Shop 8

• Auditor

• Date

  Date

• Audit Title

• Schedule ID Number

• Audit Group

  Base

• Audit Type

  Select Ad Hoc (Req. by other dept) Area Audit - DWH Area Audit - TUL CASE Allocated Class I Class I Quarterly (Ramp, Compliance etc) Class II Class III Class IV Compliance 121 In-Process Audits Contract Maintenance De-icing/De-icing Pre-award DG Dry Cleaners EASA 145 Line Maintenance Engine Lease Engineering Document Process Audits Essential Maintenance FAA ATOS Facilitation Follow-up (Overall Risk Serious or High) Fueling/Fueling Pre-award IATP Parts Pool LOI/VSD Manufacturer/Manufacturer Pre-award New Station Startup ODA CFR 183 Pre Award - On-Call Maintenence Pre Award - Repair/Overhaul ROV SAI/EPI Specialized Services/Pre-Award Specialized Services Surplus/Distributor System Audit (M&E) TULE 145 Repair Stations TULE 145 RSQCM Procedural/In-Process

  • Ad Hoc (Req. by other dept)
  • Area Audit - DWH
  • Area Audit - TUL
  • CASE Allocated
  • Class I
  • Class I Quarterly (Ramp, Compliance etc)
  • Class II
  • Class III
  • Class IV
  • Compliance 121 In-Process Audits
  • Contract Maintenance
  • De-icing/De-icing Pre-award
  • DG
  • Dry Cleaners
  • EASA 145 Line Maintenance
  • Engine Lease
  • Engineering Document Process Audits
  • Essential Maintenance
  • FAA ATOS Facilitation
  • Follow-up (Overall Risk Serious or High)
  • Fueling/Fueling Pre-award
  • IATP Parts Pool
  • LOI/VSD
  • Manufacturer/Manufacturer Pre-award
  • New Station Startup
  • ODA CFR 183
  • Pre Award - On-Call Maintenence
  • Pre Award - Repair/Overhaul
  • ROV
  • SAI/EPI
  • Specialized Services/Pre-Award Specialized Services
  • Surplus/Distributor
  • System Audit (M&E)
  • TULE 145 Repair Stations
  • TULE 145 RSQCM Procedural/In-Process

• Checklist

  Shop 8

• Auditee Entity (Station)

• Auditee

• Audit Purpose

01 Airworthiness Directive (AD) Management

• 01.01.00 - Verify ADs are accomplished as applicable. GPM 16.22

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

02 Life Limited Parts Management

• 02.01.00 - Verify life limited parts determined to be scrap are mutilated to become unusable for their original intended use? If none observed, can the interviewee explain the procedure? GPM 27.03.4 GPM 30.03.5.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

06 Major Repairs and Alterations

• 06.01.00 - Verify major repairs that are in progress to primary structure include the repair authorization reference. GPM 02.26.2

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 06.02.00 - Verify major repairs and major alterations are tracked in the Major Repair & Tracking (MRT). GPM 17.06

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 06.03.00 - Verify for SRM, AARD, or Structure EA repairs, the BOW includes Section 12 work card 51-92-02 for each repair. GPM 17.09.2

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

08 Compliance with Scheduled Maintenance Programs

• 08.01.00 - Verify compliance of ECO / FCD and S/B accomplishment reporting procedures (if applicable). GPM 16.05

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 08.02.00 - Verify compliance of aircraft and engine component time control procedures (if applicable). GPM 16.08

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

09 Maintenance Contractual Agreement

• 09.01.00 - Verify no work is performed until authorization given by customer or customer designee. CAM 12.01 CAM 12.03

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 09.02.00 - Verify Customer supplied parts are segregated from repair station owned parts. RSQCM 03.05.4.2

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 09.03.00 - Verify training and qualifications, required by customer, are completed and documented. RSQCM 05.01

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 09.04.00 - Verify Production Control has attached all appropriate paperwork, including Customer Identification Tag 8350 and/or Contract Shop Order and budgetary quote (if required), prior to routing to appropriate shop. CAM 12.03 A. RSQCM 11.02.4 E. RSQCM 03.15.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 09.05.00 - Verify the technician processes the part(s) per the Contract Shop Order and authority. Verify the authority lists the repair reference. RSQCM 03.15.4 D.3.

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10 Parts, Components, and Materials

• 10.00.01.00 - Verify compliance of procedures for Certification of Serviceable Components Removed for Reasons Other than Time or Failure. GPM 20.12.

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.00.02.00 - Verify that suspected unapproved parts are identified and tagged with a QPA Form 8204. GPM 18.03

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.00.03.00 - Verify Shops and hangar docks that keep raw material in their area keep a copy of the certification documents for that material GPM 20.13.7.3 C

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.00.04.00 - Verify procedures for originating, usage, and processing of Special Handling/Non-Conforming Parts tag. GPM 20.01

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.01 Storage/Identification

• 10.01.01.00 - Verify serviceable and unserviceable parts are segregated and properly identified. GPM 20.14.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.01.02.00 - Verify parts stored in bins, drawers or shelves meet the following conditions. They must be segregated by type and identified by part number, are bagged to prevent foreign objects from entering (for example, O-rings, fittings, bearing, filters), are capped to prevent foreign objects from entering (for example, ducts, hoses, tubing) unless tagged unserviceable, and are protected to eliminate the possibility of damage to them. Aircraft parts must be segregated from non-aircraft parts. GPM 20.14.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.01.03.00 - Verify compliance of procedures for handling of unserviceable parts. GPM 27.03

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.01.04.00 - Verify approved parts are identified with an FAA form 8130-3, EASA Form One (1), Transport Canada Authorized Release Certificate Form 24-0078, Certificate of Conformance statement or Material Certification. GPM 20.13.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.01.05.00 - Verify aircraft wheel assemblies are stored properly and have appropriate paperwork attached. Check for evidence of metal-to-metal contact. GPM 07.06.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.01.07.00 - Verify O-rings/Bearings are stored in their original bags, envelopes, boxes, or other packaging. GPM 20.15.2

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.02 AA Manufactured Parts

• 10.02.01.00 - Verify AA manufactured parts produced by AA drawing are correctly identified. GPM 27.20.4 C, MPSM Section 19

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.02.02.00 - Verify the use of AA manufactured parts is for the intended aircraft/component as identified on the AA drawing. GPM 27.20

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.03 Oxygen Component Handling

• 10.03.01.00 - Verify compliance of handling procedures of oxygen components (Oxygen Generators, Oxygen Bottles, Protective Breathing Equipment (PBE) and all oxygen parts from the Passenger Service Units (PSU), Attendant Service Units (ASU) and Lavatory Service Units (LSU). GPM 12.02

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.05 ESD Parts Handling

• 10.05.01.00 - Verify ESDS identified LRUs are protected from electrostatic discharge (capped and/or bagged) unless actively being worked on otherwise the component is unserviceable and should be labeled as such. GPM 20.39.3 ESDS 01.01.5

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.05.02.00 - Verify repair procedures are being followed per the manual/ESO/etc. GPM 20.39.4, ESDS 01.01.6

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.05.03.00 - Verify permanent ESDS workstation wrist strap serviceability testing on first working day. Previous month and current log sheets are to be retained (ESD Workstations using an approved Continuous Monitoring System do not require recurrent testing and logs heet entries). GPM 20.39.9, ESDS 1.01.10

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.05.04.00 - Verify personnel are grounding themselves with a wrist strap before handling ESD devices. Are all procedures on open ESD components performed at approved ESD workstations. GPM 20.39

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.06 Shelf Life Material

• 10.06.01.00 - Verify shelf life materials are identified with the AA shelf life label. GPM 12.06, MSM 02.03

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.06.02.00 - Verify out of date shelf life controlled materials are properly disposed of or marked with a red X. GPM 12.06.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.06.03.00 - Verify that the basis of multi-part kit shelf-life dates is on the shortest shelf life indicated on any component of the multi-part kit. GPM 12.06.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.06.04.00 - Verify shelf-life materials are stored with new stock behind older/partially used stock. GPM 12.06.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.06.05.00 - Verify that shelf life materials that have multiple shelf lives based on storage temperature are re-identified with the correct expiration date by the group degrading the shelf life. GPM 12.06.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.07 Shelf Life-Sealant and Structural Bonding Material

• 10.07.01.00 - Verify where PREMIXED SEALANTS are stored in freezers, the shelf life is printed on pre-mix frozen tubes. If a freezer does not have a certified temperature control, the temperature of the freezer is checked each month and a record of the temperature at the time of the check in Stores. If a freezer has a certified temperature control, temperature checks and records are not required but the sealant storage freezer must have a temperature graph to give a continuing record of freezer temperature and proof of constant temperature. GPM 12.06.11

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.00 - Verify shelf life limited STRUCTURAL MATERIALS are stored in a sealed bag and kept free from moisture. GPM 12.09.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.01 - Verify shelf-life limited STRUCTURAL MATERIALS received in the area are certified prior to use. GPM 12.09.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.02 - Verify TULE Form 8403 will be originated by Tulsa Composite Center before shipment of STRUCTURAL BONDING MATERIAL for use outside the Center, Production maintains the form, and the remains in the area where the freezer is located. At locations where QC is based, they shall audit, no less than monthly, the previous and current temperature discs to ensure the temperature is within required ranges and the form is current and properly completed. Production replaces the temperature disc every 7 days and temperature discs are retained for a period of 1 year. GPM 12.09.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.03 - Verify shelf life limited STRUCTURAL BONDING MATERIAL that is sub-kitted at a local station has a TULE form 8403 that contains the original information from the original form, in the block for KIT number, use the original roll number, followed as #-A, #-B, #-C, etc., for each kit made from the original kit (for example, 050-A). Sub-kits of these rolls will be identified with a -1, -2 (for example, 050-A-1). GPM 12.09.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.04 - Verify shelf life limited STRUCTURAL MATERIALS exposed to temperatures above 32° are recorded on TULE form 8403 or CC form 93-1 and those exceeding exposure time are discarded (exposure time is cumulative and shall not be zeroed by revalidation testing). GPM 12.09.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.05 - Verify the re-validation of shelf life limited STRUCTURAL MATERIALS, which have gone beyond the manufacturer prescribed shelf life. GPM 12.09.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.07.02.06 - Verify if miscellaneous STRUCTURAL MATERIALS (non-temperature controlled), used in bonded parts and assemblies, are stored as required. GPM 12.09.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

10.09 MRQ Procedures

• 10.09.01.00 - Verify Repair of Parts and Return to Higher Assembly (MRQ) procedures. Did the MRQ contain a list of all applicable non-routine(s), Maintenance Check Manual (MCM) work cards and Engineering Change Orders (ECOs) on MRQ before being routing to the shop for repair. GPM 27.09.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.09.01.01 - Verify during repairs, per MRQ procedures, if the shop observed other defects requiring repair, non-routine(s) were initiated documenting all repairs done. Verify additional shop-generated non-routine(s) are listed on the MRQ Form. GPM 27.09.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.09.01.02 - Verify, per MRQ procedures, all completed non-routine(s), MCM work cards, ECOs and the MRQ tag accompany the part to the originating shop or dock. GPM 27.09.1<br>

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 10.09.01.03 - Verify the shop Engineering Specification Order (ESO) for parts routed for repair using the MRQ procedure allows for repair of the specific defect and does not require full repair. GPM 27.09.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

11 Maintenance Task Accomplishment

• 11.01.00 - Verify personnel are using the correct revision of manuals, work cards, drawings. GPM 03.02.4, GPM 03.02.5

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 11.02.00 - Verify personnel are following the documented processes and procedures as published. GPM 03.06.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

13 Maintenance Records

• 13.00.01.00 - Verify the shop order lists the appropriate authority. GPM 30.06.7

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.02.00 - Verify compliance of maintenance document signature requirements (payroll signature and legible employee number in black or blue ink). GPM 09.03.11

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.04.00 - Verify maintenance documents signed off as NA include what task is duplicated on another open document or another source document (maintenance manual, IPC, work cards, etc.) and gives authorization that the task is not applicable. GPM 9.03.10

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.05.00 - Verify maintenance documents signed off as PA include an accompanying signature that signifies he/she accepts the responsibility for the completion of the task/repair in an airworthy manner. GPM 09.03.10

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.07.00 - Verify build Logs are utilized for recording and confirming P/Ns and S/Ns for LLP/Time Controlled parts at assembly for the purpose of reporting correct information to the Log Records Department and verifying the remaining life limit of all parts. GPM 26.02.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.09.00 - Verify compliance of procedures for wheel and tire recording. GPM 07.05

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.10.00 - Verify there are records for all work done on airframes, engines and accessories. These records show the work done, who did the work and what date the work was completed, i.e.8130-3, shop order, BOW and build logs. GPM 09.03.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.11.00 - Verify unserviceable parts have either an AA Unserviceable Parts Tag (Form 8212), AA Inventory Identification Tag and Unserviceable Tag (Form 8480), or a Shop Order attached. GPM 27.03.6 GPM 27.03.7

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.00.14.00 - Verify areas using Signature Stamps maintain a Stamp Record Card Form B-7-28 issued for each stamp including a complete chronological history and signature of recipients of a stamp. GPM 18.19.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

13.02 Aircraft Repair Items Non-Routine

• 13.02.01.00 - Verify compliance of procedures for paper NON ROUTINE issuance and log requirements. GPM 17.11.3.

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.02.00 - Verify corrective actions on paper non-routine repair items are entered in the Repair/Corrective Action Section and signed for in the Mechanic block adjacent to the last line of the corrective action. GPM 17.11.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.03.00 - Verify maintenance discrepancies signed off as, Checked and Approved for Service, contain the authority or reference. GPM 17.11.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.04.00 - Verify corrective actions on NON ROUTINEs are descriptive to indicate positive repair action and do not contain general statements like fixed, repaired, or replaced and includes authority reference. GPM 17.11.5

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.05.00 - Verify compliance of procedures for transferring information from one NON ROUTINE to another. GPM 17.11.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.06.00 - Verify a rejected item has the reason for rejection entered on the paper NON ROUTINE in red ink and identified as RII or QC. Only one discrepancy is written in the discrepancy block. GPM 17.11.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.07.00 - Verify compliance of procedures for repair item turnover on NON ROUTINEs. GPM 17.11.6 DWMS GPM 17.11.8 Paper

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 13.02.08.00 - Verify compliance of procedures for lost or misplaced NON ROUTINE forms at C Check, Base Check, MBV and Phase Check for TUL and DWH. GPM 17.11.4 GPM 17.11.12

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

14 Maintenance Training Programs

• 14.01.00 - Verify that office codes for personnel are correct. GPM 19.02

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 14.02.00 - Verify area in audit is complying with the Form 8435 Process for new hires, recalls, and transfer employees. GPM 19.01.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 14.03.00 - Verify that required training is established and accomplished. GPM 19.02.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 14.04.00 - Verify that personnel medical exams are current, including but not limited to hearing and eye exams.

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 14.05.00 - Verify maintenance personnel are qualified, fleet or otherwise. For fleet quals, A180. If not, is he/she accomplishing the work only under the guidance of a person who is properly trained and qualified on the particular fleet or task? GPM 19.01.03. GPM 19.03.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 14.06.00 - Verify training is current for personnel who operate a powered industrial truck. SSE 2.150

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

15 Tools, Test Equipment, and Ground Equipment

• 15.01.00 - Verify that tools and test equipment are correctly identified, stored (equipment capped and plugged), and within calibration time requirements. GPM 21.01.2 NDT 01.03.1

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 15.02.00 - Verify tools/test equipment used to give the final acceptance or make aircraft, engines or components serviceable that are out of calibration time intervals or are in unserviceable condition have a Unserviceable Ground Equipment Tag Form E760B, Small Tool Repair Tag, or Home Shop Tag attached. GPM 21.01.8

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 15.03.00 - Verify tools/test equipment which are exempt by a GSER or authorized by an Engineer, Manager or Supervisor are identified as Calibration Not Required. GPM 21.02.8

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 15.04.00 - Verify slings, hoists and other overhead lifting devices have the required individual serialization and proofload certificates maintained applicable to the last performed proofload, per GSER GN9910, latest revision. GPM 21.04.4

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 15.05.00 - Verify tools/test equipment that are not used to test or adjust aircraft systems and components are labeled Certification Not Required with placard CPN 5473507. Note, a CSN is required for stickers dated after June 1, 2005. GPM 21.02.09

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

16 Required Inspection Program

• 16.01.00 - Verify that Required Inspection Items are designated RII on maintenance records. GPM 18.01, GPM 17.11.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 16.02.00 - Verify that corrective actions include a signature, employee number, date, and RII expiration. GPM 18.01.10 and GPM 05.01.3

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

17 Work Place Safety

• 17.01.00 - Verify flammable liquids are kept in covered containers or tanks when not actually in use. Verify flammable liquids and paints are stored in approved flammable liquid storage cabinets or rooms. Verify flammable solvents are kept from potential ignition sources. SSE 2.95, SSE 2.150 GPM 13.09.2

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.02.00 - Verify that flammable liquid storage cans have pouring outlets equipped with tight fitting caps or valves, which close by spring action and are in good condition. SSE 2.95

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.03.00 - Verify there is clear and unobstructed access to fire alarm boxes. SSE 2.85

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.04.00 - Verify that the shop has an emergency action plan to ensure employee safety in the event of fire and other emergencies in writing that is reviewed with affected employees. The plan shall include the following elements: escape procedures and routes, critical operations, employee accounting following an emergency evacuation, rescue and medical duties, means of reporting emergencies, and persons to be contacted for information or clarification. SSE 2.150

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.05.00 - Verify emergency eye washes or showers are identified with a highly visible sign positioned so that the sign is visible within the area served by the eyewash or shower. The area around emergency eyewash or shower is well lighted. Emergency eyewash and shower equipment is inspected monthly. SSE 2.83

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.08.00 - Verify machines designed for a fixed location are securely anchored to prevent movement, or designed in such a manner that in normal operation they will not move. SSE 2.150

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.09.00 - Verify chemical products have labels to communicate essential product information and safety requirements to individuals using the materials. SSE 2.120

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action

• 17.10.00 - Verify bench grinder work rests are adjusted so that they are no more than 1/8 inch (3.2 millimeters) from the abrasive wheel and the adjustable tongue (tongue guard) or end of the peripheral member at the top does not exceed 1/4 inch (6 millimeters). SSE 2.150

  Pass

  Fail

  Not Observed

  Not Applicable

• Date and time observed

  Date

• Area

• Manual Reference

• Repeat Finding

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• Risk Assessment

  Select IV-D Low IV-C Low IV-B Minor IV-A Moderate III-D Low III-C Minor III-B Moderate III-A Serious II-D Minor II-C Moderate II-B Serious II-A High I-D Moderate I-C Serious I-B High I-A High

  • IV-D Low
  • IV-C Low
  • IV-B Minor
  • IV-A Moderate
  • III-D Low
  • III-C Minor
  • III-B Moderate
  • III-A Serious
  • II-D Minor
  • II-C Moderate
  • II-B Serious
  • II-A High
  • I-D Moderate
  • I-C Serious
  • I-B High
  • I-A High

• CAR Owner

• Root Cause

• Corrective Action

• Preventative Action