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Form Approved

OMB No. 0704-0188

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Je erson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting O icer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.
0001

B. EXHIBIT

TDP ☐
E. CONTRACT/PR NO.

D. SYSTEM/ITEM

4T-1355-01-620-4752-CWRT

1. DATA ITEM NO.
A001

C. CATEGORY:

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE GROUP

Test Procedure

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

DI-NDTI-80603A

7. DD 250 REQ

TM ☐

OTHER ☐

F. CONTRACTOR

9. DIST STATEMENT

REQUIRED

DD

6. REQUIREING OFFICE

ALL DRAWINGS

10. FREQUENCY

12. DATA OF FIRST

SUBMISSION

18. ESTIMATED TOTAL

PRICE

NUWC NEWPORT

14.

DISTRIBUTION

ONE TIME

D

8. ADP CODE

11. AS OF DATE

30 DAC

13. DATE OF SUBSEQUENT

SUBMISSION

A

16.REMARKS

THE PLAN IS TO SPECIFY PROCESS CONTROL INSTRUCTIONS AND INSPECTION PROCEDURES NEEDED TO ENSURE PRODUCT CONFORMANCE TO DRAWINGS, SPECIFICATIONS, AND CONTRACT REQUIREMENTS IAW ANSI/ASQC Q90002000 OR EQUIVALENT. THE PLAN IS TO INCLUDE FIRST ARTICLE AND PRODUCTION LOT QUALITY CONFORMANCE INSPECTION PROCEDURES IAW DI-NDTI-80603A ALONG WITH ALL APPLICABLE DATA ENTRY SHEETS TO BE USED TO

DOCUMENT PROCESS

INSPECTIONS.

BLK 14: DISTRIBUTION ADDRESS

1.
NAVSUP Weapon Systems Support
2.
NAVSUP Ammunition Logistics Center
3.
Naval Surface Warfare Center

POC INFORMATION: SEE SEC H

b. COPIES

a. ADDRESSEE

Draft

SEE BLOCK 16

Final
Reg

Repro

15. TOTAL

G. PREPARED BY

H. DATE

I. APPROVED BY

Richard Rzomp

5/15/2024

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED.

J. DATE

LCDR Hardman

5/15/2024

Page

o
f

Pages

Form Approved

OMB No. 0704-0188

CONTRACT DATA REQUIREMENTS LIST

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