APPENDIX 1
QA INSPECTION FORM - ENVIRONMENTAL READINGS & PAINT STORAGE
SHIP NAME & HULL #:
LOCATION:
(I):
DATE/TIME:
CONTRACT/TASK ORDER/CLIN/TWD:
PARA NO.
WORK ITEM:
(V):
(G):
REQ'T DOCUMENT:
PRODUCT BEING APPLIED.:
/FY:
TABLE:
LINE:
COLUMN:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE SECTIONS,
MAINTAIN A SEPARATE LOG FOR EACH SECTION.
NOTE #1 FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN IN THE COMMENTS BLOCK.
NOTE #2 UNLESS OTHERWISE STATED IN SPECIFICATION, SURFACE TEMPERATURE MUST BE A MINIMUM OF 50 DEG F AND AT LEAST 5 DEG F ABOVE DEW
POINT.
NOTE #3 ALL SPACES IN A SECTION ARE TO BE FILLED IN. IF NOT APPLICABLE, INSERT N/A. UNUSED SECTIONS SHALL BE CROSSED OUT AND MARKED N/A.
ACCEPT CRITERIA: ENV: % RH:
Date
Time
SURFACE TEMP: MIN:
MAX:
STORAGE TEMP: MIN:
Enter Activity/Process: Cleanliness Check, Surface Preparation, Prime Application, Prime Cure,
Substrate Dew
Stripe Application, Stripe Cure, Intermediate Application, Intermediate Cure, Tack Application, Top
Surface
Point
Coat Application, Top Coat Cure, etc.
Temp. (°F) (°F)
Gage #:
Gage Cal Due Date:
Gage #:
Gage Cal Due Date:
Condition of Reading SAT
MAX:
% RH
Dry Bulb
(Ambient
Temp) (°F)
Wet
Bulb
(°F)
UNSAT
Contractor (Signature):
Contractor (Print):
Comments:
Date
Time
Enter Activity/Process: Cleanliness Check, Surface Preparation, Prime Application, Prime Cure,
Substrate Dew
Stripe Application, Stripe Cure, Intermediate Application, Intermediate Cure, Tack Application, Top
Surface
Point
Coat Application, Top Coat Cure, etc.
Temp. (°F) (°F)
Gage #:
Gage Cal Due Date:
Gage #:
Gage Cal Due Date:
Condition of Reading SAT
% RH
Dry Bulb
(Ambient
Temp) (°F)
Wet
Bulb
(°F)
UNSAT
Contractor (Signature):
Contractor (Print):
Comments:
Date
Time
Enter Activity/Process: Cleanliness Check, Surface Preparation, Prime Application, Prime Cure,
Substrate Dew
Stripe Application, Stripe Cure, Intermediate Application, Intermediate Cure, Tack Application, Top
Surface
Point
Coat Application, Top Coat Cure, etc.
Temp. (°F) (°F)
Gage #:
Gage Cal Due Date:
Gage #:
Gage Cal Due Date:
Condition of Reading SAT
% RH
Dry Bulb
(Ambient
Temp) (°F)
Wet
Bulb
(°F)
UNSAT
Contractor (Signature):
Contractor (Print):
Comments:
Paint Storage
Date
Contractor (Print):
Time /
Time Range
Enter Product/Component & Prime, Stripe
Min. & Max. Temp for 24hr
Intermediate, Tack, Top Coat
Period Prior to Initiation of Application
--OR---OR-Storage Temp.
Core Temp. After
Manually Measured Component Mixed
Method of Measurement
Contractor (Signature):
Comments:
FY10 Version
APPENDIX 2
QA INSPECTION FORM - SSPC CLEANLINESS CHECKPOINT
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
WORK ITEM:
LOCATION:
(I):
(V):
(G):
REQ'T DOCUMENT:
DATE/TIME:
PARA NO.
PRODUCT BEING APPLIED.:
/FY:
SQFT OF AREA PRESERVED:
PARTIAL AREA:
/FINAL:
(NSTM 631, 634, PPI, NSI 009-32 FY)
Accomplish degreasing/ leaning to ensure the removal of surface
contaminants, such as sea salts, mud, marine growth, grease, oil, and/
or other petroleum products.
Date/Time:
SAT
UNSAT
Accomplish degreasing/cleaning a maximum of 4 hrs. prior to surface
preparation, ensuring the adequate removal of surface contaminants.
Date/Time:
SAT
UNSAT
If evidence of contamination exists, accomplish degreasing/cleaning a
maximum of 4 hrs. prior to the application of each coat of paint to ensure
removal of surface contaminants.
Date/Time:
SAT
UNSAT
Comments:
Contractor
(Print):
Contractor
(Signature):
Date/Time:
Subcontractor
(Print):
Subcontractor
(Signature):
Date/Time:
Govt. Insp.
(Print):
Govt. Insp.
(Signature):
Date/Time:
FY10 Version
APPENDIX 3
QA INSPECTION FORM - SURFACE PROFILE/PREPARATION & CLEANLINESS LOG
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
WORK ITEM:
LOCATION:
(I):
DATE/TIME:
(V):
(G):
PARA NO.
PRODUCT BEING APPLIED.:
REQ'T DOCUMENT:
/FY:
SQFT:
PARTIAL:
FINAL:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE
SECTIONS, MAINTAIN A SEPARATE LOG FOR EACH SECTION.
NOTE #1 FOR PAINTS: 1 PROFILE READING REQUIRED FOR EVERY 200 SQFT (3 INDIVIDUAL TAPES FOR METHOD C) FOR THE FIRST 1000 SQFT
AREA (15 INDIVIDUAL TAPES TOTAL FOR METHOD C); 2 PROFILE READINGS REQUIRED FOR EACH ADDITIONAL 1000 SQFT AREA (6
INDIVIDUAL TAPES FOR METHOD C).
NOTE #2 FOR NONSKID: 1 PROFILE READINGS REQUIRED EVERY 100 SQFT (3 INDIVIDUAL TAPES FOR METHOD C) FOR THE FIRST 500 SQFT
AREA (15 INDIVIDUAL TAPES TOTAL FOR METHOD C); F READINGS ARE SATISFACTORY, 1 PROFILE READING PER 1000 SQFT
REMAINING (3 INDIVIDUAL TAPES FOR METHOD C).
NOTE #3 FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN IN THE COMMENTS
BLOCK.
ACCEPT CRITERIA: PROFILE RANGE
MILS
TO:
MILS
Mil (Average
of 3 tapes)
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
Reading:
MILS
TOTAL AVG:
Comments:
Abrasive Manufacturer:
(If Applicable)
Type:
(If Applicable)
Mesh Size
(If Applicable)
TYPE OF SURFACE PREPARATION:
GAGE #
GAGE CAL DUE DATE:
Base Metal Reading
(Type 1 gage)
BMR
SURFACE PROFILE INSP:.
SAT
UNSAT
SURFACE PREP. INSP:
SAT
UNSAT
Contractor
(Print):
Contractor
(Signature):
Date/Time:
Subcontractor
(Print):
Subcontractor
(Signature):
Date/Time:
Govt. Insp.
(Print):
Govt. Insp.
(Signature):
Date/Time:
CLEANLINESS INSP:
SAT
UNSAT
FY10 Version
APPENDIX 4
QA INSPECTION FORM - SURFACE CONDUCTIVITY / CHLORIDE LOG
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
WORK ITEM:
LOCATION:
(I):
(V):
(G):
DATE/TIME:
PARA NO.
PRODUCT BEING APPLIED.:
REQ'T DOCUMENT:
/FY:
SQFT OF AREA PRESERVED:
LINE:
/FINAL:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE
SECTIONS, MAINTAIN A SEPARATE LOG FOR EACH SECTION.
MAXIMUM READING (IMMERSED SURFACES):
MAXIMUM READING (NON-IMMERSED SURFACES):
CONDUCTIVITY (30) µS/cm
CONDUCTIVITY (70) µS/cm
CHLORIDE (3) µg/cm2
CHLORIDE (5) µg/cm2
1 READING REQUIRED FOR EVERY 200 SQFT FOR THE FIRST 1000 SQFT, THEN 2 READINGS PER EACH ADDITIONAL 1000 SQFT
NOTE
FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN IN
THE COMMENTS BLOCK.
TEST LOCATIONS
CHLORIDE (µg/cm2)
CONDUCTIVITY (µS/cm)
SAT
UNSAT
UNSAT
SAT
Gage Cal DueGage
Date:#: Condition of Reading
Comments:
GAGE #
CONDITION OF CHECKPOINT:
GAGE CAL DUE DATE:
Contractor
(Signature):
Contractor
(Print):
Date/Time:
Subcontractor
(Signature):
Subcontractor
(Print):
Date/Time:
Govt. Insp.
(Signature):
Govt. Insp.
(Print):
SAT
UNSAT
Date/Time:
FY10 Version
APPENDIX 5
QA INSPECTION FORM - SURFACE CLEANLINESS (DUST) TAPE
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
WORK ITEM:
LOCATION:
(I):
DATE/TIME:
(V):
(G):
REQ'T DOCUMENT:
PARA NO.
PRODUCT BEING APPLIED.:
/FY:
SPECIFIC FEATURES OF AREA TO BE TESTED:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE
SECTIONS, MAINTAIN A SEPARATE LOG FOR EACH SECTION.
NOTE #1
NOTE #2
NOTE #3
FOR UNDERWATER HULL, 1 PROFILE READING REQUIRED FOR EVERY 200 SQFT FOR THE FIRST 1000 SQFT
AREA; IF READINGS ARE SATISFACTORY, 2 INDIVIDUAL READINGS REQUIRED FOR EACH ADDITIONAL 1000 SQFT
AREA.
FOR FLIGHT DECK NONSKID, 3 INDIVIDUAL READINGS REQUIRED EVERY 100 SQFT FOR THE FIRST 500 SQFT; IF
READINGS ARE SATISFACTORY, 1 INDIVIDUAL READING PER 1000 SQFT REMAINING.
FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN
IN THE COMMENTS BLOCK.
Spot
Measurement
Dust Quantity
Rating
Dust Size
Class
Approximate
Location
Spot
Measurement
Spot
Measurement
Dust Quantity
Rating
Dust Size
Class
Approximate
Location
Spot
Measurement
Spot
Measurement
Dust Quantity
Rating
Dust Size
Class
Approximate
Location
Dust Quantity
Rating
Dust Quantity
Rating
Dust Size
Class
Dust Size
Class
Approximate
Location
Approximate
Location
CONDITION OF CHECKPOINT:
SAT
UNSAT
Comments:
Contractor
(Print):
Contractor
(Signature):
Date/Time:
Subcontractor
(Print):
Subcontractor
(Signature):
Date/Time:
Govt. Insp.
(Print):
Govt. Insp.
(Signature):
Date/Time:
FY10 Version
APPENDIX 6
QA INSPECTION FORM - PAINT EQUIPMENT AND PAINT CONSUMPTION LOG
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
WORK ITEM:
LOCATION:
(I):
DATE/TIME:
(V):
(G):
REQ'T DOCUMENT:
PARA NO.
PRODUCT BEING APPLIED.:
/FY:
TABLE:
LINE:
COLUMN:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE
SECTIONS, MAINTAIN A SEPARATE LOG FOR EACH SECTION.
Prime Coat
Stripe Coat Intermediate Coat Stripe Coat
(if applicable)
(if applicable)
(if applicable)
Top Coat
Other
Airless Paint Hose Size
Airless Paint Hose Length
Airless Tip Orifice Diameter / Fan Width
Plural Airless
Airless Pump
Used & Model Conventional Airless
Airless Pump Ratio
(if Plural Component):
Fixed:
Variable:
If Using Inline
Heater, Temp. in °F
(Fahrenheit)
Temp. Setting At
Heater
Temp. At Tip
Other:
Brush, Roller, Conventional Spray
Product Applied
Product Manufacturer
Color Applied
Product VOC
Base Portion Batch No # (Part A)
Expiration Date (Part A)
Hardener Portion Batch No # (Part B)
Expiration Date (Part B)
Gallons Used Per Coat
Square Feet Painted
Start (Date/Time)
Stop (Date/Time)
FY10 Version
APPENDIX 7
QA INSPECTION FORM - DRY FILM THICKNESS MEASUREMENTS
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
LOCATION:
DATE/TIME:
WORK ITEM:
(I):
(V):
(G):
PARA NO.
PRODUCT BEING APPLIED.:
REQ'T DOCUMENT:
/FY:
SQFT OF AREA PRESERVED:
PARTIAL AREA:
/FINAL:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE SECTIONS, MAINTAIN A SEPARATE
LOG FOR EACH SECTION.
NOTE:
FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN IN COMMENTS BLOCK.
Select Type of Gage being used:
Type 1:
Gage #:
Current Calibration Due Date:
Base Metal Reading (Type 1gage):
Type 2:
Accuracy Adjustment (Type 1gage):
ACCEPTANCE CRITERIA
PRIMER COAT DFT
TO
MILS
TOP COAT DFT
TO
MILS
INTERMEDIATE COAT DFT
TO
MILS
TOTAL SYSTEM DFT
TO
MILS
STRIPE COAT (for cleanliness & holiday QA)
TOTAL SPOT MEASUREMENTS REQUIRED PER SQUARE FOOT OF AREA PRESERVED
0 - 100 SQFT = 5 SPOTS REQUIRED
101 - 200 SQFT = 10 SPOTS REQUIRED
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
201 - 1000 SQFT = 15 SPOTS REQUIRED
> 1000 SQFT = 5 ADDITIONAL SPOTS REQUIRED PER 1000 SQFT AREA
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
1
1
2
2
3
3
4
4
5
5
Average:
Average:
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
1
1
2
2
3
3
4
4
5
5
Average:
Average:
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
Note: Each Spot Measurement = The AVG of Three Gage Readings.
Spot
DFT (Mils) AVG of 3 Gage
Approximate
Measurement
Readings
Location
1
1
2
2
3
3
4
4
5
5
Average:
HOLIDAY INSP.:
CLEANLINESS INSP.:
Average:
SAT
UNSAT
SAT
UNSAT
Comments:
Contractor
(Print):
Contractor
(Signature):
Date/Time:
Subcontractor
(Print):
Subcontractor
(Signature):
Date/Time:
Govt. Insp.
(Print):
Govt. Insp.
(Signature):
Date/Time:
FY10 Version
APPENDIX 7A
QA INSPECTION FORM - WET FILM THICKNESS MEASURES
SHIP NAME & HULL #:
CONTRACT/TASK ORDER/CLIN/TWD:
LOCATION:
DATE/TIME:
WORK ITEM:
(I):
(V):
(G):
REQ'T DOCUMENT:
PARA NO.
PRODUCT BEING APPLIED.:
/FY:
SQFT OF AREA PRESERVED:
PARTIAL AREA:
/FINAL:
(NSTM 631, 634, PPI, NSI 009-32 FY)
MAINTAIN SEPARATE LOG FOR EACH AREA/LOCATION, PREPARED OR PAINTED SURFACE, WHEN AN AREA IS DIVIDED INTO SEPARATE SECTIONS,
MAINTAIN A SEPARATE LOG FOR EACH SECTION.
NOTE #1 FOR ANY UNSAT CONDITION FOUND, PROVIDE THE TECHNICAL ADJUDICATION AND CORRECTIVE ACTION TAKEN IN THE COMMENTS BLOCK
WHERE REQUIRED IN LIEU OF DFT.
Indicate Coating System Sequence
Prime Coat
Intermediate Coat (if applicable)
Stripe Coat (if applicable)
Stripe Coat (if applicable)
METALLIC SURFACES
2 SPOT READINGS PER 1000 SQFT:
0 - 1000 SQFT = 2 SPOTS REQUIRED
1001 - 2000 SQFT = 4 SPOTS REQUIRED
WFT Measurement Number
Top Coat
Other Coat (Specify)
NON-METALLIC SURFACES
0 - 100 SQFT = 5 SPOTS REQUIRED
101 - 200 SQFT = 10 SPOTS REQUIRED
201 - 1000 SQFT = 15 SPOTS REQUIRED
> 1000 SQFT = 5 SPOTS REQUIRED PER 1000 SQFT AREA
WFT Measurement
IAW ASTM D 4414
Location of Readings
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Comments:
Contractor
(Print):
Contractor
(Signature):
Date/Time:
Subcontractor
(Print):
Subcontractor
(Signature):
Date/Time:
Govt. Insp.
(Print):
Govt. Insp.
(Signature):
Date/Time:
Print Form
Save As
FY10 Version