W91QVN22R0137_Exhibit B- Form B. DA Form 2407.pdf

2 MB Posted

Attached to
Tactical Wheeled Vehicle (TWV) Maintenance, Amendment 0003
Solicitation number
W91QVN-22-R-0137
Issued by

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Other files

File Type Posted
W91QVN22R0137-0003_Amendment 0003.pdf PDF
W91QVN22R0137-0002 Amendment 0002.pdf PDF
B08 W91QVN22R0137_Exhibit D - Site Information and Manpower.xlsx XLSX spreadsheet
W91QVN22R0137-0001_Amendment 0001.pdf PDF
W91QVN22R0137_Exhibit C - Historical data.xlsx XLSX spreadsheet
W91QVN22R0137_Exhibit B-Form C. DA Form 5988e.pdf PDF
W91QVN22R0137_Exhibit B- Form A. DA Form 2404.pdf PDF
W91QVN22R0137_Exhibit D - Site Information.xlsx XLSX spreadsheet
W91QVN22R0137_Attachment 1-ELINs List for TWV Maintenance.xlsx XLSX spreadsheet
W91QVN22R0137_Solicitation.pdf PDF

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MAINTENANCE REQUEST

For use of this form, see DA PAM 738-750 and 738-751;

the proponent agency is DCSLOG

PAGE NO. NO OF PAGES REQUIREMENT CONTROL SYMBOL

SECTION I - CUSTOMER DATA SECTION II - MAINTENANCE ACTIVITY DATA

1a. UIC CUSTOMER 1b. CUSTOMER UNIT NAME 1c. PHONE NO 3a. WORK ORDER NUMBER (WON) 3b. SHOP 3c. PHONE NO

2a. SAMS-2 UIC/SAMS-I/TDA 2b. UTILIZATION CODE 2c. MCSR 4a. UIC SUPPORT UNIT 4b. SUPPORT UNIT NAME

SECTION III - EQUIPMENT DATA

5. TYPE MNT

REQ CODE

6. ID 7. NSN 15a. FAILURE DETECTED DURING/WHEN DISCOVERED CODE (Enter code)

- See DA Pamphlet 738-750 and 738-751

15b. FIRST INDICATION OF TROUBLE/ HOW RECOGNIZED CODE (Enter Code) See DA Pamphlet 738-750 and 738-751

16. MILES/KILOMETERS/HOURS/ROUNDS

8. MODEL M K

9. NOUN

10a. ORG WON/DOC NO 10b. EIC H R

11 SERIAL NUMBER 12. QTY 13. PD 17. PROJECT CODE

(if assigned)

18. ACCOUNT PROCESSING

CODE

19. IN WARRANTY?

(enter Y or N)

20. ADMIN NO

14. MALFUNCTION DESCRIPTION (for DSU, GSU/AVIM, DEPOT use) 21. RE MBURSABLE CUSTOMER (if Intransit customer enter Y or N)

22. LEVEL OF WORK 23. SIGNATURE

24. DESCRIBE DEFICIENCIES OR SYMPTOMS ON THE BASIS OF COMPLETE CHECKOUT AND DIAGNOSTIC PROCEDURES IN EQUIPMENT TM (Do not prescribe repairs)

25. REMARKS

PREPARATION INSTRUCTIONS FOR THIS PAGE

SECTION I

Block 1a. Enter UIC of submitting organization.

Block 1b. Enter name of submitting organization.

Block 1c. Enter number to be called when maint. is completed.

Block 2a. Enter UIC of supporting SAMS-2/SAMS-I/TDA if work is requested while in transit and away from your support maintenance unit.

Block 2b. Enter utilization code. See DA Pamphlets 738-750 and 738-751.

Block 2c. Enter "Y" if reportable under AR 700-138. If not, leave blank.

SECTION II

Leave blank. To be completed by the support maintenance DSU/GSU/AVIM/DEPOT.

SECTION III

Block 5. Enter the Type Maintenance Request Code.

See DA Pamphlet 738-750 and 738-751.

Block 6. Enter ID associated with block 7. See DA Pamphlets 738-750 and 738-751.

Block 7. Enter the NSN or stock number of the item being submitted.

Block 8. Enter model of item being submitted.

Block 9. Enter noun/nomenclature of item being submitted.

Block 10a. Enter Work Order Number (WON)/DOC NO assigned when item is submitted. Otherwise, leave blank.

Block 10b. Enter End Item Code. See AMDF.

Block 11. Enter serial number of item being submitted.

SECTION III (Cont'd)

Block 12. Enter the quantity of items being submitted.

Block 13. Enter the maintenance priority designator determined from DA PAM 710-2-1.

Block 14. For DSU, GSU/AVIM, DEPOT use.

Block 15a. Enter the code that most accurately describes when the fault or deficiency was detected. See DA Pamphlets 738-750 and 738-751.

Block 15b. Select one. Enter the code. See DA Pamphlets 738-750 and 738-751.

Block 16. Enter the accumulated usage data in blocks, when equipment is subject to usage reporting.

Block 17. Enter the project code if one has been assigned. If not, leave blank.

Block 18. See DA Pamphlets 738-750 and 738-751.

Block 19. Enter "Y" or "N" to indicate whether equipment is still under manufacturer's warranty.

Block 20. Enter the admin number assigned for property control purposes for the equipment being submitted.

Block 21. For DSU/GSU/AVIM/Depot use.

Block 22. Enter level of work performed "O" for UNIT LEVEL/AVUM, "F" for DSU/AVIM, "H" for GSU, "D" for DEPOT, "K" for contractor or "L" for Spc Rpr Act.

Block 23. Enter the signature of the CO or the CO's designated representative when the priority designator is 01-10. For priority designators 11-15, leave blank.

Block 24. Enter a brief description of the deficiencies or symptoms that you feel require attention at this level of maint.

Block 25. Self-explanatory.

34a. SUBMITTED BY 35a. ACCEPTED BY 35c. DATE

34b. DATE 35b. STATUS 35d. TIME

Block 34a. Enter first initial and last name of submitter.

Block 34b. Enter ordinal date submitted (YYYY-MM-DD).

Block 35a. Enter first initial and last name of person accepting maint. request.

Block 35b. Enter the initial status. See DA Pamphlets 738-750 and

738-751.

Block 35c. Enter ordinal date accepted (YYYY-MM-DD).

Block 35d. Enter military time (format HH:MM)

DA FORM 2407, JUL 94 PREVIOUS EDITIONS OF DA FORM 2407 AND DA FORM 5504 ARE OBSOLETE RECEIPT COPY 1

CSGLD-1047(R1)

"FOR UMAINTENANCE ACTIVITY ONLY"

A

Reset FormPrint Form

High Priority Signature on Page 2

MAINTENANCE REQUEST

For use of this form, see DA PAM 738-750 and 738-751;

the proponent agency is DCSLOG

PAGE NO. NO OF PAGES REQUIREMENT CONTROL SYMBOL

CSGLD-1047(R1)

SECTION I - CUSTOMER DATA SECTION II - MAINTENANCE ACTIVITY DATA

1a. UIC CUSTOMER 1b. CUSTOMER UNIT NAME 1c. PHONE NO 3a. WORK ORDER NUMBER (WON) 3b. SHOP 3c. PHONE NO

2a. SAMS-2 UIC/SAMS-I/TDA 2b. UTILIZATION CODE 2c. MCSR 4a. UIC SUPPORT UNIT 4b. SUPPORT UNIT NAME

SECTION III - EQUIPMENT DATA

5. TYPE MNT

REQ CODE

6. ID 7. NSN 15a. FAILURE DETECTED DURING/WHEN DISCOVERED CODE (Enter code)

- See DA Pamphlet 738-750 and 738-751

15b. FIRST INDICATION OF TROUBLE/ HOW RECOGNIZED CODE (Enter Code) See DA Pamphlet 738-750 and 738-751

16. MILES/KILOMETERS/HOURS/ROUNDS

8. MODEL M K

9. NOUN

10a. ORG WON/DOC NO 10b. EIC H R

11 SERIAL NUMBER 12. QTY 13. PD 17. PROJECT CODE

(if assigned)

18. ACCOUNT PROCESSING

CODE

19. IN WARRANTY?

(enter Y or N)

20. ADMIN NO

14. MALFUNCTION DESCRIPTION (for DSU, GSU/AVIM, DEPOT use) 21. REIMBURSABLE CUSTOMER (if Intransit customer enter Y or N)

22. LEVEL OF WORK 23. SIGNATURE

24. DESCRIBE DEFICIENCIES OR SYMPTOMS ON THE BASIS OF COMPLETE CHECKOUT AND DIAGNOSTIC PROCEDURES IN EQUIPMENT TM (Do not prescribe repairs)

25. REMARKS

26. TECHNICAL REFERENCES

SECTION IV - TASK REQUIREMENTS DATA

27a. FILE

INPUT

ACT CD

27b.

TASK

NO

27c.

ACT

CODE

27 d. TASK DESCRIPTION 27e. QTY

TO BE RPR

27f. WORK

CENTER

27g.

FAILURE

CODE

27h. MH

PROJ

27i MH

EXP

SECTION V - PART REQUIREMENTS

28a. FILE

INPUT

ACT CD

28b.

TASK

NO

28c.

ID

NO

28d. NSN OR PART NUMBER 28e.

SFX

CD

28f.

QTY

RQD

28g.

QTY

ISSUED

28h.

NMCS

CD

28i.

FAILURE

CODE

28j. STORAGE

LOCATION

28k.

INITIALS

28l.

COST

28m. TOTAL MANHOURS 28n. TOTAL MANHOURS COSTS $ 28o. TOTAL PARTS COSTS$

SECTION VI - COMPLETION DATA

29. QTY RPR 30. QTY CONDEMN 31. QTY NRTS 32. EVAC WON 33. EVAC UNIT NAME

SECTION VII - ACTION SIGNATURES

34a. SUBMITTED BY 35a. ACCEPTED BY 35c. DATE 36a. WORK STARTED BY 37a. INSPECTION BY 38a. PICKED UP BY

34b. DATE 35b. STATUS 35d. TIME 36b. STATUS 36c. DATE 36d. TIME 37b. STATUS 37c. DATE 37d. TIME 38b. STATUS 38c. DATE 38d. TIME

DA FORM 2407, JUL 94 NMP COPY 2

BA

Reset FormPrint Form

CSGLD-1047(R1)

"FOR UMAINTENANCE ACTIVITY ONLY"

26 TECHNICAL REFERENCESRow1:
27a FILE INPUT ACT CDRow1:
27b TASK NORow1:
27c ACT CODERow1:
27 d TASK DESCRIPTIONRow1:
27e QTY TO BE RPRRow1:
27f WORK CENTERRow1:
27g FAILURE CODERow1:
27h MH PROJRow1:
27i MH EXPRow1:
27a FILE INPUT ACT CDRow2:
27b TASK NORow2:
27c ACT CODERow2:
27 d TASK DESCRIPTIONRow2:
27e QTY TO BE RPRRow2:
27f WORK CENTERRow2:
27g FAILURE CODERow2:
27h MH PROJRow2:
27i MH EXPRow2:
27a FILE INPUT ACT CDRow3:
27b TASK NORow3:
27c ACT CODERow3:
27 d TASK DESCRIPTIONRow3:
27e QTY TO BE RPRRow3:
27f WORK CENTERRow3:
27g FAILURE CODERow3:
27h MH PROJRow3:
27i MH EXPRow3:
27a FILE INPUT ACT CDRow4:
27b TASK NORow4:
27c ACT CODERow4:
27 d TASK DESCRIPTIONRow4:
27e QTY TO BE RPRRow4:
27f WORK CENTERRow4:
27g FAILURE CODERow4:
27h MH PROJRow4:
27i MH EXPRow4:
27a FILE INPUT ACT CDRow5:
27b TASK NORow5:
27c ACT CODERow5:
27 d TASK DESCRIPTIONRow5:
27e QTY TO BE RPRRow5:
27f WORK CENTERRow5:
27g FAILURE CODERow5:
27h MH PROJRow5:
27i MH EXPRow5:
27a FILE INPUT ACT CDRow6:
27b TASK NORow6:
27c ACT CODERow6:
27 d TASK DESCRIPTIONRow6:
27e QTY TO BE RPRRow6:
27f WORK CENTERRow6:
27g FAILURE CODERow6:
27h MH PROJRow6:
27i MH EXPRow6:
28a FILE INPUT ACT CDRow1:
28b TASK NORow1:
28c ID NORow1:
28d NSN OR PART NUMBERRow1:
28e SFX CDRow1:
28f QTY RQDRow1:
28g QTY ISSUEDRow1:
28h NMCS CDRow1:
28i FAILURE CODERow1:
28j STORAGE LOCATIONRow1:
28k INITIALSRow1:
28l COST Row1:
28a FILE INPUT ACT CDRow2:
28b TASK NORow2:
28c ID NORow2:
28d NSN OR PART NUMBERRow2:
28e SFX CDRow2:
28f QTY RQDRow2:
28g QTY ISSUEDRow2:
28h NMCS CDRow2:
28i FAILURE CODERow2:
28j STORAGE LOCATIONRow2:
28k INITIALSRow2:
28l COST Row2:
28a FILE INPUT ACT CDRow3:
28b TASK NORow3:
28c ID NORow3:
28d NSN OR PART NUMBERRow3:
28e SFX CDRow3:
28f QTY RQDRow3:
28g QTY ISSUEDRow3:
28h NMCS CDRow3:
28i FAILURE CODERow3:
28j STORAGE LOCATIONRow3:
28k INITIALSRow3:
28l COST Row3:
28a FILE INPUT ACT CDRow4:
28b TASK NORow4:
28c ID NORow4:
28d NSN OR PART NUMBERRow4:
28e SFX CDRow4:
28f QTY RQDRow4:
28g QTY ISSUEDRow4:
28h NMCS CDRow4:
28i FAILURE CODERow4:
28j STORAGE LOCATIONRow4:
28k INITIALSRow4:
28l COST Row4:
28a FILE INPUT ACT CDRow5:
28b TASK NORow5:
28c ID NORow5:
28d NSN OR PART NUMBERRow5:
28e SFX CDRow5:
28f QTY RQDRow5:
28g QTY ISSUEDRow5:
28h NMCS CDRow5:
28i FAILURE CODERow5:
28j STORAGE LOCATIONRow5:
28k INITIALSRow5:
28l COST Row5:
28a FILE INPUT ACT CDRow6:
28b TASK NORow6:
28c ID NORow6:
28d NSN OR PART NUMBERRow6:
28e SFX CDRow6:
28f QTY RQDRow6:
28g QTY ISSUEDRow6:
28h NMCS CDRow6:
28i FAILURE CODERow6:
28j STORAGE LOCATIONRow6:
28k INITIALSRow6:
28l COST Row6:
28m TOTAL MANHOURS:
28n TOTAL MANHOURS COSTS:
28o TOTAL PARTS COSTS:
29 QTY RPR:
30 QTY CONDEMN:
31 QTY NRTS:
32 EVAC WON:
33 EVAC UNIT NAME:
36a WORK STARTED BY:
37a INSPECTION BY:
36c DATE:
36d TIME:
37c DATE:
37d TIME:
38c DATE:
38d TIME:
PAGE NO: 2
NO OF PAGES: 2
1a UIC CUSTOMER:
1b CUSTOMER UNIT NAME:
1c PHONE NO:
3a WORK ORDER NUMBER WON:
3c PHONE NO:
2a SAMS2 UICSAMSITDA:
4b SUPPORT UNIT NAME:
7 NSN:
8 MODEL:
9 NOUN:
M:
K:
R:
H:
10a ORG WONDOC NO:
10b EIC:
11 SERIAL NUMBER:
12 QTY:
20 ADMIN NO:
14 MALFUNCTION DESCRIPTION for DSU GSUAVIM DEPOT use:
24 DESCRIBE DEFICIENCIES OR SYMPTOMS ON THE BASIS OF COMPLETE CHECKOUT AND DIAGNOSTIC PROCEDURES IN EQUIPMENT TM Do not prescribe repairsRow1:
25 REMARKSRow1:
Text2:
Text1: GSGLD-1047(R1)
Dropdown4: [F]
Dropdown8: [U]
LOW: [F - DIRECT SUPPORT/FIELD]
WAR: [Y]
APC:
PD: [13]
34a SUBMITTED BY:
34b DATE:
35a ACCEPTED BY:
35c DATE:
35d T ME:
4a UIC SUPPORT UNIT:
GSGLD-1047(R1): GSGLD-1047(R1)
Text6:
Text3:
Text8:
UTILIZATION CODE: [Q - Equipment assigned to service schools and training centers]
ID: [A]
FC: [D - Normal Operation]
TYPE MAINT: [1 - Rtn to user]
15b: [099 - Other]
SHOP: [B]
REIMB: [N]
Text11:
Text7: REV. 07/15
Text12: YYYY-MM-DD
Text14: HH:MM
MCSR: [N]
PC: [0D1 - Garrison]
PAGE #: 1
# OF PAGES: 2
Text18:
Text5: PREVIOUS EDITIONS OF DA FORM 2407 AND DA FORM 5504 ARE OBSOLETE
POC: POC NAME:
NAME:
PHONE #: PHONE #:
NUMBER:
BLD LOC: BLDG #/ROOM #:
BLD #:
EMAIL: EMAIL:
EMAIL ADDRESS:
FOR USE BY MAINTENANCE ACTIVITY ONLY:
Text9: 750-8
Text10: ; G4
Text4: Block 1a. Enter UIC of submitting organization.

Block 1b. Enter name of submitting organization.

Block 1c. Enter number to be called when maintenance is completed.

Block 2a. Enter UIC of supporting SAMS-2E/SAMS-IE if intransit.

Block 2b. Enter Utilization Code. See DA PAM 750-8, Appendix B.

Block 2c. Print the word“yes” or the letter “Y” if the item is reported under AR 700–138.

Text13: Block 5. Enter Type Maintenance Request Code. See DA PAM 750-8, Appendix B, Table B–20.

Block 6. Enter ID associated with Block 7. See DA PAM 750-8.

Block 7. Enter the NSN or appropriate number identified in block 6.

Block 8. Enter model number of item being submitted.

Block 9. Enter noun nomenclature of item.

Block 10a. Enter ORGWON or DOC NO. assigned when item is submitted. See DA PAM 750-8, Paragraph 3–6c.

Block 10b. Enter the end item code (EIC). See AMDF.

Block 11. Enter the serial number of the item in Block 9.

Text15: Block 12. Enter the number of items being submitted.

Block 13. Enter the Priority Designator. (See DA Pam 710–2–1).

Block 14. For DS, GS, AVIM, Depot Use.

Block 15a. Enter failure detected code. See DA PAM 750-8, Table B–3 or When Discovered Code from DA Pam 738–751.

Block 15b. Enter first indication of trouble code. See DA PAM 750-8, Table B–4 or DA PAM 738–751.

Block 16. Enter the miles or kilometers from the odometer when equipment is subject to usage reporting Block 17. Enter the project code if one has been assigned. If not, leave blank.

Block 18. Enter the Account Processing Code (APC) if required by your unit. if not leave blank. See TM 38-711-13.

Block 19. In Warranty? Enter“Y” or “N” to indicate whether equipment is still under manufacturer’s warranty. If “Y”, submit one work request for each serial numbered item.

Block 20. Enter the bumper number/material control number, or administrative number assigned to the item of equipment.

Block 21. For DSU/GSU/AVIM/ Depot use.

Block 22. Enter code for level of work from DA PAM 750-8, Table B–24.

Block 23. Enter the signature of commander or designated representative when the priority is 01 through 10 requests. For priority designators 11-15, leave blank.

Block 24. Enter a brief description of the deficiencies or symptoms that you feel require attention at this level of maintenance.

Block 25. Self-explanatory.

Text16: REIMBURSABLE CUSTOMER

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