attach0006.pdf

b. HOURS d. HOT STARTS

8b. TIME 10. MAN HOURS

REQUIRED

TM INITIAL

ITEM STATUS WHEN

NO. CORRECTED

a b e

5. DATE3. REGISTRATION/SERIAL/NSN 4a. MILES c. ROUNDS 6. TYPE INSPECTION

TM DATE TM NUMBER

7. APPLICABLE REFERENCE

TM NUMBER

"X" - Indicates a deficiency in the equipment that places

STATUS SYMBOLS

COLUMN d - Show corrective action for deficiency or shortcoming listed in Column c.

COLUMN a - Enter TM item number.

action initial in this column.

COLUMN e - Individual ascertaining completed corrective COLUMN b - Enter the applicable condition status symbol.

COLUMN c - Enter deficiencies and shortcomings.

EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET

For use of this form, see DA PAM 738-750 and 738-751; the proponent agency is DCSLOG

1. ORGANIZATION 2. NOMENCLATURE AND MODEL

TM DATE

9a. SIGNATURE (Maintenance Supervisor)

HORIZONTAL DASH "(-)" - Indicates that a required inspection, component replacement, maintenance operation check, or test flight is due but has not been accomplished, or an overdue MWO has not been accomplished.

condition exists.

FOR AIRCRAFT - Status symbols will be recorded in red.

corrective action can be accomplished.

equipment may be operated under specific limitations as directed by higher authority or as prescribed locally, until

LAST NAME INITIAL IN BLACK, BLUE-BLACK INK,

OR PENCIL - Indicates that a completely satisfactory

DIAGONAL "(/)" - Indicates a material defect other than it in an inoperable status.

CIRCLED "X" - Indicates a deficiency, however, the

ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED

IN ACCORDANCE WITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.

8a. SIGNATURE (Person(s) performing inspection) than a deficiency which must be corrected to increase efficiency or to make the item completely serviceable.

9b. TIME

CORRECTIVE ACTIONDEFICIENCIES AND SHORTCOMINGS

c d

Replaces edition of 1 Jan 64, which will be used DA FORM 2404, APR 79

USAPPC V1.10

DRAFT

TM INITIAL

ITEM STATUS WHEN

NO. CORRECTED

a b e

USAPPC V1.10

c d

DEFICIENCIES AND SHORTCOMINGS CORRECTIVE ACTION

DRAFT