TGI_3819P58316A01_c0v0_redact.pdf

FOUO

FOUO: Public availability to be determined under 5 USC 552

TASK GROUP INSTRUCTION

AIM REV 20.11.4.0 (OCTOBER 2020)

TGI COMPONENT NAME: TYPE: PHASE: REPEAT: CHANGE:

NO.: S/A 81028K LIFE RAFT 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 81028K, ACCOMPLISH STRL & PSVTN WORK FOR INFLATABLE LIFERAFT REPL

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

HIROYUKI TANAKA 231B 315-243-4491 28-FEB-2025

APPROVED BY: CODE PHONE DATE

RYOUTA TAKAGI 231B 315-243-4502 28-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:

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.: S/A 81028K LIFE RAFT 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.

1-6 QA17

(1-3)

J1-2 M1-2 Map (1- 2)

1. SCOPE/PURPOSE

1.1 Title: S/A 81028K, Structural and Preservation Work for Inflatable Life Raft Replacement; accomplish

1.2 Location of Work:

1.2.1 Main Deck Weather, Frames between A and 41, Port and Starboard (Stbd)

1.2.2 Freeboard Weather, Frames between A and 41, Port and Stbd

1.2.3 Anchor and Line Handling Space (2-F-0-Q)

1.2.4 C7F First DMSION Office (2-14-6-Q)

1.2.5 Stateroom (2-16-2-A)

1.2.6 Officer WR, WC, SH, FW, and SW Decontamination Station No. One (2-20-2-L)

1.2.7 Stateroom (2-22-4-L)

1.2.8 Stateroom (2-24-2-L)

1.2.9 Stateroom (2-26-2-L)

1.2.10 Stateroom (2-28-2-L)

1.2.11 Inaccessible Void (2-29-2-V)

1.2.12 Void (2-31-2-V)

1.2.13 ACOS Stateroom (2-32-2-L)

1.2.14 N3 LCPO (2-36-4-Q)

1.2.15 Supplementary Plot (2-14-5-Q)

1.2.16 Officer WR, WC, SH Decontamination Station (2-18-5-L)

1.2.17 Stateroom (2-22-3-L)

1.2.18 Stateroom (2-24-3-L)

1.2.19 Stateroom (2-26-3-L)

1.2.20 Stateroom (2-28-1-L)

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1.2.21 Executive Officer Stateroom (2-30-5-L)

1.2.22 Inaccessible Void (2-29-1-V)

1.2.23 Void (2-31-1-V)

1.2.24 Wardroom Storeroom (2-36-3-A)

1.2.25 COMMSEC Equipment (2-40-3-A)

1.3 Identification:

1.3.1 Quantity (One EA), Inaccessible Void (2-29-2-V)

1.3.2 Quantity (One EA), Inaccessible Void (2-29-1-V)

1.3.3 Quantity (One Lot), Structural and Preservation Work for S/A 81028K, Inflatable Life Raft Replacement

Remarks: See 2.4 through 2.9 for material and details, and Mapping Plan Enclosure-01 for location details

1.4 Security Classification:

1.4.1 Spaces - 1.2.4, 1.2.14, 1.2.15, and 1.2.21

1.5 Initial Condition:

1.5.1 Potential Asbestos Hazard

1.5.2 Potential Lead Hazard

1.6 Contractor work start date: 1/12/2026

1.7 Contractor work completion date: 4/2/2027

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 100-

2491007

SPONSON & STRG FWD FR76½ G Y AL

L

4 DWG 600-

8781528

INFLATABLE LIFERAFT LIFELINE

AND RAIL MODS

- Y AL

L

5 DWG 601-

8781529

INFLATABLE LIFERAFT

REPLACEMENT 25 MAN

LIFERAFT REMOVALS

- Y AL

L

6 DWG 601-

8781530

50 MAN INFLATABLE LIFERAFT

INSTALLATION

- Y AL

L

7 DWG 606-

8781531

INFLATABLE LIFERAFT

REPLACEMENT DECK

COVERING MODIFICATION

- Y AL

L

8 LAR SRFY-

0021-25

FAB DET OF LIFERAIL STAN AND

INSTL OF WATERWAY SCUP

- Y AL

L

9 DWG 510-

2491623

WATERWAY SCUPPER

EXTENSION

B 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

10 LAR SRFY-

0076-25

THE MOUNTING METHOD OF

THE RETAINING STRAP ASSY

FOR THE NEW LIFE RAFT

- Y AL

L

11 DWG 804-

5184155

LIFERAILS, LIFELINES &

AWNING STANCHIONS (AL &

CRES) DETAILS & L/M

A N

12 MIL MIL-

STD-1689

Fabrication, Welding and Inspection of Ships Structure

A N

13 MIL MIL-

STD-2035

Nondestructive Testing Acceptable Criteria

A 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 Accomplish the requirements of 099-902YO of 2.2 for each space listed in 1.3.1 and 1.3.2, using 2.3 for guidance.

5.1.1 Notify SUPERVISOR 3 working days prior to start of waste liquid disposal operation.

5.1.2 Install new rust preventive compound conforming to MIL-PRF-16173, Grade 3.

5.2 Accomplish the structural and preservation work for S/A 81028K, inflatable life raft replacement listed in 1.3.3 in accordance with 2.4 through 2.9, using 2.3 and 2.10 for guidance.

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

5.2.2 Accomplish a load test of each new top staple of stanchion.

(I)(G) “LOAD TEST”

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

5.2.2.2 Hold test load for 10 minutes.

5.2.2.3 No permanent deformation, cracks, separation or visible damage of top staple and stanchion is acceptable.

5.2.2.4 Document the test on QA Form 17 Enclosure-02-1.

5.2.3 Accomplish visual (VT) inspection of each new weld of staple of stanchion in accordance with 2.11 and Paragraphs 6.4 and 7.2 of 2.12. The accept or reject criteria must be in accordance with 2.11 and Paragraph 4 Class 3 of 2.13.

(I) “VT INSPECTION”

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5.2.3.1 Document the VT inspection on QA Form 17 Enclosure-02-2.

5.2.4 Accomplish a load test of each synthetic rope guardline assembly.

(I)(G) “LOAD TEST”

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

5.2.4.2 Hold test load for 10 minutes.

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

5.2.4.4 Document the test on QA Form 17, Enclosure-02-3.

5.2.5 Accomplish the requirements of 009-32 of 2.1.

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

5.4 Notes:

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

Planner: Code 231B M. Hayashi, 243-6145 Planner: Code 233 M. Takemura, 080-9350-1458 Engineer: Code 250 K. Matsunari, 243-5816

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

5.4.3 Fabrication of tie down assembly will be covered by TGI No. 3819P58316H02 (SRF-JRMC TGI).

5.4.4 Removal and installation of life raft, tie down assembly, and hydrostatic release device will be covered by TGI No(s). 3819P58316U01 and 3819P58316R01 (SRF-JRMC TGI).

5.4.5 Opening, initial cleaning, and closing of each space listed in 1.2.12 and 1.2.23 will be covered by the following TGI No(s).

Void (2-31-1-V): 3819P12383A01 (KTR TGI) Void (2-31-2-V): 3819P12384A01 (KTR TGI)

5.4.6 JCN EXSA-ZC05 is related to this TGI.

5.5 Government Furnished Material (GFM):

5.5.1 All IAF material except hazmat listed in each S/A drawing will be provided as kitted material by SRF-JRMC.

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

5.6 SRF-JRMC will provide the following service work: (TGI No. 3819P58316S02).

5.6.1 [C740] Crane and crane rigging service.

5.6.2 [X99E] Utility service, electrical.

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

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

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

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

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J-1

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APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

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

VERSION:

CASREP

CAT:

S/A 81028K LIFE RAFT AY A 0 0

CU PHASE TITLE:

(RE) F/O - S/A 81028K, ACCOMPLISH STRL & PSVTN WORK FOR INFLATABLE LIFERAFT REPL

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

MAIN DECK WEA PORT MS LIFE LINE MAIN DECK RZ MAIN DECK WEA STBD MS LIFE RAIL MAIN DECK

RZ VOID 2-29-1-V VD VOID 2-29-2-V VD

ATTACHMENT LIST:

1. ENCLOSURE-01 (3819P58316A01-Map.pdf) saved on 26-FEB-2025 0000.

2. ENCLOSURE-02 (3819P58316A01-QA17.docx) saved on 26-FEB-2025 0000.

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

KONDO ,SHINYA

JO: KO: TOTAL MAN HRS: PLANNING ACCEPTANCE:

3819P58316 A01

TOTAL DURATION:

CU PHASE DESCRIPTION:

The purpose of this TGI is to accomplish structural and preservation work for S/A 81028K, inflatable life raft replacement.

Location of Work:

Main Deck Weather, Frames between A and 41, Port and Starboard (Stbd) Freeboard Weather, Frames between A and 41, Port and Stbd Anchor and Line Handling Space (2-F-0-Q) C7F First DMSION Office (2-14-6-Q) Stateroom (2-16-2-A) Officer WR, WC, SH, FW, and SW Decontamination Station No. One (2-20-2-L) Stateroom (2-22-4-L) Stateroom (2-24-2-L) Stateroom (2-26-2-L) Stateroom (2-28-2-L) Inaccessible Void (2-29-2-V) Void (2-31-2-V) ACOS Stateroom (2-32-2-L)

N3 LCPO (2-36-4-Q)

Supplementary Plot (2-14-5-Q) Officer WR, WC, SH Decontamination Station (2-18-5-L) Stateroom (2-22-3-L) Stateroom (2-24-3-L) Stateroom (2-26-3-L) Stateroom (2-28-1-L) Executive Officer Stateroom (2-30-5-L) Inaccessible Void (2-29-1-V) Void (2-31-1-V) Wardroom Storeroom (2-36-3-A)

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J-2

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

CU PHASE DESCRIPTION:

COMMSEC Equipment (2-40-3-A)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

5.1 STRL , PNTR , LBR 22 KE PC

5.2 SFTR , STML , WELD , INSL , ELEC , PNTR , RGRS , QA 22 KE PC

5.3 PNTR , QA 22 KE PC

Dewatering and Cleaning Work CFM: or marine chemist, and all paints, and misc.

22 MQ CS

Structural and Preservation Work CFM: For all paints, thinner, grits including disposal cost, firewatch cost, confined space watch cost, asbestos sampler cost and analysis cost for compartment insulation, lead sampling/analysis cost, fasteners, adhesive, and misc such as electrode, gases, covering materials, 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 other consumable materials.

22 MQ CS

Process Funding Document. 10 CT OM

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M-1

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

APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

S/A 81028K LIFE RAFT AY A 0 0

CU PHASE TITLE:

(RE) F/O - S/A 81028K, ACCOMPLISH STRL & PSVTN WORK FOR INFLATABLE LIFERAFT REPL

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

3819P58316 A01

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

001 M BAR,META, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 9510 001881690 NA 4 N 10/FT

002 M PLUG, 1-1/2"NPT, PLUG, 1-1/2"-

11-1/2 NPT, 1"LG, DEPTH OF

SLOT 3/8" MAX, SQUARE

SLOT, QQ-N-281, CL B, NICKEL

COPPER ALLOY GR 400

MONEL.

ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

LL9304947 NA 4 N 4/EA

003 M CORROSION PREVENTIV,

ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 8030 002441294 NA 4 Y 40/DR

NOTES:

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M-2

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

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

004 M RUBBER SCUPPER ASSEM,

RUBBER SCUPPER

ASSEMBLY, DIM A = 4", DIM B

= 8.-1/4", 18"LENGTH, IAW BIW

DWG: 8100-5220-0003 SHEET

11&12, PC 21 THRU 025 & 028,

CATALOG NUMBER: 54165-

005, 42179-035, 53048-030, 53239-081, 53110-011 & 53048-

ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

LL4896570 NA 4 N 8/EA

005 M STRIP,EL, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 5999 013438667 NA 4 N 8/EA

006 M NUT,SLEE, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 5310 014231667 NA 4 N 16/EA

007 M SCREW,CA, ORDER FOR KTR

ORIG: C231B, H.TANAKA, 243-

9B 5305 014535741 NA 4 N 16/EA

100 M INSULATI, ORIG: C-231B M.

HAYASHI 243-6145

ORDERED FOR KTR

9Q 5640 008096315 NA 4 N

150/EA

101 M INSULATI, 12SH / 1BX

5BX

ORIG: C-231B M. HAYASHI 243-

ORDERED FOR KTR

9Q 5640 008096312 NA 4 N 60/SH

102 M SOUND CO, 1BX

ORIG: C-231 M. HAYASHI 243-

ORDERED FOR KTR

9Q 5640 007565866 NA 4 N

210/SH

103 M CAP,SNAP, 100EA / PG

10PG

ORIG: C-231B M.HAYASHI 243-

ORDERED FOR KTR

9B 5325 007377648 NA 4 N

1000/E

A

104 M TAPE,TEX, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 8315 002671632 NA 4 N 20/RO

105 M TAPE,TEX, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 8315 002671633 NA 4 N 10/RO

106 M ADHESIVE, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 8040 002738708 NA 4 Y 8/GL

107 M ANCHOR,P, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 5342 010245124 NA 4 N

500/EA

108 M PLATE,MO, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 5340 010245086 NA 4 N

200/EA

109 M ADHESIVE, ORIG: C-231B

M.HAYASHI 243-6145

ORDERED FOR KTR

9B 8040 009035081 NA 4 Y 5/KT

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 S/A 81028K LIFE RAFT AY A 0

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

3819P58316 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 S/A 81028K LIFE RAFT AY A 0

MAPPING PLAN

ENCLOSURE-01 SHEET 1 OF 23819P58316A01

PLAN VIEW

MAIN DK WEA, PORT

FR 1 - 12

PLAN VIEW

MAIN DK WEA, STBD

FR 1 - 12

LIFERAIL STAN ASSY

SEE ELEV 2-A

LIFERAIL STAN ASSY

SEE ELEV 2-B

MAPPING PLAN

ENCLOSURE-01 SHEET 2 OF 23819P58316A01

ELEVATION 2-A

LIFERAIL STAN ASSY

FR 5 - 8, PORT

ELEVATION 2-B

LIFERAIL STAN ASSY

FR 5 - 8, STBD

ST-1

ST-3

ST-4

ST-2

EXIST LIFERAIL ASSY

EXIST LIFERAIL ASSY

SG-1

SG-2

SG-3

SG-4

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

3819P58316A01 ENCLOSURE-02-1 TOTAL 3

TEST AND INSPECTION RECORD

QA FORM 17 Planning must fill in blocks identified by a prior to issuing

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC SER NO. 5. SYSTEM/COMPONENT

USS BLUE RIDGE LCC-19 EXSA-ZC05 KTR N/A Liferail Stanchion

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

A. JFMM Rev. D Chg-3 Vol IV Ch 13 B. Dwg 804-5184155 Rev. A C. Dwg 600-8781528 Rev. “-“

D. E. F.

7. PART DESCRIPTION/PIECE NO.: Staple on Liferail Stanchion, See Mapping Plan Enclosure-01

8. DESCRIPTION OF TEST AND/OR INSPECTION:

STATIC LOAD TEST FOR TOP STAPLE ON LIFERAIL STANCHION

Total of 2 EA top staple(s) on liferail stanchion in accordance with Reference C.

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

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

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

ACCEPTANCE CRITERIA

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

9. RESULTS:

Use Continuation Sheet-1.

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

12. RECORD HAS BEEN REVIEWED FOR COMPLETENESS

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

3819P58316A01 ENCLOSURE-02-1 (Continuation Sheet-1) TOTAL 3

9. RESULTS (Continued):

TEST ITEM TEST LOAD TEST DURATION TEST RESULT

STAPLE No. ST-1 LBs Min SAT / UNSAT STAPLE No. ST-3 LBs Min SAT / UNSAT

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

ACCEPTANCE CRITERIA

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

*TEST FIXTURE INFO:

3819P58316A01 ENCLOSURE-02-2 TOTAL 3

TEST AND INSPECTION RECORD

QA FORM 17 Planning must fill in blocks identified by a prior to issuing

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC SER NO. 5. SYSTEM/COMPONENT

USS BLUE RIDGE LCC-19 EXSA-ZC05 KTR N/A Liferail Stanchion

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

A. Dwg 804-5184155 Rev. A B. DWG 600-8781528 Rev. “-“ C. MIL-STD-1689 Rev. A

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

7. PART DESCRIPTION/PIECE NO.: Staple on Liferail Stanchion, See Mapping Plan Enclosure-01

8. DESCRIPTION OF TEST AND/OR INSPECTION:

Visual (VT) inspection of each new weld of staples (ST-1, ST-2, ST-3, and ST-4) in accordance with Reference A, Reference B, and Paragraphs 6.4 and 7.2 of Reference C. The accept or reject criteria must be in accordance with Reference A and Paragraph 4 Class 3 of Reference D.

9. RESULTS:

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

3819P58316A01 ENCLOSURE-02-3 TOTAL 3

TEST AND INSPECTION RECORD

QA FORM 17 Planning must fill in blocks identified by a prior to issuing

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC SER NO. 5. SYSTEM/COMPONENT

USS BLUE RIDGE LCC-19 EXSA-ZC05 KTR N/A Liferail Stanchion

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

A. JFMM Rev. D Chg-3 Vol IV Ch 13 B. Dwg 804-5184155 Rev. A C. DWG 600-8781528 Rev. “-“

D. E. F.

7. PART DESCRIPTION/PIECE NO.:

Synthetic Rope Guardline Assembly

8. DESCRIPTION OF TEST AND/OR INSPECTION:

STATIC LOAD TEST FOR SYNTHETIC ROPE GUARDLINE ASSEMBLY

Total of 4 AY synthetic rope guardline assembly in accordance with Reference C.

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

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

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

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

ACCEPTANCE CRITERIA

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

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

9. RESULTS:

Use Continuation Sheet-1.

10. CRAFTSMAN SIGNATURE DATE 11. QA INSPECTOR SIGNATURE DATE

3819P58316A01 ENCLOSURE-02-3 (Continuation Sheet-1) TOTAL 3

9. RESULTS (Continued):

TEST ITEM TEST LOAD TEST DURATION TEST RESULT

GUARDLINE NO. SG-1 LBs Min SAT / UNSAT

GUARDLINE NO. SG-2 LBs Min SAT / UNSAT

GUARDLINE NO. SG-3 LBs Min SAT / UNSAT

GUARDLINE NO. SG-4 LBs Min SAT / UNSAT

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

ACCEPTANCE CRITERIA

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

*TEST FIXTURE INFO: