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|  MIL-R-23016(Wep)
MIL-R-23016(Wep)
NON--STANDARD PART DATA SHEET
(Type designation of major assembly.)
1.
Part is used in
(List all applications.)
Circuit reference symbol(s)
2.
4.
Contract No.
Prime contractor
3.
(Same as on production list.)
Description of part:
5.
7.
Part No.
Prime contractor's Drawing No.
6.
9.
Part or dwg.
Actual manufacturer
8.
for use
Previously approved to
10.
on contract
in
Comparison between non-standard part and standard part whose character-
11.
istics are nearest to those required for the application: (Include
reasons for not using standard part.)
(Test data sheets and comments may be attached
12.
Test data and comments:
as necessary.)
As the designated representative of the contractor I certify that to the
best of my knowledge the above information and data are correct and the
non-standard part for which approval is requested is suitable for its in-
tended use.
Date
14.
13.
Engineer's signature
acceptable to the Government.
These data are
Date
Engineer's signature
FIGURE 1.
Sample Non-Standard Part Data Sheet
9
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