Title Page
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Arriving/Departing Flight Numbers
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Aircraft Registration
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Airport
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Stand
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Conducted on
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Prepared by
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Operator/Truck Number
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1. Does the operator perform a brake check before positioning onto the aircraft?
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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)
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3. Is the rinse/charge hose connected?
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4. Is the rinsing procedure carried out for a minimum or 90 seconds, or 57 litres discharged? (ask operator if necessary)
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5. Do staff wear all necessary clothing and P.P.E (overalls, mask, hi-visibility clothes, gloves etc.)?
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6. Are staff in posession of company issued hearing protection?
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7. Do staff close the gate after climbing onto the operator platform of toilet service units?
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8. Do staff close the valve before disconnecting the discharge hose?
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9. Do staff close and check panels before leaving?
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10. Do staff fully lower the cage before exiting?
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11. Do staff double check that all hoses are disconnected before leaving the cage?
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12. Do staff secure the hose before leaving the cage?
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13. Do staff take their gloves off before opening cab doors?
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14. If any non-conformities were observed were they discussed with the operator on site?
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Any other observations/comments
