Reports

of inspection measuring gages and test equipment shall

n. Block 14. Enter the surveillance cycle required

be established in accordance with the requirements of

by the applicable supply bulletin and reference that

AR 750-25.

The records and reports required in

bulletin by number.

calibration of army equipment are described in TM 38-

o. Block 15. Self-explanatory.

750.

p. Block 16.

Record the manufacturer or

13. Reports. Inspection and/or tests performed in

reconditioning agency.

When more than one

accordance with this bulletin and the applicable storage

manufacturer is represented due to the nature of the lot

serviceability standard for the item shall be reported to

enter N/A.

the designated command utilizing the applicable

q. Block 17, and Block 18. Self-explanatory.

form(s).

r. Block 19.

Enter date of manufacture or

13.1 Forms.

reconditioning. When more than one manufacturer is

13.1.1 Munitions Surveillance Report (DA Form 984).

represented due to the nature of the lot, enter N/A.

This form will be used to record and report the results of

s. Block 20 thru Block 25. Record condition of

all examinations and test when conducting prestorage

inspection, initial receipt inspection, periodic cycle

packing, packaging, and marking.

inspection or pre-issue inspection. (NOTE: This form

t. Block 26. State if not passed or failed the visual

may also be utilized for special inspection when so

examination requirements established in the applicable

directed by higher headquarters). In completing the

supply bulletin. Record all visual defects or defectives

form the following instructions shall be followed:

as applicable observed by category, defect number, and

number of defects or defectives. (Category and defect

Part I

Descriptive Data Of

number shall be as given in the classification of defects

Ammunition Represented By Samples

table of the applicable supply bulletin). Reference the

a. Block 1. Enter the actual storage location,

applicable supply bulletin and appendix.

which may not necessarily be the depot or storage

Example:

activity having accountability.

SB 740-94-9 APPENDIX D

Categories

Defect

Number of

b. Block 2. Enter the local report number.

Defectives

c. Block 3. Enter the date of the report.

Critical

None

d. Block 4.

Enter the complete standard

Major

105

nomenclature and model number of the item.

108

e. Block 5. Record complete manufacturer's lot

Minor

204

number. When surveillance is authorized on the basis

207

of a depot lot, miscellaneous lot or grand lot, enter the

u. Block 27. Any observations relevant to the

lot number applicable to the type of lot indicated in

condition of the items or to the actual inspection should

Block 15 and complete DA Form 985 (Data Sheet for

be noted in this block. Examples of such observations

Grand Lots, Miscellaneous Lots or Depot Lots).

are:

different storage conditions of lot segments,

f. Block 6. Describe packing of items in narrative

unlisted defects, inspection equipment not available or

form.

calibration interval exceeded, severity of defects listed

g. Block 7. Enter Federal Stock Number (FSN) of

in block 26, etc.. A brief lot history shall be included.

the item.

v. Block 28a. Self-explanatory.

h. Block 8. Enter current and past type of storage,

w. Block 28b. Based on the results of visual

i.e., heated warehouse, unheated warehouse, outdoor

examination (Part 1, Block 26) and test results (Part II,

(indicate type of outdoor storage).

block 12) enter condition code.

i. Block 9.

Record the number of samples

x. Block 29. Self-explanatory.

selected for examination and test(s).

PART II:

Results of Surveillance Test

j. Block 10. Record the number of items less

a. Blocks 1 through 4.

Enter meteorological

sample size, remaining in the lot at the depot.

conditions at test area if relevant to the test. If not

k. Block 11. Self-explanatory.

relevent, enter N/A.

l. Block 12. Enter date and type of last inspection;

b. Blocks 5, 5a and 5b. Enter supply bulletin

i.e., Prestorage, 10 July 70.

number, revision or change, and date of supply bulletin

m. Block 13. Enter type inspection and date that

revision or change. When applicable, enter the letter of

this inspection was complete, i.e., Periodic cycle, 1 July

authority or directive for any special surveillance

72.

performed not in accord with the basic document

indicated above.