Title Page
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Conducted on
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Prepared by
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Name of Person Conducting the Inspection
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Radio Check Completed
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Corrective Action
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General Safety Hazards
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Corrective Action
Airfield Lighting
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ARCAL System
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Runway Lights
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Windsock 28
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Windsock 10
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PAPI 28
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PAPI Inspection Report Completed
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PAPI 10
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PAPI Inspection Report Completed
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Taxiway Lights
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Strobe Beacon
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Obstruction Lights
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Signs
Runway, Taxiway & Apron
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During snow/ice removal days keep this report open until the last RCR/CRFI are complete for the day. Include all Snowiz report numbers and CRFI print outs.
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Maneuvering Surface Condition
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Contaminant (only list the initial contaminant at start of shift)
- Ice
- Dry Snow
- Wet Snow
- Frost
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Corrective Action
- De-Ice
- Plow
- Plow and Sweep
- Sweep
- Anti-Ice
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RCR Submitted on Snowiz (Add report # in Notes) (Required between October 15th & April 15th or anytime there are contaminants)
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Reason for no RCR
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CRFI Completed (Enter results in Notes)
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Reason No CRFI Conducted
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Take photo of CRFI paper print out (add all print outs for the day)
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Birds & Wildlife
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Complete the Wildlife Activity Form
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Security Gates Closed
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Corrective action
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Was corrective action successful?
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Create Action Item
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Foreign Object Debris (FOD) (Enter debris type in notes)
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Corrective action
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Was corrective action successful?
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Create Action Item
OLS Obstructions
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Equipment
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Structures
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Snow Piles or Windrows
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What is the corrective action?
Buildings
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Shop/Office
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Terminal Building (Unlock Doors Code: #1232#399#1)
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Floodlights & Sewer Alarms
Miscellaneous Items
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Parked Aircraft on Apron or Grass? (Enter Identifier in Notes)
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AWOS Site
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Private & Commercial Hangar Areas
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Airport Road
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Parking Lot
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Ditches (Flooding, Backed Up)
NOTAM Record
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Any NOTAMS required (Does not include Winter Maintenance)
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Print NOTAM and file in NOTAM Binder - put photo into this inspection
Inspection Sign Off
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Add signature
