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
The records and reports required in
bulletin by number.
o. Block 15. Self-explanatory.
p. Block 16.
Record the manufacturer or
13. Reports. Inspection and/or tests performed in
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
the designated command utilizing the applicable
q. Block 17, and Block 18. Self-explanatory.
r. Block 19.
Enter date of manufacture or
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
Descriptive Data Of
number shall be as given in the classification of defects
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
activity having accountability.
SB 740-94-9 APPENDIX D
b. Block 2. Enter the local report number.
c. Block 3. Enter the date of the report.
d. Block 4.
Enter the complete standard
nomenclature and model number of the item.
e. Block 5. Record complete manufacturer's lot
number. When surveillance is authorized on the basis
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).
different storage conditions of lot segments,
f. Block 6. Describe packing of items in narrative
unlisted defects, inspection equipment not available or
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.
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).
Results of Surveillance Test
j. Block 10. Record the number of items less
a. Blocks 1 through 4.
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
performed not in accord with the basic document