HNL Tie-Down Aircraft Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Airport Information

• Airport Name

• Airport Classfication

• Aircrafts Parking Area On Airport

• Date & Time of Aircraft Audit

  Date

HNL Bldg 423, 187A

• Name of Tenant

• Aircraft Number

• Does Aircraft have a current HDOT Registration Decal Visible?

  Yes

  No

  N/A

• Does Aircraft Owner have a current Revocable Permit with AIR-PM?

  Yes

  No

  N/A

• Is Aircraft Air-worthy?

  Yes

  No

  N/A

HNL Bldg 423, 187B

• Name of Tenant

• Aircraft Number

• Does Aircraft have a current HDOT Registration Decal Visible?

  Yes

  No

  N/A

• Does Aircraft Owner have a current Revocable Permit with AIR-PM?

  Yes

  No

  N/A

• Is Aircraft Air-worthy?

  Yes

  No

  N/A

HNL Bldg 423, 187C

• Name of Tenant

• Aircraft Number

• Does Aircraft have a current HDOT Registration Decal Visible?

  Yes

  No

  N/A

• Does Aircraft Owner have a current Revocable Permit with AIR-PM?

  Yes

  No

  N/A

• Is Aircraft Air-worthy?

  Yes

  No

  N/A

HNL Bldg 423, 187D

• Name of Tenant

• Aircraft Number

• Does Aircraft have a current HDOT Registration Decal Visible?

  Yes

  No

  N/A

• Does Aircraft Owner have a current Revocable Permit with AIR-PM?

  Yes

  No

  N/A

• Is Aircraft Air-worthy?

  Yes

  No

  N/A

HNL Bldg 423, 187E

• Name of Tenant

• Aircraft Number

• Does Aircraft have a current HDOT Registration Decal Visible?

  Yes

  No

  N/A

• Does Aircraft Owner have a current Revocable Permit with AIR-PM?

  Yes

  No

  N/A

• Is Aircraft Air-worthy?

  Yes

  No

  N/A

Compliance Assessment Photo(s)

• Photo(s)

  Media

Name & Signature of Inspector

• Name of Inspector

  Sign

HDOT Review

• AIR-L, AIR-LF, AIR-LG, AIR-LC, AIR-PM

  Date

• AIR-O, AIR-OO

  Date