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Invoice

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Invoice
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12/6/2011
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SHIP’S CONFIGURATION CHANGE FORM OPNAV 4790/CK (5-84) CONFIG FILE COMP M/A COMP

S/N 0107-LF-047-9001 CORR NO DEFL DEFL

SECTION I JOB IDENTIFICATION

JOB CONTROL NUMBER ALTERATION IDENTIFICATION

1. SHIP’S UIC 2. WORK CENTER 3. JOB SEQ. NR. 4. ALTERATIONS (SHIPALT, FLD CHG., ETC.)





A. SHIP’S NAME B. HULL NUMBER 5. EIC 6.ACT TKN





7. EQUIPMENT NOUN NAME 8. S/F MNHRS EXP. 9. ACT MAINT TIME 10. COMP DATE 11. M/R





SECTION II JOB DESCRIPTION/REMARKS

12. JOB DESCRIPTION/REMARKS









SECTION III COMPONENT CONFIGURATION CHANGE IDENTIFICATION

13. COMPONENT NOUN NAME 14. QUANTITY 15. CA





16. COMPONENT IDENTIFICATION 17. COMPONENT SERIAL NUMBER





18. COMPONENT APL/AEL 19. LOCATION (DECK/FRAME/SIDE) 20. EIC





21. NEXT HIGHER ASSEMBLY 22. S. A. C. 23. WORK CENTER





24. NAME PLATE DATA









25. MIP 26. EOSS





27. TM





SECTION IV SPECIAL PURPOSE

28. RIN 29. AILSIN 30. SECAS OFFICE USE





-INSTRUCTIONS-

ITEM SECTION I & II SECTION-INSTRUCTIONS-

I & II LEGEND

NUMBER DESCRIPTION

1-3 JOB CONTROL NUMBER M M IA IF AVAILABLE O OPTIONAL

4 ALTERATION IDENTIFICATION IP IP IP IF APPLICABLE NR NOT REQUIRED

5 EQUIPMENT IDENTIFICATION CODE M NR M MANDATORY

6 ACTION TAKEN M NR

7 EQUIPMENT NOUN NAME M NR

8 SHIP’S FORCE MANHOURS EXPENDED M NR SECTION 1, BLOCK 6 SECTION III, BLOCK 15

9 ACTIVE MAINTENANCE TIME M NR ACTION TAKEN COMPONENT ACTION

10 COMPLETION DATE M NR 5A PARTIALLY COMPLETED

11 METER READING IP NR ALTERATION

12 JOB DESCRIPTION (REMARKS) O NR 5B FULLY COMPLETED MAINTENANCE

ITEM SECTION III REMOVE INSTALL MODIFY ALTERATION ACTIONS

NUBMER DESCRIPTION R/D I/A M/C 5C FULLY COMPLETED

13 COMPONENT NOUN NAME M M M EQUIVALENT TO ALTERATION R REMOVED EQUIPMENT

14 QUANTITY M M M 5D ALTERATION DIRECTIVE I INSTALLED EQUIPMENT

15 COMPONENT ACTION M M M NOT APPLICABLE M MODIFIED EQUIPMENT

16 COMPONENT IDENTIFICATION IP IP IP 1 MAINTENANCE ACTION

17 COMPONENT SERIAL NUMBER IA IA IA COMPLETED: PARTS CONFIG FILE

18 COMPONENT APL/AEL M IA IA DRAWN FROM SUPPLY CORR

19 LOCATION M M M 2 MAINTENANCE ACTION NO MAINTENANCE

20 EQUIPEMENT IDENTIFICATION CODE NR IA NR COMPLETED: REQUIRED PARRS ACTION

21 NEXT HIGHER ASSEMBLY IP IP IP NOT DRAWN FROM SUPPLY

22 SERVICE APPLICATION CODE IA IA IA (LOCAL MANUFACTURE, PRE- A ADDITION OF RECORD

23 WORKCENTER NR M NR EXPENDED BINS) D DELETION OF RECORD

24 NAMEPLATE DATA NR M NR 3 MAINTENANCE ACTION C CORRECT/CHANGE

25 MAINTENANCE INDEX PAGE IA IA IA COMPLETED NO PARTS EXISTING RECORD

26 EOSS IP IP IP REQUIRED

27 TECH MANUAL NUMBER IA IA IA SHIP SEQUENCE

WORK CENTER DIVISION OFF SUPPLY DEPT 3 M COORDINATOR NUMBER

SUPERVISOR PAGE: OF



*GPO: 1984-587-019/30328 MSWord ™ form developed by Stan Meyers 4928TB 22Jul96


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