DD Form 416 Purchase Request for Coal, Coke or Briquettes

DD Form 416 - also known as the "Purchase Request For Coal, Coke Or Briquettes" - is a Military form issued and used by the United States Department of Defense.

The form - often incorrectly referred to as the DA form 416 - was last revised on December 1, 2008. Download an up-to-date fillable DD Form 416 down below in PDF-format or find it on the Department of Defense documentation website.

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1. For 12 Month Period (From - Thru)
Instructions
Purchase Request for Coal, Coke or
Prepare separate request for each kind of Coal
Briquettes
2. Program Number
(See reverse)
3. Thru
4. From (Department, Agency or Installation)
5. To (Chief of Service)
6. Consign To
7. Purchase Request Number
8. Date
9. Kind (Anthracite, bituminous, sub-
10. Tons in Storage
11. Storage Capacity
14. Size (In Inches)
bituminous,lignite, or coke.)
a. Top
b. Bottom
(2) Minimum
(2) Minimum
(1) Maximum
(1) Maximum
12. Tons Due on Existing
13. Actual Consumption
Contracts
(Last 12 Months)
17.
Tentative Ship Schedule
15. Analytical Specifications Required
Do Not Write In These Columns
a.
Month & Year
b. Estimated Tons
16.
Approved Analytical Specifications
c. Dust Suppressant
c. Dust Suppressant
Jan 20
a. Min
b. Max
a. Min
b. Max
(Check if applicable)
(Check if applicable)
Feb 20
(1) Moisture
(1) Moisture
Mar 20
(2) Vol
(2) Vol
D
D
R
R
d. Freeze Conditioning
d. Freeze Conditioning
Apr 20
Y
(3) Ash
Y
(3) Ash
(Check if applicable)
(Check if applicable)
May 20
C
C
(4) Sul
(4) Sul
O
O
A
A
Jun 20
(5) Btu
(5) Btu
L
L
e. Approved
Jul 20
(6) AST °F
(6) AST °F
Tonnage
Aug 20
(7) Hardgrove Grindability
(7) H. Grind
Sep 20
(8) FSI
(8) FSI
Oct 20
a.
Maximum % Retained On
b.
Maximum % Passing THRU
18. Screen Size (Round Hole)
Nov 20
(1) Top
Dec 20
(2) Bottom
20. Delivering Railroad
21. Total Purchase Request (Tons)
a. Rail
19. Preferred Method of Delivery (Check One)
0
b. Truck
c. Rail or Truck
d.Barge
22. Railhead for Carload Shipments
23a. Alternate Method of Delivery
23b. Estimated Additional Cost
24. Type of Railroad Cars Required
25. Estimated Charges for Labor and Equipment if Commercial Service is Required for Unloading, Hauling and Storage of Coal
26. State or Local Regulatory Sulfur Dioxide Emission Limits (Show Units)
27. Spur Track To Installation (Check One)
a. Yes
b. No
28. Remarks
29. Technical Point of Contact at Requesting Activity
a. Typed Name (Last, First, Middle Initial)
b. E-mail Address
c. Telephone No.
30. Prepared By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
31. Approved at Requesting Activity By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
32. Approved By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
DD FORM 416, DEC 2008
PRINT
E-MAIL
CLEAR
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
1. For 12 Month Period (From - Thru)
Instructions
Purchase Request for Coal, Coke or
Prepare separate request for each kind of Coal
Briquettes
2. Program Number
(See reverse)
3. Thru
4. From (Department, Agency or Installation)
5. To (Chief of Service)
6. Consign To
7. Purchase Request Number
8. Date
9. Kind (Anthracite, bituminous, sub-
10. Tons in Storage
11. Storage Capacity
14. Size (In Inches)
bituminous,lignite, or coke.)
a. Top
b. Bottom
(2) Minimum
(2) Minimum
(1) Maximum
(1) Maximum
12. Tons Due on Existing
13. Actual Consumption
Contracts
(Last 12 Months)
17.
Tentative Ship Schedule
15. Analytical Specifications Required
Do Not Write In These Columns
a.
Month & Year
b. Estimated Tons
16.
Approved Analytical Specifications
c. Dust Suppressant
c. Dust Suppressant
Jan 20
a. Min
b. Max
a. Min
b. Max
(Check if applicable)
(Check if applicable)
Feb 20
(1) Moisture
(1) Moisture
Mar 20
(2) Vol
(2) Vol
D
D
R
R
d. Freeze Conditioning
d. Freeze Conditioning
Apr 20
Y
(3) Ash
Y
(3) Ash
(Check if applicable)
(Check if applicable)
May 20
C
C
(4) Sul
(4) Sul
O
O
A
A
Jun 20
(5) Btu
(5) Btu
L
L
e. Approved
Jul 20
(6) AST °F
(6) AST °F
Tonnage
Aug 20
(7) Hardgrove Grindability
(7) H. Grind
Sep 20
(8) FSI
(8) FSI
Oct 20
a.
Maximum % Retained On
b.
Maximum % Passing THRU
18. Screen Size (Round Hole)
Nov 20
(1) Top
Dec 20
(2) Bottom
20. Delivering Railroad
21. Total Purchase Request (Tons)
a. Rail
19. Preferred Method of Delivery (Check One)
0
b. Truck
c. Rail or Truck
d.Barge
22. Railhead for Carload Shipments
23a. Alternate Method of Delivery
23b. Estimated Additional Cost
24. Type of Railroad Cars Required
25. Estimated Charges for Labor and Equipment if Commercial Service is Required for Unloading, Hauling and Storage of Coal
26. State or Local Regulatory Sulfur Dioxide Emission Limits (Show Units)
27. Spur Track To Installation (Check One)
a. Yes
b. No
28. Remarks
29. Technical Point of Contact at Requesting Activity
a. Typed Name (Last, First, Middle Initial)
b. E-mail Address
c. Telephone No.
30. Prepared By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
31. Approved at Requesting Activity By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
32. Approved By
a. Typed Name (Last, First, Middle Initial)
b. Signature
c. E-mail Address
d. Telephone No.
DD FORM 416, DEC 2008
PRINT
E-MAIL
CLEAR
PREVIOUS EDITION IS OBSOLETE.
Adobe Professional 8.0
Instructions for completion of DD Form 416, Purchase Request for Coal, Coke or Briquettes
Block
1.
FOR 12 MONTH PERIOD. Enter the 12 month period of request (i.e., 1 May 08 - 30 Apr 09).
2.
PROGRAM NUMBER. As stated.
3.
THRU. Enter name and mailing address of organization request is submitted thru.
FROM. Enter name and address of Department, Agency or Installation. (i.e., CDR, Red River Army Depot,
4.
Houston, TX 77507-5000).
5.
TO. Enter To (Chief of Service) organization.
6.
CONSIGN TO. Enter Consign to location (i.e., Red River Army Depot).
7.
PURCHASE REQUEST NUMBER. As stated.
8.
DATE. As Stated.
9.
KIND. As stated.
10.
TONS IN STORAGE. As stated
11.
STORAGE CAPACITY. As stated.
12.
TONS DUE ON EXISTING CONTRACTS. As stated.
13.
ACTUAL CONSUMPTION. Enter last 12 months actual consumption.
14.
SIZE. Enter in inches and maximum and minimum size for Top and Bottom
ANALYTICAL SPECIFICATIONS REQUIRED. Enter minimum and maximum specifications. Check if DUST
15.
SUPPRESSANT and/or FREEZE CONDITIONING is required. (State time frame in Blk 28 "Remarks")
16.
APPROVED ANALYTICAL SPECIFICATIONS. APC or DESC use only.
17.
TENTATIVE SHIP SCHEDULE. As stated
18.
SCREEN SIZE (Round Hole). Enter Screen Size.
19.
PREFERRED METHOD OF DELIVERY. Check Rail, Truck, Rail or Truck, or Barge.
20.
DELIVERING RAILROAD. As Stated.
21.
TOTAL PURCHASE REQUEST. Enter Tons.
22.
RAILHEAD FOR CARLOAD SHIPMENTS. Enter Name/location of Railhead.
23a. ALTERNATE METHOD OF DELIVERY. Enter Rail, Truck, Rail or Truck, or Barge.
23b. ESTIMATED ADDITIONAL COST. As stated.
24.
TYPE OF RAILROAD CARS REQUIRED. As stated.
ESTIMATED CHARGES FOR LABOR AND EQUIPMENT IF COMMERCIAL SERVICE IS REQUIRED FOR
25.
UNLOADING, HAULING AND STORAGE OF COAL. As stated.
26.
STATE OR LOCAL REGULATORY SULFUR DIOXIDE EMISSION LIMITS. Enter in units.
27.
SPUR TRACK TO INSTALLATION. Check yes or no.
28.
REMARKS. (Include special conditions and distribution e-mail addresses) Or use separate attachment.
29.
TECHNICAL POINT OF CONTACT REQUESTING ACTIVITY. Enter typed name, e-mail, and telephone.
30.
PREPARED BY. Enter typed name, signature, e-mail, and telephone.
APPROVED AT REQUESTING ACTIVITY BY. Enter typed name, signature, e-mail, and telephone of approving
31.
official.
32.
APPROVED BY. Enter typed name, signature, e-mail, and telephone of approving official.
DD FORM 416 (BACK), DEC 2008

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