Surveillance Worksheet - De-Icing Quality Control

• Regulatory Service/ Surveillance Number and Port:

• Station:

• Handling Company Name:

• Address:

• Type of Company:

  Airline

  Ground Handling

  Other

• Responsible Manager:

• Conducted on

  Date

• Inspectors

  Select Peter Marsh Tony Aytlett Rizwan Sheikh Derek Fox Owen Richards Michael Rossiter Alex Gonzalez David Smith Bruce Reilly

  • Peter Marsh
  • Tony Aytlett
  • Rizwan Sheikh
  • Derek Fox
  • Owen Richards
  • Michael Rossiter
  • Alex Gonzalez
  • David Smith
  • Bruce Reilly

De-Icing and Ant-Icing Fluids

Deicing Fluids

• Manufacturer and Brand name:

• Type I

  Type II

  Type III

  Type IV

Previous Inspection Results

• Were there any discrepancies noted at the previous winter inspection?

  Yes

  No

• Details of Finding:

• Has the finding been closed?

  Yes

  No

  N/A

Procedures and Documentation

• Does the Deicing/Anti-icing handling company have its own deicing/anti-icing procedures manual?

  Yes

  No

• Specify Manual name and Revision status.

• Are deicing/anti-icing procedure manuals available from any Part 121 (Air Transport) operators?

  Yes

  No
Procedure Manuals

• Airline:

• Manual Name:

• Revision status:

• Are the procedures used by the handling company based upon the approved company manual?

  Yes

  No

  N/A

• Findings:

Deicing/Anti-icing Fluids

• Are fluid release documents (Certificate of Conformance or equivalent) received from the fluid manufacturer for each fluid delivery/batch and retained by the consignee for inspection as necessary?

  Yes

  No

  N/A

• Findings:

• Are fluid delivery checks (incoming inspection) performed and records retained?

  Yes

  No

  N/A

• Findings:

• Are pH checks on equipment carried out prior to first use of the day and after each refilling of fluids? Are the results recorded and is the information available to operators?

  Yes

  No

  N/A

• Findings:

• Are concentration checks (refractive index checks) on equipment carried out prior to first use of the day and after each refilling of fluids? Are the results recorded and is the information available to operators?

  Yes

  No

  N/A

• Findings:

• NOTE:
  For details and exceptions, refer to the International Chapter 13.2.1.1

• Are fluid laboratory checks carried out periodically on fluid samples (Type II, III, and IV fluids), the result recorded and is the information available to the operators?

  Yes

  No

  N/A

• Findings:

• NOTE:
  Fluid laboratory checks shall be performed at the start of the winter season. Fluid sample shall be taken from all deicing/anti-icing vehicle spraying nozzles of all vehicles and from all storage tanks.
  

• Does the handling company apply an acceptable procedure for fluid sampling and is this procedure documented?

  Yes

  No

  N/A

• Finding:

Training and Qualification

• Do the personal carrying out the deicing/anti-icing operation receive training in cold weather operations?

  Yes

  No

  N/A

• Findings:

• Do the personal carrying out the post deicing/anti-icing check receive training in cold weather operations?

  Yes

  No

  N/A

• Findings:

• Are the training materials used by the handling company based on the approved company manual?

  Yes

  No

  N/A

• Findings:

• Do all personal mention above receive annual refresher training?

  Yes

  No

  N/A

• Findings:

• Are training records and authorisations maintained?

  Yes

  No

  N/A

• Findings:

• Is the success of the training evaluated?

  Yes

  No

  N/A

• Select Theoretical Test Practical Assessment

  • Theoretical Test
  • Practical Assessment

• Findings:

• NOTE:
  Practical assessment is optional for the personal performing the post-deicing/anti-icing check.

• Is the pass mark established? (min 75%)

  Yes

  No

  N/A

• Findings:

• Is there evidence to show knowledge deficiencies have been addressed?

  Yes

  No

  N/A

• Findings:

• Place a Check mark for all fleets types that are trained.

  Select ATR-42 A300 A310 A318 A319 A320 A321 A330 A340 A380 B1900 B727 B737 B747 B757 B767 B777 B787 MD11 DH8 BAe146 E135/145 E170 Dor328 Falcon F100 Golfstream Learjet Jet31/41 DC8 DC( DC10 CRJ/CJ65 Saab340 Shorts 360

  • ATR-42
  • A300
  • A310
  • A318
  • A319
  • A320
  • A321
  • A330
  • A340
  • A380
  • B1900
  • B727
  • B737
  • B747
  • B757
  • B767
  • B777
  • B787
  • MD11
  • DH8
  • BAe146
  • E135/145
  • E170
  • Dor328
  • Falcon
  • F100
  • Golfstream
  • Learjet
  • Jet31/41
  • DC8
  • DC(
  • DC10
  • CRJ/CJ65
  • Saab340
  • Shorts 360

Post Deicing/Anti-icing Check and transmission of the Anti-icing code to the Captain

• Are the responsibilities for the post deicing/anti-icing check in compliance with the company manual?

  Compliant

  Non-Compliant

  Not Observed

• Findings:

• Are written procedures established for the communication between the flight crew and the ground crew performing the deicing/anti-icing and post deicing/anti-icing checks?

  Yes

  No

  N/A

• Company Manual reference.

• Was communication between the flight crew and the ground crew conducting the deicing/anti-icing operation in compliance with documented procedures?

  Yes

  No

  N/A

• Findings:

• Where necessary, does the person performing the Post Deicing/Anti-icing Check, have (assess to ) equipment offering sufficient visibility of the aircraft critical parts to be checked?

  Yes

  No

  N/A

• Specify details:

• Findings:

Deicing/Anti-icing Facilities

• Where are the deicing/anti-icing operations carried out?

  Select Gate After pushback Remote/ Centralised position End of Taxi-way Other (specify)

  • Gate
  • After pushback
  • Remote/ Centralised position
  • End of Taxi-way
  • Other (specify)

• Details:

• If deicing/anti-icing operations are carried out in an area away from the gate, who certifies that the aircraft has been correctly deiced/anti-iced and that the appropriate surfaces are free from all forms of frost, ice, slush, and snow?

• Do airline personal have access to the remote deicing/anti-icing position/s?

  Yes

  No

• How is the fluid stored?

  Select Fixed Tanks Mobile Tanks/Trailor Cubitainer/Barrels

  • Fixed Tanks
  • Mobile Tanks/Trailor
  • Cubitainer/Barrels

• Is the fluid heated in the storage tanks?

  Yes

  No

  N/A

• What method of heating is employed and to what temperature is the fluid heated?

• Are all storage tanks and filling ports labelled for fluid type/mix?

  Yes

  No

  N/A

• Are all components of the storage facility constructed and maintained in accordance with the company Manual?

  Yes

  No

  N/A

• Findings:

• Are all the refractometers calibrated or functional checks performed periodically and documented?

  Yes

  No

  N/A

• Types of Checks performed?

  Calibrated

  Functional Checks

• Interval:

• Findings:

• Are deicing/anti-icing vehicles available which are reported not to be used by the handling company?

  Yes

  No

Deicing/Anti-icing Equipment

• 
  

Equipment

• Manufacturer:

• Model:

• Total Number of this model:

• Fluid Type:

• Concentration:

• Fluid temp (C)

• Fluid temp at nozzle if available (C):

• Applicable for anti-icing with Type I fluid only:<br> Is the temperature of the heated fluids and fluid mixtures at or above 60 degs C (140F) at the nozzle?

  Compliant

  Non-Compliant

  N/A

• How is it ensured that the temperature of the heated fluids and fluid mixtures is at or above 60 degrees C (140F) at the nozzle?

  a temperature sensor (eg a thermometer) is installed at or near the nozzle

  the temperature of the fluid/water mixtures in the tank and at the nozzle is measured and recorded several times during the season and both temperature readings are correlated.

  other

• Explain method:

• Are vehicle tanks/filling ports labelled for fluid type and/or mixture rate?

  Yes

  No

• How is the fluid mixed?

  By a vehicle proportional mix system

  Manually in vehicle

  In storage facilities

  Premix from manufactuer