Information

  • Document No.

  • Airstrip Name

  • Program/Base

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Airstrip

Diagram the airstrip (optional)

  • Use this tool to draw a diagram of the airstrip.

Length & Width

  • Measure and record the airstrip length

  • Does the measured length match the airstrip directory?

  • Measure and record the airstrip rollable width

  • Does the measured width match the airstrip directory?

  • Measure and record the wingtip clearance width

  • Does the rollable width AND wingtip clearance allow for a 20' excursion for the largest aircraft using the airstrip?

  • Does the rollable width AND wingtip clearance allow for a 10' excursion for the largest aircraft using the airstrip?

  • When any aircraft is placed on the edge of the rollable surface, are all obstructions still clear of wingtip?

Altitude

  • Record the Airstrip Elevation

  • Does it match the elevation on the airstrip chart?

Slope

  • Measure and Record the Airstrip Average Slope

  • Measure and Record any Side Slope(s)

  • Measure and Record any Slope Changes

  • Measure and Record any Bounders

  • Do the measured slopes match the slopes recorded on the airstrip chart?

  • Is the slope in first 300' less than 15%?

  • Are all the bounders less than a rise of 5" in 50'?

  • Are all the bounders less than a rise of 10" in 50'?

  • Is the rate of slope change in the first 500' less than 1.5% per 100 feet?

  • Is the rate of slope change in the first 500' less than 2.5% per 100 feet?

  • Is the side slope less than 2%?

  • Is the side slope less than 4%?

Surface

  • Mark all the types of Surface at this location

  • Enter description of other surface type

  • Is the grass cut well enough?

  • Is the airstrip firm with no areas of recent construction/repairs that could leave soft spots?

  • Is the surface level with no Ruts/holes on the rollable surface?

  • Have all areas with an increased risk of softness been properly tested?

Obstructions

  • Are all obstructions on approach/landing listed on the chart?

  • Is the angle to the top of the highest obstacle on departure from the 75% point greater than 1.5 degrees?

  • Is the angle marked on the Airstrip Directory?

  • Measure and record the angle in degrees to top of highest obstacle on approach from the TDP:

  • Is the TDP on the chart being used by the pilots?

Sides of Airstrip

  • Are the sides clearly defined?

  • Would rolling off the sides result in less than substantial damage?

  • Do the wings clear vegetation/obstructions when the wheels are on the edge of strip?

Ends of airstrip

  • Are the ends clearly visible on approach?

  • Would running off the end on landing rollout result in less than substantial damage?

Turn Around and Parking Area

  • Is there adequate room to turn around?

  • Is there adequate wing clearance?

  • Is the parking area firm with no recent construction/repairs that could leave soft spots?

Markers and windsocks

  • Are all 50% and 75% (90%) markers in place and easily visible?

  • Check this box if there is currently a windsock at this location

  • Are windsocks visible in the pattern, on approach and takeoff?

  • Is the current windsock location and quantity sufficient?

  • Is the sock complete, not torn?

  • Does the sock rotate freely?

  • Do you know the wind speed rating of the sock?

  • Is the wind speed rating noted on the chart or all socks on program the same?

  • Is it acceptable to NOT have a windsock at this location?

Incursions

  • Has this airstrip been incursion free the past year?

  • Check all types of incursions within the last year

  • List other types of Incursions

  • Are there any controls in place to mitigate incursions?

Airstrip chart

  • Is the landing abort point marked on the chart?

  • Has an IP or CP confirmed the validity of the landing abort point?

  • Date of last confirmation

  • Does the chart clearly state or depict approved takeoff/landing directions?

  • Are environmental conditions when takeoff restrictions were established available to the pilot?

  • Are unusual or critical approach and departure paths depicted?

  • Is the chart up to date?

  • Date of last revision

Fueling

  • Check here if fuel is stored at this location for refueling of company aircraft.

Drum Storage

  • Are drums and other containers clearly marked and separate?

  • Are other liquids stored separately from the AVTUR/AVGAS?

  • Check this box if any drums are stored outside

  • Are the Drums stored on their side?

  • Are drums stored in a shaded area?

  • Are drums stored off the ground?

  • Select the type(s) of aviation fuel stored at this location

Turbine Fuel

  • Is Biobor or Kathon used in every drum? (SMP-06)

  • Do the drums have a date when they were filled?

  • Have all drums of turbine fuel been stored less than 2 years?

  • Is rolling of drums minimized, and are they checked for contaminants and allowed to settle before draining?

AVGAS

  • Do the drums have a date when they were filled?

  • Have all drums of AVGAS been stored less than 2 years?

Fueling/defueling equipment

  • Is bonding wire used to fuel and defuel?

  • If plastic containers are used are they wet or is a hygrometer used to confirm 90% humidity?

  • If use Mr. Funnel, is the nozzle full length? (not cut off - a risk only for plastic)

  • Is there defueling procedures in place, i.e. hose available, helpers know how to fill hose, insert hose into fuel in container to reduce static electricity, bond aircraft to container, etc.?

  • Is all fueling equipment dry, with no evidence of leaks?

  • Is fuel transferred without siphoning fuel by mouth?

Security

  • Are controls in place to prevent unauthorized people from gaining access to the fuel?

  • Are drum openings marked/sealed to show if someone tampered with them?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.