Electrical/Electronic Cable Connector Assembly and Test Record

COMUSFLTFORCOMINST 4790.3 REV C CH-5

ELECTRICAL/ELECTRONIC CABLE CONNECTOR QA FORM 34B PAGE 1 OF 1 ASSEMBLY AND TEST RECORD (DSS) A separate QA Form 34B must be used for each connector requiring controlled assembly documentation. The QA Form 34B shall be used to provide: 1) Stand alone documentation for cable connector reconnection when controlled assembly is required by authorized REC exception; or 2) QA Form 34B will be included in CWP/REC packages when documentation of controlled assembly is required as OQE for the work performed. Planning shall fill in blocks identified by a  prior to issuing. u1. DSS PLATFORM HULL u2. JCN u3. LWC/SHOP u4. CWP/REC SER u5. SYSTEM(S) NO. NO. COMPONENT

u6. CONNECTOR DESIGNATION u7. CABLE DESIGNATION u8. CONNECTOR SIZE

u9. REFERENCES

10. NEW MATERIAL

PC REF. DESCRIPTION QTY LOE IDENT (e.g., MIC R/I NO. NO/NSN/TRACEABILITY NO)

11. INSPECTION PINS SEALING SURFACES u[ ] NOT APPLICABLE THREADS u[ ] NOT APPLICABLE PLUG JACK PLUG JACK VENT SCREW PLUG JACK VENT SCREW SAT______SAT______SAT______SAT______SAT______SAT______SAT______SAT______UNSAT____ UNSAT____ UNSAT____ UNSAT____ UNSAT____ UNSAT____ UNSAT____ UNSAT____ 12. TORQUE DOCUMENTATION u[ ] TORQUE DOCUMENTATION NOT REQUIRED uREQUIRED TORQUE FINAL TORQUE TORQUE DEVICE/INSTRUMENT USED VENT SCREW RANGE SERIAL NUMBER CAL DUE DATE u[ ] NOT IN-LB IN-LB IN-LB APPLICABLE FT-LB FT-LB FT-LB uREQUIRED TORQUE FINAL TORQUE TORQUE DEVICE/INSTRUMENT USED COUPLING RING RANGE SERIAL NUMBER CAL DUE DATE IN-LB IN-LB IN-LB FT-LB FT-LB FT-LB CRAFTSMAN SIGNATURE DATE QAI SIGNATURE DATE

13. LOCKWIRE/LOCKING CABLE MATL. DESCRIPTION/NSN/PC NO. CRAFTSMAN SIGNATURE DATE INSTALLATION

SAT______uNA______

14. REMARKS/RECORD OF REPAIRS, MODIFICATIONS, INSPECTIONS (e.g., LIST OF ASSOCIATED RECORDS)

QAS SIGNATURE DATE 15. RECORD HAS BEEN REVIEWED FOR COMPLETENESS