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| MIL-M-82433A(OS)
APPENDIX A
REPORT FORM
QUALITY ASSURANCE PROVISION
QUALITY CONFORMANCE TESTS AND EXAMINATIONS
FOR
MOTOR, DIRECT CURRENT
2540053
(For Torpedo Mk 46 Mod 1)
EQUIPMENT STATUS
CONTRACTOR CERTIFICATION
GOVERNMENT ACCEPTANCE
I
Contractor
Date of Acceptance
I
Contract
Accepted by
Equipment Ser. No.
Title
Insp. Req. Satisfied
Agency
I
33
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