TGI_3819P31003A01_c0v0_redact.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.: SA 79243 SSDG STRUCT 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:

(RE) F/O - S/A 79243K, ACCOMPLISH STRL, SH METAL, & PSVTN WORK FOR SSDG UPGRADE

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

YUUICHI YOSHIHARA 231B. 315-243-9984 17-FEB-2025

APPROVED BY: CODE PHONE DATE

RYOUTA TAKAGI 231B. 315-243-4502 17-FEB-2025

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.

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL II AND 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.: SA 79243 SSDG STRUCT 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.

1-8 Engrg Inst (1)

J1-2 Map (1)

M1-6 QA20

(1-10) Engrg Inst (1- 2)

1. SCOPE/PURPOSE

1.1 Title: S/A 79243K, Structural, Sheet Metal, Preservation, and Insulation Work for Ship Service Diesel Generator (SSDG) Generator Set Upgrade; accomplish

1.2 Location of Work:

1.2.1 SSDG No. One (5-121-1-E)

1.2.2 SSDG Enclosed Operating Station (5-133-1-E)

1.2.3 Escape Trunk (5-131-1-T)

1.2.4 Physical Fitness Room (5-121-2-L)

1.2.4.1 SSDG Exhaust Trunk

1.2.5 Fan Room (5-119-0-Q)

1.2.6 Crew Living Space (5-109-0-L)

1.2.7 Freeboard Weather, Frames between 129 and 132, Starboard (Stbd)

1.2.8 Used Lube Oil Sump (6-122-1-F)

1.2.9 Jacket Water Tank (6-123-1-W)

1.2.10 Oily Waste Tank (6-124-1-F)

1.2.11 Grey Water Tank (6-125-1-W)

1.2.12 Fuel Oil Drain Tank (6-126-1-F)

1.2.13 Distillate Fuel Overflow or Ballast (9-121-1-F)

1.2.14 Distillate Fuel or Ballast (9-127-1-F)

1.2.15 Distillate Fuel or Ballast (9-121-2-F)

1.2.16 Distillate Fuel or Ballast (9-127-2-F)

1.2.17 Trunk (6-117-0-T)

1.2.18 DK Department Cleaning Gear Storeroom (6-118-1-A)

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

1.2.19 Damage Control Shop (4-129-1-Q)

1.2.20 Damage Control Shop Office (4-125-1-Q)

1.2.21 LD CTR No. 51 (4-133-6-Q)

1.2.22 Metalsmith Shop (4-133-2-Q)

1.2.23 Damage Control Repair Station 1A Annex (3-133-6-Q)

1.2.24 Passage (3-133-4-L)

1.2.25 Fuel Oil Service Tank No. 1A (5-122-1-F)

1.2.26 Fuel Oil Service Tank No. 1B (5-123-1-F)

1.2.27 Lube Oil Service Tank (5-124-1-F)

1.2.28 Underwater Hull Weather, Frames between 101 and 128, Port

1.2.29 Underwater Hull Weather, Frames between 101 and 129, Stbd

1.2.30 Fan Room (5-121-4-Q)

1.3 Identification:

1.3.1 Quantity (One EA), Lube Oil Service Tank

Tank No.: 5-124-1-F Capacity: 721 Gallons

1.3.2 Quantity (One EA), Jacket Water Tank

Tank No.: 6-123-1-W Capacity: 259 Gallons

1.3.3 Quantity (One Lot), Structural, Sheet Metal, Preservation, and Insulation Work for S/A 79243K SSDG Generator Set Upgrade

Remarks: See 2.3 through 2.22, Engrg Inst Enclosure-01, and Engrg Inst Enclosure-02 for material and detail

1.3.3.1 Quantity (1,510 SF), SSDG Pit in 5-121-1-E

Remarks: The area including all structure members, foundation, grating frames and support, deck fittings, bulkhead fittings, piping, piping hangers, top side of manhole covers, and boundary bulkheads

1.3.3.2 Quantity (50 SF), Entire Interior Surface of Jacket Water Tank (6-123-1-W)

Remarks: The area includes tank side of manhole cover plate(s), AVHC cover plate(s), and bolting ring

1.3.4 Quantity (One Lot), Piping Work for S/A 79243K SSDG Generator Set Upgrade

Remarks: See 2.21 for detail

1.3.4.1 Quantity (One EA), Gate Valve

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

Size: 1/2 Inch IPS Item No.: V1 (Label Plate No. L2) of 2.21

1.3.4.2 Quantity (2 EA), Globe Valve

Size: 1/4 Inch OD Item No.: V2 (Label Plate No. L3 and L4) of 2.21

1.4 Security Classification: None.

1.5 Initial Condition:

1.5.1 Potential Asbestos Hazard

1.5.2 Potential Lead Harzard

1.5.3 Dry Dock Work

1.5.4 Critical Coated Area: CCNY-LCC19-072-25 for the area listed in 1.3.3.1 and 1.3.3.2.

1.6 Contractor work start date:1/12/2026

1.7 Contractor work completion date: 8/5/2027

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 104-

8578012

SCD 9243 SS/EDG GENSET

UPGRADE STRUCTURAL

REMOVALS SSDG SSDG NO. 1

(5-121-1-E)

A Y AL

L

4 DWG 145-

8578060

SCD 9243 SHIPPING ACCESS

SSDG RM NO 1 (5-121-1-E)

SS/EDG UPGRADE

A Y AL

L

5 DWG 145-

8578061

SCD 9243 C&A & LABEL PLATE

MODS EXPANSION TANKS NO.

1A & 1B SSDG NO. 1 5-121-1-E

A Y AL

L

6 DWG 104-

8578063

SCD 9243 SS/EDG GENSET

UPGRADE STRUCTURAL

INSTALLATIONS SSDG NO. 1 (5-

121-1-E)

B Y AL

L

7 DWG 113-

8578064

SCD 9243 FOUNDATION

REMOVALS SSDG NO. 1 (5-121-1-

E) SS/EDG UPGRADE

A Y AL

L

8 DWG 113-

8578065

SCD 9243 SS/EDG GENSET

UPGD FOUNDATION

INSTALLATION & PREFAB SSDG

B Y AL

L

9 DWG 603-

8578068

SCD 9243 GRATING

MODIFICATIONS SSDG MCHRY

RM (5-121-1-E) SS/EDG

UPGRADE

A Y AL

L

10 DWG 104-

8578069

SCD 9243 STRUCTURAL

MODIFICATIONS EXHAUST

PIPING SHIP SERVICE DIESEL

GENERATOR

A Y AL

L

11 DWG 123-

8974323

SCD 9243 HATCH, SCUTTLE,

MANHOLE & LADDER

MODIFICATIONS FOR SSDG

- Y AL

L

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REF.

NO.

DOCUMENT

/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV CHG

NO.

COPY

REQ’D

(Y/N)

SOURCE

DOC

(Y/N)

PARA SEC PG CHP

12 DWG 113-

8974328

SCD 9243 SS/EDG GENSET

UPGRADE WATER TRAP

FOUNDATION (3-133-6-Q)

- Y AL

L

13 LAR SRFY-

0008-25

Modification & correction for discrepancies

- Y AL

L

14 DWG 603-

2492591

STD DETS-FL FRAMING-MACHY

SP

F Y AL

L

15 DWG 603-

2492595

HR & HANGER MCHRY SP DET C Y AL

L

16 DWG 803-

8499809

MANHOLES, WATERTIGHT &

OILTIGHT

- N

17 DWG 805-

1626726

FLUSH W.T. & O.T. BOLTED

PLATE MANHOLE 15" X 23" & 15"

X 18"

F N

18 PDD 167-

ELM-160649

SRF-JRMC STD ELM

REFERENCE DWG FOR

MANHOLE

- Y AL

L

19 DWG 804-

1927788

PSNS TYPE DRAWING LABELS

AND LABEL PLATES

Q N

20 DWG 501-

8620521

SCD 9243 HVAC MODIFICATIONS

SSDG INTERFERENCE 5TH DK

FR 121-137 (P & S)

A Y AL

L

21 DWG 300-

8576360

SCD 9243 COMBUSTION AIR

MODIFICATIONS - SSDG

GENERATOR UPGRADE

B Y AL

L

22 DWG 605-

8578062

SCD 9243 ESLP SS/EDG GENSET

UPGRADE SDG PAINT

INSULATION & DECK COVERING

MODS

A Y AL

L

23 TM T9074-

AS-GIB-

010/271

Requirements for Nondestructive Testing Methods

1 N

24 MIL MIL-

STD-2035

Nondestructive Testing Acceptable Criteria

A N

25 TM T-9630-

AB-MMD-

Corrosion Control Assessment and Maintenance Manual (CCAMM)

3 N

26 TM NAVSEA

4790/14

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

- N

27 MIL MIL-

STD-1627

Bending of Pipe or Tube for Ship Piping Systems

C 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 each bilge space located in 1.2.1 to free from oil, debris, and other foreign matter.

5.2 Accomplish the requirements of 099-902YO of 2.2 for each tank listed in 1.3.1 and 1.3.2.

5.2.1 Accomplish the requirements of 009-107 of 2.1.

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5.2.1.1 Accomplish the requirements of 009-09 of 2.1 for each tank listed in 1.3.1.

5.2.1.2 Ensure General Cleaning must be Level II for each tank listed in 1.3.1.

5.2.1.3 Ensure General Cleaning must be Level III for each tank listed in 1.3.2.

5.3 Accomplish each structural, sheet metal, preservation, and insulation work listed in 1.3.3 in accordance with 2.1 through 2.22, Enclosure-01, and Enclosure-02.

5.3.1 Drill hole(s) on each existing exhaust pipe support located in 1.2.4 for gas free inspection.

5.3.2 Accomplish build up weld of remaining hole(s) on each exhaust pipe support.

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

5.3.4 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of each new weld of the watertight/airtight structural boundary. Allowable leakage: None.

5.3.5 Accomplish the requirements of 009-25 of 2.1 for a completion air test of each exhaust trunk. Test pressure must be 2 PSIG. Allowable drop in pressure: None.

5.3.6 Temporary access must be in accordance with 2.4, 2.13, and Enclosure-01.

5.3.6.1 Accomplish the requirements of 099-911YO of 2.2, using QA Form 20 Enclosure-04-1 through Enclosure-04-

10. Each joint identification number must be in accordance with Mapping Plan Enclosure-03.

5.3.6.2 Accomplish the requirements of 009-09 of 2.1 for welding procedure of each joint shown on Mapping Plan Enclosure-03.

5.3.6.3 Accomplish ultrasonic (UT) inspection of each new weld of each shell plate in accordance with Paragraph 6 of 2.23. The accept or reject criteria must be in accordance with Paragraph 8, Class One of 2.24.

(I)(G) “UT INSPECTION”

5.3.7 Accomplish the requirements of 009-11 of 2.1 to install new duct and compartment insulation.

5.3.7.1 Accomplish the requirements of 009-12 of 2.1.

5.3.7.2 Accomplish the requirements of 009-32 of 2.1 for receiving surface and top surface where new insulation is installed.

5.3.8 Accomplish the requirements of 009-32 of 2.1.

5.3.9 Accomplish the requirements of 009-32 of 2.1, including Table 3, Line(s) 13, for each area listed in 1.3.3.1.

5.3.10 Accomplish the requirements of 009-32 of 2.1, including Table 4, Line(s) 8, for each area listed in 1.3.3.2.

5.3.10.1 Submit new coating data applied to the SUPERVISOR in accordance with 2.25 and 2.26.

5.4 Accomplish each piping work listed in 1.3.4 in accordance with 2.21.

5.4.1 Bend new pipe in accordance with 2.27.

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

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

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

5.4.4 Cycle each valve listed in 1.3.4.1 and 1.3.4.2 from full closed to full open to full closed 4 times. Allowable sticking or binding: None.

(V) “VALVE CYCLING”

5.5 Confirm that all personnel have exited the space prior to closure of the space listed in 1.2.4.1. Designate one person to account for all personnel who may have entered the space.

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

5.7 Notes:

5.7.1 Planner: Code 231B Y. Yoshihara, 243-9984

Planner: Code 231B S. Ootsubo, 243-7152 Planner: Code 231B N. Kurokawa, 243-0108 Planner: Code 231B K. Yoshida, 243-0163 Planner: Code 231B A. Suzuki, 243-0968 Planner: Code 232 M. Fudo, 243-4512 Planner: Code 233 K. Uchimura, 080-9350-1432 Planner: Code 234 T. Shibano, 243-3583 Planner: Code 234 Y. Yajima, 243-0977 Engineer: Code 250 I. Hayasaka, 243-4334

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

5.7.3 2.26 is available on P:\C200\C225\Enclosures\C231\Tank and Void Structural and Coating Condition Survey

(MRC G1N5).

5.7.4 Opening, initial cleaning, and closing of each space listed in 1.2.8, and 1.2.10 through 1.2.16 will be covered by the following TGI No(s).

Used Lube Oil Sump (6-122-1-F): 3819P12345A01 (KTR TGI) Oily Waste Tank (6-124-1-F): 3819P12346A01 (KTR TGI) Grey Water Tank (6-125-1-W): 3819P12353A01 (KTR TGI) Fuel Oil Drain Tank (6-126-1-F): 3819P12347A01 (KTR TGI) Distillate Fuel Overflow or Ballast (9-121-1-F): 3819P12306A01 (KTR TGI) Distillate Fuel or Ballast (9-127-1-F): 3819P12308A01 (KTR TGI) Distillate Fuel or Ballast (9-121-2-F): 3819P12307A01 (KTR TGI) Distillate Fuel or Ballast (9-127-2-F): 3819P12309A01 (KTR TGI)

5.7.5 Opening, initial cleaning, closing, and installation/removal of FMEs of each space listed in 1.2.25 and 1.2.26 will be covered by the following TGI No(s).

Fuel Oil Service Tank No. 1A (5-122-1-F): 3819P12301A01 (KTR TGI) Fuel Oil Service Tank No. 1B (5-123-1-F): 3819P12301A01 (KTR TGI)

5.7.6 Steam cleaning and preservation of interior surface of skeg will be covered by TGI No. 3819P11001A01 (KTR

TGI).

5.7.7 Preservation work for disturbed exterior surfaces of underwater hull and freeboard will be covered by TGI No.

3819P11001A01 (KTR TGI).

5.7.8 Preservation work for new and disturbed surfaces of each space listed 1.2.8 and 1.2.10 through 1.2.14 will be covered by the following TGI No(s).

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

Used Lube Oil Sump (6-122-1-F): 3819P12345A01 (KTR TGI) Oily Waste Tank (6-124-1-F): 3819P12346A01 (KTR TGI) Grey Water Tank (6-125-1-W): 3819P12353A01 (KTR TGI) Fuel Oil Drain Tank (6-126-1-F): 3819P12347A01 (KTR TGI) Distillate Fuel Overflow or Ballast (9-121-1-F): 3819P12306A01 (KTR TGI) Distillate Fuel or Ballast (9-127-1-F): 3819P12308A01 (KTR TGI)

5.7.9 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.

5.7.10 Provision of oily/chemical water barge will be coordinated by Project Team.

5.7.11 JCN EE01-L107 is related to this TGI.

5.8 Government Furnished Material (GFM):

5.8.1 All installing activity furnished (IAF) material and manufactured item (MN) material except hazardous material listed in each S/A drawing will be provided as kitted material by SRF-JRMC.

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

5.9 SRF-JRMC will provide the following service work: (TGI No. 3819P31003S02).

5.9.1 [C740] Crane and crane rigging service.

5.9.2 [X99E] Utility service, electrical.

5.9.3 [X99M] Utilities service, including water supply, steam supply, and low pressure air supply except onboard blasting work.

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

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

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

5.9.7 [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:

SA 79243 SSDG STRUCT AY A 0 0

CU PHASE TITLE:

(RE) F/O - S/A 79243K, ACCOMPLISH STRL, SH METAL, & PSVTN WORK FOR SSDG UPGRADE

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

CMPT 5-121-1-E IN POT WTR 6-123-1-W TK CMPT 5-121-1-E MS VNT E4-124-1 DT VNT

S4-124-2 DT #1 SSDG COMB AIR DT CMPT 5-133-1-E MS CMPT 5-121-2-L MS

TRUNK 5-121-2-L MS FB FR 98-153 STBD FB FB FR 98-153 PORT FB WO 6-122-1-F

TK WO 6-124-1-F TK WW 6-125-1-W TKWO 6-126-1-F TK FO/BLST 9-121-1-F TK

FO/BLST 9-127-1-F TK FO/BLST 9-121-2-F TK FO/BLST 9-127-2-F TK TRUNK 6-117-

0-T MS CMPT 6-118-1-A MS CMPT 4-133-6-Q MS CMPT 3-133-6-Q MS FO

SVC 5-122-1-F TK FO SVC 5-123-1-F TK CMPT 5-121-2-L IN LO SVC 5-124-1-F TK VNT

S5-123-2 DT VNT SS 3-136-1 DT VNT R5-136-2 DT

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P31003A01-Engrg Inst-01.pdf) saved on 13-FEB-2025 0000.

2. ENCLOSURE-02 (3819P31003A01-Engrg Inst-02.pdf) saved on 13-FEB-2025 0000.

3. ENCLOSURE-03 (3819P31003A01-Map.pdf) saved on 13-FEB-2025 0000.

4. ENCLOSURE-04 (3819P31003A01-QA20.docx) saved on 17-FEB-2025 0000.

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

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P31003 A01

TOTAL MAT’L COST TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to accomplish structural work, sheet metal work, preservation work, and insulation work for S/A 79243K ship service diesel generator (SSDG) generator set upgrade.

Location of Work:

SSDG No. One (5-121-1-E) SSDG Enclosed Operating Station (5-133-1-E) Escape Trunk (5-131-1-T) Physical Fitness Room (5-121-2-L) SSDG Exhaust Trunk Fan Room (5-119-0-Q) Crew Living Space (5-109-0-L) Freeboard Weather, Frames between 129 and 132, Starboard (Stbd) Used Lube Oil Sump (6-122-1-F) Jacket Water Tank (6-123-1-W) Oily Waste Tank (6-124-1-F) Grey Water Tank (6-125-1-W) Fuel Oil Drain Tank (6-126-1-F) Distillate Fuel Overflow or Ballast (9-121-1-F) Distillate Fuel or Ballast (9-127-1-F) Distillate Fuel or Ballast (9-121-2-F) Distillate Fuel or Ballast (9-127-2-F) Trunk (6-117-0-T) DK Department Cleaning Gear Storeroom (6-118-1-A) Damage Control Shop (4-129-1-Q)

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CU PHASE DESCRIPTION:

Damage Control Shop Office (4-125-1-Q) LD CTR No. 51 (4-133-6-Q) Metalsmith Shop (4-133-2-Q) Damage Control Repair Station 1A Annex (3-133-6-Q) Passage (3-133-4-L) Fuel Oil Service Tank No. 1A (5-122-1-F) Fuel Oil Service Tank No. 1B (5-123-1-F) Lube Oil Service Tank (5-124-1-F) Underwater Hull Weather, Frames between 101 and 128, Port Underwater Hull Weather, Frames between 101 and 129, Stbd Fan Room (5-121-4-Q)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.1 PNTR , LBR 22 KE PC

5.2 SFTR , LBR , RGRS , QA 22 KE PC

5.3 SFTR , WELD , SMTL , IMCH , OMCH , ELEC , PFTR ,

INSL , CARP , PNTR , RGRS , LBR , QA

22 KE PC

5.4 PFTR , WELD , QA 22 KE PC

5.5 SFTR 22 KE PC

5.6 PNTR , QA 22 KE PC

Dewatering and Cleaning Work CFM: for marine chemist, gaskets, fasteners, all paints, thinner, tank watch cost, and

MISC.

22 MQ CS

Structure Work CFM: for fire watch cost, confined space watch cost, marine chemist cost, label plate cost, UT inspection cost, deck covering, asbestos sampler/analysis cost for deck covering, air compressor rental cost and fuel oil cost for air hose test, gaskets and fasteners, compound, and MISC such as ---continue to below---

22 MQ CS

---continued to from above--- electrode, gases, temporary closure/covering/safety equipment material, tape, and other consumable.

22 MQ CS

Sheet Metal Work CFM:for firewatch cost, asbestos sampler/ analysis cost for compartment and duct insulation, misc such as electrode, gases, fastener, covering material, and consumable.

22 MQ CS

Electrical Work CFM: for banding material, fasteners, insulation tape, plastic bags, rope, and other consumable.

22 MQ CS

Piping Work CFM: for fire watch cost and MISC such as other consumable material.

22 MQ CS

Lagging Work CFM: for asbestos sampler and analysis cost, covering material, tyvek suit, and MISC such as other consumable material.

22 MQ CS

Preservation Work CFM: for all paints, thinners, stud pin, adhesive, tyvex suit, grits including disposal cost, fire watch cost, confined space watch cost, sampler/analysis cost for asbestos/lead, dryer/fuel oil cost/compressor rental cost for blast machine, and MISC such as covering material and other consumable.

22 MQ CS

Process Funding Document 10 CT OM

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M-1

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APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

SA 79243 SSDG STRUCT AY A 0 0

CU PHASE TITLE:

(RE) F/O - S/A 79243K, ACCOMPLISH STRL, SH METAL, & PSVTN WORK FOR SSDG UPGRADE

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

1 501-5287967 2 5287967 J

3 LAR SRFY-0008-25

JOB ORDER: KEY OP:

3819P31003 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 INSULATI, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9Q 5640 008096312 NA 4 N 50455319

200/EA

002 M SOUND CO, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9Q 5640 007565866 NA 4 N 50455321 80/SH

003 M TAPE,TEX, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9B 8315 002671632 NA 4 N 50455322 17/RO

004 M TAPE,TEX, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9B 8315 002671633 NA 4 N 50455323 3/RO

005 M CAP, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9Z 5340 LL4601470 NA 4 N 50457513

500/EA

NOTES:

FOUO

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

006 M CAP,SNAP, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9B 5325 007377648 NA 4 N 50455162

200/EA

007 M ADHESIVE, ORIG C231B N.

KUROKAWA 243-0108

ORDER FOR KTR

9B 8040 002738708 NA 4 Y 50455076 13/GL

060 1 M SCREW, HEX CAP, 3/8",

SCREW, HEX CAP. SIZE: 3/8"-

16UNC-2A X 1"LG,

MATL: ZINC COATED CARBON

STEEL, ASTM A449 TYPE I,

SECTION 6 ITEM 17 FOR DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5305 LL9301548 NA 4 N 50/EA

061 1 M NUT,STL,HEX, SECTION 6

ITEM 18 FOR DUCT HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

1H 5310 016922315 X3 NA 4 N 50455441 50/EA

062 1 M TAPE,INSULATION,ELE,

SECTION 6 ITEM 22 FOR DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5970 005506498 NA 4 N 50455442 1/RO

063 1 M BAR,METAL, SECTION 6 ITEM

25 FOR DUCT HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9530 005422585 NA 4 N 50455260 40/FT

064 1 M STRIP,METAL, SECTION 6

ITEM 27 FOR DUCT HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9515 002043974 NA 4 N 50455257 40/FT

065 1 M BAR,METAL, SECTION 6 ITEM

28 FOR DUCT HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9510 012447695 NA 4 N 50455443 40/FT

066 1 M ANGLE,STRUCTURAL,

SECTION 6 ITEM 35 FOR DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9520 002774903 NA 4 N 50455255 40/FT

067 1 M ANGLE,STRUCTURAL,

SECTION 12 ITEM 6 FOR DUCT

FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9540 005422700 NA 4 N 50455223 40/FT

068 1 M ANGLE,STRUCTURAL,

SECTION 12 ITEM 5 FOR DUCT

FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9540 005422696 NA 4 N 50455446 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

069 1 M RUBBER SHEET,SOLID,

SECTION 12 ITEM 22 FOR

DUCT FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9320 002440192 NA 4 N 50455220 27/FT

070 1 M SCREW, HEX CAP, 1/4",

SCREW, HEX CAP. SIZE: 1/4"-

20UNC-2A X 1-1/4"LG, MATL:

ZINC COATED CARBON

STEEL, ASTM A449 TYPE I,

ITEM NO. 23 OF 501-5287967 J

SEC 12

ORDERED FOR KTR

ORIG: C231B S. OOTSUBO,

243-7152

9B 5305 LL9811454 NA 4 N

1000/E

A

071 1 M NUT,SELF, SECTION 12 ITEM

27 FOR DUCT FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5310 013954695 NA 4 N 50455165

1000/E

A

072 1 M ANGLE,STRUCTURAL,

SECTION 12 ITEM 8 FOR DUCT

FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9520 002775988 NA 4 N 50455253 80/FT

073 1 M ANGLE,STRUCTURAL,

SECTION 12 ITEM 9 FOR DUCT

FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9520 002774902 NA 4 N 50455250 80/FT

074 1 M SHEET,ME, SECTION 12 ITEM

4 FOR DUCT FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 9515 002375417 NA 4 N 50455324 2/SH

075 1 M SCREW, HEX CAP, 3/8",

SCREW, HEX CAP. SIZE: 3/8"-

16UNC-2A X 1-1/4"LG, MATL:

ZINC COATED CARBON

STEEL, ASTM A449 TYPE I,

ITEM NO. 24 OF 501-5287967 J

SEC 12

SECTION 12 ITEM 24 FOR

DUCT FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5305 LL9811455 NA 4 N

500/EA

076 1 M NUT,SELF, SECTION 12 ITEM

28 FOR DUCT FLANGE

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5310 013587622 NA 4 N 50455166

500/EA

077 1 M SEALER,CHEMICAL, SECTION

5 ITEM 11 FOR DUCT SEALING

ORIG: C231B S. OOTSUBO 243-

9B 6850 010234535 NA 4 Y 50455447 1/BK

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

078 M INSULATI, COMPARTMENT

INSULATION FOR

INSTALLATION OF DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9Q 5640 008096312 NA 4 N 50455325 20/EA

079 M SOUND CO, COMPARTMENT

INSULATION FOR

INSTALLATION OF DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9Q 5640 007565866 NA 4 N 50455326 20/SH

080 M TAPE,TEX, COMPARTMENT

INSULATION FOR

INSTALLATION OF DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 8315 002671632 NA 4 N 50455327 3/RO

081 M TAPE,TEX, COMPARTMENT

INSULATION FOR

INSTALLATION OF DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 8315 002671633 NA 4 N 50455329 1/RO

082 M ADHESIVE, COMPARTMENT

INSULATION FOR

INSTALLATION OF DUCT

HANGER

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 8040 002738708 NA 4 Y 50455079 4/GL

083 M CAP,SNAP, FOR DUCT

INSULATION

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5325 007377648 NA 4 N 50455167 50/EA

084 M CAP, FOR DUCT INSULATION

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9Z 5340 LL4601470 NA 4 N 50457516

300/EA

085 M PLATE,MO, FOR DUCT

INSULATION

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 5340 010245086 NA 4 N 50455168

400/EA

086 M ADHESIVE, FOR DUCT

INSULATION

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 8040 009035081 NA 4 Y 50455245 4/KT

087 M CLOTH,PL, FOR DUCT

INSULATION

ORIG: C231B S. OOTSUBO 243-

ORDER FOR KTR

9B 8305 001487363 NA 4 N 50455331 1/RO

088 M ADHESIVE, ”ARMACELL

REQUIRED”

FOR DUCT INSULATION

ORIG: C231B S. OOTSUBO 243-

9B 8040 005508835 NA 4 Y 50455246 4/GL

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

089 2 M ROUND NWT PRESSED FL,

ROUND NWT PRESSED

FLANGE, 11”DIA, CRES 316L,

0.063" THK, ASTM-A-240

FINISH-2, OD OF DUCT + 2-

1/2”, WITH HOLE IAW SECTION

12 NOTE 6.

ORDER FOR KTR

ORIG: C231B, S. OOTSUBO,

243-7152

FOR ITEM 18 OF 8620521 REV

A TERMINAL ADJUSTABLE

BLAST

NA 4 N 3/SE

100 3 M BEAM,STRUCTURAL T-SH,

FOR DWG 104-8578063,

BEAM, STRUCTURAL T-

SHAPE, SIZE: 4" X 4" X 5LBS,

MATL: STEEL, OS,T-BEAM,MIL-

S-22698,ABS GR-A, ASTM A36,

QTY: 10 FT (ONE

CONTINUOUS LENGTH

REQUIRED) X 1 EA,

ORDER FOR KTR

ORIG: C226 H.SHIMIZU, 080-

9350-1431

LL4601720 NA 4 N 10/FT

101 3 M PLATE,ME, FOR DWG 104-

8578063 & 104-8578065, SIZE: 1 FT X 2 FT,

ORDER FOR KTR

ORIG: C226 H.SHIMIZU, 080-

9350-1431

9B 9515 002375333 NA 4 N 50455229 2/SF

102 3 M PLATE,ME, FOR DWG 104-

8578069 & 104-8578069, ORDER FOR KTR

ORIG: C226 H.SHIMIZU, 080-

9350-1431

9B 9515 002336261 NA 4 N 50455332 1/PM

103 3 M PLATE,ME, FOR DWG 104-

8578069 & 104-8578069, SIZE: 5 FT X 20 FT,

ORDER FOR KTR

ORIG: C226 H.SHIMIZU, 080-

9350-1431

9B 9515 001533184 NA 4 N 50455230

100/SF

104 3 M BEAM,STRUCTURAL, FOR

DWG 104-8578069,

ORDER FOR KTR

ORIG: C226 H.SHIMIZU, 080-

9350-1431

9B 9520 002780932 NA 4 N 50455449 20/FT

450 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 4-1/8" OD TUBE,

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

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDER FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 5640 LL9607847 NA 4 N 50457517 3/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

451 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013, FOR 5" IPS, SIZE: 5-

5/8" ID X 3/4" THK X 6 FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED), MATL:

NON-HALOGEN, 2EA/BOX

ORDER FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 5640 LL9607849 NA 4 N 50457518 3/EA

452 M INSULATI, INSULATION, PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 1" IPS,

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

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

**GSA ADVANTAGE ITEM**

ORDER FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 5970 LL4783096 NA 4 N 50457519 2/EA

453 M SEALING COMPOUND, ORDER

FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 8030 001742588 NA 4 Y 50455247 2/GL

454 M ADHESIVE, ADHESIVE FOR

PLASTIC TUBE

ORDER FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 8040 008419773 NA 4 Y 50455172 2/PT

455 M ADHESIVE, ADHESIVE FOR

CLOTH,

ORDER FOR KTR

ORIG: C234 Y.YAJIMA, 243-

9B 8040 002738708 NA 4 Y 50455082 2/GL

456 M INSULATI, 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,

ORIG:C234 Y.YAJIMA, 243-0977

ORDERED FOR KTR

9B 5640 LL9607848 NA 4 N 50457521 3/EA

457 M INSULATI, 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

ORIG:C-234 Y.YAJIMA, 243-

ORDERED FOR KTR

9B 5640 LL9607850 NA 4 N 50457522 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 SA 79243 SSDG STRUCT AY A 0

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

3819P31003 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 SA 79243 SSDG STRUCT AY A 0

3819P31003A01 ENCLOSURE-01 Sheet 1 of 2

AutoCAD SHX Text SUBJECT: SUPPLEMENTAL INFO FOR NDT INSPECTION & MOD OF CUT LINE OF SUPPLEMENTAL INFO FOR NDT INSPECTION & MOD OF CUT LINE OF NDT INSPECTION & MOD OF CUT LINE OF STGR FOR TEMP ACCESS HOLE INCID TO SCD 9243 TEMP ACCESS HOLE INCID TO SCD 9243 ICN; 3819P31003 ; 3819P31003 3819P31003 JCN; EE01-L107 ; EE01-L107 EE01-L107 ORIGINATOR; C250 I.HAYASAKA GINATOR; C250 I.HAYASAKA INATOR; C250 I.HAYASAKA ; C250 I.HAYASAKA C250 I.HAYASAKA I.HAYASAKA DATE; 1/28/2025 1/28/2025 /28/2025 28/2025 /2025 2025 REFERENCES: (a) LAR NO. SRFY-0008-25, MODIFICATION & CORRECTION FOR DISCREPANCIES LAR NO. SRFY-0008-25, MODIFICATION & CORRECTION FOR DISCREPANCIES SRFY-0008-25, MODIFICATION & CORRECTION FOR DISCREPANCIES MODIFICATION & CORRECTION FOR DISCREPANCIES (b) LCC19-145-8578060 "A", SHIPPING ACCESS SSDG RM NO. 1 (5-121-1-E) SS/EDG UPGRADE LCC19-145-8578060 "A", SHIPPING ACCESS SSDG RM NO. 1 (5-121-1-E) SS/EDG UPGRADE SHIPPING ACCESS SSDG RM NO. 1 (5-121-1-E) SS/EDG UPGRADE - OQE IS REQUIRED (SEE NOTE NO. 3) - OQE IS REQUIRED (SEE NOTE NO. 3) - 3) - 3) - ) - NOTES: 1. THE PURPOSE OF THIS ENGINEERING INSTRUCTION IS TO PROVIDE SUPPLEMENTAL INFORMATION FOR NDT THE PURPOSE OF THIS ENGINEERING INSTRUCTION IS TO PROVIDE SUPPLEMENTAL INFORMATION FOR NDT TO PROVIDE SUPPLEMENTAL INFORMATION FOR NDT NDT INSPECTION & MODIFICATION OF CUT LINE OF STRINGER FOR TEMPORARY ACCESS HOLE INCIDENTAL TO TEMPORARY ACCESS HOLE INCIDENTAL TO SCD 9243 OF USS BLUE RIDGE (LCC 19). OF USS BLUE RIDGE (LCC 19). BLUE RIDGE (LCC 19). (LCC 19). LCC 19). ). 2. ALL WELDING AND INSPECTION FOR STEEL MATERIALS SHALL BE CONDUCTED IN ACCORDANCE WITH ALL WELDING AND INSPECTION FOR STEEL MATERIALS SHALL BE CONDUCTED IN ACCORDANCE WITH SRF-JRMC PROCESS INSTRUCTION NO. 100-2 OR TABLE 2 OF NAVSEA STD ITEM NO. 009-12 RESPECTIVELY. VT INSPECTION SHALL BE REQUIRED IN ACCORDANCE WITH PARAGRAPH 6.4 OF IN ACCORDANCE WITH PARAGRAPH 6.4 OF MIL-STD-1689. . 3. FOR WELDS REFERENCED TO THIS NOTE, UT INSPECTION SHALL BE REQUIRED BY SECTION I.E.(2) OF FOR WELDS REFERENCED TO THIS NOTE, UT INSPECTION SHALL BE REQUIRED BY SECTION I.E.(2) OF E.(2) OF .(2) OF 2) OF ) OF TABLE-III OF MIL-STD-1689 AND PERFORMED IN ACCORDANCE WITH NOTE 2. QA FORM-20 SHALL BE NOTE 2. QA FORM-20 SHALL BE 2. QA FORM-20 SHALL BE . QA FORM-20 SHALL BE REQUIRED FOR EACH WELD AND UT INSPECTION AS OBJECTIVE QUALITY EVIDENCE (OQE) RECORD RETENTION FOR PRIMARY HULL STRUCTURAL WELDING IN ACCORDANCE WITH COMUSFLTFORCOMINST 4790.3 (JFMM), VOLUME-V, PART I, PARAGRAPH 2.2.4.d.(3). 4. FOR INFORMATION OF HULL STRUCTURE NOT SHOWN ON THIS INSTRUCTION, SEE REF (a) & (b). ALL FOR INFORMATION OF HULL STRUCTURE NOT SHOWN ON THIS INSTRUCTION, SEE REF (a) & (b). ALL a) & (b). ALL ) & (b). ALL & (b). ALL . ALL ALL EXISTING STRUCTURE'S MATERIALS SHOWN ON THIS INSTRUCTION ARE MEDIUM STEEL (MS, MIL-S-22698).

AutoCAD SHX Text_1

ENGRG INST

3819P31003A01 ENCLOSURE-01 Sheet 2 of 2

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FWD

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REF LINE

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AutoCAD SHX Text_10 INSTL SHELL PLTG (EXPANDED) EXPANDED) ) STBD, LKG INBD FOR INFO NOT SHOWN, SEE REF (a) & (b)

AutoCAD SHX Text_11

EL 2-A 2-A2-A-AA

AutoCAD SHX Text_12

5TH DECK

AutoCAD SHX Text_13 STGR-16A 14 x 6 3/4 x 30# I-T

AutoCAD SHX Text_14 STGR-16B 14 x 6 3/4 x 30# I-T

AutoCAD SHX Text_15 STGR-17 12 x 6 1/2 x 27# I-T

AutoCAD SHX Text_16

4TH DECK

AutoCAD SHX Text_17 STGR-18 12 x 6 1/2 x 27# I-T

AutoCAD SHX Text_18 STGR-19 12 x 6 1/2 x 27# I-T

AutoCAD SHX Text_19 B

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AutoCAD SHX Text_21 B

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AutoCAD SHX Text_23 B

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AutoCAD SHX Text_25 B

AutoCAD SHX Text_26

AutoCAD SHX Text_27

STGR (TYP)

AutoCAD SHX Text_28

PLAN 2-B

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B2(S)V.2 (S)V.2 S)V.2 )V.2 V.2 2 NOTE 3 TYP

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FWD

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REF LINE

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SHELL

AutoCAD SHX Text_37 STGR-16A, 16B 14 x 6 3/4 x 30# I-T

AutoCAD SHX Text_38 STGR-17, 18, 19 12 x 6 1/2 x 27# I-T

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TEMP ACCESS REUSED

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ENGRG INST

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1" (TYP)

3819P31003A01 ENCLOSURE-02 Sheet 1 OF 1

AutoCAD SHX Text_42 SUBJECT: SUPPLEMENTAL INFO FOR ADDITIONAL CHOCK SUPPLEMENTAL INFO FOR ADDITIONAL CHOCK ICN; 3819P31003 ; 3819P31003 3819P31003 JCN; EE01-L107 ; EE01-L107 EE01-L107 ORIGINATOR; C250 I.HAYASAKA GINATOR; C250 I.HAYASAKA INATOR; C250 I.HAYASAKA ; C250 I.HAYASAKA C250 I.HAYASAKA I.HAYASAKA DATE; 1/31/2025 1/31/2025 /31/2025 31/2025 /2025 2025 REFERENCE: (a) LAR NO. SRFY-0008-25, MODIFICATION & CORRECTION FOR DISCREPANCIES LAR NO. SRFY-0008-25, MODIFICATION & CORRECTION FOR DISCREPANCIES MODIFICATION & CORRECTION FOR DISCREPANCIES NOTES: 1. THE PURPOSE OF THIS ENGINEERING INSTRUCTION IS TO PROVIDE SUPPLEMENTAL INFORMATION FOR THE PURPOSE OF THIS ENGINEERING INSTRUCTION IS TO PROVIDE SUPPLEMENTAL INFORMATION FOR TO PROVIDE SUPPLEMENTAL INFORMATION FOR ADDITIONAL CHOCK DIRECTED BY LAR RESPONSE IN REF (a) INCIDENTAL TO SCD 9243. . 2. ALL SNIPES SHALL BE 1/2 x 1/2. ALL SNIPES SHALL BE 1/2 x 1/2. 3. ALL WELDING AND INSPECTION FOR STEEL MATERIALS SHALL BE CONDUCTED IN ACCORDANCE WITH ALL WELDING AND INSPECTION FOR STEEL MATERIALS SHALL BE CONDUCTED IN ACCORDANCE WITH SRF-JRMC PROCESS INSTRUCTION NO. 100-2 OR TABLE 2 OF NAVSEA STD ITEM NO. 009-12 RESPECTIVELY. VT INSPECTION SHALL BE REQUIRED IN ACCORDANCE WITH PARAGRAPH 6.4 OF ELY. VT INSPECTION SHALL BE REQUIRED IN ACCORDANCE WITH PARAGRAPH 6.4 OF IN ACCORDANCE WITH PARAGRAPH 6.4 OF MIL-STD-1689. . 4. FOR INFORMATION OF HULL STRUCTURE NOT SHOWN ON THIS INSTRUCTION, SEE REF (a).FOR INFORMATION OF HULL STRUCTURE NOT SHOWN ON THIS INSTRUCTION, SEE REF (a).a).).

AutoCAD SHX Text_43

ENGRG INST

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LIST OF MATERIAL

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PC NOC NO

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DESCRIPTIONESCRIPTION

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QTYTY

AutoCAD SHX Text_48

MATERIAL

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SPECPEC

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REMARKSEMARKS

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AutoCAD SHX Text_52 1 3/4 x 3/16 FB M/F PLATE, 7.65#PLATE, 7.65#LATE, 7.65#

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1 SF

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STEEL (OS)

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MIL-S-22698 GR A

AutoCAD SHX Text_56 4 x 4 x 5# T OS

AutoCAD SHX Text_57 CHOCK FOR HORIZ STIF FOR INFO NOT SHOWN, SEE DET 55-B IN Attachment-1 OF REF (a).

AutoCAD SHX Text_58

DET 1-AT 1-A1-A

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TRANSV BHD FR 121

AutoCAD SHX Text_60 VERT STIF 6 x 4 x 11# T, MS (TYP)

AutoCAD SHX Text_61 3/16

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AutoCAD SHX Text_63

CHOCK (TYP)

3819P31003A01 ENCLOSURE-03 Sheet 1 OF 1

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AutoCAD SHX Text_67

AutoCAD SHX Text_68

FWD

AutoCAD SHX Text_69

REF LINE

AutoCAD SHX Text_70

SHELL PLTG (EXPANDED) EXPANDED) ) STBD, LKG INBD

AutoCAD SHX Text_71

EL 1-A 1-A1-A-AA

AutoCAD SHX Text_72

5TH DECK

AutoCAD SHX Text_73 STGR-16A 14 x 6 3/4 x 30# I-T, MS

AutoCAD SHX Text_74 STGR-16B 14 x 6 3/4 x 30# I-T, MS

AutoCAD SHX Text_75 STGR-17 12 x 6 1/2 x 27# I-T, MS

AutoCAD SHX Text_76

4TH DECK

AutoCAD SHX Text_77 STGR-18 12 x 6 1/2 x 27# I-T, MS

AutoCAD SHX Text_78 STGR-19 12 x 6 1/2 x 27# I-T, MS

AutoCAD SHX Text_79

TEMP ACCESS REUSED

AutoCAD SHX Text_80

HJ-1-1

AutoCAD SHX Text_81

HJ-1-2

AutoCAD SHX Text_82

HJ-1-4

AutoCAD SHX Text_83

HJ-1-6

AutoCAD SHX Text_84

HJ-1-81-8-8

AutoCAD SHX Text_85

HJ-1-3

AutoCAD SHX Text_86

HJ-1-71-7-7

AutoCAD SHX Text_87

HJ-1-91-9-9

AutoCAD SHX Text_88

HJ-1-5

AutoCAD SHX Text_89

HJ-1-101-10-10

AutoCAD SHX Text_90

MAPPING PLAN

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P31003A01 ENCLOSURE-04-1 TOTAL 10

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

EE01-L107

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

17 FEB 2025

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

STRINGER

9. DWG NO.

DWG 145-8578060 REV. A & Engrg Inst Enclosure-01

10. CWP STEP NO.

5.3.6.1

11. JOINT ID

HJ-1-1

12. JOINT DESIGN

B2(S)V.2

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.

3819P31003A01 ENCLOSURE-04-1 TOTAL 10

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

3819P31003A01 ENCLOSURE-04-2 TOTAL 10

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

EE01-L107

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

17 FEB 2025

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

STRINGER

9. DWG NO.

DWG 145-8578060 REV. A & Engrg Inst Enclosure-01

10. CWP STEP NO.

5.3.6.1

11. JOINT ID

HJ-1-2

12. JOINT DESIGN

B2(S)V.2

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

3819P31003A01 ENCLOSURE-04-2 TOTAL 10

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

3819P31003A01 ENCLOSURE-04-3 TOTAL 10

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

EE01-L107

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

17 FEB 2025

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

STRINGER

9. DWG NO.

DWG 145-8578060 REV. A & Engrg Inst Enclosure-01

10. CWP STEP NO.

5.3.6.1

11. JOINT ID

HJ-1-3

12. JOINT DESIGN

B2(S)V.2

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

3819P31003A01 ENCLOSURE-04-3 TOTAL 10

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

3819P31003A01 ENCLOSURE-04-4 TOTAL 10

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

EE01-L107

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

17 FEB 2025

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

STRINGER

9. DWG NO.

DWG 145-8578060 REV. A & Engrg Inst Enclosure-01

10. CWP STEP NO.

5.3.6.1

11. JOINT ID

HJ-1-4

12. JOINT DESIGN

B2(S)V.2

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

3819P31003A01 ENCLOSURE-04-4 TOTAL 10

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

3819P31003A01 ENCLOSURE-04-5 TOTAL 10

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

EE01-L107

4. CWP/REC SER. NO.

N/A

5. LWC

KTR

6. DATE

17 FEB 2025

7. SYSTEM

PRIMARY STRUCTURE

8. COMPONENT

STRINGER

9. DWG NO.

DWG 145-8578060 REV. A & Engrg Inst Enclosure-01

10. CWP STEP NO.

5.3.6.1

11. JOINT ID

HJ-1-5

12. JOINT DESIGN

B2(S)V.2

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

3…