Appendix G - Airstrip Checklist_ fortunato

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Yes

  No

  N/A

• KENMARE FIRE AND EMERGENCY SERCICES

  Yes

  No

  N/A

• Airport Checklist for Arrivals and Departures

  Yes

  No

  N/A

• Date:

  Date

• Time:

  Date

Check Items - Runway

• Serviceable

  Yes

  No

  N/A

• Unserviceable

  Yes

  No

  N/A

• Runway Lights

  Yes

  No

  N/A

• Runway Visibility

  Yes

  No

  N/A

• Perimeter Fence

  Yes

  No

  N/A

• Bird or Animal Activity

  Yes

  No

  N/A

• Runway Security

  Yes

  No

  N/A

• Runway FOD and Contamination

  Yes

  No

  N/A

• Wind sock condition

  Yes

  No

  N/A

• Fire Truck on Standby

  Yes

  No

  N/A

• Fire Truck Serviceabilty Checked

  Yes

  No

  N/A

• Fire Hydrant

  Yes

  No

  N/A

• Emergency Response Vehicle

  Yes

  No

  N/A

• Check Items - Apron

  Yes

  No

  N/A

• Serviceable

  Yes

  No

  N/A

• Unserviceable

  Yes

  No

  N/A

• Gate and Fences secure

  Yes

  No

  N/A

• FOD Check

  Yes

  No

  N/A

• Fuel or Contamination

  Yes

  No

  N/A

• Apron Free of Obstructions

  Yes

  No

  N/A

• Security on Standby

  Date

• Jet / Prop Blast Area safe

  Yes

  No

  N/A

• Apron or Runway Incident Occurrence

  Yes

  No

  N/A

• ERT Coordinator:

• Any incident involving an aircraft at the Airpot must be reported immediately to the Safety Officer

  Yes

  No

  N/A

• If YES, has Safety Officer been notified?

  Yes

  No

  N/A

• ERT Coordinator:

• Any incident involving an aircraft at the Airpot must be reported immediately to the Safety Officer

  Yes

  No

  N/A

• Details of Reporting Action

  Yes

  No

  N/A

• ERT Members

  Yes

  No

  N/A

• Security Supervisor on Duty

• Name

• Signature

  Sign

• Any significant occurrences or defects identified are recorded along with action taken to rectify the problem. For example:

• Movement area deficiencies requiring a Works Order (note serial number);

  Yes

  No

  N/A

• Significant safety or security events (INX number);

  Yes

  No

  N/A

• NOTAM issued (separate NOTAM Request form also required);

  Yes

  No

  N/A

• OLS infringements;

  Yes

  No

  N/A

• Brief details of AEP events (more comprehensive details may be required in a separate report);

  Yes

  No

  N/A

• Bird or animal strikes; or

  Yes

  No

  N/A

• Significant bird activity

  Yes

  No

  N/A

• Inspection records are retained as a permanent record of airport serviceability and made available on request for audit by authorised IACM staff

  Yes

  No

  N/A

• This Page Intentionally Left Blank

  Yes

  No

  N/A