De-icing audit form equivalent X622

• Document No.

• Prepared by

• Conducted on

  Date

• Location

  Select

• Stand number

  Select

• Stand number

  Select

• Stand number

  Select

• OPERATION TYPE

  FULL DE-ICE

  OVER WING AND TAIL

  2 STEP

  SPOT

• AIR TEMPERATURE

• WEATHER CONDITIONS

• DRIVER NAME AND STAFF NUMBER

• OPERATOR NAME AND STAFF NUMBER

• VEHICLES USED

  Select

SAMPLE CHECK (RECORD ANY CORRECTIVE ACTION TAKEN)

• Was aircraft configured correctly for fluid application

  Yes

  No

  N/A

• Fluid mix

  100%

  75/25

  50/50

  other

• Enter fluid ratio

• Is fluid mix correct for OAT and hold over time

  Yes

  No

  N/A

• Check and record the refractive index of the fluid used

• Is the refractive index within limits

  Yes

  No

  N/A

• Record temperature of the fluid applied

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

  Yes

  No

  N/A

• Was the time taken to complete the operation acceptable

  Yes

  No

  N/A

• Was the aircraft treated symmetrically

  Yes

  No

  N/A

• We're any prohibited areas respected during the operation

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Was the final inspection performed correctly

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Was the equipment suitable for the operation

  Yes

  No

  N/A

• We're the personnel competent in performing the task

  Yes

  No

  N/A

• Are operatives and release staff approved

  Yes

  No

  N/A

• Are station records maintained for all de-icing operations

  Yes

  No

  N/A

• General observations

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