NW Powered Parachute Coalition



Six Chuter Inc.

PPC Annual/100-Hour Airworthiness Inspection Form

|Aircraft Make/Model       |SN:      |

|Engine Make/Model       |SN:      |

|Date of Inspection:       |TT Airframe:       |TT Engine:       |

1. Each person performing an annual or 100-hour inspection shall, before that inspection, remove or open all necessary inspection plates, access doors, fairing, and cowling. The vehicle and vehicle engine shall be thoroughly cleaned.

A. All plates, access doors, fairing, cowling and other inspection ports opened Yes No

B. The vehicle and vehicle engine have been thoroughly cleaned prior to inspection Yes No

2. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the fuselage group:

| Pass Fail |A |Systems and Components – For improper installation, apparent defects, and unsatisfactory operation. |

| Pass Fail |B |Frame: |

| | |Check tubes for dents, damage All bolts in place & secure |

| | |All safety and cotter pins Outriggers in poor condition/secure |

| | |Cables - Poor condition - Check kinks, frays, abrasions, broken strands |

| | |Ends of flying cables – Poor Condition – Bolts Secure |

| Pass Fail |C |Steering Bars – For poor condition, proper installation, movement, wear, and deterioration, steering lines are in |

| | |poor condition, control pulleys for cracks and wear and secure attachment. |

Notation:      

3. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the cabin and cockpit group:

| Pass Fail |A |General – For cleanliness and loose equipment that might foul the controls. |

| Pass Fail |B |Seat and safety belts – For poor condition and apparent defects. |

| Pass Fail |C |Windshields – For deterioration and breakage |

| Pass Fail |D |Instruments – For poor condition, mounting, marking, and improper operation |

| Pass Fail |E |Flight and Engine Controls – For improper installation and improper operation |

| Pass Fail |F |Battery – For improper installation and improper charge |

| Pass Fail |G |Instrument pod is in poor condition and secure to frame with all screws. Kill switches are securely fastened to |

| | |pod. Interior wiring of pod is poor. EIS is securely fastened to the pod. |

| Pass Fail |H |All systems – For improper installation, poor general condition, apparent and obvious defects, and insecurity of |

| | |attachment. |

Notation:      

4. Each person performing an annual or 100-hour inspection shall inspect components of the engine and nacelle group as follows:

| Pass Fail |A |Engine Section – For visual evidence of excessive oil, fuel, or hydraulic leaks, and sources of such leaks. |

| Pass Fail |B |Studs and nuts – For improper torquing and obvious defects. |

| Pass Fail |C |Internal Engine – For cylinder compression and for metal particles or foreign matter on screens and drain plugs. |

| | |If there is weak cylinder compression, for improper internal condition and improper internal tolerances. |

| Pass Fail |D |Engine Mount – For cracks, corrosion, looseness of mounting, and looseness of engine to mount. |

| Pass Fail |E |Flexible vibration dampeners – For poor condition and deterioration |

| Pass Fail |F |Engine Controls – For defects, improper travel, and improper safetying. |

| Pass Fail |G |Lines, hoses and clamps - For Leaks, improper condition and looseness. |

| Pass Fail |H |Exhaust/Manifold/Header – For cracks, defects and improper attachment. Check safety wires |

| Pass Fail |I |Fuel System: Check for poor condition, cracks, wear, deterioration |

| | |Fuel Lines Filters Hose Clamps Fuel Pump Primer Bulb |

| Pass Fail |J |Rotary Valve Oil – Poor condition, cloudy |

| Pass Fail |K |Radiator – Secure to frame, leaks, hoses for wear or damage, loose clamps |

| Pass Fail |L |Accessories – For apparent defects in security of mounting |

| Pass Fail |M |All Systems – For improper installation, poor general condition, defects, and insecure attachment. |

Notation:      

5. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the landing gear group:

| Pass Fail |A |All units - For poor condition and insecurity of attachment. |

| Pass Fail |B |Shock Absorbing Devices – For poor condition. |

| Pass Fail |C |Linkages, Trusses and Members – For undue or excessive wear, fatigue and distortion. |

| Pass Fail |D |Wheels – For cracks, defects, and condition of bearings |

| Pass Fail |E |Tires – For wear, cuts, proper pressure |

| Pass Fail |F |Brakes – For improper adjustment |

| Pass Fail |G |Front gear steering – Bolt security and wear, proper clearance and smooth steering. |

Notation:      

6. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the propeller group.

| Pass Fail |A |Propeller Assembly - For cracks, nicks, binds and oil leakage |

| Pass Fail |B |Bolts – For improper torquing and lack of safetying |

| Pass Fail |C |Control Mechanism – For Improper operation, insecure mounting, and restricted travel. |

Notation:      

7. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the parachute.[1]

| Pass Fail |A |Lines and Fittings – For deterioration, tears, ultra violent light deterioration, distortion, other evidence of |

| | |failure, and defective or insecure attachment of fittings |

| Pass Fail | |Parachute – For tears, torn or loose stitching, abrasions, deterioration |

| Pass Fail |B |Pulleys – For cracks, wear, deterioration, proper attachment |

Notation:      

8. Each person performing an annual or 100-hour inspection shall inspect (where applicable) the following components of the radio group:

| Pass Fail |A |Radio and electronic equipment – For improper installation and insecure mounting. |

| Pass Fail |B |Wiring and Conduits – For Improper routing, insecure mounting, and obvious defects. |

| Pass Fail |C |Bonding and Shielding – For improper installation and poor condition |

| Pass Fail |D |Antenna – For poor condition, insecure mounting and improper operation. |

Notation:      

9. Each person performing an annual or 100-hour inspection shall inspect (where applicable) each installed miscellaneous item that is not otherwise covered by this listing for improper installation and improper operation.

| Pass Fail |A |All safety wires secure and in good condition |

| Pass Fail |B |      |

| Pass Fail |C |      |

| Pass Fail |D |      |

| Pass Fail |E |      |

Notation:      

10. Use the following space to identify areas of concern. For example, If item B in section 5 above was found to be un-airworthy note that in the chart as Item Number 5, Item Letter B, described the issue in the “Notes and Explanation “ area, and date when the item was repaired or replaced.

|Item Number |Item Letter |Notes and Explanation of un-airworthy Items Found |Date Item Repaired/Replaced |

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|Inspector Name (Print):       |Inspector Signature: |

|Date:       |Cert.#       |

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