Ramp Servicing 2012.2

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

LAVATORY SERVICING

• Was a guide person used when backing the lavatory truck to the aircraft? N/A if cart.

  Yes

  No

  N/A

• Were proper safety stops performed while approaching aircraft; 1 at 25 feet and 1 at 8 feet?

  Yes

  No

  N/A

• Were face shield and rubber gloves available in vehicle and were they in usable condition?

  Yes

  No

  N/A

• Were face shield and rubber gloves used when servicing the lavatories?

  Yes

  No

  N/A

• Did the ramp teammate use the back of the truck or a step ladder to reach the panel?

  Yes

  No

  N/A

• Did the ramp teammate connect:<br>Waste hose to the waste tank drain, and<br>

  Yes

  No

  N/A

• Did the ramp teammate ensure that the drain hose was securely locked into place?<br>

  Yes

  No

  N/A

• Did the ramp teammate move the flapper to the "open" position?

  Yes

  No

  N/A

• Did the ramp teammate slowly pull the drain valve handle from the "normal" to the "drain" position?

  Yes

  No

  N/A

• Did the ramp teammate pump fifteen (15) gallons of fluid through the tank with the dump hose attached to rinse the tank?

  Yes

  No

  N/A

• Did the ramp teammate wait until all fluid had drained completely, before returning drain valve handle to the "normal" position?

  Yes

  No

  N/A

• Did the ramp teammate pump three (3) gallons of disinfectant fluid from the lavatory truck / cart into the aircraft lavatory system?

  Yes

  No

  N/A

• Did the ramp teammate disconnect the waste hose and close the cover for the port?

  Yes

  No

  N/A

• Did the ramp teammate remove the full hose and let any fluid in the fill port to properly drain to prevent "blue ice"?

  Yes

  No

  N/A

• Did the ramp teammate close the fill port cap?

  Yes

  No

  N/A

• Did the ramp teammate close the lavatory service panel on the aircraft and make sure that the panel was secured?

  Yes

  No

  N/A

• Did the ramp teammate secure all of those hoses and gear, prior to leaving the circle of safety?

  Yes

  No

  N/A

• Did the ramp teammate drive in a safe manner away from the aircraft?

  Yes

  No

  N/A

FRESH WATER SERVICING

• Was a guide person used when backing the water truck to the aircraft? N/A if cart or cabinet.

  Yes

  No

  N/A

• Were proper safety stops performed while approaching aircraft; 1 at 25 feet and 1 at 8 feet? N/A if cart or cabinet.

  Yes

  No

  N/A

• Did the water come from a health department approved source? (Potable Water Truck, Cart or Cabinet)

  Yes

  No

  N/A

• Was the hose kept clean and free from contamination, while secured and while being used?

  Yes

  No

  N/A

• Was the potable water hose flushed for a minimum of thirty (30) seconds before connecting to the aircraft?

  Yes

  No

  N/A

• Did the ramp teammate remove the cap on the fill port and attach the water hose?

  Yes

  No

  N/A

• Did the ramp teammate pull the fill / drain handle and twist to the "pull to fill" mark?

  Yes

  No

  N/A

• Did the ramp teammate turn on the water and fill the tank as indicated?

  Yes

  No

  N/A

• Did the ramp teammate stop the fill hose and turn the fill / drain handle back to the "normal" position?

  Yes

  No

  N/A

• Did the ramp teammate remove the water hose and allow residual water in the line to drain before replacing the cap on the fill port?

  Yes

  No

  N/A

• Did the ramp teammate close and secure the water panel?

  Yes

  No

  N/A

• Did the ramp teammate secure all of those hoses and gear on the truck or cart prior to leaving the circle of safety? N/A if cabinet.

  Yes

  No

  N/A

• Did the ramp teammate drive the water truck in a safe manner away from the aircraft? N/A if cart or cabinet.

  Yes

  No

  N/A

AUDIT CONFIRMATION

• On site representative

  Sign

• Auditor's signature

  Sign