Title Page
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Airline / Flight Number
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Station
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Conducted on
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Prepared by
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Airline
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Flight Number
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Aircraft Number
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Gate
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Schedule Arrival Time
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Schedule Departure Time
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Actual Arrival Time
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Actual Departure Time
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Delay Code
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Reason for late arrival (If applicable)
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Total Time of Delay
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Fuel Agent
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Fueling Equipment Number
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Total Fuel Load Requested
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Total Gallons Added From Meter
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Root Cause
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Contributing Factors
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Corrective Action(s) Taken or Recommended
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Detailed Explanation of How the Delay Happen:
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Supervisor/Duty Manager
