TGI_38K5216705_A01_c0v1.pdf

PDF 230 KB Posted

Attached to
USS RALPH JOHNSON DDG114 FY25 SRA 5C1 Bundle 2 (YOKOSUKA, JAPAN)
Solicitation number
N6264925RA025
Issued by

About this file

This is a Task Group Instruction (TGI) document for overhauling a watertight hatch and scuttle assembly (1-428-2) on the USS RALPH JOHNSON (DDG-114). The work involves overhauling a 36" x 48" steel watertight hatch and 21" diameter scuttle located on the main deck weather level at frame 428 port side, leading to passage 2-410-0-L.

The TGI details specific requirements including removing existing rubber insulation, disassembling dog assemblies, removing gaskets and label plates, blast cleaning surfaces, installing new gaskets conforming to A-A-59588 Class 3B Grade 30, and conducting operational testing. The work affects a fire zone boundary requiring non-flammable closure fabrication. The period of performance is July 14, 2025 through November 26, 2025, with an estimated 305 man-hours and material cost of $11,531.80. The document includes detailed material lists specifying 25 different components including spindles, bearings, bushings, washers, nuts, plungers, insulation materials, and adhesives. SRF-JRMC will provide government furnished materials and various support services including crane operations, utilities, and safety inspections.

View the file

Other files

File Type Posted
2.03 Amendment 0003 25RA025.pdf PDF
2.03 Amendment 0002 25RA025.pdf PDF
2.03 Amendment 0001 25RA025.pdf PDF
TGI_38K5263408A01_c0v0.pdf PDF
TGI_38K5212351A01_c3v1.rev1.pdf PDF
2.02 Attachment V Contract Data Sheet 25RA025.pdf PDF
TGI_38K5259310A01_c0v0.pdf PDF
TGI_38K5212347A01_c0v0.rev1.pdf PDF
TGI_38K5212352A01_c0v0.rev1.pdf PDF
TGI_38K5212346A01_c0v0.rev1.pdf PDF
TGI_38K5212389A01_c0v0.pdf PDF
TGI_38K5213001A01_c1v1.pdf PDF
TGI_38K5212317_A01_c2v2.rev1.pdf PDF
TGI_38K5212314_A01_c0v0.rev1.pdf PDF
TGI_38K5212315_A01_c0v0.rev1.pdf PDF
TGI_38K5212382A01_c0v0.pdf PDF
TGI_38K5212365A01_c0v0.pdf PDF
TGI_38K5213102A01_c1v1.pdf PDF
TGI_38K5215401A01_c0v0.pdf PDF
TGI_38K5212329_A01_c1v1.rev1.pdf PDF
TGI_38K5212363T01_c0v0.pdf PDF
TGI_38K5212321A01_c2v0.rev1.pdf PDF
TGI_38K5212342A01_c0v0.rev1.pdf PDF
TGI_38K5212364A01_c0v0.pdf PDF
TGI_38K5216702_A01_c0v0.pdf PDF
TGI_38K5212325_A01_c0v0.rev1.pdf PDF
TGI_38K5212377A01_c1v1.pdf PDF
TGI_38K5212312_A01_c0v0.rev1.pdf PDF
TGI_38K5212340A01_c0v0.rev1.pdf PDF
TGI_38K5212313_A01_c0v1.rev1.pdf PDF
TGI_38K5212323_A01_c0v0.rev1.pdf PDF
TGI_38K5212309_A01_c0v0.rev1.pdf PDF
TGI_38K5212392A01_c1v1.pdf PDF
2.02 Attachment IV N6264925RA025 Request for Information Form.doc DOC document
TGI_38K5216704_A01_c0v0.pdf PDF
TGI_38K5212356A01_c0v0.rev1.pdf PDF
TGI_38K5212391A01_c0v0.pdf PDF
2.02 Attachment II Price Proposal Form N6264925RA025.xlsx XLSX spreadsheet
TGI_38K5212336_A01_c0v0.pdf PDF
TGI_38K5212320_A01_c1v1.rev1.pdf PDF
TGI_38K5212328_A01_c0v0.rev1.pdf PDF
TGI_38K5212319_A01_c2v1.rev1.pdf PDF
TGI_38K5212390A01_c0v0.pdf PDF
TGI_38K5212330_A01_c0v0.rev1.pdf PDF
TGI_38K5212327_A01_c1v2.rev1.pdf PDF
TGI_38K5212355A01_c0v0.rev1.pdf PDF
2.02 Attachment III N6264925RA025 Government Furnished Property (GFP-GFM listings).xlsx XLSX spreadsheet
TGI_38K5212348A01_c0v0.pdf PDF
TGI_38K5216703_A01_c0v0.pdf PDF
TGI_38K5212311A01_c1v0.rev1.pdf PDF
Show 40 more

Latest 50 of 73 listed here. See the rest on GovTribe.

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

FOUO

FOUO: Public availability to be determined under 5 USC 552

TASK GROUP INSTRUCTION

AIM REV 20.11.4.0 (OCTOBER 2020)

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

NO.: HATCH ASSY 1-428-2 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 - OVERHAUL WATERTIGHT HATCH AND SCUTTLE 1-428-2 IN WEATHER DECK

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

TSUBASA KOSUGE 231A 315-243-4371 11-NOV-2024

APPROVED BY: CODE PHONE DATE

YUUJI NAKAMURA 231A 315-243-6041 11-NOV-2024

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

CONCURRED BY: CODE PHONE DATE

REASON FOR WORK/NEED FOR CHANGE:

CHANGE INSTRUCTIONS:

SPECIAL REQUIREMENTS:

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

WORK CERTIFICATION SIGNATURES

COMPLETION OF WORK REVIEW: BADGE NO.: SHOP/CODE: PHONE: DATE:

ACCEPTANCE OF COMPLETED WORK

PHYSICAL INSPECTION PHYSICAL INSPECTION COMPLETED: BADGE NO.: SHOP/CODE: PHONE: DATE:

REQUIRED:☐YES ☒NO

RECORDS REVIEW: BADGE NO.: SHOP/CODE: PHONE: DATE:

TGI NO.: HATCH ASSY 1-428-2 AY A 0

FOUO

SHIP: DDG-114 CHG/VER: 0/1

LIST OF EFFECTIVE PAGES

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

1-6 J1-2 M1-3

1. SCOPE/PURPOSE

1.1 Title: Watertight Hatch and Scuttle 1-428-2; overhaul

1.2 Location of Work:

1.2.1 Main Deck Level Weather, Frame 428, Port

1.2.2 Passage (2-410-0-L)

1.3 Identification:

1.3.1 Quantity (10 SF), Rubber Insulation on Interior Side of Hatch Panel of Watertight Hatch 1-428-2

Material: Form Rubber, NH Armaflex, 3/4 Inch Thickness

1.3.1.1 Quantity (3 SF), Rubber Insulation on Interior Side of Scuttle Panel of Watertight Scuttle 1-428-2

Material: Form Rubber, NH Armaflex, 3/4 Inch Thickness

1.3.2 Quantity (One EA), Hatch, Watertight

Hatch No. :1-428-2 Size: 36 Inches x 48 Inches Material: Steel Type: Ramped Low Profile Individually with Ramp 8 Dogs

1.3.2.1 Quantity (One EA), Scuttle, Watertight

Scuttle No.:1-428-2 Size: 21Inches Diameter Panel: Steel Coaming: CRES Type: Ramped Low Profile Quick Acting with Ramp3 Dogs

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

1.3.3.1 Quantity (One EA), Label Plate, Exterior

Material: CRES, Type-II of 2.9 Inscription: 1st. Line: 1-428-2

2nd. Line: PASSAGE 3rd. Line: 2-410-0-L

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

Material: CRES, Type-II of 2.9 Remarks: Figure-D of 2.9

FOUO

SHIP: DDG-114 CHG/VER: 0/1

1.3.3.3 Quantity (One EA), Label Plate, Interior

Material: Aluminum Alloy, Type-I of 2.9 Inscription: 1st. Line: 1-428-2

2nd. Line: WEATHER

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

Material: Aluminum Alloy, Type-I of 2.9 Remarks: Figure-D of 2.9

1.3.4 Quantity (4 EA), Label Plate, Watertight Scuttle

1.3.4.1 Quantity (One EA), Label Plate, Exterior

Material: CRES, Type-II of 2.9 Inscription: 1st. Line: 1-428-2

2nd. Line: PASSAGE 3rd. Line: 2-410-0-L

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

Material: CRES, Type-II of 2.9 Remarks: Figure-D of 2.9

1.3.4.3 Quantity (One EA), Label Plate, Interior

Material: Aluminum Alloy, Type-I of 2.9 Inscription: 1st. Line: 1-428-2

2nd. Line: WEATHER

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

Material: Aluminum Alloy, Type-I of 2.9 Remarks: Figure-D of 2.9

1.3.5 Quantity (10 SF), Compartment Insulation on Interior Side of Hatch Panel of Watertight Hatch 1-428-2

Material: Anti-Sweat, Polyimide, 3/4 Inch Thickness, MIL-DTL-24688, Type II

1.3.5.1 Quantity (3 SF), Compartment Insulation on Interior Side of Scuttle Panel of Watertight Scuttle 1-428-2

Material: Anti-Sweat, Polyimide, 3/4 Inch Thickness, MIL-DTL-24688, Type II

1.4 Security Classification: None.

1.5 Initial Condition:

1.5.1 Potential Asbestos Hazard.

1.6 Contractor work start date: 14 JUL 2025

1.7 Contractor work completion date: 26 NOV 2025

2. REFERENCES:

FOUO

SHIP: DDG-114 CHG/VER: 0/1

REF.

NO.

DOCUMENT

/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV CHG

NO.

COPY

REQ’D

(Y/N)

SOURCE

DOC

(Y/N)

PARA SEC PG CHP

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

3 DWG 167-

7062377

HATCH AND SCUTTLE LIST SHIP

WIDE

- Y 7F, 8J

4 DWG 8100-

1252-0235

Hatches Structural (Steel) Arrangement

K N

5 DWG 8100-

1252-0236

Hatches, Structural (Steel) Assemblies & Details

AH N

6 DWG 8100-

1253-0237

SCUTTLE STRUCURAL(STEEL)

WTQA 3 & 4 DOG

ARRANGEMENT

R N

7 DWG 8100-

1253-0238

SCUTTLE STRUCTURAL(STEEL)

WTQA ASSEMBLIES & DETAILS

AF N

8 TM

SYSTEMS &

SPECIFICAT

IONS

SSPC Painting Manual Volume 2 - N

9 PDD 602-

ELM-150531

SRF-JRMC STD ELM LABEL

PLATE FOR CLOSURE

A Y AL

L

10 PDD 635-

ELM-230114

SRF-JRMC Std ELM Sub Matl of Elastomeric Plstc Foam for Hull Insul

- Y AL

L

3. APPENDICES:

3.1. Appendix “J” TGI Job Summary Information Sheet

3.2. Appendix "M" TGI Material List

3.3. Appendix “D” Deficiency Form

4. GENERAL REQUIREMENTS:

4.1 Not Applicable.

5. PROCEDURE:

5.1 Remove each existing rubber insulation listed in 1.3.1.

5.2 Remove existing hatch and scuttle panel of each hatch listed in 1.3.2, using 2.3 through 2.7 for guidance.

5.2.1 Disassemble dog assembly.

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

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

5.3 Accomplish the requirements of 009-32 of 2.1, including Table 2, Line(s) 9, for exterior surfaces and Table 3, Line(s) 25, for interior surfaces of hatch and scuttle panel of each hatch listed in 1.3.2.

5.3.1 Near-white blast clean for each hatch and scuttle panel. Accomplish each requirement of Surface Preparation Specification SSPC-SP 10 of 2.8.

5.4 Prepare and align hatch and scuttle panel of each hatch listed in 1.3.2 for reinstallation, using 2.3 through 2.7 for guidance.

Masato.Endo.ja Cross-Out

Masato.Endo.ja Typewritten Text

1/11/2025 C-1209 M. ENDO 11030028

FOUO

SHIP: DDG-114 CHG/VER: 0/1

5.4.1 Fabricate and install new gasket conforming to A-A-59588 Class 3B Grade 30.

5.5 Reinstall hatch panel and scuttle of each hatch listed in 1.3.2, using 2.3 through 2.7 for guidance.

5.5.1 Reassemble dog assembly.

5.5.1.1 Lubricate each dogging mechanisms.

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

5.6 Accomplish the requirements of 009-25 of 2.1 for a chalk test of each hatch and scuttle listed in 1.3.2.

5.7 Accomplish the requirements of 009-25 of 2.1 for a local air hose test of hatch and scutle panel gasket and knife edge mating area of each hatch listed in 1.3.2. Allowable leakage: None.

5.8 Accomplish an operational test of each hatch and scuttle listed in 1.3.2 to assure unobstructed operation.

Allowable sticking or binding: None.

(V)(G) “OPERATION TEST”

5.9 Fabricate and install new each label plate listed in 1.3.3 and 1.3.4 in accordance with 2.9.

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

5.10 Accomplish the requirements of 009-11 of 2.1 to install each new compartment insulation listed in 1.3.5 in accordance with 2.10.

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

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

5.12 Notes:

5.12.1 Planner: Code 231A T. Kosuge, 243-4371

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

5.12.3 Work per this instruction involves cutting an access (or removal of a door) through a fire zone bulkhead, through the hull of the ship above the turn of the bilge, through ventilation components (ducting, plenums, etc.), or through any air-tight, fume-tight or watertight bulkheads normally used to control air flow in the event of a shipboard fire. A nonflammable closure is required in accordance with COMNAVSEASYSCOM MSG R 261400Z JUL 12. The closure, if not continuously in use, shall be staged near the access, readily visible and accessible, so that any emergency responder can install the closure to affect proper air flow onboard the ship.

5.12.4 JCN ER09-L028 is related to this TGI.

5.13 Government Furnished Material (GFM):

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

5.14 SRF-JRMC will provide the following service work: (TGI No. 38K5216705S02).

5.14.1 [C740] Crane and crane rigging service.

5.14.2 [X99E] Utility service, electrical.

FOUO

SHIP: DDG-114 CHG/VER: 0/1

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

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

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

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

FOUO

J-1

SHIP: DDG-114 CHG/VER: 0/1

APPENDIX "J"

TGI JOB SUMMARY INFORMATION SHEET

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

VERSION:

CASREP

CAT:

HATCH ASSY 1-428-2 AY A 0 1

CU PHASE TITLE:

*F/O - OVERHAUL WATERTIGHT HATCH AND SCUTTLE 1-428-2 IN WEATHER DECK

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

SCUTTLE 1-428-2 HA HATCH 1-428-2 HA

ATTACHMENT LIST:

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

YAGINUMA ,TAKEHIDE

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

38K5216705 A01 305 $11,531.80 1

CU PHASE DESCRIPTION:

The purpose of this TGI is to overhaul watertight hatch and scuttle 1-428-2.

Location of Work:

Main Deck Level Weather, Frame 428, Port Passage (2-410-0-L)

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

FOUO

J-2

SHIP: DDG-114 CHG/VER: 0/1

TASK NAME

SHOP TSD/WC TS CREW# MHRS

HIGH RAD

HOURS

RC

GRID#

Version-01: add reference number 8. C231A Y. Aoki, 11/11/2024.

-/-/N

V-01 0 0 0

FOUO

M-1

SHIP: DDG-114 CHG/VER: 0/1

APPENDIX “M”

TGI MATERIAL LIST

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

VERSION:

CASREP

CAT:

HATCH ASSY 1-428-2 AY A 0 1

CU PHASE TITLE:

*F/O - OVERHAUL WATERTIGHT HATCH AND SCUTTLE 1-428-2 IN WEATHER DECK

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

38K5216705 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 SPINDLE,HATCH, ORGI: C231A

T. KOSUGE

243-4371

ORDERED FOR KTR

9B 2040 014197132 NA 4 N 8/EA

002 M BEARING,SLEEVE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 3120 014841528 NA 4 N 8/EA

003 M BUSHING,SLEEVE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 3120 014841530 NA 4 N 16/EA

004 M WASHER,FLAT, ORIG: C231A

T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5310 014844047 NA 4 N 16/EA

005 M NUT,SELF-LOCKING, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5310 014502851 NA 4 N 8/EA

006 M PLUNGER,DETENT, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5340 014207020 NA 4 N 8/EA

NOTES:

FOUO

M-2

SHIP: DDG-114 CHG/VER: 0/1

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

007 M PIN,COTTER, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 5315 014198257 NA 4 N 4/EA

008 M WASHER,FLAT, ORIG: C231A

T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5310 014815484 NA 4 N 4/EA

009 M PIN,STRAIGHT,HEADLE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5315 014871105 NA 4 N 4/EA

010 M RUBBER , ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 5330 013717183 NA 4 N 30/FT

011 M SPRING, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 5360 014209907 NA 4 N 3/EA

012 M SCREW,CAP,HEXAGON ,

ORIG: C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5305 014508865 NA 4 N 3/EA

013 M SPINDLE,MECHANICALL,

ORIG: C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 3040 014498455 NA 4 N 1/EA

014 M BUSHING,SLEEVE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 3120 014207110 NA 4 N 1/EA

015 M BUSHING,SLEEVE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 3120 014207113 NA 4 N 1/EA

016 M SETSCREW, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 5305 009806819 NA 4 N 1/EA

017 M PIN,SHOULDER,HEADLE,

ORIG: C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 5315 014501351 NA 4 N 1/EA

018 M COLLAR,SPINDLE, ORIG:

C231A T. KOSUGE

243-4371

ORDERED FOR KTR

9B 2040 014198601 NA 4 N 1/EA

019 M INSULATION, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9Q 5640 013713263 NA 4 N 1/SH

020 M INSULATION, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9Q 5640 013713262 NA 4 N 1/SH

021 M INSLULATION, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9Q 5640 013837815 NA 4 N 4/SH

022 M ADHESIVE, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 8040 002738708 NA 4 Y 1/GL

FOUO

M-3

SHIP: DDG-114 CHG/VER: 0/1

MATERIAL LIST

ITEM

NO.

PC

NO.

REF

NO.

M

C DESCRIPTION

STOCK

NUMBER

GENERIC

MATL

TYPE LVL QA

HAZ

MAT

DOC

NO.

QTY

REQD/

UNIT

QTY

USED/

UNIT

023 M ADHESIVE, ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 8040 005508835 NA 4 Y 1/GL

024 M TAPE, 2", ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 8315 002671632 NA 4 N 1/RO

025 M TAPE, 3", ORIG: C231A T.

KOSUGE

243-4371

ORDERED FOR KTR

9B 8315 002671633 NA 4 N 1/RO

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 HATCH ASSY 1-428-2 AY A 0

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

38K5216705 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 HATCH ASSY 1-428-2 AY A 0

File details come from the government source that posted it. Updated .