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Decom Checklist
| Acquisition Program Management, Deployment and Logistics Division |
| Purpose: |
Decommission Date: OTA No.: Prepared By:
Task Order: Airport Code: Prepared For:
| POC Information | | | |
| Name | Title | Phone | Email |
| TSE Information | | | | | | |
| Unit Type | Unit Quantity | OEM | Model | Speed System | System Type | Terminal Location |
| Decommission Information | | | | | | | | | | |
| Ship To Location: | | Expected Date of Arrival: | | Condition Code | | TSA-LC Warehouse Impacts (if applicable) | | | | |
| Ship to TSA-LC Warehouse? | | | | | | Expected Stay Time: | | | | |
| Ship to Rigger's Warehouse? | | | | | | Requires Testing? | | | | |
| Ship to an airport? If yes, list code: | | | | | | Redeployment Date (if known): | | | | |
| Decommissioning Checklist | | | | | | | | | | |
| System Requirements | | | | | Pedestal Materials | | | | | |
| Unit Part | Serial Number | | Serviceable (Y/N/Missing) | | Component | | Part Number | Actual Quantity | Quantity Required | Serviceable (Y/N/Missing) |
| CT-80 Scanner | | | | | Conveyor Pedestal_Stringer | | | | | |
| Scanner TSA Barcode | | | | | Converyor Pedestal_Front | | | | | |
| Infeed Ramp | | | | | Angle 12 Inch Lift | | | | | |
| Infeed Ramp TSA Barcode | | | | | SCR_SCH_M10 x 25_BO | | | | | |
| Outfeed Ramp | | | | | WSHR_ FL_ M10_ ZP | | | | | |
| Outfeed Ramp TSA Barcode | | | | | NUT_ HEX_ LOCKING_ M10_ ZP | | | | | |
| Omniblock X-Ray Tank | | | | | SCR_ HEX_ M8 x 70_ BO | | | | | |
| Power Supply 350v | | | | | NUT_ HEX_ M12_ ZP | | | | | |
| Datalink Receiver | | | | | Leveling Foot | | | | | |
| Brush Assembly | | | | | WSHR_ FL_ M12_ ZP | | | | | |
| PCB Serializer | | | | | NUT_ HEX_ LOCKING_ M8_ ZP | | | | | |
| Conveyor Gear Assembly | | | | | WSHR_ FL_ M8_ ZP | | | | | |
| Conveyor Motor Controller | | | | | Angle Connector Sloped Conveyor | | | | | |
| Conveyor Belt Encoder | | | | | SCR_ SCH_ M8 X 30_ BO | | | | | |
| Gantry Motor Assembly | | | | | | | | | | |
| Micromaster 440 | | | | | | | | | | |
| Encoder Gantry | | | | | Equipment Condition Quality Assurance | | | | | |
| 12V Power Supply | | | | | Requirements | | Status | Comments | | |
| Host PC | | | | | Removal of dust, dirt, trash, stains, stickers, etc. from interior and exterior of system components | | | | | |
| Algorithm PC | | | | | | | | | | |
| FPGA Adapter Board | | | | | | | | | | |
| BVS PC | | | | | Replacement of any damaged, missing, or excessively worn system components, including but not limited to, belts, lead curtains, trim pieces, panels, access doors, etc. | | | | | |
| FDRS PC | | | | | | | | | | |
| Level 1 Maintenance Checklist Completed (Y/N) | |
| Witness proper packing/crating |
| Overall Recommendation for Decommissioned Unit | Required photos submitted via e-mail |
| Replacement of any damaged or missing decals |
| OEM Approval | Adhere decals that indicate the model of the EDS (CT80DR or CT80 DR+) |
| OEM Representative (print): | |
| OEM Phone/Email: | |
Decommission Report and Checklist Version 1.0
Photos
| Acquisition Program Management, Deployment and Logistics Division |
| Please include any associated pictures to the Decommission Report on this page. |
Electronic Baggage Screening Program Decommission Report and Checklist Decommission Report and Checklist Version 1.0
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