TGI_3819P14208A01_c1v1.pdf

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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.: STRUCT 8-86-0-E 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:

F/O - REPAIR STRUCTURAL MEMBER IN 8-86-0-E

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

TOMOHIKO ANDO 231B 315-243-4372 22-JUN-2024

APPROVED BY: CODE PHONE DATE

RYOUTA TAKAGI 231B 315-243-4502 22-JUN-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:

Revising of the Paragraph 5.11.4 is needed.

CHANGE INSTRUCTIONS:

CH1: Revising of the Paragraph 5.11.4. (7/16/2024)

SPECIAL REQUIREMENTS:

This work affects a fire zone boundary. Fabrication and/or staging of a non-flammable closure is required.

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL III

CLASS P-2 PIPING

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.: STRUCT 8-86-0-E AY A 0

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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.

1-11 Map (1- 2)

J1-2 QA20

(1-7)

M1-9 QA17

(1)

Sketch (1-3)

1. SCOPE/PURPOSE

1.1 Title: Structural Member in 8-86-0-E; repair

1.2 Location of Work:

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

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

1.2.3 Fresh Water Ballast (9-86-6-W)

1.2.4 Distillate Fuel or Ballast (9-86-2-F)

1.2.5 Cofferdam (9-86-4-V)

1.2.6 Clean Salt Water Ballast (9-98-2-W)

1.2.7 Collection Holding Tank No. 4 (8-98-2-W)

1.2.8 Potable Water Tank (9-76-4-W)

1.2.9 Potable Water Tank (9-83-2-W)

1.2.10 Waste Water Bilge Sump (9-85-2-W)

1.2.11 Waste Water Bilge Sump (9-87-2-W)

1.2.12 Waste Oil Tank (9-94-0-F)

1.2.13 Distillate Fuel or Ballast (9-86-1-F)

1.2.14 Oily Water Bilge Sump (9-87-1-W)

1.2.15 Potable Water Tank (9-83-1-W)

1.2.16 Clean Salt Water Ballast (9-98-1-W)

1.2.17 Collection Holding Tank No. 3 (8-98-1-W)

1.2.18 Fresh Water Ballast (9-86-5-W)

1.2.19 Cofferdam (9-86-3-V)

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

1.2.20 Oily Water Bilge Sump (9-84-2-W)

1.2.21 Ship Fitter Storeroom (6-86-2-A)

1.2.22 B Division Storeroom (6-76-2-A)

1.2.23 Self Service Storeroom (6-86-1-A)

1.2.24 Medical Storeroom (7-98-2-A)

1.2.25 SD Storeroom No. One (7-98-1-A)

1.2.26 Cross Flooding Duct Frame 86

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

1.2.28 Pump Room No. 2 and Air Conditioning Machinery Room No. 2 (7-109-2-E)

1.3 Identification:

1.3.1 Quantity (One EA), No.4 Collection, Holding and Transfer (CHT) Pump Unit

Mfr: Eddy Pump Corporation Mfr Id: CC-3000 Type: Motor Closed Coupling, Centrifugal Tornade Volute Capacity: 300 GPM Pressure: 39 PSI Speed: 1750 RPM

1.3.2 Quantity (One EA), No.3 CHT Pump Discharge Cutout Valve

Size: 3 Inch IPS Type: Plug Flanged Straight Way Valve Number: 8-98-3

1.3.3 Quantity (One EA), No.4 CHT Pump Suction Cutout Valve

Size: 3 Inch IPS Type: Plug Flanged Straight Way Valve Number: 8-98-5

1.3.4 Quantity (One EA), Degaussing Cable

Cable Type: MDGY-15(3) Circuit Number: D-2A-4

1.3.5 Quantity (One Lot), Collection, Holding and Transfer (CHT) Piping for CHT Pump No. 3 and No. 4

Remarks: See Sheet 3 (Zone ID 9-A through 9-D) of 2.8 and Sheet 5 (Part Plan 34-A) of 2.5 for detail.

1.3.5.1 Quantity (One AY), CHT Piping including Valve (CHT-E8) and Pressure Gage, between outlet flange of valve (8-98-5) to inlet flange of CHT pump No. 4

Size: 3 Inch IPS (3.500 Inch OD X 0.095 Inch WT) Material: Copper Nickel Alloy Specification: MIL-T-16420

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

1.3.5.2 Quantity (One AY), CHT Piping, between outlet flange of the valve (8-87-5), inlet flange of the valve (8-98-5), inlet flange of the valve (8-98-7), and the portion of pipe on inlet of the lateral side from CHT tank No. 4

Size: 5 Inch IPS (5.563 Inch OD X 0.125 Inch WT) 3 Inch IPS (3.500 Inch OD X 0.095 Inch WT)

Material: Copper Nickel Alloy Specification: MIL-T-16420

1.3.6 Quantity (One Lot), Structural Member in 8-86-0-E

1.3.6.1 Quantity (One Lot), Bulkhead Plate, Transverse Bulkhead, Frame 86 Port and Starboard (Stbd)

Remarks: See Sheets 4 and 5 of 2.9 for material and detail JCN: ES01-NPL4, ES01-NPL5, ES01-NPL9, ES01-NPLA, ES01-NPLE, ES01-NPLF, and ES01-NPLH

1.3.6.2 Quantity (One Lot), Bulkhead Plate of Cross Flooding Duct, Frames between 86 and 87, Port and Stbd

Remarks: See Sheet 12 of 2.9 for material and detail JCN: ES01-NPLM, ES01-NPLN, and ES01-NPLP

1.3.6.3 Quantity (One Lot), Bulkhead Plate, Longitudinal Bulkhead, Frames between 86 and 96, Port

Remarks: See Sheet 6 of 2.9 for material and detail JCN: ES01-NPLQ, ES01-NPLT, ES01-NPLU, ES01-NPLV, and ES01-NPLW

1.3.6.4 Quantity (One Lot), Bulkhead Plate, Longitudinal Bulkhead, Frames between 89 and 93, Stbd

Remarks: See Sheet 7 of 2.9 for material and detail

JCN: ES01-NPLY

1.3.6.5 Quantity (3 EA), Deck Plate, Frames between 89 and 93, Stbd

Remarks: See Sheet 8 of 2.9 for material and detail

JCN: ES01-NPLZ

1.3.6.6 Quantity (2 EA), Deck Plate, Frames between 89 and 92, Port

Remarks: See Sheet 9 of 2.9 for material and detail JCN: ES01-NPM0 and ES01-NPM1

1.3.6.7 Quantity (One Lot), Bulkhead Plate, Transverse Bulkhead, Frame 98, Port and Stbd

Remarks: See Sheets 10 and 11 of 2.9 for material and detail JCN: ES01-NPMF, ES01-NPMG, ES01-NPMH, ES01-NPMK, ES01-NPMP, ES01-NPF7, and ES01-NPEP

1.3.6.8 Quantity (One Lot), Side Plate of Main Propulsion Foundation in 8-86-0-E, Frames between 97 and 98, Stbd

Remarks: See Sheet 13 Elevation 13-A of 2.9 for material and detail

JCN: ES01-NPM9

1.3.6.9 Quantity (One EA), Reinforcing Bar on Side Plate of Main Propulsion Foundation in 8-86-0-E, Frames between 97 and 98, Port

Remarks: See Sheet 13 Elevation 13-B of 2.9 for material and detail

JCN: ES01-NPM9

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

1.3.7 Quantity (One Lot), Structural Member in 8-86-0-E, Port and Stbd

Remarks: See 2.9 for base material and location detail JCN: ES01-NPL3, ES01-NPL6, ES01-NPL7, ES01-NPL8, ES01-NPLB, ES01-NPLC, ES01-NPLD, ES01-

NPLG, ES01-NPLJ, ES01-NPLK, ES01-NPLL, ES01-NPLR, ES01-NPLS, ES01-NPLX, ES01-NPM2, ES01-NPM3, ES01-NPM4, ES01-NPM5, ES01-NPM6, ES01-NPM7, ES01-NPM8, ES01-NPM9, ES01-NPMB, ES01-NPMC, ES01-NPMD, ES01-NPME, ES01-NPMJ, ES01-NPML, ES01-NPMM, ES01-NPMN, ES01-NPMQ, ES01-NPMR, ES01-NPMS, ES01-NPMT

1.3.8 Quantity (33 SF), Corroded Area of Bulkhead Plate in 8-86-0-E, Transverse Bulkhead, Frame 98, Stbd

Material: Steel Remarks: See Sheet 3 of Sketch Enclosure-01 for location detail

JCN: ES01-NPMH

1.3.9 Quantity (17 SF), Corroded Area of Main Propulsion Foundation in 8-86-0-E, Frames between 97 and 98-1/2, including vertical surface up to height of 12 inches from Deck Plate, Port and Stbd

Material: Steel Remarks: See Sheet 2 Sketch Enclosure-01 for location detail

JCN: ES01-NPMA

1.3.10 Quantity (328 SF in Total), Interior surface of 8-86-0-E where new material is installed and disturbed by the hot work

1.3.10.1 Quantity (69 SF), Interior surface of 8-86-0-E, Frames between 86 and 87, Port

Remarks: See Sheet 4 of 2.9 for location detail JCN: ES01-NPL9 and ES01-NPLA

1.3.10.2 Quantity (58 SF), Interior surface of 8-86-0-E, Frames between 86 and 87, Port and Stbd

Remarks: See Sheet 5 and 12 of 2.9 for location detail JCN: ES01-NPLE, ES01-NPLF, ES01-NPLH, ES01-NPLM, ES01-NPLN, and ES01-NPLP

1.3.10.3 Quantity (80 SF), Interior surface of 8-86-0-E, Frames between 89 and 93, Stbd

Remarks: See Sheet 7 and 8 of 2.9 for location detail JCN: ES01-NPLY and ES01-NPLZ

1.3.10.4 Quantity (27 SF), Interior surface of 8-86-0-E, Frames between 89 and 92, Port

Remarks: See Sheet 9 of 2.9 for location detail JCN: ES01-NPM0 and ES01-NPM1

1.3.10.5 Quantity (30 SF), Interior surface of 8-86-0-E, Frame 98, Stbd

Remarks: See Sheet 10 of 2.9 for location detail JCN: ES01-NPMF and ES01-NPMG

1.3.10.6 Quantity (20 SF), Interior surface of 8-86-0-E, Frames between 97 and 98, Port

Remarks: See Sheet 11 of 2.9 for location detail

JCN: ES01-NPMK

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

1.3.10.7 Quantity (44 SF), Interior surface of 8-86-0-E, Frames between 97 and 98, Stbd

Remarks: See Sheet 13 Elevation 13-A of 2.9 for location detail

JCN: ES01-NPM9

1.3.11 Quantity (103 SF in Total), Interior surface of 8-76-0-E, where new material is installed and disturbed by the hot work

1.3.11.1 Quantity (90 SF), Interior surface of 8-76-0-E, Frames between 85 and 86, Port

Remarks: See Sheet 4 of 2.9 for location detail JCN: ES01-NPL9 and ES01-NPLA

1.3.11.2 Quantity (13 SF), Interior surface of 8-76-0-E, Frames between 85 and 86, Stbd

Remarks: See Sheet 5 of 2.9 for location detail JCN: ES01-NPLE, ES01-NPLF, and ES01-NPLH

1.3.12 Quantity (81 SF), Interior Surface of Distillate Fuel or Ballast (9-86-1-F), Frames between 90 and 93, Stbd, where new material is installed and disturbed by the hot work

Remarks: See Sheet 8 of 2.9 for location detail

JCN: ES01-NPLZ

1.3.13 Quantity (30 SF in Total), Interior Surface of Distillate Fuel or Ballast (9-86-2-F), Frames between 89 and 93, Port, where new material is installed and disturbed by the hot work

Remarks: See Sheet 9 of 2.9 for location detail JCN: ES01-NPM0 and ES01-NPM1

1.3.14 Quantity (28 SF in Total), Interior surface of Cross Flooding Duct, Port and Stbd, where new material is installed and disturbed by the hot work

Remarks: See Sheet 12 of 2.9 for location detail JCN: ES01-NPLM, ES01-NPLN, and ES01-NPLP

1.3.15 Quantity (39 SF), Interior Surface of Fresh Water Ballast Tank (9-86-6-W), Frames between 92 and 96, Port, where new material is installed and disturbed by the hot work

Remarks: See Sheet 6 of 2.9 for location detail JCN: ES01-NPLT, ES01-NPLU, ES01-NPLV and ES01-NPLW

1.3.16 Quantity (14 SF in Total), Interior Surface of Fresh Water Ballast Tank (9-86-5-W), Frames between 89 and 93, Port, where new material is installed and disturbed by the hot work

Remarks: See Sheet 7 of 2.9 for location detail

JCN: ES01-NPLY

1.3.17 Quantity (12 SF), Interior Surface of Clean Salt Water Ballast (9-98-1-W), Stbd where new material is installed and disturbed by the hot work

Remarks: See Sheet 10 of 2.9 for location detail JCN: ES01-NPMF and ES01-NPMG

1.3.18 Quantity (14 SF), Interior Surface of Clean Salt Water Ballast (9-98-2-W), Port where new material is installed and disturbed by the hot work

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

Remarks: See Sheet 11 of 2.9 for location detail

JCN: ES01-NPMK

1.3.19 Quantity (52 SF), Interior Surface of CHT No. 3 (8-98-1-W), Frame 98, Stbd, where new material is installed and disturbed by the hot work

Remarks: See Sheet 10 of 2.9 for location detail

JCN: ES01-NPMH

1.3.20 Quantity (26 SF), Interior Surface of CHT No. 4 (8-98-2-W), Frame 98, Port, where new material is installed and disturbed by the hot work

Remarks: See Sheet 11 of 2.9 for location detail

JCN: ES01-NPEP

1.4 Security Classification: None.

1.5 Initial Condition:

1.5.1 Dry Dock Work.

1.5.2 Potential Asbestos Hazard.

1.5.3 Potential Lead Hazard.

1.5.4 Critical Coated Area: CCNY-LCC19-063-25 for the area listed in 1.3.9 through 1.3.20

1.6 Contractor work start date: 1/12/2026

1.7 Contractor work completion date: 5/15/2027

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 545-

7292494

S/A LCC19-1309K

ARRANGEMENT MODIFICATION

INCIDENTAL TO CHT PUMP

REPLACEMENT

- Y 3

4 DWG 113-

7292499

S/A 1309K-2 FDN CHT SYSTEM

UPGRADE

- Y 4

5 DWG 505-

7292783

CHT PP MODS INCID PUMP REPL A Y 5,6

,7

6 DWG 403-

2493371

DEGAUSSING SYSTEM

ISOMETRIC WIRING DIAGRAM

D Y 4

7 DWG 403-

2493370

DEGAUSSING SYSTEM

ELEMENTARY WIRING DIAGRAM

C Y 19

8 DWG 528-

4346220

CHT PIPING SYSTEM SUCTION &

DISCHARGE TKS #1,2,3 & 4

C Y 3

9 PDD 100-

ELM-240291

REPAIR PLAN OF CORRODED

STRL MEMBERS IN ENGINE

ROOM (8-86-0-E)

- Y AL

L

10 PDD 114-

ELM-240052

TEMP RPR PLAN OF CORRODED

WTRTT TRANSV BHD FR 98 IN

ENGINE ROOM (8-86-0-E)

- Y AL

L

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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

11 PDD 475-

ELM-240284

SRF-JRMC STD ELM

ELECTRICAL TESTING

REQUIREMENT FOR

DEGAUSSING CABLE

- Y AL

L

12 TM S9AA0-

AB-GOS-

010/GSO

General Specifications for Overhaul of Surface Ships (GSO)

11 N

13 MRC 34

6DNR N

Measure Degaussing Coil IR of Energized Equipment or De-energized Equipment

- N

14 TM T-9630-

AB-MMD-

Corrosion Control Assessment and Maintenance Manual (CCAMM)

3 N

15 TM NAVSEA

4790/14

Tank and Void Structural and Coating Condition Survey (MRC G1N5)

- N

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 Pump out, clean and dry the bilge area located in 1.2.1 and 1.2.2 free from oil, debris, and other foreign matter.

5.2 Accomplish the following machinery work for the equipment listed in 1.3.1, 1.3.2 and 1.3.3, using 2.3 through 2.5 for guidance.

5.2.1 Accomplish the requirements of 009-09 of 2.1.

5.2.2 Remove each equipment listed in 1.3.1, 1.3.2, and 1.3.3, using 2.3 through 2.5 for guidance.

5.2.2.1 Clean each exposed part free of foreign matter, leaving no residue or injurious effects.

5.2.2.2 Remove each high spot, burr, abrasion, nick, corrosion, gasket material, and foreign matter from each exposed flange and mating surface.

5.2.2.3 Chase and tap each exposed threaded area.

5.2.3 Install each equipment listed in 1.3.1, 1.3.2 and 1.3.3 after completion of structural repair, using 2.3 through

2.5 for guidance.

5.2.3.1 Install each new CHT piping joint gasket. Gasket must conform to HH-P-151, Class I, cloth inserted rubber, or MIL-PRF-1149, Type II, Class II, synthetic rubber.

5.3 Pull back the cable listed in 1.3.4, using Sheet 4 of 2.6 and Sheet 19 of 2.7 for guidance.

5.4 Remove existing and reinstall each CHT piping listed in 1.3.5 for supporting of structural work, using 2.5 and 2.8 for guidance.

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

5.4.1 Accomplish the requirements of 009-09 of 2.1 for the certification process.

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

5.5 Remove existing, fabricate and install new each structural member listed in 1.3.6 in accordance with 2.9.

5.5.1 Remove existing temporary doubler plate, using 2.10 for guidance.

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

5.5.2.1 Accomplish nondestructive testing in accordance with Line(s) 9.

5.5.2.2 Accomplish the requirements of 099-911YO of 2.2, using QA Form 20 Enclosure-03-1 through Enclosure-03-

7. Each joint identification number must be in accordance with Mapping Plan Enclosure-02.

5.5.2.3 Accomplish the requirements of 009-09 of 2.1 for welding procedure of each joint shown on Mapping Plan Enclosure-02.

5.5.3 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of each bulkhead plate and deck plate listed in 1.3.6.1 through 1.3.6.7. Allowable leakage: None.

5.5.3.1 Document the local air hose test on QA Form 17 Enclosure-04-1.

5.6 Install the cable listed in 1.3.4, using Sheet 4 of 2.6 and Sheet 19 of 2.7 for guidance.

5.6.1 Accomplish an electrical test for the cable in accordance with 2.11 through 2.13.

5.7 Accomplish weld repair of corroded areas on each existing structural member listed in 1.3.7 in accordance with 2.9.

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

5.8 Accomplish the requirements of 009-32 of 2.1, including Table 3, Line(s) 13, for each area listed in 1.3.8 through 1.3.11.

5.9 Accomplish the requirements of 009-32 of 2.1, including Table 4, Line(s) 11, for each area listed in 1.3.12 and 1.3.13, Table 4, Line(s) 17, for each area listed in 1.3.14 through 1.3.18, and Table 4, Line(s) 16, for each area listed in 1.3.19 and 1.3.20.

5.9.1 Submit new coating data applied to the SUPERVISOR in accordance with 2.14 and 2.15.

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

5.11 Notes:

5.11.1 Planner: Code 231B T. Ando, 243-4372

Planner: Code 232 T. Funaki, 243-2494 Planner: Code 233 T. Takemura, 080-9350-1458 Planner: Code 234 H. Ito, 243-4534 Planner: Code 234 T. Tsunoi, 243-4204

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

5.11.3 This TGI clears DFS LCC-19-1050-2023 and LCC-19-1001-2024 in its entirety.

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

5.11.4 Opening, initial cleaning, and closing of the following tanks will be covered by the following TGI No(s).

Fresh Water Ballast Tank (9-86-6-W): 3819P12319A01 (KTR TGI) Distillate Fuel or Ballast (9-86-2-F): 3819P12319A01 (KTR TGI) Cofferdam (9-86-4-V): 3819P12361A01 (KTR TGI) Clean Salt Water Ballast (9-98-2-W): 3819P12357A01 (KTR TGI) Collection Holding Tank No. 4 (8-98-2-W): 3819P12357A01 (KTR TGI) Potable Water Tank (9-76-4-W): 3819P12325A01 (KTR TGI) Potable Water Tank (9-83-2-W): 3819P12389A01 (KTR TGI) Waste Water Bilge Sump (9-85-2-W): 3819P12349A01 (KTR TGI) Waste Water Bilge Sump (9-87-2-W): 3819P12319A01 (KTR TGI) Waste Oil Tank (9-94-0-F): 3819P12352A01 (KTR TGI) Distillate Fuel or Ballast (9-86-1-F): 3819P12319A01 (KTR TGI) Oily Water Bilge Sump (9-87-1-W): 3819P12350A01 (KTR TGI) Potable Water Tank (9-83-1-W): 3819P12326A01 (KTR TGI) Clean Salt Water Ballast (9-98-1-W): 3819P12344A01 (KTR TGI) Collection Holding Tank No. 3 (8-98-1-W): 3819P12356A01 (KTR TGI) Fresh Water Ballast Tank (9-86-5-W): 3819P12343A01 (KTR TGI) Cofferdam (9-86-3-V): 3819P12360A01 (KTR TGI) Oily Water Bilge Sump (9-84-2-W): 3819P12349A01 (KTR TGI)

5.11.5 The removal and installation of No. 2 low pressure compressor (LPAC) unit and dehydrator have been covered TGI No. 3819P55101A01 (KTR TGI).

5.11.6 The removal and installation of halon bottle No. 12 and No. 13 (in fire room 8-76-0-E) will be covered by ship’s force.

5.11.7 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.

5.11.8 JCNs ES01-NPEP, ES01-NPL3, ES01-NPL4, ES01-NPL5, ES01-NPL6, ES01-NPL7, ES01-NPL8, ES01- NPL9, ES01-NPLA, ES01-NPLB, ES01-NPLC, ES01-NPLD, ES01-NPLE, ES01-NPLF, ES01-NPLG, ES01-NPLH, ES01-NPLJ, ES01-NPLK, ES01-NPLL, ES01-NPLM, ES01-NPLN, ES01-NPLP, ES01-NPLQ, ES01-NPLR, ES01- NPLS, ES01-NPLT, ES01-NPLU, ES01-NPLV, ES01-NPLW, ES01-NPLX, ES01-NPLY, ES01-NPLZ, ES01-NPM0, ES01-NPM1, ES01-NPM2, ES01-NPM3, ES01-NPM4, ES01-NPM5, ES01-NPM6, ES01-NPM7, ES01-NPM8, ES01- NPM9, ES01-NPMA, ES01-NPMB, ES01-NPMC, ES01-NPMD, ES01-NPME, ES01-NPMF, ES01-NPMG, ES01- NPMH, ES01-NPMJ, ES01-NPMK, ES01-NPML, ES01-NPMM, ES01-NPMN, ES01-NPMP, ES01-NPMQ, ES01- NPMR, ES01-NPMS, ES01-NPMT, and ES01-NPF7 are related to this TGI.

5.12 Government Furnished Material (GFM):

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

5.13 SRF-JRMC will provide the following service work: (TGI No. 3819P14208S02).

5.13.1 [C740] Crane and crane rigging service.

5.13.2 [X99E] Utility service, electrical.

5.13.3 [X99M] Utility service, including water supply, steam supply, and low pressure air except for onboard blasting.

FOUO

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

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

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

5.13.6 [C133] QA inspection for (G) symbol(s) and review of coating application data.

5.13.7 [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:

STRUCT 8-86-0-E AY A 0 1

CU PHASE TITLE:

F/O - REPAIR STRUCTURAL MEMBER IN 8-86-0-E

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

CMPT 8-86-0-E MSBLST 9-98-2-W TK CHT 8-98-2-W TK VOID 9-86-4-V VD FO/BLST 9-86-2-F TK CMPT 8-76-0-E MSCHT 8-98-1-W TK BLST 9-98-1-W TK BLST 9-86-6-W TK FO/BLST 9-86-

1-F TK VOID 9-86-3-V VD POT WTR 9-83-2-W TK WO 9-94-0-F TK SEW 8-86-0-E PP

VOID XFLD DUCT FR86 VD BLST 9-86-5-W TK POT WTR 9-83-1-W TK WO 9-85-2-W TK

DEGAUSSING CKT D C- WO 9-84-2-W TK

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P14208A01-Sketch.pdf) saved on 07-JUN-2024 0000.

2. ENCLOSURE-02 (3819P14208A01-Map.pdf) saved on 07-JUN-2024 0000.

3. ENCLOSURE-03 (3819P14208A01-QA20.docx) saved on 21-JUN-2024 0000.

4. ENCLOSURE-04 (3819P14208A01-QA17.docx) saved on 17-JUN-2024 0000.

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

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P14208 A01

TOTAL MAT’L COST TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to repair structural member in 8-86-0-E.

Location of Work:

Engine Room (8-86-0-E) Fire Room (8-76-0-E) Fresh Water Ballast (9-86-6-W) Distillate Fuel or Ballast (9-86-2-F) Cofferdam (9-86-4-V) Clean Salt Water Ballast (9-98-2-W) Collection Holding Tank No. 4 (8-98-2-W) Potable Water Tank (9-76-4-W) Potable Water Tank (9-83-2-W) Waste Water Bilge Sump (9-85-2-W) Waste Water Bilge Sump (9-87-2-W) Waste Oil Tank (9-94-0-F) Distillate Fuel or Ballast (9-86-1-F) Oily Water Bilge Sump (9-87-1-W) Potable Water Tank (9-83-1-W) Clean Salt Water Ballast (9-98-1-W) Collection Holding Tank No. 3 (8-98-1-W) Fresh Water Ballast (9-86-5-W) Cofferdam (9-86-3-V) Oily Water Bilge Sump (9-84-2-W) Ship Fitter Storeroom (6-86-2-A) B Division Storeroom (6-76-2-A) Self Service Storeroom (6-86-1-A) Medical Storeroom (7-98-2-A)

FOUO

J-2

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

CU PHASE DESCRIPTION:

SD Storeroom No. One (7-98-1-A) Cross Flooding Duct Frame 86 Shaft Alley (9-98-0-Q) Pump Room No. 2 and Air Conditioning Machinery Room No. 2 (7-109-2-E)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.1 SFTR HRs, LBR HRs 22 KE PC

5.2 OMCH HRs, RGRS HRs, ELEC HRs, QA HRs 22 KE PC

5.3 ELEC HRs, SFTR HRs 22 KE PC

5.4 PFTR HRs, WELD HRs, PNTR HRs, QA HRs 22 KE PC

5.5 SFTR HRs, WELD HRs, SMTL HRs, RGRS HRs, INSL

HRs, CARP HRs, PNTR HRs, OMCH HRs, ELEC HRs, PFTR HRs, QA HRs

22 KE PC

5.6 ELEC HRs, SFTR HRs 22 KE PC

5.7 WELD HRs, PNTR HRs, QA HRs 22 KE PC

5.8 PNTR HRs, QA HRs 22 KE PC

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

5.10 PNTR HRs QA HRs 22 KE PC

Structure Work CFM for asbestos sampler cost and analysis cost for compartment and duct insulation and deck covering, UT inspection cost, air compressor rental cost and fuel oil cost for air hose test, marine chemist, ---continue to below---

22 MQ CS

---continued to from above---lead analysis cost, tankwatch cost, firewatch cost, fasteners, and misc such as electrode, gases, temporary covering and closure material, and other consumable.

22 MQ CS

Preservation Work CFM for all paints, thinner, grits including disposal cost, fuel oil, dryer for compressor, dehumidifier, air conditioner, tankwatch cost, and MISC such as temporary covering and closure material, and other consumable.

22 MQ CS

Machinery Work CFM bag plastic, strap tie down and other consumable.

22 MQ CS

Electrical Work CFM for air compressor rental and fuel oil cost, asbestos take and analysis cost, fastener, plastic bag, insulation tape, cable band and misc mat'l.

22 MQ CS

Piping Work CFM for fire watch and tank watch cost, asbestos sample cost, lead paint sample cost, air compressor rental cost, fuel oil cost, welding rod, paint, gasket and MISC such as gas, plastic sheet, covering material, tape, plastic bag, disposable coverall, saw blade, thinner and other consumable.

22 MQ CS

Lagging Work CFM for asbestos sampler and analysis cost, covering material, wire, tyvek suit, painting material and other consumable material (MISC).

22 MQ CS

Process Funding Document. 10 CT OM

Version-1: revise Other Special Requirements/Note. C231B R.

Takagi, 6/24/2024, -/-/N

V-01

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:

STRUCT 8-86-0-E AY A 0 1

CU PHASE TITLE:

F/O - REPAIR STRUCTURAL MEMBER IN 8-86-0-E

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

1 517-6576869 2 517-6576916 3 113-8573253

JOB ORDER: KEY OP:

3819P14208 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 PLATE,ME, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

QTY: 30 SF

5 FT X 6 FT X 1 PM

9B 9515 001533217 NA 4 N 41525118 30/SF

002 M PLATE,ME, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

QTY: 16SF

4 FT X 4 FT X 1 PM

9B 9515 001533223 NA 4 N 41525119 16/SF

003 M PLATE,ME, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

QTY: 300 SF

5 FT X 20 FT X 3 PM

9B 9515 001533230 NA 4 N 41525134

300/SF

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

004 M PLATE,ME, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

QTY: 200 SF

5 FT X 20 FT X 2 PM

9B 9515 001533248 NA 4 N 41525139

200/SF

005 M INSULATI, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9Q 5640 008096312 NA 4 N 41525120 20/EA

006 M INSULATI, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9Q 5640 008096315 NA 4 N 41525121 20/EA

007 M ADHESIVE, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9B 8040 002738708 NA 4 Y 41525138 1/GL

008 M ADHESIVE, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9B 8040 005508835 NA 4 Y 41525140 1/GL

009 M TAPE,TEX, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9B 8315 002671632 NA 4 N 41525122 2/RO

010 M TAPE,TEX, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9B 8315 002671633 NA 4 N 41525123 1/RO

011 M CAP,SNAP, ORIG: C231B, T.

ANDO 243-4372

ORDERED FOR KTR

9B 5325 007377648 NA 4 N 41525124

100/EA

200 F38 1 M RUBBER S, FOR KTR

DWG#517-6576869, P#F38 (1A

SW FEED PUMP FLANGE

GASKET)

POC" C232 T.FUNAKI

243-2494

9B 9320 002449276 NA 4 N 41255089 1/SY

201 F38 2 M RUBBER S, FOR KTR

DWG# 5176576916, PC#F-38

(1A EVAP BRINE PUMP) & OILY

WATER SEPARATOR FLANGE

GASKET

& NO.4 CHT PUMP FLANGE

AND CHT VALVE (8-98-3 & 88-

98-5)

POC: C232 T.FUNAKI

243-2494

9B 9320 002449277 NA 4 N 41255107 3/SY

201 F38 2 M RUBBER S, FOR KTR

DWG# 5176576916, PC#F-38

(1A EVAP BRINE PUMP) & OILY

WATER SEPARATOR FLANGE

GASKET

& NO.4 CHT PUMP FLANGE

AND CHT VALVE (8-98-3 & 88-

98-5)

POC: C232 T.FUNAKI

243-2494

9B 9320 002449277 NA 4 N 41275063 3/SY

202 2 M O-RING, FOR KTR

T/M: S6225-W6-MMA-010,

FIG#6-7-11 SEPARATOR

ABRASIVE FOR NO.3 FIRE

PUMP

M83248/1-906

POC: C232 T.FUNAKI

243-2494

9B 5331 000200186 CP NA 4 N 41255106 20/EA

FOUO

M-3

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

203 2 M O-RING, FOR KTR

1A EVAP BRINE PUMP FOR

SEPARATOR ABRASIVE

M83248/1-906

POC: C232 T.FUNAKI

243-2494

9B 5331 001675166 NA 4 N 41255105 10/EA

204 2 M O-RING, FOR KTR

1A EVAP BRINE PUMP FOR

SEPARATOR ABRASIVE

M83248/1-904

POC: C232 T.FUNAKI

243-2494

9B 5331 010263795 CP NA 4 N 41255104 10/EA

205 2 M O-RING, FOR KTR

1A EVAP BRINE PUMP FOR

SEPARATOR ABRASIVE

M83248/1-908

POC: C232 T.FUNAKI

243-2494

9B 5331 000200105 NA 4 N 41255090 10/EA

206 2 M NUT,SELF-LOCKING,HE, FOR

KTR

DWG#113-8573253, PC#31

OILY WATER SEPARATOR

FOOT FASTENER SIZE 7/8-9

POC: C232 T.FUNAKI

243-494

9B 5310 014812096 NA 4 N 41255110 12/EA

207 28 3 M SCREW, HEX CAP,, FOR KTR

NOMEN: SCREW, HE CAP

SIZE: 7/8"-9UNC-2A X 2-1/2"LG,

MATL: STEEL GRADE 8.

DWG#113-8573253, REV.A

PC#28

POC: C232 T.FUNAKI

243-2494

9B 5305 LL9310676 NA 4 N 41277506 12/EA

208 M COMPLETE KIT, COMPLETE

KIT, GASKET & INSULATION

1. FLANGE SIZE & PRESSURE

RATING: 5" IPS, 150#

2. FLANGE SPEC : ASME B16.5

3. GASKET : PGE, RAISED

FACE (TYPE-F), GASKET

RETAINER MATERIAL: NEMA

GRADE G-10

4. SEAL TYPE FOR GASKET :

NITRILE

5. INSULATING WASHER

MATERIAL : G-10/DOUBLE

9B 5330 LL9306222 NA 4 N 41277426 1/EA

209 M RUBBER S, FOR KTR

DWG#511-2492446 REV.D

FUEL FIL & TRANSFER CO

VALVE 8-76-9, 8-76-11

DWG#511-8432425 REV.A

FUEL FILL & TRANSFER CO

VAVE FOS-E-15 FLANGE

GASKET

POC: C232 T.FUNAKI

243-2494

9B 5330 014905071 NA 4 N 41255103 2/SH

210 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

FIG: 6-7 SEPARATOR

ABRASIVE FOR NO.3 FIRE

PUMP

M83248/1-024

POC: C232 T.FUNAKI

243-2494

9B 5331 001661020 NA 4 N 41255102 10/EA

FOUO

M-4

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

211 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

FIG: 6-7 SEPARATOR

ABRASIVE FOR NO.3 FIRE

PUMP

M83248/1-906

POC: C232 T.FUNAKI

243-2494

9B 5331 001651981 NA 4 N 41255101 20/EA

212 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

FIG: 6-7 SEPARATOR

ABRASIVE FOR NO.3 FIRE

PUMP

M83248/1-910

POC: C232 T.FUNAKI

243-2494

9B 5331 000200067 QF NA 4 N 41255100 10/EA

213 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

FIG: 6-7 SEPARATOR

ABRASIVE FOR NO.3 FIRE

PUMP

M83248/1-013

POC: C232 T.FUNAKI

243-2494

9B 5331 001660988 B8 NA 4 N 41255099 20/EA

214 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

NO.3 FIRE PUMP SERVICE

VALVE UNION FLANGE

M83248/1-017

POC: C232 T.FUNAKI

243-2494

9B 5331 001660993 NA 4 N 41255098 10/EA

215 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

NO.3 FIRE PUMP SERVICE

VALVE UNION FLANGE

M83248/1-019

POC: C232 T.FUNAKI

243-2494

9B 5331 001660996 NA 4 N 41255097 10/EA

216 M O-RING, FOR KTR

TM: S6225-M6-MMA-010

NO.3 FIRE PUMP SERVICE

VALVE UNION FLANGE

M83248/1-023

POC: C232 T.FUNAKI

243-2494

9B 5331 001661017 NA 4 N 41255096 10/EA

217 M NUT,PLAI, FOR KTR

NO.4 CHT PUMP SUCTION &

DISCHARGE FLANGE

M83248/1-017

POC: C232 T.FUNAKI

243-2494

9B 5310 002725700 NA 4 N 41255095 32/EA

218 M SCREW,CA, FOR KTR

NO.4 CHT PUMP FLANGE

M83248/1-017

POC: C232 T.FUNAKI

243-2494

9B 5305 001744056 NA 4 N 41255094 8/EA

219 M SCREW,CA, FOR KTR

NO.4 CHT PUMP FLANGE

M83248/1-017

POC: C232 T.FUNAKI

243-2494

9B 5305 001744057 NA 4 N 41255093 8/EA

400 M CLOTH,PLAIN WEAVE, FIRE

RESISTANT CLOTH

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 8305 001487364 NA 4 N 41365072 1/RO

FOUO

M-5

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

401 M CEMENT,INSULATION,

INSULATION CEMENT FINISH

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9Q 5640 002264540 NA 4 Y 41365100 1/BG

402 M INSULATION SLEEVING,

1/2"IPS X 1-1/2"THK

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9Q 5640 010420971 NA 4 N 41365052 3/EA

403 M SILICA PIPE COVER,, SILICA

PIPE COVER,3/4"IPS X 2"THK

(50MM), THERMO-12 GOLD,

SILICA PIPE COVER, NON

ASBESTOS, EACH / 3FT LG,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9Q 5640 LL6995288 NA 4 N 41367451 3/EA

404 M INSULATION SLEEVING,

SILICA PIPE COVER

SIZE: 1/2" IPS X 2" THK, 3 FT

LONG PER EACH

12 EA/BOX

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9Q 5640 LL6995286 NA 4 N 41367450 3/EA

405 M INSULATI, INSULATION,

FIBROUS GLASS, THERMAL,

BLANKET WITHOUT BINDER,

UNFACED, SIZE: 5FT W X 45FT

L X 1"THK, MIL-DTL-32585,

TYPE I, FORM 3, NSN: 5640-00-

173-6591 (NSN MISTAKENLY

INDICATES FACING D, BUT

CORRECT ITEM IN THIS NSN

IS UNFACED.)

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9Q 5640 LL9607458 NA 4 N 41367444 1/RO

406 M CLOTH,PLAIN WEAVE, CLOTH

WEIGHT: 8.50 OUNCES PER

SQUARE YARD PLUS OR

MINUS 0.10 (10%) OUNCES

PER SQUARE YARD; LENGTH:

50 YARDS PLUS OR MINUS 5

YARDS; WIDTH: 60 INCHES

PLUS OR MINUS 1 INCH

COLOR: NATURAL BOTH

SIDES

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 8305 001487363 NA 4 N 41365074 1/RO

FOUO

M-6

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

407 M INSULATION, PIPE,

INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 1/4" IPS,

SIZE: 1/2" ID X 3/4" THK X 6FT

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

30EA/BOX.

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL9607840 NA 4 N 41367445 2/EA

408 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 1-1/4" IPS,

SIZE: 1-5/8" ID X 3/4" THK X 6FT

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL4783095 NA 4 N 41367442 2/EA

409 M INSULATION, PIPE,

INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 2-1/8" OD TUBE,

SIZE: 2-1/8" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL9607843 NA 4 N 41367446 1/EA

410 M INSULATION, PIPE,

INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 2-1/2" IPS,

SIZE: 2-7/8" ID X 3/4" THK X 6FT

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL9607845 NA 4 N 41367447 1/EA

FOUO

M-7

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

411 M INSULATION, PIPE,

INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 4" IPS,

SIZE: 4-1/2" ID X 3/4" THK X 6

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL9607848 NA 4 N 41367448 2/EA

412 M INSULATION, PIPE,

INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 6" IPS,

SIZE: 6-5/8" ID X 3/4" THK X 6FT

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 5970 LL9607850 NA 4 N 41367449 2/EA

413 M SHIELD,SAFETY,PIPE, 4" WIDE

SPRAY SHIELD

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 9390 013753347 NA 4 N 41365076 1/RO

414 M SHIELD,SAFETY,PIPE, 5" WIDE

SPRAY SHIELD

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 4730 010100997 NA 4 N 41365077 1/EA

415 M SHIELD,SAFETY,PIPE, SHIELD,

6 INCH WIDE,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 4730 010100998 NA 4 N 41365079 1/EA

416 M SHIELD,SAFETY,PIPE, SHIELD,

8 INCH WIDE,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 4730 010101000 NA 4 N 41365081 1/EA

417 M SHIELD,SAFETY,PIPE, SIZE: 9

INCH WIDTH X 20 FT

MATERIAL: ALUMINIZED

FIBERGLASS

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 4730 010106123 NA 4 N 41365054 1/EA

418 M SHIELD,SAFETY,PIPE, SIZE: 10

INCH WIDTH X 20FT

MATERIAL: ALUMINIZED

FIBERGLASS

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 4730 010101001 NA 4 N 41365082 1/EA

FOUO

M-8

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

419 M ADHESIVE, ADHESIVE FOR

CLOTH,

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 8040 002738708 NA 4 Y 41365099 3/GL

420 M ADHESIVE, ADHESHIVE FOR

RUBBER

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 8040 008419773 NA 4 Y 41365098 5/PT

421 M SEALING COMPOUND, VAPOR

BARRIER COATING FOR

INSULATED REFRIGERANT

AND CHILLED WATER LINES

ORDERED FOR KTR

ORIG: C234 T. TSUNOI, 243-

9B 8030 001742588 NA 4 Y 41365097 1/GL

450 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014635873 NA 4 N 41525141 1/EA

451 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014635873 NA 4 N 41525142 2/EA

452 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225473 NA 4 N 41525144 2/PG

453 M BACKING,, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558783 NA 4 N 41537414 2/EA

454 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225475 NA 4 N 41525145 2/EA

455 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558788 NA 4 N 41537416 2/EA

456 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225467 NA 4 N 41525146 1/FV

457 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558777 NA 4 N 41537410 2/EA

458 M BACKING RING, SIZE: ,

BACKING RING, SIZE: 5"IPS,

1"WIDE, CARBON STEEL, SCH

40, MIL-STD-22D.

*REQUEST ENSURE THAT

THREE (3) SPACERS SHALL

BE WELDED AROUND THE

OUTER SURFACE OF THE

BACKING RING WITH

ACCURACY AND SHALL BE

PROTECTED AGAINST

SHIPPING DAMAGE AS

NECESSARY.

ORDERED FOR KTR, C234

H,ITO , 243-4534

9B 4730 LL9301791 NA 4 N 41927511 4/EA

FOUO

M-9

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

459 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225475 NA 4 N 41525147 2/EA

460 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558916 NA 4 N 41537419 2/EA

461 M SLEEVE,, ORDERED FOR KTR,

C234 H.ITO, 243-4534

9C 4730 LL4462301 NA 4 N 41537407 2/EA

462 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558817 NA 4 N 41537418 2/EA

463 M SLEEVE,, ORDERED FOR KTR,

C234 H.ITO, 243-4534

9C 4730 LL4462305 NA 4 N 41537408 2/EA

464 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4358122 NA 4 N 41537406 2/EA

465 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225467 NA 4 N 41525148 1/FV

466 M BACKING, ORDERED FOR

KTR, C234 H.ITO, 243-4534

9C 4730 LL4558777 NA 4 N 41537411 2/EA

467 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 007225467 NA 4 N 41525149 1/FV

468 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014645439 NA 4 N 41525150 2/EA

469 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014635878 NA 4 N 41525153 2/EA

470 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014635857 NA 4 N 41525154 2/EA

471 M COUPLING,TUBE, ORDERED

FOR KTR, C234 H.ITO, 243-

9B 4730 014635878 NA 4 N 41525155 2/EA

472 M RUBBER SHEET,SOLID,,

ORDERED FOR KTR, C234

H.ITO, 243-4534

9B 5330 014905014 NA 4 N 41525156 1/RO

473 M RUBBER SHEET,SOLID,,

ORDERED FOR KTR, C234

H.ITO, 243-4534

9B 5330 014905005 NA 4 N 41525157 1/RO

474 M RUBBER SHEET,SOLID,,

ORDERED FOR KTR, C234

H.ITO, 243-4534

9B 5330 014909769 NA 4 N 41525159 1/RO

475 M GASKET,SPIRAL WOUND,

ORDERED FOR KTR, C234

H.ITO, 243-4534

9B 5330 013387792 NA 4 N 41525160 2/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 STRUCT 8-86-0-E AY A 0

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

3819P14208 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 STRUCT 8-86-0-E AY A 0

Preservation Work Location

FR 98-1/2

3819P14208A01 Sheet 1 of 3

ENGINE ROOM

8-86-0-E

FR 86

FR 98

FWD

CL

See Detail 2-A

See Detail 3-A

ENCLOSURE-01

SKETCH

BHD

BHD FR 98-1/2

Detail 2-A

12”

See Detail 2-B

Detail 2-B

3819P14208A01 Sheet 2 of 3

40”

= Preservation Area

ENCLOSURE-01

SKETCH

FR 98-1/2

FR 98JCN

ES01-NPMA

18”

3819P14208A01 Sheet 3 of 3

Detail 3-A

= Preservation Area

SKETCH

ENCLOSURE-01

72”

BHD

JCN

ES01-NPMH

3819P14208A01 Enclosure-02

3819P14208A01 Enclosure-02

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P14208A01 ENCLOSURE-03-1 TOTAL 7

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

ES01-NPLZ

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

20 JUN 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

DECK PLTG

9. DWG NO.

100-ELM-240291 REV. “-”

10. CWP STEP NO.

5.5.2.2

11. JOINT ID

HJ-1

12. JOINT DESIGN

B2V.1

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.

3819P14208A01 ENCLOSURE-03-1 TOTAL 7

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

3819P14208A01 ENCLOSURE-03-2 TOTAL 7

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

ES01-NPLZ

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

20 JUN 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

DECK PLTG

9. DWG NO.

100-ELM-240291 REV. “-”

10. CWP STEP NO.

5.5.2.2

11. JOINT ID

HJ-2

12. JOINT DESIGN

B2V.1

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

3819P14208A01 ENCLOSURE-03-2 TOTAL 7

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

3819P14208A01 ENCLOSURE-03-3 TOTAL 7

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

ES01-NPLZ

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

20 JUN 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

DECK PLTG

9. DWG NO.

100-ELM-240291 REV. “-”

10. CWP STEP NO.

5.5.2.2

11. JOINT ID

HJ-3

12. JOINT DESIGN

B2V.1

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

3819P14208A01 ENCLOSURE-03-3 TOTAL 7

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

3819P14208A01 ENCLOSURE-03-4 TOTAL 7

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

ES01-NPM0 & ES01-NPM1

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

20 JUN 2024

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

DECK PLTG

9. DWG NO.

100-ELM-240291 REV. “-”

10. CWP STEP NO.

5.5.2.2

11. JOINT ID

HJ-4

12. JOINT DESIGN

B2V.1

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…