TGI_38K5212382A01_c0v0.pdf

FOUO

FOUO: Public availability to be determined under 5 USC 552

TASK GROUP INSTRUCTION

AIM REV 20.11.4.0 (OCTOBER 2020)

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

NO.: STRCT 5-300-01-E AY A 0 0

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

DDG-114 USS RALPH JOHNSON K52

CU PHASE TITLE:

F/O – REPAIR STRUCTURAL MEMEBR IN 5-300-01-E

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

TETSUYA UEMATSU 231A 315-243-9943 23-SEP-2024

APPROVED BY: CODE PHONE DATE

YUUJI NAKAMURA 231A 315-243-6041 23-SEP-2024

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

REASON FOR WORK/NEED FOR CHANGE:

CHANGE INSTRUCTIONS:

SPECIAL REQUIREMENTS:

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL II

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.: STRCT 5-300-01-E AY A 0

FOUO

SHIP: DDG-114 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.

1-5 Map (1)

J1-2 QA34A

(1) M1-4 Sketch (1-2)

1. SCOPE/PURPOSE

1.1 Title: Structural Member in 5-300-01-E; repair

1.2 Location of Work:

1.2.1 Air Conditioning Machinery and Pump Room (5-300-01-E)

1.2.2 Vacuum Collection Holding Tank Room No. 2 (4-300-0-E)

1.2.3 IC and Gyro Room No. 2 (3-300-0-C)

1.3 Identification:

1.3.1 Quantity (One Lot), Longitudinal 4P in 5-300-01-E and 4-300-0-E, Frames between 301 and 313

JCN: ES01-NA53

Material: HTS, MIL-S-22698 GR-AH36, 12 Inches x 4 Inches x 14 LBs IT Remarks: See Elevation 3-A of 2.3 for detail

1.3.2 Quantity (One EA), Cable Penetration on Longitudinal 4P in 5-300-01-E, Frame 309

JCN: ES01-NA53

Material: Steel, ASTM-A53, 3 Inches IPS Schedule 40, Pipe Remarks: See Elevation 3-A of 2.3 for detail

1.3.3 Quantity (2 EA), Bracket on Longitudinal 4P in 5-300-01-E, Frames between 312 and 313

JCN: ES01-NA53

Material: HTS, MIL-S-22698 GR-DH36, 10.2 LBs Plate Remarks: See Elevation 3-C of 2.3 for detail

1.3.4 Quantity (One EA), Web Frame on Longitudinal 4P in 5-300-01-E, Frame 308

JCN: ES01-NA53

Material: HTS, MIL-S-22698 GR-AH36, 12 Inches x 4 Inches x 14 LBs IT Remarks: See Elevation 3-C of 2.3 for detail

1.3.5 Quantity (One EA), No. 4 Air Conditioning (A/C) Plant Check Valve Mfr Id: 803-1385721-8 Type: Swing, Union End Size: 2.00-Inch IPS Valve No: REA/V0127

1.3.6 Quantity (2 EA), Closure plate on Longitudinal 4P in 5-300-01-E, Frames between 322 and 323

FOUO

SHIP: DDG-114 CHG/VER: 0/0

JCN: ES01-NA54

Material: HTS, MIL-S-22698 GR-DH36, 10.2 LBs Plate Remarks: See Elevation 3-A of 2.3 for material and detail

1.3.6.1 Quantity (One EA), Closure plate, Frames between 319 and 320

1.3.6.2 Quantity (One EA), Closure plate, Frames between 322 and 323

1.3.7 Quantity (One Lot), Web Plate of Stringer 5S on Shell Plating in 5-300-01-E, Frame between 307, Starboard

JCN: ES01-NA51

Remarks: See 2.8 for base material and Sketch Enclosure-01 for material and detail

1.4 Security Classification: None.

1.5 Initial Condition: None.

1.6 Contractor work start date:

1.7 Contractor work completion date:

2. REFERENCES:

REF.

NO.

DOCUMENT

/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV CHG

NO.

COPY

REQ’D

(Y/N)

SOURCE

DOC

(Y/N)

PARA SEC PG CHP

1 NSI FY-25 NAVSEA Standard Items - 1 N 2 LI FY-25 Local Standard Items - ORG N

3 PDD 100-

ELM-240397

RPR OF DEFORMED & MECH

HOLES IN L-4P IN AIR COND

MCHRY & PUMP RM (5-300-01-E)

- Y AL

L

4 DWG 516-

7060039

REFRIGERATION SYSTEM

DIAGRAM

E Y 5D

5 DWG 516-

7061971

REFRIGERATION GAS SYSTEMS,

ZONE 3120

- Y 4,5 A

6 DWG 803-

1385721

Valves Bronze 1/4 - 2 Union End Swing Check

Y N

7 DWG 803-

7063850

TAILPIECE ASSEMBLIES, UNION

END (BW, SW, SB), 1/4 - 2 INCH.

400PSI WOG

B Y 1

8 DWG 100-

7063209

UNIT STRUCTURAL ARR DWG

ASSY UNIT 3110

- Y 9A ,9-

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

Masato.Endo.ja Typewritten Text

11 DEC 2025

Masato.Endo.ja Typewritten Text

14 JUL 2025

Masato.Endo.ja Cross-Out

Masato.Endo.ja Typewritten Text

12/21/2024 C-1209 M. ENDO 11030028

FOUO

SHIP: DDG-114 CHG/VER: 0/0

5.2 Remove existing, fabricate and install new each longitudinal 4P, penetration coaming, and bracket listed in 1.3.1 through 1.3.3 in accordance with 2.3.

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

5.3 Fabricate and install each new web frame listed in 1.3.4 in accordance with 2.3.

5.3.1 Remove unused stud for cableway on longitudinal 4P frame 308.

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

5.4 Remove and install each valve listed in 1.3.5, using DETAIL 5D-10E of Sheet 5D on 2.4 and 2.5 for guidance.

5.4.1 Restore each mating surface exposed by removal. Repair by removing each high spot, burr, abrasion, and foreign matter, where removal can be accomplished by hand tool.

5.4.2 Remove existing and install new each piping joint gasket. Union gaskets must conform to MIL-G-24748, Type A or equal.

5.4.3 Connect each mechanical joint shown on Mapping Plan Enclosure-02, using 2.6 and 2.7 for guidance.

5.4.3.1 Document the controlled assembly joints on QA Form 34A Enclosure-03-1.

(I) “CONTROLLED ASSEMBLY JOINT INSTALLATION”

5.5 Fabricate and install each new closure plate listed in 1.3.6 in accordance with 2.3.

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

5.6 Accomplish weld repair of mechanical hole on each existing stringer 5S listed in 1.3.7, using 2.8 for guidance.

See 5.8.4.

5.6.1 Shape mechanical hole to minimum 20 degrees countersink.

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

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

5.8 Notes:

5.8.1 Planner: Code 231A T. Uematsu, 243-9943

Planner: Code 232 K. Nakamura, 070-7787-1977 Planner: Code 233 H. Sasano, 080-9350-1453 Planner: Code 234 H. Komoto, 243-0975 Planner: Code 234 K. Furukawa, 243-2242 Engineer: Code 250 M. Kunugi, 070-7787-2080

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

5.8.3 This TGI clears DFS DDG-114-1022-2023 in its entirety.

5.8.4 Installation, maintaining, and removal of cofferdam on exterior side of underwater hull, and preservation work for disturbed exterior surfaces of underwater hull for weld repair of stringer 5S listed in 1.3.7 will be covered by TGI Nos. 38K5212382R02, 38K5212382M02, and 38 K5212382U02 (SRF-JRMC TGI).

5.8.5 JCNs ES01-NA51, ES01-NA53, and ES01-NA54 are related to this TGI.

FOUO

SHIP: DDG-114 CHG/VER: 0/0

5.9 Government Furnished Material (GFM):

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

5.10 SRF-JRMC will provide the following service work: (TGI No. 38K5212382S02).

5.10.1 [C740] Crane and crane rigging service.

5.10.2 [X99E] Utility service, electrical.

5.10.3 [X99M] Utilities service, including low pressure air supply, water supply, and steam supply.

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

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

5.10.6 [C133] QA inspection for (G) symbol(s).

FOUO

J-1

SHIP: DDG-114 CHG/VER: 0/0

APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

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

VERSION:

CASREP

CAT:

STRCT 5-300-01-E AY A 0 0

CU PHASE TITLE:

F/O – REPAIR STRUCTURAL MEMEBR IN 5-300-01-E

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

CMPT 5-300-01-E MS CMPT 4-300-0-E MS REA-V-0127 V-

ATTACHMENT LIST:

1. ENCLOSURE-01 (38K5212382A01-Sketch.pdf) saved on 19-SEP-2024 0000.

2. ENCLOSURE-02 (38K5212382A01-Map.docx) saved on 29-AUG-2024 0000.

3. ENCLOSURE-03 (38K5212382A01-QA34A.docx) saved on 29-AUG-2024 0000.

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

YAGINUMA ,TAKEHIDE

JO: KO: TOTAL MAN HRS: TOTAL MAT’L COST TOTAL DURATION: PLANNING ACCEPTANCE:

38K5212382 A01 1787 $7,437.77 1

CU PHASE DESCRIPTION:

The purpose of this TGI is to repair structural member in 5-300-01-E.

Location of Work:

Air Conditioning Machinery and Pump Room (5-300-01-E) Vacuum Collection Holding Tank Room No. 2 (4-300-0-E) IC and Gyro Room No. 2 (3-300-0-C)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

FOUO

J-2

SHIP: DDG-114 CHG/VER: 0/0

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

FOUO

M-1

SHIP: DDG-114 CHG/VER: 0/0

APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

STRCT 5-300-01-E AY A 0 0

CU PHASE TITLE:

F/O – REPAIR STRUCTURAL MEMEBR IN 5-300-01-E

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

38K5212382 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, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

(2FT X 2FT)

9B 9515 002243086 NA 4 N 42645035 4/SF

002 M BEAM,STRUCTURAL, I -,

BEAM,STRUCTURAL, I -SHAPE,

12" X 4" X 14LBS. STEEL,MIL-S-

22698, GRADE AH36,HIGH

TENSILE STRENGTH STEEL

ORDERED FOR KTR

ORIG: C231, T.UEMATSU, 243-

LL4729849 NA 4 N 16/FT

003 M PIPE,METALLIC, ORDERED

FOR KTR

ORIG: C231, T.UEMATSU, 243-

9B 4710 002785344 NA 4 N 42645038 1/FT

004 M SHEET,METAL, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9B 9515 002306720 NA 4 N 42645039 2/SH

NOTES:

FOUO

M-2

SHIP: DDG-114 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

005 M ACOUSTIC, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9Q 5640 LL4558975 NA 4 N 42657404 5/SH

006 M INSULATI, ORDERED FOR KTR

ORIG: C231, T.UEMATSU, 243-

9Q 5640 LL4558976 NA 4 N 42657405 12/SH

007 M CAP,SNAP, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9B 5325 007377648 NA 4 N 42645041

100/EA

008 M ADHESIVE, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9B 8040 002738708 NA 4 Y 42645045 1/GL

009 M TAPE,TEX, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9B 8315 002671632 NA 4 N 42645047 3/RO

010 M TAPE,TEX, ORDERED FOR

KTR

ORIG: C231, T.UEMATSU, 243-

9B 8315 002671633 NA 4 N 42645048 1/RO

011 M MATTING,FLOOR, ORDERED

FOR KTR

ORIG: C231, T.UEMATSU, 243-

9Q 7220 010249040 NA 4 N 42645049 1/RO

201 M GASKET, ORIG: C232 K.

NAKAMURA, 070-7787-1977

ORDRED FOR KTR

UNION GASKET, 2” IPS, MIL-G-

24748, TYPE A

FOR CONTD ASSY JT: ITEM

NO. 9 OF DWG 803-7063850

REV. B

9B 5330 013776202 NA 4 N 42435278 2/EA

400 M COUPLING,TUBE, SIZE: ONE

INCH IPS

MATERIAL: CU-NI 90-10

ORDERED FOR: KTR

ORIG: C234 H. KOMOTO 070-

7787-2047

9B 4730 014635857 NA 4 N 42565088 8/EA

401 M COUPLING,TUBE, SIZE: 1-1/2

INCH IPS

MATERIAL: CU-NI 90-10

ORDERED FOR: KTR

ORIG: C234 H. KOMOTO 070-

7787-2047

9B 4730 014645439 NA 4 N 42565090 4/EA

FOUO

M-3

SHIP: DDG-114 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

450 M INSULATION, PIPE,

INSULATION, PIPE, K-FLEX

ECO, NON-HALOGEN,

SPECIFICATION COMPLIANCE:

EB 4013,

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

LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

**GSA ADVANTAGE ITEM**

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 5970 LL9607843 NA 4 N 42487446 2/EA

451 M INSULATION, PIPE,

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 K.FURUKAWA,

243-2242

9B 5970 LL4783096 NA 4 N 42487444 4/EA

452 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, **GSA

ADVANTAGE ITEM**

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 5970 LL9607845 NA 4 N 42487447 2/EA

453 M INSULATION, PIPE,

NSULATION, 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,

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 5640 LL9607850 NA 4 N 42487448 3/EA

454 M INSULATION, INSULATION,

PIPE,

BRAND: K-FLEX ECO,

SPECIFICATION COMPLIANCE:

EB 4013,

FOR SIZE: 8" IPS,

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

FT LG,

UI: EA/6 FT(ONE CONTINUOUS

LENGTH REQUIRED),

MATL: NON-HALOGEN,

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 5970 LL9607851 NA 4 N 42487449 2/EA

FOUO

M-4

SHIP: DDG-114 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

455 M ADHESIVE, ADHESIVE FOR

CLOTH,

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 8040 002738708 NA 4 Y 42485076 1/GL

456 M ADHESIVE, ADHESIVE FOR

PLASTIC TUBE

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 8040 008419773 NA 4 Y 42485093 2/PT

457 M SEALING COMPOUND,

ADHESIVE FOR INSULATION

SLEEVING

ORDER FOR KTR

ORIG: C234 K.FURUKAWA,

243-2242

9B 8030 001742588 NA 4 Y 42485094 1/GL

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:

DDG-114 STRCT 5-300-01-E AY A 0

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

38K5212382 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:

DDG-114 STRCT 5-300-01-E AY A 0

AIR COND MCHRY & PUMP ROOM (5-300-01-E)

PLAN VIEW

SKETCH

ENCLOSURE-0138K5212382A01 SHEET 1 OF 2

LOCATION MAP OF MECHANICAL HOLE ON STRINGER 5S IN 5-300-01-E

SECT A-A

Tetsuya.Uematsu.ja Rectangle

Tetsuya.Uematsu.ja_1 Line

Tetsuya.Uematsu.ja_2 Line

Tetsuya.Uematsu.ja_3 Line

Tetsuya.Uematsu.ja_4 Line

Tetsuya.Uematsu.ja_5 Line

Tetsuya.Uematsu.ja_6 Line

SECT A-A

STRINGER 5S FR307

STBD LKG INBD

DET A-B

DET A-B

SKETCH

ENCLOSURE-0138K5212382A01 SHEET 2 OF 2

Tetsuya.Uematsu.ja_7 Rectangle

Tetsuya.Uematsu.ja_8 Rectangle

38K5212382A01

MAPPING PLAN

ENCLOSURE-02 SHEET 1 OF 1

CJ-1

CJ-2

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

38K5212382A01 ENCLOSURE-03-1 TOTAL 1

JOINT/COMPONENT ASSEMBLY RECORD Planning must fill in blocks identified by a prior to issuing.

QA FORM 34A

(For Assemblies Not Requiring Torque Documentation)

1. SHIP HULL NO. 2. JCN 3. LWC/SHOP 4. CWP/REC NO. 5. SYSTEM/COMPONENT/ROTATABLE POOL NO USS RALPH JOHNSON DDG-114 ES01-NA51, ES01-NA53 and

ES01-NA54

KTR N/A Valve REA/V0127

6. REFERENCES (Specify Assembly Number if applicable.)

A. DWG: 516-7061971 Rev. - B. DWG: 803-1385721 Rev. Y C. DWG: 803-7063850 Rev. B

D. MAPPING PLAN of 38K5212382A01 E. 38K5212382A01 F.

7. NEW MATERIAL

PC

NO.

REF. JOINT

ID

DESCRIPTION

(Include thickness for shims; diameter and thread pitch for fasteners)

QTY LOE IDENT (E.G., MIC NO/NSN/ROTATABLE POOL

NO)

(FOR LEVEL I FASTENERS: Include Material Marking, Color Code, Heat/Lot Number, and

Manufacturer’s Symbol)

CRAFT

INT

8. JOINT DATA

FOR OTHER THAN JOINT MAKE-UP, DESCRIBE

THE SPECIFIC ATTRIBUTE AND LOCATION OF

THE ACCEPTANCE CRITERIA. IDENTIFY

JOINTS THAT REQUIRE CONTROLLED

ASSEMBLY PROCEDURES.

INSPECTOR (SHIPYARDS ONLY - FOR CONTROLLED ASSEMBLY JOINTS ONLY) & CRAFTSMAN

SIGNATURE CERTIFIES:

(1) JOINT SEALING SURFACES, ALIGNMENT, GAP AND PARALLELISM ARE SAT PER

SPECIFIED REQUIREMENTS AND STUDS HAVE BEEN CHECKED FOR ROTATION IF APPLICABLE, OR

ATTRIBUTE IS ACCEPTABLE PER SPECIFIED CRITERIA.

(2) ALL NEW MATERIAL ASSOCIATED WITH THIS JOINT MEETS SPECIFIED REQUIREMENTS, IS

INSTALLED & LISTED IN BLOCK 7; EXISTING MATERIAL ASSOCIATED WITH THIS JOINT IS

ACCEPTABLE AND CORRECTLY INSTALLED.

FOR FLEET ONLY: FOR NON-CONTROLLED ASSEMBLIES WHEN NO SPECIFIC ATTRIBUTE IS

SPECIFIED, INSPECTOR SIGNATURE CERTIFIES ACCEPTANCE OF LEVEL I MATERIAL ONLY.

JOINT ID & JOINT TYPE OR ATTRIBUTE

DESCRIPTION

JT.

REF

(C) FOR

CRAFTSMAN OR

(I) FOR

INSPECTOR

CRAFTSMAN SIGNATURE/BADGE/DATE (FOR EACH JOINT/ATTRIBUTE)

INSPECTOR SIGNATURE/BADGE/DATE (FOR EACH (I) JOINT/ATTRIBUTE)

(I)

A. CJ-1

A,B,C ,D,E

(I)

B. CJ-2

A,B,C ,D,E

C.

D.

E.

9. LOCKING DEVICE INSTALLED

OR REQD ACTION:

NA

MATL. DESCRIPTION/NSN/PC. NO. JT. ID. CRAFTSMAN SIGNATURE/BADGE/DATE SAT

10. REMARKS (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA) (FOR USE WHEN SIGNATURE DOES NOT ALREADY

APPEAR ON FORM)

INITIAL SIGNATURE/BADGE NO.

11. LWC SUPERVISOR/SHOP SUPERVISOR SIGNATURE/BADGE NO (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

12. QAS SIGNATURE /BADGE NO (RECORD HAS BEEN REVIEWED FOR

COMPLETENESS)