Title Page

  • Arriving/Departing Flight Numbers

  • Aircraft Registration

  • Airport

  • Stand

  • Conducted on

  • Prepared by

  • Operator/Truck Number

  • 1. Does the operator perform a brake check before positioning onto the aircraft?

  • 2. Does the duration of the procedure last more than 2 minutes 30 seconds for A320/321 aircraft, or more than 5 minutes for A330 aircraft? (time from panel open to panel closed)

  • 3. Is the rinse/charge hose connected?

  • 4. Is the rinsing procedure carried out for a minimum or 90 seconds, or 57 litres discharged? (ask operator if necessary)

  • 5. Do staff wear all necessary clothing and P.P.E (overalls, mask, hi-visibility clothes, gloves etc.)?

  • 6. Are staff in posession of company issued hearing protection?

  • 7. Do staff close the gate after climbing onto the operator platform of toilet service units?

  • 8. Do staff close the valve before disconnecting the discharge hose?

  • 9. Do staff close and check panels before leaving?

  • 10. Do staff fully lower the cage before exiting?

  • 11. Do staff double check that all hoses are disconnected before leaving the cage?

  • 12. Do staff secure the hose before leaving the cage?

  • 13. Do staff take their gloves off before opening cab doors?

  • 14. If any non-conformities were observed were they discussed with the operator on site?

  • Any other observations/comments

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