Information
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Document No.
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Airstrip Name
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Program/Base
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Conducted on
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Prepared by
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Location
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Personnel
Airstrip
Diagram the airstrip (optional)
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Use this tool to draw a diagram of the airstrip.
Length & Width
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Measure and record the airstrip length
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Does the measured length match the airstrip directory?
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Measure and record the airstrip rollable width
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Does the measured width match the airstrip directory?
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Measure and record the wingtip clearance width
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Does the rollable width AND wingtip clearance allow for a 20' excursion for the largest aircraft using the airstrip?
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Does the rollable width AND wingtip clearance allow for a 10' excursion for the largest aircraft using the airstrip?
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When any aircraft is placed on the edge of the rollable surface, are all obstructions still clear of wingtip?
Altitude
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Record the Airstrip Elevation
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Does it match the elevation on the airstrip chart?
Slope
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Measure and Record the Airstrip Average Slope
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Measure and Record any Side Slope(s)
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Measure and Record any Slope Changes
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Measure and Record any Bounders
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Do the measured slopes match the slopes recorded on the airstrip chart?
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Is the slope in first 300' less than 15%?
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Are all the bounders less than a rise of 5" in 50'?
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Are all the bounders less than a rise of 10" in 50'?
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Is the rate of slope change in the first 500' less than 1.5% per 100 feet?
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Is the rate of slope change in the first 500' less than 2.5% per 100 feet?
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Is the side slope less than 2%?
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Is the side slope less than 4%?
Surface
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Mark all the types of Surface at this location
- Grass
- Gravel
- Asphalt
- Dirt
- Other
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Enter description of other surface type
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Is the grass cut well enough?
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Is the airstrip firm with no areas of recent construction/repairs that could leave soft spots?
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Is the surface level with no Ruts/holes on the rollable surface?
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Have all areas with an increased risk of softness been properly tested?
Obstructions
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Are all obstructions on approach/landing listed on the chart?
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Is the angle to the top of the highest obstacle on departure from the 75% point greater than 1.5 degrees?
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Is the angle marked on the Airstrip Directory?
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Measure and record the angle in degrees to top of highest obstacle on approach from the TDP:
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Is the TDP on the chart being used by the pilots?
Sides of Airstrip
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Are the sides clearly defined?
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Would rolling off the sides result in less than substantial damage?
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Do the wings clear vegetation/obstructions when the wheels are on the edge of strip?
Ends of airstrip
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Are the ends clearly visible on approach?
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Would running off the end on landing rollout result in less than substantial damage?
Turn Around and Parking Area
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Is there adequate room to turn around?
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Is there adequate wing clearance?
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Is the parking area firm with no recent construction/repairs that could leave soft spots?
Markers and windsocks
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Are all 50% and 75% (90%) markers in place and easily visible?
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Check this box if there is currently a windsock at this location
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Are windsocks visible in the pattern, on approach and takeoff?
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Is the current windsock location and quantity sufficient?
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Is the sock complete, not torn?
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Does the sock rotate freely?
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Do you know the wind speed rating of the sock?
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Is the wind speed rating noted on the chart or all socks on program the same?
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Is it acceptable to NOT have a windsock at this location?
Incursions
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Has this airstrip been incursion free the past year?
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Check all types of incursions within the last year
- People
- Animals
- Vehicles
- Other
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List other types of Incursions
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Are there any controls in place to mitigate incursions?
Airstrip chart
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Is the landing abort point marked on the chart?
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Has an IP or CP confirmed the validity of the landing abort point?
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Date of last confirmation
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Does the chart clearly state or depict approved takeoff/landing directions?
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Are environmental conditions when takeoff restrictions were established available to the pilot?
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Are unusual or critical approach and departure paths depicted?
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Is the chart up to date?
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Date of last revision
Fueling
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Check here if fuel is stored at this location for refueling of company aircraft.
Drum Storage
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Are drums and other containers clearly marked and separate?
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Are other liquids stored separately from the AVTUR/AVGAS?
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Check this box if any drums are stored outside
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Are the Drums stored on their side?
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Are drums stored in a shaded area?
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Are drums stored off the ground?
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Select the type(s) of aviation fuel stored at this location
- AVGAS
- AVTUR
Turbine Fuel
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Is Biobor or Kathon used in every drum? (SMP-06)
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Do the drums have a date when they were filled?
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Have all drums of turbine fuel been stored less than 2 years?
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Is rolling of drums minimized, and are they checked for contaminants and allowed to settle before draining?
AVGAS
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Do the drums have a date when they were filled?
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Have all drums of AVGAS been stored less than 2 years?
Fueling/defueling equipment
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Is bonding wire used to fuel and defuel?
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If plastic containers are used are they wet or is a hygrometer used to confirm 90% humidity?
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If use Mr. Funnel, is the nozzle full length? (not cut off - a risk only for plastic)
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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.?
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Is all fueling equipment dry, with no evidence of leaks?
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Is fuel transferred without siphoning fuel by mouth?
Security
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Are controls in place to prevent unauthorized people from gaining access to the fuel?
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Are drum openings marked/sealed to show if someone tampered with them?