Contract Att01 - AIT-1 and AIT-2 - L3 Decommission Checklist.pdf

Section Yes No

The comments/concerns section may be used to provide further detail concerning unit quality, quantity, or general notes on unit/part condition

Decommission Checklist For the L3

Advanced Imaging Technology (AIT) 1 & 2

Operation Test Kit (OTK)?

AIT S/N: TSA/FAA Bar Code Number:

Airport Code: Terminal: Date of Test: Time:

Software is up to date?

Passed SAT?

T es ti n g

ASCU: record SW version and scan count

Comments/ConcernsEvaluation Criteria

Operators Manual included?

System Keys?

Metal components free from rust/scratches?

Floor and ramps in good condition?

Foot prints clearly visible?

UPS present?

In v en to ry

L3 AIT Provision 2 System?

Power Supply?

Inner Radomes free from scratches?

Outer Radomes free from scratches?

FDRS Reports exported 30 days before decommission?

AC Power Cord in good condition?

BlueMan Panel in good condition?

OCP in good condition?

Skins free from scratches?

Warning lights illuminate?

E-stop functions correctly?

Ceiling lights all illuminate?

ASCU fans operate normally?

Motor/Gearbox operate normally?

Passed image quality test?

Motor Brake Release functional?

Last Updated May 2019

Yes No

Email Address Phone Number

Signature DateCompany Name

Take a photo of the SERIAL NUMBER and BARCODE on the unit and document any damage or concerns.

Operator Cart raises and lowers?

V is u a l V er if ic a ti o n U n it

C o n d it io n

Is the shipping label correct on the packaging?

Does the unit have any Exterior Damage?

(i.e. broken pieces, dents, paint chipping, locally added stickers)

Does the unit have Interior Damage?

(i.e. broken pieces, dust, locally added stickers)

Visible hardware tightened and secured?

Subcontractor Contact Information and Verification

Evaluation Criteria Comments/Concerns

System Integrator Section (This section should be filled in by the System Integrator ONLY)

Has all damage been documented? If NO, please specify in the comments section.

Printed Name

Sign and date this Decommission Checklist and leave a copy with the unit.

Systems Integrator Additional Comments

Performed By:

Are there any components missing? If YES, please specify in the comments section, to include those items in the above inventory section.

Is an Operational Test Kit (OTK) being returned with this unit?

If YES, please note it in the comments section.

U n it

P a ck a g in g

Take a photo of the unit while OPERATIONAL and document any damage or concerns.

Take a photo of the FRONT of the unit and document any damage or concerns.

Take a photo of the SIDES of the unit and document any damage or concerns.

Take a photo of the BACK of the unit and document any damage or concerns.

Take photo of the unit PACKAGED and document any damage or concerns.

Panels are flush and fit satisfactorily?

Conveyor belts are free from tears?

Roller tables legs attached with all hardware?

DateSignature

Federal Employee Comments/Concerns

Federal Employee Verification

As a witness, sign and date this Decommission Checklist to confirm the document was completed on-site.

Confirmed By:

Printed Name

Systems Integrator Contact Information and Verification

Sign and date this Decommission Checklist and leave a copy with the unit.

Reviewed By:

Printed Name Email Address Phone Number

Company Name Signature Date