Attachment_0010_MEO_C4659D.pdf

C4659, Rev D

COMPONENT DATA FORM (AMSAM-MMC Form 723)

All Depot Maintenance Work Requirements (DMWRs) as listed below.

AGEN X DAA

C30704

Components Data Form, AMSAM-MMC Form 723, has replaced PSA Data Form. Rev A: To remove engine & engine component DMWRs, which will retain original forms, specific to engines data. Rev B added "if applicable" to 2410 req't.

RON WALTERICK HUMBERTO HERNANDEZ, JR. CLAYTON D. VANCE

This AED applies to all DMWRs except those that do not have a PSA Check List or PSA Data form.

Change paragraph on PSA Data Form (usually found in paragraph 3.7 of most DMWRs except for those written in Work Package format) as follows:

COMPONENT DATA FORM. A Component Data Form (AMSAM-MMC Form 723, 1 July 06) will be completed for each assembly overhauled. In completing the data form, provide a qualifying statement encompassing the location and degree of each discrepancy, defect, or failure observed. Copies of the Component Data Form and if applicable, DA Form 2410 will be forwarded to the following organization for each unit processed:

U.S. Army Aviation and Missile Command Maintenance Information Operations Branch

ATTN: AMSAM-MMC-MA-NM

Redstone Arsenal, AL 35898-5000

As an alternative to the hard copy Component Data Form an electronic Preshop Analysis Form is available at https://tammsa.redstone.army.mil

Delete Table with Preshop Analysis Checklist or PSA Data Form found in DMWRs listed below and replace it with the Component Data Form found on pages 3 and 4 of this MEO.

4Oct 23 2007

YES

NO

lll lll lll lll lll l

Tolerances are:

2 4

Affected DMWRs:

DMWR 1-1560-285, 286, 287, 298, 290, 291, 293, 294, 295, and 300, DMWR 1-1615-279, 280, 281, 282, 285, 287, 288, 294, 297, 299, 302, 312, 314, 315, 336, 365, 370, 371, 372, 373, 374, 376, 377, and 381, DMWR 1-1620-243, 244, 245, 247, and 248, DMWR 1-1650-358, 375, 376, 377, 378, 381, 382, 384, 385, 394, 410 and 418, DMWR 1-1660-246, and 251.

DMWR 1-1680-324, 327, 331, 332, 336, 337, 349,

DMWR 1-2910-203,

DMWR 1-2915-238, 347, 351, and 359, DMWR 1-2995-239, DMWR 1-3010-204, DMWR 1-4030-200, DMWR 1-4140-226, 228

DMWR 1-4320-271 and 285, DMWR 1-4810-216, 217, 221, 223 and 228, DMWR 1-5930-216, DMWR 1-5945-212 and 213, DMWR 1-6115-504 and 513, DMWR 1-6220-214, DMWR 1-6340-207, DMWR 1-6620-213, DMWR 55-1560-302, DMWR 55-1615-275, 279, 286, 296, 297, 301, 302, 316, 317, 321, 322, 323, 324, 325, and 327, DMWR 55-1620-208, 224, and 225, DMWR 55-1650-153, 154, 166, 302, 384, 395, 396, 397, 398, 399, 400, 403, 404, 405, 407, 411, 412, and 414, DMWR 55-1680-133, 225, 288, 289, 335, 341, 350, and 351, DMWR 55-2995-108, DMWR 55-4140-220, 221, 223, and 225, DMWR 55-4320-278, DMWR 55-4810-215, DMWR 55-6625-729.

lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll lll l

3 4

1. NOUN 2. PART NO. 3. SERIAL NO. 4. SEQUENCE 5. DATE

8. O/H 9. TSN 10. TSO

14. FAILED P/N

14A. FAILED P/N

14B. FAILED P/N

14C. FAILED P/N

14D. FAILED P/N

14E. FAILED P/N

14F. FAILED P/N

AMSAM-MMC Form 723, 1 Jul 06

15F. CONDITION/DISCREPANCY

16. OTHER REMARKS

15B. CONDITION/DISCREPANCY

15C. CONDITION/DISCREPANCY

15D. CONDITION/DISCREPANCY

15E. CONDITION/DISCREPANCY

COMPONENT DATA FORM

6. PREPARED BY

11. DESCRIPTION OF ACTUAL COMPONENT FAILURE(S)

7. CUSTOMER'S REASON FOR RETURN

12. PRIMARY CAUSE OF FAILURE

13. SECONDARY FAILURE(S)

15. CONDITION/DISCREPANCY

15A. CONDITION/DISCREPANCY

4 4

1. NOUN - Nomenclature for component being inducted.

2. PART NO. - Part number of component being inducted.

3. SERIAL NO. - Serial number of component being inducted.

4. SEQUENCE - Sequence number is the identification code for processed items.

5. DATE - Date that the component was inducted.

6. PREPARED BY - Name of person that prepared this form.

7. CUSTOMER'S REASON FOR RETURN - Stated reason for return per field tag or other documentation.

8. O/H - Number of previous overhauls, if known.

9. TSN - Time since component was new, if known.

10. TSO - Time since last overhaul, if applicable.

11. DESCRIPTION OF COMPONENT FAILURE(S) - Description of specific actual failure mode(s) for the component as observed during the overhaul process. The actual reason(s) the unit was returned for maintenance. This data will not necessary match the data for box 7 since a more detailed analysis can be performed as the component is disassembled for overhaul.

12. PRIMARY CAUSE OF FAILURE - Determination of the primary cause of failure.

13. SECONDARY FAILURE(S) - Description of damage that may have occurred as a result of primary failure.

14. FAILED P/N - Part Number for each failed or nonconforming part. Additional boxes (14 A-F) are available for each failed or nonconforming part found during the inspection process.

15. CONDITION / DISCREPANCY - Condition of and/or discrepancies for each failed or nonconforming part as discovered during the overhaul inspection process. Additional boxes (15 A-F) are available for each failed or nonconforming part found during the inspection process.

16. OTHER REMARKS - Other comments related to the particular unit not covered elsewhere.

A copy of this Component Data Form will be forwarded to the following address for each unit processed:

U.S. Army Aviation and Missile Command Maintenance Information Operations Branch

ATTN: AMSAM-MMC-MA-NM

Redstone Arsenal, AL 35898-5000

Reverse of AMSAM-MMC Form 723, 1 Jul 06

INSTRUCTIONS FOR COMPONENT DATA FORM

As an alternative to the hard copy Component Data Form an electronic Preshop Analysis Form is available at https://tammsa.redstone.army.mil

The component data form shall be completed for each unit processed. Fill in each box with the required data as applicable. Boxes for which data is not applicable or not available may be marked with "N/A."