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MATERIAL INSPECTION AND RECEIVING REPORT70=1 Approved No. 0704-0248 The public reporting burden for this collection of information is estimated to average 30 mnutes pe response,including the time for reviewing instructions.searching existing data sources. gathering and maintaining the data needed,and Completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including sugcaestuons for rebucing the burden. to Department of Defense. Washington Headquarters Services. Directorate for Information Operations and Reports (0704-0248). 1215 Jefferson DDavis Highway.Suite 1204.Arlington.VA 22202-4302. Respondents should be aware that nolwdhslanding any othe-provision of law,no person slap be subject to any penally for fading to comply with a collection of information if it does not display a currently valid OMB control number. ^s. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ADDRE SEND THIS FORM IN ACCORDANCE WITH THE INSTRUCTIONS CONTAINED IN THE DFARS,* PENDIX F-401. 1. PROCUREMENT INSTRUMENT IDENTIFICATION ORDER NO. 6. INVOICE NO./DATE 7. PAGE OF B.ACCEPTANCE POINT (CONTRACT)NO. SP0450-99-D-4048 0 13Z 1 1 S 2. SHIPMENT NO. 3.DATE SHIPPED 14. B/L 53 7604-105. DISCOUNT TERMS HCCO015 020CT08E 50.500°/d-1 U DAYS TCN A 9. PRIME CONTRACTOR CODE OH3M4 10. ADMINISTERED BY CODE S31 0 1 A HATCO CORPORATION DCM SPRINGFIELD 1020 KING GEORGE POST ROAD BLJILDING I-ARDEC FORDS NJ 08863 PICATINNY NJ 07806-5000 11.SHIPPED FROM(If other than 9) CODE OH3M4 FOB:D 12. PAYMENT WILL BE MADE BY CODE HQ0337 SEE BLOCK#9 DFAS COLUMBUS CENTER NORTH ENTITLEMENT OPERATIONS POST OFFICE BOX 182266 COLUMBUS OH 43218-2266 13.SHIPPED TO CODE W62152T 14. MARKED FOR CODE XU DEF DISTRIBUTION DEPOT SAN JOAQUIN NON-MILSTRIP RDD 10/09/2002 PRO1 25600 S CHRISMAN ROAD-REC WHSE 10 TRACY CA 95376-5000 15. 16.STOCK/PART NO. DESCRIPTION 17.QUANTITY 18. 19. 20. ITEM NO, pndticate number of shipping containers-type of SHIP/REC'D' UNIT UNIT PRICE AMOUNT container-container number. UOU6 9150-00-782-2679 MIL-PRF-7808L 85 DR 595.500 50,617.50 LUBI:ICATING OIL,AIRCRAFT TURBINE ENGINE p SYNTHETIC GRADE 3 0 I,OT#F2I588 0 85 DRUMS(1-85)FILLED 55 GALLONS EACH 0 0 0 GROSS WEIGHT 40,885 LBS. () 21. CONTRACT QUALITY ASSURANCE 22.RECEIVER'S USE a. ORIGIN b. DESTINATION Quantities shown in column 17 were received in X CQA Fx_1 ACCEPTANC& ist id items CQA FIACCEPTANCE of listed items has apparent good condition except as noted. has been made by me under my supervisio nd been made by me or under my supervision and they they conform to act, Pt a ein or conform to contract,except as noted herein or on R CEIVEDeA IT i i� on supportin amn in documents. GRAN ENT REPRESENTA VE TYPED NAME: 02OCT08 TITLE: DATE ENT REPRESS TATNE DATE GOVERNMENT REPRESENTATIVE MAILING ADDRESS: TYPED NAME: A.CHEC.CHIA S3101A TYPED NAME: TITLE: QAR,DCMA SPRINGFIELD NJ TITLE: COMMERCIAL TELEPHONE MAILING ADDRESS: MAILING ADDRESS: NUMBER: I I 1 Chambersbrook rctBranchburg 4 08V6 'If quantity received by the Govemment is the same acheccia(adcmm deAca.mil c H as quantity shipped,indicate by(X)mark;it different. COMMERC TELEPHONE COMMERCIAL TELEPHONE enter actual quantity received below quantity shipped NUMBER: 908-252-9096 O%4 NUMBER: and encircle. 23. CONTRACTOR USE ONLY TRUCKER SEA MATES TRUCK APLU 4981434-_ -- SEAL 003697 DD FORM 250, AUG 2000 PREVIOUS EDITION IS OBSOLETE.