Technical Data Lem Engineering Change Proposal Worksheet

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NAVAIRINST 4130.1D
TECHNICAL DATA LEM ENGINEERING CHANGE PROPOSAL WORKSHEET
1. TYPE CHANGE
2. CHANGE NUMBER
4. COGNIZANT LEM
5. DATE TO LEM
ECP
3. DOCUMENT TRACKING NO.
RAMEC
OTHER
6. COGNIZANT LEM ACTION
6a. AIRCRAFT/EQUIPMENT
6b. ECP ORIGINATOR
7. TECHNICAL DIRECTIVE
8. TECHNICAL MANUAL
7a. AIRCRAFT/EQUIPMENT
8a. PREPARATION COST
8b. REPRO, PRINT and DISTR COST
7b. PREPARATION COST
7d. REPRO, PRINT and DISTR COST
7c. MILSTONE DATE
8c. MILESTONE DATE
8d. TM TOTAL COST
9. TECHNICAL MANUAL'S IMPACTED
(list each impacted Technical Manual in TM Breakdown)
YES
NO
YES
NO
YES
NO
"O" LEVEL
MRC
WEAPONS LOADING
"I" LEVEL
TACMAN
WEAPONS EMPLOYMENT
"D" LEVEL
NATOPS
SUPPORT EQUIPMENT
PMIC
10. TECHNICAL MANUAL BREAKDOWN
Estimated
10a.
10b.
10c.
10d.
10e.
10f.
10g.
10h.
MANUAL
PEO/PMA
TYPE
MILESTONE
PREP
REPRO, PRINT
TOTAL COST
FUNDING CODE
NUMBER
COG
MANUAL
DATE
COST
& DISTR COST
PER MANUAL
(APN-5, ETC.)
11. REMARKS
12. RETURN TO AIR-6.8
12a. REVIEWING LEM
12b. CODE
12d. Sent to: e-mail address, Phone, and/or FAX Number
12c. DATE
(SIGNATURE)
13. CCB DISPOSITION
13b.
13a. CCB CONTROL NUMBER
13c. DATE
Approved
Disapproved
Page 1 of 2
NAVAIR 4130/13 (REV 05/2011 )

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