST FIXTURE INFO:

3819P13339A01 ENCLOSURE-03-2 TOTAL 4

TEST AND INSPECTION RECORD

QA FORM 17 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

USS BLUE RIDGE LCC-19 DA02-9737 KTR N/A Lifeline/Guardline Stanchion

6. REFERENCES (COMPONENT DETAIL/ASSEMBLY DRAWING AND REV)

A. Dwg 804-5184155 Rev. A B. ELM 600-230333 Rev. “-“ C. MIL-STD-1689 Rev. A

D. MIL-STD-2035 Rev. A E. F.

7. PART DESCRIPTION/PIECE NO.: Staple on Lifeline/Guardline Stanchion, See Mapping Plan Enclosure-02

8. DESCRIPTION OF TEST AND/OR INSPECTION:

Visual (VT) inspection of each new weld of staples (ST-1, ST-2, ST-3, ST-4, ST-5, ST-6, ST-7, ST-8, ST-9, ST- 10, ST-11, ST-12, ST-13, ST-14, ST-15, ST-16, ST-17, and ST-18) in accordance with Reference A, Reference B, and Paragraphs 6.4 and 7.2 of Reference C. The accept or reject criteria must be in accordance with Reference A and Paragraph 4 Class 3 of Reference D.

9. RESULTS:

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

3819P13339A01 ENCLOSURE-03-3 TOTAL 4

TEST AND INSPECTION RECORD

QA FORM 17 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

USS BLUE RIDGE LCC-19 DA02-9737 KTR N/A Stanchion Lifeline

6. REFERENCES (COMPONENT DETAIL/ASSEMBLY DRAWING AND REV)

A. JFMM Rev. D Chg-3 Vol IV Ch 13 B. Dwg 804-5959308 Rev. “-“ C. ELM 600-230333 Rev. “-“

D. E. F.

7. PART DESCRIPTION/PIECE NO.:

Kevlar Rope Lifeline Assembly

8. DESCRIPTION OF TEST AND/OR INSPECTION:

STATIC LOAD TEST FOR KEVLAR ROPE LIFELINE ASSEMBLY

Total of kevlar lifeline assembly – 6 AY

1. Rig the one end of lifeline assembly to appropriate fixture (bitt or ground structure) using rigging gear equipment (shackles, wire rope and etc.).

2. Rig the load indicating device to the other end of lifeline assembly using rigging gear equipment.

3. Observe the load indicating device and slowly apply a static test load of 3,000 (+150, -0) LBs to the lifeline assembly. Hold for 10 minutes. Record test data below.

4. Slowly release the test load from tested lifeline assembly. Remove sleeve from socket and visually inspect the tested lifeline assembly to meet the following acceptance criteria. Record test result below.

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, separation, snapping, fraying or visible damage of tested lifeline assembly. The both end ropes of the tested lifeline assembly still extend beyond grip cones.

5. Restore the removed sockets to sleeves of both ends on the tested lifeline assembly.

9. RESULTS:

Use Continuation Sheet-1.

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

3819P13339A01 ENCLOSURE-03-3 (Continuation Sheet-1) TOTAL 4

9. RESULTS (Continued):

TEST ITEM TEST LOAD TEST DURATION TEST RESULT

LIFELINE No. KL-1 LBs Min SAT / UNSAT

LIFELINE No. KL-2 LBs Min SAT / UNSAT

LIFELINE No. KL-3 LBs Min SAT / UNSAT

LIFELINE No. KL-4 LBs Min SAT / UNSAT

LIFELINE No. KL-5 LBs Min SAT / UNSAT

LIFELINE No. KL-6 LBs Min SAT / UNSAT

TEST LOAD = 3,000 (+150, -0) LBs / TEST DURATION = 10 MINUTES (Reference A and B)

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, separation, snapping, fraying or visible damage of lifeline assembly.

The both end ropes of the tested lifeline assembly still extend beyond grip cones.

3819P13339A01 ENCLOSURE-03-4 TOTAL 4

TEST AND INSPECTION RECORD

QA FORM 17 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

USS BLUE RIDGE LCC-19 DA02-9737 KTR N/A LIFELINE STANCHON

6. REFERENCES (COMPONENT DETAIL/ASSEMBLY DRAWING AND REV)

A. JFMM Rev. D Chg-3 Vol IV Ch 13 B. Dwg 804-5184155 Rev. A C. ELM 600-230333 Rev. “-“

D. E. F.

7. PART DESCRIPTION/PIECE NO.:

Synthetic Rope Guardline Assembly

8. DESCRIPTION OF TEST AND/OR INSPECTION:

STATIC LOAD TEST FOR SYNTHETIC ROPE GUARDLINE ASSEMBLY

Total of 3 AY synthetic rope guardine assembly in accordance with Reference C.

1. Rig one end of synthetic rope guardline assembly to appropriate fixture (bitt or ground structure) using rigging gear equipment (shackles, wire rope and etc.).

2. Rig the load indicating device to another end of synthetic rope guardline assembly using rigging gear equipment.

3. Observe the load indicating device and slowly apply a static test load of 1,100 (+55, -0) LBs to the synthetic rope guardline assembly. Hold for 10 minutes. Record test data below.

4. Slowly remove the test load and visually inspect the tested synthetic rope guardline assembly to meet the following acceptance criteria. Record test result below.

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, snapping, fraying or visible damage of synthetic rope guardline assembly.

5. Remove all test equipment and rigging gear equipment after completion of this test.

9. RESULTS:

Use Continuation Sheet-1.

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

3819P13339A01 ENCLOSURE-03-4 (Continuation Sheet-1) TOTAL 4

9. RESULTS (Continued):

TEST ITEM TEST LOAD TEST DURATION TEST RESULT

GUARDLINE NO. SG-1 LBs Min SAT / UNSAT

GUARDLINE NO. SG-2 LBs Min SAT / UNSAT

GUARDLINE NO. SG-3 LBs Min SAT / UNSAT

REQUIRED TEST LOAD 1,100 (+55, -0) LBs / REQUIRED TEST DURATION 10 MINUTES (Reference A and B)

ACCEPTANCE CRITERIA

There must be no permanent deformation, cracks, separation, snapping, fraying or visible damage of synthetic rope lifeline assembly.