INFORMATION

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

TRAINING

  • Is there at least one valid certificate Designated Trainer on-site? <br>

  • Is the Designated Deice/Anti-Icing Designated trainer certificate on file? (or via electronic LMS) <br>

  • Is there a Deicing/Anti-Icing Certificate of Training on file for each qualified individual? (or via LMS) <br>

  • Does the DT have the required training form #S102 on file? (if using the Mesa training program)

  • Is there a Deicing/Anti-Icing Differences Certificate of Instruction on file for each deice/anti-ice qualified individual? (for stations that don’t utilize the United/United Express Aircraft Deicing/Anti-Icing Training Program) <br>

  • Are there a sufficient amount of agents trained per shift to properly and safely deice Mesa aircraft according to our ops specs?(ie: Truck and boom operator if one truck operation, etc) <br>

  • Has yearly recurrent deice training been performed prior to October 1st and are the records on file? <br>

  • Does the qualified Designated Trainer have a form S102 on file? (for stations that don’t utilize the United/UAX Winter Ops Guide)

  • Does each Mesa Airlines, Inc. deice qualified agent have a properly completed S105? (for stations that don’t utilize the United/UAX Winter Ops Guide)

MANUAL

  • Does the station have a current and controlled copy of the Mesa Airlines, Inc. Deicing Manual 335? <br>

  • If not in electronic electronic format, are revisions, bulletins, & temporary revisions properly inserted & recorded in the station copy? <br>

  • Are revisions, bulletins, & temporary revisions properly inserted & recorded in the vendor copy? <br>

  • Does the station have access to the United/United Express Aircraft Deicing/Anti-Icing Training Program? (via CD, Expressnet, or Pocket Guide) <br>

  • If the station or vendor is using electronic manuals, can they access them during normal flight hours? <br>

FLUID STORAGE

  • Are tanks and storage containers conspicuously labeled to avoid contamination with other fluids (e.g. SAE Type 1 Aircraft Deicing Fluid)? <br>

  • Have Type II/IV tanks been examined annually for corrosion and/or contamination? <br>

  • If corrosion or contamination was evident, have tanks been properly repaired or replaced? <br>

  • Have fluids been checked to assure that no degradation/contamination has taken place? <br>

  • Are storage tanks sealed and remain sealed when not in use? <br>

SAFETY

  • Are Material Safety Data Sheets (MSDS) available? <br>

  • Is PPE and fall protection equipment available (provided free of charge) to all personnel? <br>

  • Eye protection

  • Gloves

  • Fall protection

  • Is the pad/ramp area that is used for deicing in adequate condition? (List any needed repairs).

EQUIPMENT

  • Are refractometers or approved glycol testers available and in acceptable condition? <br>

  • Lenses Inact

  • Batteries Functional (if needed)

  • Tested daily (Oct 1-April 30)

  • On deice fluid transfer equipment (e.g. trucks, stands, booms, etc.) are compatible pumps, control valves, piping, and application devices installed in accordance with the manufacturer’s recommendations to prevent mechanical shearing of fluid? <br>

  • On deice fluid transfer equipment (e.g. trucks, stands, booms, etc.) are fill ports & discharge points conspicuously labeled to prevent contamination due to inadvertent product mixing? <br>

  • Have deice fluid transfer equipment (e.g. trucks, stands, booms, etc.) been checked for proper operation? (Correct functioning of proportioning equipment should be verified by checking dispensed fluid coming out of the spray nozzle for refractive index to ensure intended dilution, if applicable). <br><br><br>

  • Have combustion heaters on deice fluid transfer equipment (e.g. trucks, stands, booms, etc.) been checked for proper operation? <br>

  • Have deice fluid transfer equipment used to deice Mesa Airlines, Inc. Aircraft (e.g. trucks, stands, booms, etc.) been checked for adequacy in accordance with the manufacturer’s recommendations (e.g. leaks, safety defects, serviceability, general condition, etc.) <br>

  • Are hoses used during deicing/anti-icing operation free from leaks?

  • Is a safety harness on boom trucks? <br>

  • Is sufficient support equipment available to conduct physical removal of snow, ice (brooms)? <br>

  • Is sufficient communication equipment available to conduct deicing operations (e.g. radios, dry erase/grease board, etc.)? <br>

  • Is equipment being utilized in accordance with required or accepted procedures? <br>

  • For Type l & Type III, or Type II & lV if diluted, is a fluid freeze test conducted: <br>

  • After partially or completely filling the deicing truck/cart?

  • Immediately prior to the first deicing operation each day?

  • Deicing crew change? (Truck or Cart)

  • Are Infrared deicing facilities clean and in good repair? (i.e.; no exposed wiring) Infrared panels are in good condition? <br>

RECORDS

  • Is the Glycol Storage Fill Log (#M502) (or equivalent) properly filled out & on file for the entire deice season? (must be retained until at least April 30th or until the end of the local deice season) <br>

  • Is the Aircraft Deicing Anti-icing Record (#M504) (or equivalent) properly filled out & on file for the entire deice season? (must be retained untill at least April 30th and until the end of the local deice season) <br>

  • Are fluids in use qualified per the Mesa Airlines, Inc. Deicing Manual? <br>

  • Is the Weekly Deicing Equipment Inspection Checklist (#506) (or equivalent) properly filled out & on file for the last 30 days? <br>

APPLICATION

  • Fluid was sprayed from leading edge to trailing edge of control surfaces? <br>

  • Fluid application was clockwise & started at the Captain’s wing first? <br>

  • All critical surfaces were sprayed? <br>

  • Truck/equipment maintains a 5 foot clearance from the aircraft? <br>

  • Was a visual or tactile check performed of the aircraft wings by ground personnel? <br>

  • After deicing was the fluid type, glycol mixture percentage, start time, and confirmation of deicing/anti-icing relayed to the flight crew? <br>

  • Is spraying up wind of deicing/anti-icing fluid avoided? <br>

  • When using boom-type deicing units and work stands/platforms is a safety belt or harness worn? <br>

  • Is deicing/ant-icing not performed while passengers are boarding or deplaning? <br>

  • Do agents wear a face shield or goggles when spraying fluid? <br>

  • Do ground personnel advise flight crew which communication methods will be used during the deicing/anti-icing process?

OUTBRIEF & SIGNATURE

  • Please sign below to acknowledge that the audit results have been reviewed with you.

  • Add signature

  • Auditors Signature

  • Add signature

  • Auditor Comments

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.