Information

  • Document No.

  • Prepared by

  • Conducted on

  • CONDUCTED AT LHR AT

  • OPERATION TYPE

  • AIR TEMPERATURE

  • WEATHER CONDITIONS

  • DRIVER NAME AND STAFF NUMBER

  • OPERATOR NAME AND STAFF NUMBER

  • VEHICLES USED

SAMPLE CHECK (RECORD ANY CORRECTIVE ACTION TAKEN)

  • Was aircraft configured correctly for fluid application

  • Fluid mix

  • Enter fluid ratio

  • Is fluid mix correct for OAT and hold over time

  • Check and record the refractive index of the fluid used

  • Is the refractive index within limits

  • Record temperature of the fluid applied

  • Was the fluid applied as close to the aircraft as safety would allow to prevent heat loss

  • Was the time taken to complete the operation acceptable

  • Was the aircraft treated symmetrically

  • We're any prohibited areas respected during the operation

  • We're the correct procedures adhered to during the operation

  • Was the final inspection performed correctly

  • Was the appropriate anti-icing code communicated to the flight crew

  • Was the equipment suitable for the operation

  • We're the personnel competent in performing the task

  • Are operatives and release staff approved

  • Are station records maintained for all de-icing operations

  • General observations

  • Copies of this form to the station de-icing folder

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.