TGI_38K5259310A01_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.: VARIOUS VCHT PP 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 - ACCOMPLISH REPLACEMENT OF VARIOUS VCHT PIPING

PREPARING ACTIVITY:

PREPARED BY: CODE PHONE DATE

YOSHITSUGU KAWASHIMA 234. 090-9323-5312 29 NOV 2024

APPROVED BY: CODE PHONE DATE

HIDEKUNI SHINMEI 234. 315-243-2371 29 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:

CLASS P-2 PIPING.

CLEANLINESS FOR PIPING SYSTEM/EQUIPMENT LEVEL III.

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.: VARIOUS VCHT PP 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 J-1 M1-3

QA28 (1-3)

1. SCOPE/PURPOSE

1.1 Title: Replacement of Various Vacuum, Collection, Holding and Transfer (VCHT) Piping; accomplish

1.2 Location of Work:

1.2.1 Vacuum Collection Holding Tank Room No. One (4-110-0-E)

1.2.2 Crew Living Space No. 7 (3-350-2-L)

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

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

1.3 Identification:

1.3.1 Quantity (One Lot), Vent Duct, Collective Protection System (CPS)

System No.: CPS Exhaust System 01-248-1 Type: Non-watertight Material: Steel Location: Frames between 310 and 312, Port

JCN: EA01-1657

Remarks: See 2.3 for detail.

1.3.2 Quantity (One Lot), Forward (FWD) VCHT Piping located in 1.2.1, between Frames 119 and 124, Longitudinal No. L1(P) and Center Line.

Size: 2 Inch IPS (2.375 Inch OD x 0.083 Inch WT) Material: Copper Nickel Alloy, Class 200 Specification: MIL-T-16420

JCN: ER01-0294

Remarks: See followings for detail.

2.4: Sheet 3B (Zone 3-E) 2.5: Sheet 4F (Zone 3-C and 4-C)

1.3.3 Quantity (One Lot), After (AFT) VCHT Piping located in 1.2.2, between Frames 350 and 352, Longitudinal No(s). L11(P) and L12(P).

Size: 2 Inch IPS (2.375 Inch OD x 0.083 Inch WT) Material: Copper Nickel Alloy, Class 200 Specification: MIL-T-16420

JCN: CM01-0203

Remarks: See followings for detail.

2.4: Sheet 4A (Zone 8-G) 2.6: Sheet 4A (Zone 4-F and 4-G)

FOUO

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

1.3.4 Quantity (One Lot), AFT VCHT Piping located in 1.2.3 and 1.2.4, between Frames 307 and 311, Longitudinal No. L1(P) and Center Line.

Size: 2 Inch IPS (2.375 Inch OD x 0.083 Inch WT) Material: Copper Nickel Alloy, Class 200 Specification: MIL-T-16420

JCN: EA01-1657

Remarks: See followings for detail.

2.4: Sheet 3B (Zone 7-E) 2.7: Sheet 4A (Zone 7-E) and Sheet 4C (Zone 3-G and 4-G)

1.4 Security Classification: None.

1.5 Initial Condition: None.

1.6 Contractor work start date:

1.7 Contractor work complication 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 DWG 512-

7061973

INSTL OF HVAC DESIGN ZONE

- Y 2

4 DWG 593-

7060037

VACUUM SEWAGE SYSTEM

PIPING DIAGRAM

E Y 3B 4A

5 DWG 528-

7061785

PLUMBING DRAINS ZONE 1420 - Y 4F

6 DWG 528-

7061999

PLUMBING DRAINS, ZONE 3230 - Y 4A

7 DWG 528-

7061970

PLUMBING DRAINS, ZONE 3120 - Y 4A

4C

8 MIL MIL-

STD-1627

Bending of Pipe or Tube for Ship Piping Systems

C N

9 TM T9074-

AS-GIB-

010/271

Requirements for Nondestructive Testing Methods

1 N

10 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.

Masato.Endo.ja Typewritten Text

14 JUL 2025

Masato.Endo.ja Typewritten Text

11 DEC 2025

Masato.Endo.ja Cross-Out

Masato.Endo.ja Typewritten Text

12/20/2024 C-1209 M. ENDO 11030028

FOUO

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

5. PROCEDURE:

5.1 Remove each existing vent duct listed in 1.3.1, using 2.3 for guidance.

5.2 Remove existing, fabricate, and install new each VCHT piping listed in 1.3.2 through 1.3.4, using 2.4 through

2.7 for guidance.

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

5.2.2 Bend each new pipe in accordance with 2.8.

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

5.2.4 Accomplish the requirements of 009-71 of 2.1 for hydrostatic test, using clean, fresh water at 68 PSIG, for each new and disturbed VCHT piping systems listed in 1.3.2 through 1.3.4.

5.2.4.1 Document shop hydrostatic test results on QA Form 28 Enclosure-01-1 through Enclosure-01-3.

5.2.5 Accomplish liquid penetrant test on final layer of each onboard weld joint for Class P-2 VCHT piping listed in

1.3.2 through 1.3.4 in accordance with Chapter 5 of 2.9. The accept or reject criteria must be in accordance with Class 2 of 2.10. See Note 5.5.2.

(I)(G) “NDT INSPECTION”

5.3 Reinstall each vent duct listed in 1.3.1, using 2.3 for guidance.

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

5.5 Notes:

5.5.1 Planner: Code 234 Y. Kawashima, 090-9323-5312

Planner: Code 231A T. Kawakami, 243-7064 Planner: Code 233 H. Sasano, 080-9350-1453

5.5.2 Non-destructive testing (NDT) inspection for onboard weld joint of VCHT piping listed in 1.3.2 through 1.3.4 is directed by C240 per Memorandum Ser 240/008 dated on 2 OCT 24.

5.5.2.1 Operational test for VCHT piping (Portions under vacuum) in accordance with Memorandum Ser 240/008 dated on 2 OCT 24 will be covered by T-phase.

5.5.3 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.

5.5.4 Work Integration Manager (WIM) C-333 T. Yaginuma, 080-5419-0598

5.5.5 JCNs CM01-0203, EA01-1657, and ER01-0294 are related to this TGI.

5.6 Government Furnished Material (GFM):

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

FOUO

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

5.7 SRF-JRMC will provide the following service work: (TGI No.: 38K5259310 S02)

5.7.1 [C740] Provide crane and crane rigging service.

5.7.2 [X99E] Utility service, electrical.

5.7.3 [X99M] Utility service, including low pressure air supply, water supply, and steam supply.

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

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

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

5.7.7 [C135] 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:

VARIOUS VCHT PP AY A 0 0

CU PHASE TITLE:

*F/O - ACCOMPLISH REPLACEMENT OF VARIOUS VCHT PIPING

PRIMARY COMPONENT:

COMPONENT UNIT LIST (FOR ASSEMBLIES):

SEW 3-350-2-L PP SEW 5-300-01-E PP SEW 4-110-0-E PP VNT ES 01-248-1 DT SEW 4-

300-0-E PP

ATTACHMENT LIST:

1. ENCLOSURE-01 (38K5259310A01-QA28.docx) saved on 27-NOV-2024 0000.

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

YAGINUMA ,TAKEHIDE

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

38K5259310 A01 833 $9,903.96 0

CU PHASE DESCRIPTION:

The purpose of this TGI is to accomplish replacement of various VCHT piping.

Location of Work:

Vacuum Collection Holding Tank Room No. One (4-110-0-E) Crew Living Space No. 7 (3-350-2-L) Air Conditioning Machinery and Pump Room (5-300-01-E) Vacuum Collection Holding Tank Room No. 2 (4-300-0-E)

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:

VARIOUS VCHT PP AY A 0 0

CU PHASE TITLE:

*F/O - ACCOMPLISH REPLACEMENT OF VARIOUS VCHT PIPING

MATERIAL REFERENCES

REF

NO.

DOCUMENT/DRAWING

NUMBER

DOCUMENT/DRAWING TITLE REV

JOB ORDER: KEY OP:

38K5259310 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 TUBE,METALLIC, TUBE, 2" IPS,

CNA 70-30

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

**PROVIDE ONE

CONTINUEOUS LENGTH 20 FT

FOR 1 EA, DO NOT PROVIDE

SEPARATELY.

9B 4710 002897994 NA 4 N 43325109 20/FT

002 M TUBE,MET, TUBE, 2" IPS, CNA

70-30

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

**PROVIDE ONE

CONTINUEOUS LENGTH 20 FT

FOR 1 EA, DO NOT PROVIDE

SEPARATELY.

9B 4710 002897994 NA 4 N 43325113 20/FT

003 M SLEEVE, CPLG, 2 IPS,

COUPLING, SLEEVE, 2" IPS,

CN 70-30, BW

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

9B 4730 LL4462301 NA 4 N 43347496 20/EA

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

004 M BACKING RING, 2 IPS,

BACKING RING, 2"IPS, CNA

70/30, 200PSIG

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

9B 4730 LL4558817 NA 4 N 43347497 20/EA

005 M ELBOW, 45D, BW, 2", ELBOW

45DEG, BUTT WELD, LONG

RADIUS,

SIZE: 2"IPS,

MATL: CU-NI 70/30,

PRESSURE: 200 PSI,

DWG: 810-1385880,

PREMIER COPPER P/N:

87104400, ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

9B 4730 LL4575188 NA 4 N 43347499 7/EA

006 M LATERAL, 2 IPS, CNA,

LATERAL, SIZE: 2 INCH IPS

SOCKET WELD, MATERIAL:

CU-NI 70-30 400PSI

ORDER FOR KTR, C234

Y.KAWASHIMA 234-2241

9B 4730 LL4706625 NA 4 N 43347498 1/EA

007 M ADAPTER, 2"IPS, ADAPTER,

MPT,

SIZE: 2"IPS, MALE THREAD X

FEMALE SOCKET WELDING,

MATL: CU-NI 70/30,

PRESSURE: 400PSI,

DWG: 803-6397430.

PREMIER COPPER P/N:

77160400.

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

9B 4730 LL4462282 NA 4 N 43347500 1/EA

008 M CAP,PIPE, SIZE: 2 INCH IPS,

CAP, PIPE THREAD,

MATERIAL: BRONZE

ORDER FOR KTR

C234 Y.KAWASHIMA 234-2241

9B 4730 002312403 NA 4 N 43325115 1/EA

101 M INSULATI, ACOUSTIC

INSULATION,

SPEC: MIL-DTL-32585 TYPE II

FORM 2 FACING D (FORMER:

MIL-I-22023 TYPE 3)

THK: 2",

SIZE: 24" X 36",

MATL: FIBER GLASS,

FACING: FACED WITH

POLYESTER FILM

REINFORCED WITH FIBROUS

GLASS SCRIM,

TUFFSKIN STYLE: 1613,

DO NOT CROSS NSN: 5640-01-

509-0809(SMIC: X3),

BIW CAT#: 47068-011,

9Q 5640 LL4808709 NA 4 N 43187515 1/SH

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

102 M INSULATI, ACOUSTIC

INSULATION,

SPEC: MIL-DTL-32585 TYPE 2

FORM 2 FACING D (FORMER:

MIL-I-22023 TYPE 3),

THK: 1",

SIZE: 24" X 36",

MATL: FIBER GLASS,

FACING: FACED WITH

POLYESTER FILM

REINFORCED WITH FIBROUS

GLASS SCRIM,

TUFFSKIN STYLE: 1613,

BIW CAT#: 47068-002,

9Q 5640 LL4808710 NA 4 N 43187514 1/SH

103 M SOUND CONTROLLING F,

ORDERED FOR KTR

ORIG: C231A T. KAWAKAMI,

PHONE: 243-7064

9B 5640 012965989 NA 4 N 43185057 1/RO

104 M INSULATION,THERMAL,

ORDERED FOR KTR

ORIG: C231A T. KAWAKAMI,

PHONE: 243-7064

9B 5640 016493959 NA 4 N 43185060 1/SH

105 M SOUND CO, ORDERED FOR

KTR

ORIG: C231A T. KAWAKAMI,

PHONE: 243-7064

9Q 5640 013715238 NA 4 N 43185061 1/SH

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 VARIOUS VCHT PP AY A 0

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

38K5259310 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 VARIOUS VCHT PP AY A 0

COMUSFLTFORCOMINST 4790.3 REV D CHG 3

07 Nov 2023

SHOP TEST RECORD Page 1 of 1

QA FORM 28 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/ROTATABLE POOL SER NO.

USS RALPH JOHNSON DDG114 ER01-0294 KTR N/A VCHT SYSTEM PIPING

6. REFERENCES: TEST REF (E.G., MS, TECH MAN) & OTHER REFS (E.G., VLV DWG) 7. TEST GAGE RANGE /INSTRUMENT USED SERIAL NO. CAL DUE DATE 8. RELIEF VLV SET POINT

A. S9086-RK-STM-010/CH-505 Rev. 6

B. DWG 593-7060037 Rev. E

C.

D.

9. TEST REQUIREMENTS & RESULTS

TEST TYPE KEY H = STRENGTH AND POROSITY/ELEVATED PRESSURE TEST J = MECHANICAL JOINT TIGHTNESS ST = SEAT TIGHTNESS OP = OPERATIONAL O = OTHER

(SPECIFY): ______________________

TE

ST

T Y

PE

(S

EE

K

EY

) PARAGRAPH

DESCRIBING

VALVE POSITION

AND POINT OF

ENTRY

REF

LTR

GAGE

USED

(LTR

FROM

BLK 7)

REQUIRED

MEDIUM

USED

PRESSURE

ACTUAL

MINIMUM

DURATION

ALLOWED

LEAKAGE

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.2.4 (For 1.3.2) A, B Clean Fresh Water 68 PSIG 30 minutes None

10. REMARKS. (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA)

11. QA INSPECTOR/SHOP SUPERVISOR SIGNATURE/BADGE NO. (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

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

COMPLETENESS)

DATE

38K5259310A01 ENCLOSURE-01-1 TOTAL 3

SHOP TEST RECORD Page 1 of 1

QA FORM 28 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/ROTATABLE POOL SER NO.

USS RALPH JOHNSON DDG114 CM01-0203 KTR N/A VCHT SYSTEM PIPING

6. REFERENCES: TEST REF (E.G., MS, TECH MAN) & OTHER REFS (E.G., VLV DWG) 7. TEST GAGE RANGE /INSTRUMENT USED SERIAL NO. CAL DUE DATE 8. RELIEF VLV SET POINT

A. S9086-RK-STM-010/CH-505 Rev. 6

B. DWG 593-7060037 Rev. E

C.

D.

9. TEST REQUIREMENTS & RESULTS

TEST TYPE KEY H = STRENGTH AND POROSITY/ELEVATED PRESSURE TEST J = MECHANICAL JOINT TIGHTNESS ST = SEAT TIGHTNESS OP = OPERATIONAL O = OTHER

(SPECIFY): ______________________

TE

ST

T

K

EY

) PARAGRAPH

DESCRIBING

VALVE POSITION

GAGE

USED

(LTR

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.2.4 (For 1.3.3) A, B Clean Fresh Water 68 PSIG 30 minutes None

10. REMARKS. (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA)

11. QA INSPECTOR/SHOP SUPERVISOR SIGNATURE/BADGE NO. (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

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

COMPLETENESS)

38K5259310A01 ENCLOSURE-01-2 TOTAL 3

SHOP TEST RECORD Page 1 of 1

QA FORM 28 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/ROTATABLE POOL SER NO.

USS RALPH JOHNSON DDG114 EA01-1657 KTR N/A VCHT SYSTEM PIPING

6. REFERENCES: TEST REF (E.G., MS, TECH MAN) & OTHER REFS (E.G., VLV DWG) 7. TEST GAGE RANGE /INSTRUMENT USED SERIAL NO. CAL DUE DATE 8. RELIEF VLV SET POINT

A. S9086-RK-STM-010/CH-505 Rev. 6

B. DWG 593-7060037 Rev. E

C.

D.

9. TEST REQUIREMENTS & RESULTS

TEST TYPE KEY H = STRENGTH AND POROSITY/ELEVATED PRESSURE TEST J = MECHANICAL JOINT TIGHTNESS ST = SEAT TIGHTNESS OP = OPERATIONAL O = OTHER

(SPECIFY): ______________________

TE

ST

T

K

EY

) PARAGRAPH

DESCRIBING

VALVE POSITION

GAGE

USED

(LTR

ACTUAL

LEAKAGE SAT/UNSAT SIGNATURE, BADGE NO. & DATE

H 5.2.4 (For 1.3.4) A, B Clean Fresh Water 68 PSIG 30 minutes None

10. REMARKS. (CRAFTSMAN/QAI SUBMIT A DF TO RESOLVE UNSAT DATA)

11. QA INSPECTOR/SHOP SUPERVISOR SIGNATURE/BADGE NO. (RECORD

REVIEWED FOR FINAL ACCEPTANCE)

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

COMPLETENESS)

38K5259310A01 ENCLOSURE-01-3 TOTAL 3