Line Check Report - Customs Operations (Form 5.13A)

Template date 13/2/14

• Pilots name

• Pilots rank

  Captain

  FO

• Other pilot (if applicable)

• Check type

  Recurrent line check

  Directed line check

  Check to line

  Follow up line check

• Day 1 conducted on

  Date

• Day 2 (if required) conducted on

  Date

• Check Pilot

• Day 1 aircraft

  Select ZZA ZZB ZZC ZZE ZZF ZZG ZZI ZZJ ZZN ZZP

  • ZZA
  • ZZB
  • ZZC
  • ZZE
  • ZZF
  • ZZG
  • ZZI
  • ZZJ
  • ZZN
  • ZZP

• Day 1 flight route

• Block time

• Day 2 aircraft

  Select ZZA ZZB ZZC ZZE ZZF ZZG ZZI ZZJ ZZN ZZP

  • ZZA
  • ZZB
  • ZZC
  • ZZE
  • ZZF
  • ZZG
  • ZZI
  • ZZJ
  • ZZN
  • ZZP

• Day 2 flight route

• Block time

• Documentation

  Sat.

  Unsat.

• Emergency procedures (N/A for CTL)

  Sat.

  Unsat.

• Maintenance procedures

  Sat.

  Unsat.

• PRE - FLIGHT Flight Planning, Cockpit setup, Crew briefing, Take-off briefing, Start/Taxi, Departure time

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• IN - FLIGHT Take-off, Climb, Cruise, Descent, Landing, Situational awareness, Airspace/traffic awareness, Weather avoidance

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• SURVEILLANCE PROCEDURES OMSA 3 requirements/limitations, Fuel management, Crew coordination, Work cycles

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• PHOTO PASSES Procedures, Profile management, Manoeuvring, Spacing, Speed Control, Smoothness, SOP's

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• SURVEILLANCE HOMINGS Procedures, Checklists, Descent planning, Profile management, Situational awareness, Speed control, Climb to LSALT, SOP's

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• Instrument approach type

  Select ILS LLZ RNAV/GNSS VOR NDB DGA

  • ILS
  • LLZ
  • RNAV/GNSS
  • VOR
  • NDB
  • DGA

• INSTRUMENT APPROACH Briefing, Profile management, Accuracy/IFR Tolerances, SOP's, Threat awareness

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• AUTOMATION MANAGEMENT Data input/Cross check, Mode awareness, Mode limitations, Warnings/messages, Use of AFCS/FMS, Monitoring, Appropriate automation usage

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• TECHNICAL PROFICIENCY Technical knowledge, SOP/AIP procedures, R/T procedures, Emergency procedures, Maintenance procedures

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• CREW SKILLS Communication, Leadership/Followership, Crew relationship, Monitoring

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• MANAGEMENT SKILLS Task management, Workload management, Decision making, Situational Awareness

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• THREAT AND ERROR MANAGEMENT Identifies and manages risk, Identifies and traps errors.

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

• Total Score

• OVERALL ASSESMENT

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Comments

EVALUATION SCALE 1 Unsatisfactory 2 Poor Performance Marginally Unsatisfactory 3 Acceptable Standard 3+ Solid Standard 4 High Standard 5 Well above average

• Number of photo passes?

  1

  2

  3

  4+

• Number of night homings

  1

  2

  3

  4+

• Night homing 1

  Select Simulated Actual Inshore Offshore

  • Simulated
  • Actual
  • Inshore
  • Offshore

• Night homing 2

  Select Simulated Actual Inshore Offshore

  • Simulated
  • Actual
  • Inshore
  • Offshore

• Number of IMC homings

  1

  2

  3

  4+

• IMC homing 1

  Select Simulated Actual Inshore Offshore

  • Simulated
  • Actual
  • Inshore
  • Offshore

• IMC homing 2

  Select Simulated Actual Inshore Offshore

  • Simulated
  • Actual
  • Inshore
  • Offshore

• Weather

  Light

  Moderate

  Heavy

• Contact density

  Light

  Moderate

  Heavy

• Overall comments

• Self assessment

  Select 1 2 3 3+ 4 5

  • 1
  • 2
  • 3
  • 3+
  • 4
  • 5

• Check pilot signature

  Sign

Distribution list Pilot SMOPS TC HLO HPT