____ _____ 2. Presents notarized statement FAA Form Eligibility Statement
____ _____ 3. Presents FAA Form 8130-6 Application for A/W Certificate properly filled out
____ _____ 4. ID dataplate is fireproof (steel), has Builder's name, model, serial number.
____ _____ 5. ID dataplate is installed in proper external location per FAR 45. 11(a).
____ _____ 6. N-Numbers installed, block letters, 3" proper location per FAR 45.25, or 12 inch, if a/c has cruise speed over 180 Knots CAS.
_____ _____ 7. Word Experimental Displayed, 2" min size, proper location per FAR 45.23(b).
____ _____ 8. Passenger warning placard (not required for single place) ".This aircraft does not meet U.S. safety standards for certified aircraft..."
____ _____ 9. Registration certificate available in aircraft. (NOT pink slip!)
____ _____ 10. Builder makes statement in logbook that aircraft has been inspected
____ _____ 11. A/C Weight and balance done, and shows within designer's limits.
FAR 91.9 Placards
____ _____ 12. ALL controls - flight and engine, marked as to use.
____ _____ 13. Markings for :
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______Throttle- open-closed
_____ Carb Heat- pull on _____ Flaps- Up- Down, Degrees/Inches Take Off Setting Marked _____ Trim Tab- Nose Up, Nose Down, Take Off setting _____ Trim Tab- rudder left, rudder right, neutral _____ Mixture- Push rich _____ Fuel On-Off levers _____ Fuel quantity and type marked on or near each cap |
Cockpit interior
_____ _____ Seat Belts function, and angle is slightly rearward_____ _____ Shoulder harness function, and angle is -5 to + 30 degrees
_____ _____ Seat Belt Anchor Points firm, no interference
_____ _____ Shoulder Harness Anchor Points firm, no interference
_____ _____ Seats and seat tracks o.k., stops on aft of rails
Instruments and required equipment
___ ____ 14. ELT meeting TSO-C91A properly installed, with remote switch and battery date current and recorded in aircraft records (See Checklist explanations Page) for details
FAR 91.205 and others
_____ _____ 15. Fuel gauge each tank, has been calibrated and calibration in records showing unusable fuel
_____ _____ 16. VFR Day requirements: * Note: All instruments should be marked with green/red line ranges
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____ Altimeter
____ Airspeed indicator ____ Tachometer ____ Oil Pressure ____ Oil Temperature ____ Compass _____ For retract gear aircraft, indicator of up/down gear |
____ ______ 17. VFR Night Requirements- Day VFR plus:
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____ Position Lights
____ Anti-collision strobes/rotating beacon which meets FAA standards ____ Spare fuses ____ Electrical energy sufficient for duration of aircraft range, plus reserve |
____ _____ 18. IFR Requirements Day & Night VFR, plus:
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___ Working two-way radio (See Checklist explanations Page)
___ Gyroscopic rate of turn indicator (Turn & Bank or Turn Coordinator) ___ Slip / Skid indicator ___ Sensitive altimeter ___ Artificial horizon ___ Directional gyro ___ Clock ___ Vacuum gauge, if vacuum powered, or volt and amp meter, if electric (See Checklist explanations Page) ___ Heated Pitot ___ Generator or alternator ___ Alternate Static Source (SeeChecklist explanations Page) |
Systems
Wire type and size is appropriate for load being carried, and connections are solid. All installed systems perform as intended.
Electrical
____ _____ Battery & Electrical System, wiring adequate size and secure
____ _____ Switches marked for operation, and wired properly
____ _____ Circuit Breakers or fuses labeled for value and function, and wired properly
____ _____ Ground on battery to airframe, or wired into place properly
____ _____ Ammeter
____ _____ Voltmeter
____ _____ Landing Lights / Position Lights wired correctly
____ _____ Cockpit lights/ Instrument lighting
____ _____ Battery case and battery securely mounted
_____ _____ Battery vented overboard
Avionics
_____ _____ Antennas are properly installed, and have proper support/doubler plates
_____ _____ Coax Cable secured, with slack enough to prevent disconnection
_____ _____ Radios/Avionics and cooling fans are mounted securely
_____ _____ Avionics gear is wired properly, and functions
_____ _____ Transponder "Mode C" check done, and in aircraft records
Fuel System
_____ _____ Caps fit, and are vented on all tanks
_____ _____ Fuel drains installed at lowest portion of tank, and at lowest point in fuel lines
_____ _____ Fuel Vent System contains no loops which would block venting
_____ _____ Shutoff valve/ Selector switch ease of operation, and clearly marked for intended operation
_____ _____ Fuel Line routing proper material and diameter for intended fuel supply
_____ _____ Fuel Strainer functional and safety wired
_____ _____ Fuel Lines protected from chafing, and secure from "catching a foot."(Checklist explanations Page)
_____ _____ Fuel line routing avoids areas of heat
Gear/Wheel/Brake Systems
_____ _____ Retractable Gear functions- Operations check
_____ _____ Emergency gear extension test
_____ _____ Clearance in wheel wells
_____ _____ Brake System line routing, reservoir, pumps
_____ _____ Brake & Wheel installation secure
_____ _____ Taxi test on gear toe in/ toe out o.k.
_____ _____ Tires are clear of pants or struts, including clearance of "mud scraper", no binding
_____ _____ Wheel Pants are secure
_____ _____ Tail Spring secure, well designed, and is clear of rudder
Control Surfaces
A. Designers Recommended limits: This Plane Measures:
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Aileron Up travel:
______ Degrees/Inches _______
Degrees/Inches
Down travel : ______ Degrees/Inches _______ Degrees/Inches Elevator Up travel: ______ Degrees/Inches _______ Degrees/Inches Down travel: ______ Degrees/Inches _______ Degrees/Inches Rudder Left/Right ______ Degrees/Inches _______ Left _______ Right |
General Condition- Fuselage, Wing, Tail Assembly
_____ _____ Skin condition, wrinkles, rivets, or tape
_____ _____ Vertical Fin, movement and condition
_____ _____ Elevator assembly, movement and condition
_____ _____ Trim Tabs function, no binding, heavy structure to reduce flutter potential
_____ _____ Control Travel "Stops"
_____ _____ Control Cables Safety Wired Correctly
_____ _____ Counterweights secure
_____ _____ Doors close securely and open properly, if open in flight, markings
_____ _____ Windows secure, and markings for distance if open in flight
_____ _____ Canopy secure
_____ _____ Canopy emergency release marked red and copper safety wired
_____ _____ Canopy locks/door locks work
Flight Controls
_____ _____ Proper tension of cables_____ _____ Safety wiring of cables
_____ _____ Clearance on controls/no hitting panel or floorboards
_____ _____ Freedom of movement
_____ _____ PROPER DIRECTION
_____ _____ Is everything safetied?
Engine Compartment
_____ _____ Engine Compression in Logs1=___ 2=____ 3=____ 4=____ 5=____ 6=___
_____ _____ Throttle cables anchored and functional, spring open
_____ _____ Clearances in engine compartment
_____ _____ Carb Heat Control- Functional
_____ _____ Mixture Control- Functional, spring full-rich
_____ _____ Fuel Hose routing to avoid heat & bends (Firesleave preferred)
_____ _____ Fuel strainer safety wired
_____ _____ Fuel Hose diameter sufficient for engine
_____ _____ Fuel and Oil Hoses proper material
_____ _____ Oil System Hose & Cooler installation
_____ _____ Prop Governor. Functional, proper lines
_____ _____ Firewall steel, no openings
_____ _____ Engine Mount secure, no cracks
_____ _____ Alternator, belts, accessories properly installed
_____ _____ Heater hoses proper material
_____ _____ Heater design minimizes CO poisoning chances
_____ _____ Baffles appear correct
_____ _____ All electrical and ignition wires appear correct
_____ _____ Cowling secure, (INSTALL IT NOW).
Propeller
_____ _____ Propeller nicks_____ _____ Safety Wired Bolts of sufficient size
_____ _____ Bolts torqued properly
_____ _____ Bolts clear engine, proper length
_____ _____ Prop clears ground in takeoff attitude by >7"
_____ _____ Prop Spinner o.k., clear of cowl, not uneven spin
_____ _____ Ready for Run-up.
Test Run Engine
Note: At least one hour of runup should have been done previously, and logged in the aircraft logbook. The engine compressions should also be recorded after one hour of runup. Some may be low on a fresh overhaul engine, but it is important to get this information as a base line!_____ _____ Engine starts easily
_____ _____ Oil Pressure comes up quickly to proper level
_____ _____ Oil Temp comes off cold peg
_____ _____ Check all instrument operations/tach/oil/volts/ etc.
Record all data five minutes after startup here ________________________________________________________________________ ________________________________________________________________________
_____ _____ Carb Heat Functions, RPM Drop is ________
_____ _____ Mag Drop, Left is ______ Right is _______
_____ _____ Fuel Gauges show calibrated
_____ _____ Mixture/Throttle/Prop controls work
_____ _____ Fuel Shutoff works
_____ _____ No abnormal vibration
_____ _____ Propeller tracks within specs
Airworthiness Directive Compliance
_____ ______ Engine AD's which apply have been complied with, and how(Attach list if necessary)
__________________________________________________________________________________________
_____ ______ Equipment AD's which apply have been complied with, and how
(Attach list if necessary)
__________________________________________________________________________________________
Certification
_____ ______ Logs present and builder records the following statement:_____ Discuss operating limitations with applicant, flight test areas, and flight test time.
_____ _____ Airworthiness application properly filled out and signed?
_____ Sign Logbook and issue certificate, if applicable.
Unsatisfactory Conditions
N_______ Owner __________
The following unsatisfactory conditions were noted in your inspection. It is your responsibility to correct these conditions prior to obtaining an airworthiness certificate. Please correct the deficiencies and return this list, with evidence of the corrections, to the certificating inspector.
1. Condition:______________________________________________
Corrective action taken: ___________________________________
________________________________________________________
2. Condition: ____________________________________________
Corrective action taken: _______________________________________________________
Signed: _________________________
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