VIR - Vendor Information Request.pdf

TAHEF-Form-No. 008 Rev B

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

TAHE FACILITY QUALITY PROVISIONS

RECEIPT INSPECTION REPORT

PART NUMBER

1210D1133 1210C1132

PART NOMENCLATURE

OK-410 Winch Safety Rails: Elbow Handrail and Tee Handrail

DRAWING NUMBER

1210D1133_54497_FN_E_

1210C1132_54497_FN_D_

REV

E D

SOURCE:

S/N:

N/A

PURCHASE ORDER:

PURCHASE REQUEST:

WORK ORDER:

W05115

STATEMENT OF WORK SALES ORDER:

FUTURE BUILDS

QTY RECEIVED:

UNIT THE ORDER IS FOR:

OK-410

ORDER IS FOR INVENTORY:

PURCHASE

New Manufacture

OUTSIDE SERVICE

CHARACTERISTIC MEASURED / VERIFIED DISPOSITION-REMARKS

THE FOLLOWING QUALITY DOCUMENTATION /

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 1210D1133, QTY: 6

P/N: 1210C1132, QTY: 6

Certificate of Compliance: that items were manufactured in accordance with all applicable instructions and specifications.

Required

(A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work order. ROHS is not an acceptable substitute.

(A002)

Certificate of Analysis of raw material stating that it meets the specifications identified.

Required – Material certifications required for ASTM B26, alloy A356, Temper T6 or alternate alloy permanent mold casting per B108, Alloy 356, Temper T61.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition.

Not Required

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Not Required

Process Certification: that items were manufactured in accordance with special processes identified.

Required (A005)

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

SSPC_SP-

10_1.1.2007

T9074-AS-

GIB-010-271_REV-

1_MIL-

271_09_11_2014

10/3/2023

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

TT-P-1757B_1997-

05-15

VENDOR DO NOT WRITE BELOW. FOR TAHEF QA ONLY.

TOTAL ACCEPTED

TOTAL REJECTED

INSPECTOR

DATE

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

1214C1134

PART NOMENCLATURE

OK-410 Winch Safety Rails: Support Upright Handrail

DRAWING NUMBER

1214C1134_54497_FN_F_

F

STATEMENT OF WORK:

N/A

SALES ORDER:

New Manufacture w/ Welding

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 1214C1134, QTY: 6

Certificate of Compliance: that items were manufactured in accordance with all applicable instructions and specifications.

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required - Weld filler must be per approved WPS and material certifications must be provided.

Required Raw material sourced for this work order must be certified IAW AISI 1018 or 1020 steel for 1214C1134- D1/D3.

Raw material sourced for this work order must be certified IAW Round Tube AISI 1020 or 1026 steel for 1214C1134-D2.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition, with exception of welding rods.

Required

(A004)

Process Certification that items were manufactured in accordance with special processes identified.

Required -- Provided vendor documentation shall reference applicable Weld Procedure Specification (WPS) for each weld joint and must be done IAW MIL-STD-278E Class M2.WPS/PQR must be on file prior to welding.

(A005)

Test Data: to be provided. Required - Provide NDT report. Report shall identify specific weld pass/fail and associated remarks (if required). Ensure report includes certified inspector’s name and NDT date.

(A006)

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be

10/3/2023

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required - Package to protect part features during shipping and handling.

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

1_MIL-

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

1210B1153 (-2,-4,-7,-8) 1210B1151

OK-410 Winch Safety Rails: Hand Rail Plug and Hand Rail Tubing

DRAWING NUMBER

1210B1153_54497_FN_F_

1210B1151__54497_FN_C

REV

F C

STATEMENT OF WORK:

SALES ORDER:

Ok-410

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 1210B1151, QTY: 2

P/N: 1210B1153-2, QTY: 2

P/N: 1210B1153-4, QTY: 2

P/N: 1210B1153-7, QTY: 1

P/N: 1210B1153-8, QTY: 1

Certificate of Compliance: that items were manufactured in

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required – Material certifications must conform to Fire Retardent Glass Reinforced Plastic Laminated Round Rod or tubing, Grade 1 per MIL-R-21607.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition, with exception of welding rods.

Process Certification that items were manufactured in

Not Required

Test Data: to be provided. Not Required Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Not Required

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

10/3/2023

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

1_MIL-

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

MS171662

MS35307-420

MS17830-8C

OK-410 Winch Safety Rails: Pin, Screw and Nut.

COTS/OEM

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: MS171662, QTY: 60

P/N: MS35307-420, QTY: 12

P/N: MS17830-8C, QTY: 12

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work

Note: These are COTS items that will be used to join the safety rail assembly.

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

1_MIL-

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

1210B4005 (-1, -2, -3, -4)

OK-410 Winch Safety Rails: Tubing Handrail

DRAWING NUMBER

1210B4005_54497_FN_B_

REV

B

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 1210B4005-1, QTY: 4

P/N: 1210B4005-2, QTY: 4

P/N: 1210B4005-3, QTY: 2

P/N: 1210B4005-4, QTY: 2

Certificate of Compliance: that items were manufactured in accordance with all applicable instructions and specifications.

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required – Material certifications conform to QQ-A- 200/8 Round Mechanical Tubing Al Alloy 6061-T6511 (A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition, with exception of welding rods.

Not Required

Test Data: to be provided. Not Required Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Not Required

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

1_MIL-

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

10/3/2023

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

12141135-3 and 12141135-4

PART NOMENCLATURE

OK-410 Safety Rail Assembly

DRAWING NUMBER

1214D1135_54497_FN_L_

REV

L

Future Builds

Prime/Paint

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 12141135-3; QTY: 1

P/N: 12141135-4; QTY: 2

Required Assemble all parts as shown and match drill thru, install pin, find no. 9, 2 places, IAW Note 3.

(A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work accordance with special processes identified.

Required- Treat and paint items except for 1214C1134 after assembly IAW STD 0985A0160.

Follow protocols in notes 1 & 2 pertaining to application of adhesive.

(A005)

Product Identification: identification must appear on external surfaces of items or packages. Parts must be returned with associated tags. (Military specifications will be provided upon request) Parts must be returned with associated tags.

Required Identify per Method P of STD 281-002, color:

BLACK, IAW Note 4 after painting.

Inspection: to be performed by TAHEF personnel prior to delivery

Not Required

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

T9074-AS-GIB-010-

271_REV-1_MIL-

271_09_11_2014

10/3/2023

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

8293662 (-1, -2, -3, -4, -5, -12, -13, -14, -15, -16, -17)

PART NOMENCLATURE

OK-410 Protective Screen

DRAWING NUMBER

8293662_53711_FN_F_

STATEMENT OF WORK SALES ORDER:

New Manufacture/w. Welding

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 8293662-1, QTY: 4

P/N: 8293662-2, QTY: 4

P/N: 8293662-3, QTY: 4

P/N: 8293662-4, QTY: 2

P/N: 8293662-5, QTY: 2

P/N: 8293662-12, QTY: 1

P/N: 8293662-13, QTY: 1

P/N: 8293662-14, QTY: 1

P/N: 8293662-15, QTY: 1

P/N: 8293662-16, QTY: 1

P/N: 8293662-17, QTY: 2

supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required - Weld filler must be per approved WPS and material certifications must be provided.

Required – Material certifications required for Carbon Steel, ASTM A 500. Material Certifications also required for ASTM A 6/A.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition.

Required

(A004)

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be

Process Certification: that items were manufactured in

Required -- WPS/PQR must be on file prior to welding.

10/3/2023

Required– After welding, IAW sheet 2 of 10, Treat and Paint all parts IAW STD 0985A0160 with the exception of the lower portion designated via item 1 (Ø1.94).

(A005)

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

8293662(-6,-7, -8, -9, -10, -11)

OK-410 Protective Screen

DRAWING NUMBER

8293662_53711_FN_F_

STATEMENT OF WORK SALES ORDER:

New Manufacture/w. Welding

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 8293662-6, QTY: 2

P/N: 8293662-7, QTY: 2

P/N: 8293662-8, QTY: 1

P/N: 8293662-9, QTY: 1

P/N: 8293662-10, QTY: 2

P/N: 8293662-11, QTY: 2

Certificate of Compliance: that items were manufactured in supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required - Weld filler must be per approved WPS and material certifications must be provided.

Required – Material certifications required for AL 6061 Aluminum IAW ASTM B308. Material certifications required for Polycarbonate IAW DL A-A-59502.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition.

Not Required

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Required .

Process Certification: that items were manufactured in accordance with special processes identified.

Required -- WPS/PQR must be on file prior to welding of Al 6061.

Required – After welding Window Screen Frames

10/3/2023

8293662-6, Item 6, 8293662-8, Item 8, and 8293662-10, Item 10, Treat and Paint all parts IAW

STD 0985A0160.

Do not paint Window Screens 8293662-7, Item 7, 8293662-9, Item 9, and 8293662-11, Item 11.

(A005)

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

NASM 35307-413

NASM 17830-8C

NASM 15795-817

NASM 35307-364

NASM 17830-6C

NASM 15795-814

NASM 1515E6H

MS 15795-803

MS 51957-13

PART NOMENCLATURE

OK-410 Protective Screen

COTS/OEM

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: NASM35307-413, QTY: 20

P/N: NASM 17830-8C, QTY: 20

P/N: NASM 15795-817, QTY: 40

P/N: NASM 35307-364, QTY: 92

P/N: NASM 17830-6C, QTY: 92

P/N: NASM 15795-814, QTY: 184

P/N: NAS 1515E6H, QTY: 184

P/N: MS15795-803, QTY: 4

P/N: MS51957-13, QTY: 4

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work

Note: These are COTS items that will be used to join the safety rail assembly.

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

10/3/2023

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

1_MIL-

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

8293697

OK-410 Protective Screen ID Plate

DRAWING NUMBER

8293697_53711_FN_B_D14-035

B

STATEMENT OF WORK SALES ORDER:

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 8293697, QTY: 1

Certificate of Compliance: that items were manufactured in supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work specifications identified.

Required – Plate material must conform to QQ-A-250/8 Aluminum Alloy 5052-H34.

(A003)

Domestically Sourced Material: all raw material must be sourced domestically or from a qualified country per DFARS Part 225: Foreign Acquisition.

Not Required

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Required

Process Certification: that items were manufactured in accordance with special processes identified.

Required – Plate must conform to MIL-P-15024 Type H Style III (Aluminum anodized with photosensitive silver compounds embedded with black letters IAW Note 7). Plate must also be adhesively backed with 3M 467MP High Performance Adhesive Transfer Tape.

(A005)

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

10/3/2023

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21

10/3/2023

TAHE FACILITY

NUWC, BLDG. 6

NEWPORT, RI 02841

8293662

OK-410 Protective Screen Assembly

DRAWING NUMBER

8293662_53711_FN_F

STATEMENT OF WORK SALES ORDER:

INFORMATION / INSTRUCTIONS MUST BE

PROVIDED / ADHERED TO:

P/N: 8293662, QTY: 1

Certificate of Compliance: that items were manufactured in accordance with all applicable instructions and specifications.

Required (A001)

Mercury Free Statement: A signed document from the supplying vendor certifying that mercury and mercury containing compounds were not intentionally added to nor came in contact with hardware or supplies furnished under this work

Product Identification: identification must appear on external surfaces of items or packages. (Military specifications will be provided upon request).

Required

Process Certification: that items were manufactured in accordance with special processes identified.

Required - Assemble all parts IAW sheet 10 of 10, except do not install Identification Plate, Item 25, or mounting hardware, Items 26 & 27. These items should ship with the assembly.

(A005)

Special Packaging Requirements: protect parts to prevent damage during handling and transportation.

Required

GFI: DOCUMENTATION PROVIDED

281-

002_54497_FN_H

1210B1153_54497_

FN_F_

1210B4005_54497_

FN_B_

1210C1132_54497_

FN_D_

1210D1133_54497_

FN_E_

1214C1134_54497_

FN_F_

1214D1135_54497_

FN_L_

8293662_53711_FN

_F_

8293697_53711_FN

_B_D14-035

S9074-AQ-GIB-010-

248_1995-08-01

S9074-AR-GIB-010-

278_1995.08.01

S9074-AR-GIB-010-

278_CHG-A_2013-

02-14 (MIL-STD-

278)

MIL-R-

21607E(SH)_1990-

05-25

271_09_11_2014

TAHEF-Form-No.

105 REV_-

VIR_W05115 0985A0160_54497_

TS_U_

AWS A2.4-

2020_2020-01-09

MIL-R-

21607E(SH)_1990-

05-25

MIL-STD-

22D_with_Notice- 3_1991-03-21