Self-inspection

Airfield Map on Reverse Side

APPENDIX 3

PERIODIC CONDITION INSPECTION CHECKLIST

√ Satisfactory DATE: ____________________ DAY: ________________ X Unsatisfactory TIME: ____________________ INSPECTOR: _______________________________
FACILITIES	CONDITIONS	√	REMARKS/ACTIONS TAKEN
Pavement Areas	Rubber Deposits
	Polishing
Markings and Signs	Visible
	Standards
Fueling Operations	Physical Facilities
	Mobile Fuelers
	Fire Extinguishers
	Fuel Marking/Labeling
	Frayed Wiring
Navigational Aids	RENLs/VGSI Aiming
Lighting	Power Generator Check
	Circuit Resistance Test
	Aim/Adjustment
Obstructions	Surveyed Trees/Structures
	Overhead Power Lines
Aircraft Rescue and Fire Fighting	Response Times
	Live Fire Drills
	Training
Additional Remarks

Airfield Map on Reverse Side