DA_Form_2404.pdf
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- Attached to
- Refrigerated Truck Supply
- Solicitation number
- W9124E-13-B-0001
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Attachment DA Form 2404 - see Statement of Work
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Text version
ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED
IN ACCORDANCE WITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.
EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET
For use of this form, see DA PAM 750-8; the proponent agency is DCS, G-4.
HOT
STARTS
d.HOURSb. ROUNDS
FIRED
c.
TIMESIGNATURETIME
MILES
10.9
3. REGISTRATION/SERIAL/NSN
a.
1. ORGANIZATION 2. NOMENCLATURE AND MODEL
5. DATE 6. TYPE INSPECTION
APPLICABLE REFERENCE7.
TM NUMBER TM DATE TM NUMBER TM DATE
COLUMN a
COLUMN b
COLUMN c
Enter TM item number.
Enter the applicable condition status symbol.
Enter deficiencies and shortcomings.
COLUMN d shortcoming listed in Column c.
Show corrective action for deficiency or
STATUS SYMBOLS
COLUMN e action initial in this column.
Individual ascertaining completed corrective
Indicates a deficiency in the equipment that places"X" it in an inoperable status.
Indicates a deficiency, however, the CIRCLED "X"
Indicates that a requiredHORIZONTAL DASH "(-)"
Indicates a material defect otherDIAGONAL "(/)"
LAST NAME INITIAL IN BLACK, BLUE-BLACK INK,
FOR AIRCRAFT - Status symbols will be recorded in red.
(Person(s) performing inspection) (Maintenance Supervisor) MANHOURS
REQUIRED
SIGNATURE
TM
ITEM
NO.
a
STATUS
b
DEFICIENCIES AND SHORTCOMINGS
c
INITIAL
WHEN
CORRECTED
e
CORRECTIVE ACTION
d
DA FORM 2404, FEB 2011 PREVIOUS EDITIONS ARE OBSOLETE. APD PE v1.00ES
4a.
8b. 9b.8a.
equipment may be operated under specific limitations as directed by higher authority or as prescribed locally, until corrective action can be accomplished.
inspection, component replacement, maintenance operation check, or test flight is due but has not been accomplished, or an overdue MWO has not been accomplished.
OR PENCIL - Indicates that a completely satisfactory condition exists.
than a deficiency which must be corrected to increase efficiency or to make the item completely serviceable.
DEFICIENCIES AND SHORTCOMINGS
TM
ITEM
NO.
a
STATUS
b c
INITIAL
WHEN
CORRECTED
e
CORRECTIVE ACTION
d
APD PE v1.00ESDA FORM 2404, FEB 2011
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