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Offshore Helideck Inspection Form

The document is an offshore helideck inspection form containing sections on helideck dimensions, deck landing area conditions, obstacle free areas, markings, lighting, fuel systems, rescue facilities, equipment, and personnel training. The form contains detailed questions to inspect various aspects of offshore helideck safety requirements.

Uploaded by

Sherif Abbas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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0% found this document useful (0 votes)
87 views20 pages

Offshore Helideck Inspection Form

The document is an offshore helideck inspection form containing sections on helideck dimensions, deck landing area conditions, obstacle free areas, markings, lighting, fuel systems, rescue facilities, equipment, and personnel training. The form contains detailed questions to inspect various aspects of offshore helideck safety requirements.

Uploaded by

Sherif Abbas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 20

Proc. No.:ASD.F.

150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 1 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

THIS REPORTING FORM FOR INSPECTIONS CARRIED OUT ON HELICOPTER FACILITIES AT


OFFSHORE INSTALLATIONS

IRISH AVIATION AUTHORITY APPROVED

REPORTING FORM FOR INSPECTIONS CARRIED OUT OF HELICOPTER FACILITIES AT


OFFSHORE INSTALLATIONS

Name of Inspector(s): _____________________________

Date of Inspection: _____________________________

Name of Installation: _____________________________

Type of Installation: _____________________________

Operator: _____________________________

Location: _____________________________

A helicopter operator intending to operate to an offshore installation should, as soon as


practicable after the arrival of the installation in Irish waters, complete an inspection of the
installation helicopter facilities in accordance with this IAA approved checklist. Permanent
Installations should be inspected annually.

Copies of inspection reports should be submitted to the Irish Aviation Authority at the address
given below:-

Irish Aviation Authority,


Flight Operations Department,
The Times Building
11-12 D’Olier Street,
Dublin 2, Tel :- (01) 6031117
Ireland. Fax :- (01) 6774460

1
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 2 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Part A

Section Title Page

(A) Helideck Dimensions ……………………………………………...… 3

(B) Deck Landing Area Conditions ………………………………..…… 3

(C) Obstacle Free Areas ………………………………………………… 5

(D) Limited Obstacle Sector …………………………………………….. 5


o
(E) Falling 5:1 Gradient (180 sector) ………………………………..... 6

(F) Deck Markings ………………………………………………………... 6

(G) Helicopter Landing Area – Lighting ………………………………… 7

(H) Obstacles - Marking and Lighting ………………………………..…. 7

(I) Fuel System ……………………………………………………………. 8

(J) Rescue and Fire Fighting Facilities ………………………………….. 9


(K) Helicopter Operations Support Equipment ………………………….. 11

(L) Personnel and Training ………………………………………………... 13

Annexe 1 Diagram No 1 - Obstacle Free Area 14

Annexe 2 Diagram No 2 - Obstacle Free Areas Below Landing Area Level 15

Annexe 3 Diagram No 2A - Offshore Helicopter Landing Areas 16

Annexe 4 Diagram No 3 - Helideck D Value and Obstacle-free Marking 17

Annexe 5 Diagram No 4 - Touchdown Marking 18

Annexe 6 Diagram No 4A - Dimensions of ‘H’ 18

Part B

(M) Overall Result of Inspection…………………………………………….. 20

2
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 3 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(A) Helideck Dimensions

1 Declared ‘D’ value metres

2 Measured ‘D’ value metres

3 Deck Shape metres


a) Installation feet
4 Elevation of:
b) Helicopter Landing Area feet
Scale drawings (AERAD) available
5 Yes/No
and correct
6 declared ‘t’ value – maximum helicopter mass tonnes

(B) Deck Landing Area Conditions

1 Non-slip overall coating and markings

2 Aluminium deck sections should incorporate non-slip profiles


3 Does drainage system capture any rainfall/fuel spillage safely? Yes/No
a) Can the exhaust and turbulence from the gas turbine exhaust system
Yes/No
affects the helideck performance?
4
b) Has the effect on helideck performance been quantified? Yes/No

If Landing Net Fitted: is the size of net correct for the type of helicopter to be
5 Yes/No
used?

Minimum Deck Size (D Value)


Aircraft Type Landing Net Size
Metres

EC 135 T2/T2+ 12 Not Required


AerospatialeSA365C/N 14 Small 6m x 6m
Aerospatiale AS332L 19 Medium 12m x 12m
Sikorsky S76 16 Medium 12m x 12m
AW 139 17 Medium 12m x 12m
Sikorsky S92 21 Large 15m x 15m

3
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 4 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

6 Is net non-nylon and knotted with mesh size not greater than 200mm? Yes/No
7 Is net secured every 1.5 metres around the landing area? Yes/No

8 Net tensioning. Can the net be raised more than 250 mm above the deck? Yes/No

9 If no Landing Net fitted: Is the platform a fixed installation? Yes/No

What was the date and result of the last surface friction test? Date: ____________
10
(Less than 0.65 net to be retained) Result: ____________

Perimeter Safety Net - Does net cover whole of the exposed landing area of
11 Yes/No
the flight deck?
Is the inboard edge of the perimeter safety net fastened just below the level
12 Yes/No
of the helicopter landing deck?

Does the perimeter safety net extend outwards not less than 1.5 metres in
13 Yes/No
the horizontal plane with an upward slope of at approximately 10°?
Is the general condition of the safety net sound enough to withstand and
14 contain without damage, a 100kg weight being dropped from a height of 1 Yes/No
metre?
Is the outboard edge of the perimeter safety net at a height not exceeding
15 Yes/No
the level of the landing area?

Tie-down Points – Are there sufficient tie-down points for the type of
16 Yes/No
helicopter that is going to be operated to the installation?

17 Are the tie-down points based on the centre of the touch-down markings? Yes/No
18 Do they protrude above the deck surface? Yes/No
Are the tie-down points compatible with the dimensions of the helicopters tie-
19 Yes/No
down strops?

4
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 5 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(C) Obstacle Free Areas (Check with Diagram No. 1 Attached)


o
1 Is the obstacle free sector (normally 210 ) marked on the deck? Yes/No

Within the obstacle free sector and out to 1000 metres are there any
obstructions other than the specified essentials such as light fittings,
2 Yes/No
safety rails, outboard edge of the safety perimeter net, fire fighting
equipment or unmoveable handrails?

Are all the specified essential items less than 2.5cm above the height of
3 Yes/No
the landing area?

(D) Limited Obstacle Sector (Check with Diagram No. 1 Attached)

o
The 150 sector has height restrictions measured from the centre of the landing area (To find
the ‘centre’ bisect the chevron, the point of origin, and measure outboard 0.5D).

Are any obstacles above 25 cm from the centre of the landing area to
1 Yes/No
0.62D?
1
Do any obstacles between 0.62D and 0.83D exceed the heights shown
2 Yes/No
in the table below?

Maximum Height of Obstacles within the 210° LOS


Aircraft Type Between 0.62D and 0.83D (Fig 1)
Out to 0.62D (Fig 1) metres
metres

EC 135 T2/T2+ 25 cm 0.61 to 1.88


Aerospatiale SA365C 25 cm 0.66 to 2.06
Aerospatiale
25 cm 0.68 to 2.12
SA365N/N2
Sikorsky S76 25 cm 0.80 rising to 2.48
Aerospatiale AS332L 25 cm 0.94 rising to 2.91
Sikorsky S92 25 cm 1.05 rising to 3.26

5
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 6 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(E) Falling 5:1 Gradient (180° Sector) (Check with Diagrams No. 2 Attached)
Lying centrally, and outboard, within the 210° obstacle free area is the 180° arc taken from the
centre of the landing area.
For practical purposes this can be measured from the outboard edge of the helideck perimeter
safety netting supports.

o
In the 180 sector are there any obstructions that penetrate a falling
1 Yes/No
gradient of 1 unit outwards for every 5 units of vertical fall?
Have the obstructions that infringe the falling gradient been declared and
2 Yes/No
notified to the Authority?
Are any Restricted Helideck Approvals imposed or pending as a result of
3 Yes/No
the 5:1 infringements.
Does the Thales Avionics Aerad plate reflect any infringements and list
4 Yes/No
any restrictions?

(F) Deck Markings

1 Is the helideck dark green? Yes/No

Is the perimeter of the safe landing area clearly marked with a white
2 Yes/No
painted line 0.3 metres wide? (Check with Diagram No. 3 Attached)
o
Is the 210 obstacle free sector marked with a black chevron and
3 Yes/No
correctly orientated? (Check with Diagram No. 3 Attached)
Has the helideck D value been marked on the perimeter of the helideck
4 Yes/No
in a colour that clearly contrasts with the helideck surface?

5 Does the correct aiming circle, shown in Diagram No. 4, exist? Yes/No

Is the ‘H’ in the centre of the aiming circle painted white, correctly
6 Yes/No
orientated, and in accordance with Diagrams No. 4 and 4A?

7 What is the maximum allowable weight that is marked on the helideck? Yes/No
Is maximum weight marking at least 0.9 metres tall with a width line of at
least 0.12 metres? (The marking should be readable from the preferred
8 Yes/No
final approach direction and where possible, separated from the
installation identification marking)
Is the installation identification clearly marked, not less than 1.2 metres
9 Yes/No
lettering and not obscured by the deck netting, if fitted?

6
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 7 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(G) Helicopter Landing Area - Lighting


Are omni-directional green lights visible above the landing area level and
1 Yes/No
spaced equally around the perimeter of the safe landing area?
Are the safe landing area lights not more than 3 meters apart and
2 Yes/No
coincident with the white perimeter line?
The safe landing area lights should be at least 30 candelas intensity.
Higher intensity lighting is acceptable for poor visibility daylight flying, but
3 Yes/No
must be fitted with a brilliance control to return to 30 candelas for night
use. Are all the lights working and conforming to this requirement?

4 Is floodlighting available and arranged so as not to dazzle the pilot? Yes/No

5 Can the floodlighting be switched off at the pilot’s request? Yes/No

o
6 Are there any floodlights in the Limited Obstacle Sector (150 )? Yes/No

Is the floodlighting confined to the landing area with no overspill which


7 Yes/No
could cause sea reflections?
Is the lighting under the helideck level sufficient to enhance ‘visual cues’
8 Yes/No
for night approaches?
9 Can the wind indicator be seen from the helideck? Yes/No
Is it illuminated? Yes/No
Note: CAP 437 is introducing a requirement to fit lit TD circle and ‘H’
markings in the North Sea sector. At present these are suitable for
wheeled helicopter operations only.

(H) Obstacles - Marking and Lighting


Are all the fixed obstacles that may present a hazard to the helicopter
1 Yes/No
readily visible from the air?
Does the colour chosen to enhance these obstacles, contrast with the
2 Yes/No
background?
Have all the crane booms, and any lattice tower structures that are close
o
3 to the helideck or to the 150 sector boundary, been marked with Yes/No
contrasting colours?
Has omni-directional red lights been fitted at suitable locations to objects
4 o Yes/No
that are higher and close to the helideck or the 150 sector?
Are all objects that are more than 15 metres higher than the helideck
fitted with intermediate red lights of the same intensity spaced at 10
5 metre intervals down to the level of the helideck? (Floodlights may be Yes/No
used instead of red lights to illuminate structures such as flare booms
and towers. If floodlights are used they must not dazzle the pilot.)

7
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 8 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(I) Fuel System

1 Does the installation have a Jet A-1 refuelling system installed? (If
Yes/No
answer to this question is no then go to section J)

2 Is gravity and pressure refuelling available? Yes/No

What is the date of the last Annual Inspection carried out by an


3 Yes/No
Authorised Fuel Inspector?
Have you a copy of the last report following an offshore inspection by an
4 Yes/No
Authorised Fuel Inspector?
Can you confirm a good general appearance of the refuelling systems
5 Yes/No
storage facilities, transit tanks and delivery system to the helideck?
The ‘daily storage checks’ records should be inspected. If necessary
6 monitor the check taking place and ask to see the fuel sample. Were the Yes/No
check and the sample satisfactory?
Is there a remote start/stop button on or immediately close to the
7 Yes/No
helideck?

8 Is there a pump running warning light which is visible from the helideck? Yes/No

Check the full length of the delivery hose for condition. If possible, this
9 check should be carried out while system is subject to pump pressure. Is Yes/No
hose satisfactory?

10 Is the bonding reel in good condition, unbroken and secure? Yes/No

Has the installation adequate supplies of syringes and capsule detector


11 Yes/No
kits?
Satisfy yourself that the refuelling crew are conversant with their
12 Yes/No
responsibilities during refuelling.

8
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 9 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(J) Rescue and Fire Fighting Facilities

Are there at least two access/escape routes to and from the helideck?
1 (Ideally, the routes to the helideck should be located equidistant around Yes/No
the perimeter).
If the foam monitors are co-located with the access/escape routes, do they
2 Yes/No
impede escaping personnel in the event of an emergency situation?
Do any of the handrails associated with the helideck access/escape routes
3 exceed the height of 25 cm? If so, can they be retracted, collapsed or Yes/No
removed during helicopter take-off and landings?

Does the fire fighting equipment conform to the minimum scale


requirement below?
a) Main Medium
4 i. A low expansion foam application system capable of Yes/No
Discharging foam solution at 6.0 litres per square metre
per minute onto the prescribed landing area for not less
than 5 minutes.

b) Complementary Medium
One or more dry powder fire extinguishers (not less than 45
kg) with a discharge rate of at least 1.35-2 Kg/sec.

i. One carbon dioxide fire extinguisher (not less than 22 kg), Yes/No
or
ii. One halogenated hydro-carbon fire extinguisher (not less
than 18 kg)

On what date was the foam system last checked using the foam
5 Yes/No
concentrate?

6 Were the results within acceptable limits – show documentation. Yes/No

7 Was the foam system demonstrated during your inspection? Yes/No

8 Is all the fire fighting equipment in a satisfactory condition? Yes/No

9 Is the emergency rescue equipment (crash box) located in the vicinity of


Yes/No
the helideck and suitably protected from the environment?

9
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 10 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

10 Check the following emergency equipment is available in the rescue equipment box:-

a) Adjustable wrench Yes/No


b) Rescue axe, small (non wedge or aircraft type) Yes/No
c) Bolt cutters Yes/No
d) Crowbar, large Yes/No
e) Grab Hook or salving Yes/No
f) Hacksaw, heavy duty with 6 spare blades Yes/No
g) Blanket, fire resistant Yes/No
h) Ladder, length appropriate to helicopter in use Yes/No
i) Life-line/rescue harness Yes/No
j) Pliers, side cutting Yes/No
k) Set of assorted screwdrivers Yes/No
1
l) Harness knife complete with sheath Yes/No
1
m) Gloves fire resistant Yes/No
n) Self-contained breathing apparatus (2 sets) Yes/No
1 This equipment is required for each helideck crew member.

Check all personnel assigned to rescue and fire fighting duties are provided with suitable
11
personal protective equipment, as follows:-
a) Helmet and fitted visor Yes/No
b) Fire tunic and trousers (or one-piece suit) Yes/No
c) Gloves Yes/No
d) Boots Yes/No
e) Harness knife complete with sheath Yes/No
A minimum of 4 sets of the above equipment should be provided on a Manned Offshore Installation and 2
sets for an Unmanned Offshore Installation.

All fire fighting equipment for personnel should be located at a point which
12 has easy access to the helicopter landing area. Confirm that this is being Yes/No
complied with, and that the facility is clearly indicated.

10
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 11 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(K) Helicopter Operations Support Equipment

1 Is the following miscellaneous equipment available?

a) Chocks – Appropriate to helicopter in use Yes/No

Calibrated scales for baggage/freight and passenger weighing;


b) Yes/No
What was the date of calibration of the scales?

A suitable power source for starting helicopters Yes/No


c)

d) Spare windsock Yes/No

An anemometer positioned in an unrestricted airflow. Yes/No


e)
Means of measuring air temperature and barometric pressure.
f) The barometric pressure should preferably be determined with a
Yes/No
twin altimeter kit or a precision aneroid barometer. What was the
date of calibration of the barometer?

g) Means of measuring visibility, cloud base or cover. Yes/No

h) Means of measuring sea state (mobile installations only). Yes/No

i) A hand-held anemometer for actual deck wind readings Yes/No

j) A stretcher(s) Yes/No

k)
Landing prohibited marker Yes/No

l)
2 portable safety lamps Yes/No

m)
Means of removing heavy freight from the helicopter. Yes/No

n) Correct ‘airline type’ labels for passengers baggage and freight


Yes/No
(including dangerous goods) freigh

11
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 12 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Has the HLO a portable aeronautical VHF radio for use on the Helideck,
2 Yes/No
which can both, receive and transmit?
Is the installation equipped with a non-directional beacon? Yes/No
If so, what is the ident and frequency of the beacon?
3
Ident: _____________________

Freq: _____________________

Is the crane driver equipped with a marine band radio or other means of
4 Yes/No
contact with the helideck?

5 Is the installation capable of measuring pitch, roll and heave? Yes/No

What is the contact callsign and frequency of the installation?

C/s: _____________________
6
Freq: _____________________

MHz: _____________________

Is there a voice activated recording system for the assigned helicopter


7 Yes/No
frequency?

8 Are the following publications readily available? Yes/No

a) CAP 437 Yes/No

The Management of Offshore Helideck Operations (UKOOA


b) Yes/No
publication)
Installation operators own Companies Standing Instructions for
c) Yes/No
duties and responsibilities for HLO, HDA’s and radio operators?
Does the installation operator have a suitable area to show an approved
video?
9 Yes/No
(Video should be produced by RGIT Viscom, but an alternative may be
used if approved by the helicopter operator.)

Is the passenger briefing video correct for the type of helicopters. To be


10 Yes/No
operated to the installation?

12
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 13 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(L) Personnel and Training

Have all the Helicopter Landing Officers attended courses on:


1 Helicopter firefighting, refuelling (if applicable) and an approved HLO Yes/No
course?
Is the HLO familiar with the type of helicopter to be operated to the
2 Yes/No
installation?

3 Have the HDA’s attended Helicopter firefighting and refuelling courses? Yes/No

1. 4
When was the last approved refresher training undertaken for Firefighting? Yes/No

2. 5 When did the last statutory drill take place or in house training occur for
Yes/No
HLO’s and HDA’s?

6 When did the crash rescue crews last complete a drill? Yes/No

Is the radio operator’s level of training and experience sufficient to


7 Yes/No
confidently be given the flight watch?
Are there personnel on the installation who have completed an
a) Yes/No
8 approved Dangerous Goods Awareness Course?
Are there personnel on the vessel who have completed a Dangerous
b) Yes/No
Goods Shippers’ Course?

13
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 14 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Diagram No. 1

Obstacle Free Area

14
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 15 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Diagram No. 2
Obstacle Free Areas –
Below Landing Area
Level (For all types of
helicopters)

15
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 16 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Diagram No. 2A
Offshore Helicopter
Landing Areas

16
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 17 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Diagram No. 3
Helicopter D Value and
Obstacle-free Marking

17
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 18 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

Diagram No. 4
Touchdown Marking
(Aiming Circle to be
painted yellow)

(Aiming Circle to be
painted yellow)

Diagram No. 4A
Dimensions of H (‘H’ to
be painted white)

18
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 19 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

IRISH AVIATION AUTHORITY APPROVED REPORTING FORM FOR INSPECTIONS


CARRIED OUT OF HELICOPTER FACILITIES AT OFFSHORE INSTALLATIONS

Name of
Inspector(s): ___________________________

Date of Inspection: ____________________________

Name of Installation: ____________________________

Type of Installation: ____________________________

Operator: ____________________________

Location: ____________________________

A helicopter operator intending to operate to an offshore installation should, as soon as


practicable after the arrival of the installation in Irish waters, complete an inspection of the
installation helicopter facilities in accordance with this IAA approved checklist. Permanent
Installations should be inspected annually.

Copies of inspection reports should be submitted to the Irish Aviation Authority at the address
given below:-

Irish Aviation Authority,


Flight Operations Department,
The Times Building,
D’Olier Street,
Dublin 2, Tel :- (01) 6031117
Ireland. Fax :- (01) 6774460

19
Proc. No.:ASD.F.150
Admt No: 3 SAFETY REGULATION DIVISION

Page: 20 of 20
Issue Date: 10/10/13

Title: Offshore Helideck Inspection Form

Responsibility: P. van Velzen

(M) Overall Result of Inspection

Are there any deficiencies that require immediate rectification prior to


1. Yes/No
operating to the installation?

List any deficiencies or design infringements found during the


2. inspection that require further investigating as soon as possible by the Yes/No
Offshore Operator (Use attached spare sheet if required).

List minor deficiencies or operating procedures that need to be


3. Yes/No
reviewed/replaced. (Use attached spare sheet if required).

Section Reference Comments

Section Reference Comments

Summary: ______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________

Inspection carried out by: ___________________________

On behalf of: ___________________________

Signed: ___________________________

Date: ___________________________

20

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