KANSAS WING VEHICLE INSPECTION CHECKLIST

DATE: Oct 31, 2009 MISSION #: n/a VEHICLE'S CAP ID#: 14009

UNIT OF ASSIGNMENT: NCR-KS-034 MAKE: Chevy 2500 9 Passenger YEAR: 2005

STATIC DISPLAY UNDERHOOD INSPECTION

[CIRCLE CORRECT RESPONSE] [CIRCLE CORRECT RESPONSE]

ITEM SAT UNSAT REMARKS ITEM SAT UNSAT REMARKS

Windows S Battery S

Headlights S Brake Fluid S

Taillights S Exhaust System S

Proper level? S
Brakelights S Oil Mileage at last change?

Turn signals S Coolant Level S

Emergency Flashers S Belts & Hoses S

License Plate Light S Transmission S

Back-up Lights S Battery Cables S

Back-up Alarm UNSAT Inoperative Air Cleaner Filter S

Wiper Blades S
EXTERIOR INSPECTION
[CIRCLE CORRECT RESPONSE]

Horn UNSAT Weak Body Condition S

Seats S Paint Condition S

Restraints S Bumpers S

Tires
Mirrors S S
Proper tread?
Tire gauge
Beacon Light S Check Inflation Levels: Y
in vehicle?
FRONT TIRES
Wiring S
RECOMMENDED PRESSURE
55 LF 53 RF 77
ACTUAL
REAR TIRES
Brakes S
RECOMMENDED PRESSURE
80 LR 54 RR 80

WING REQUIRED ITEMS LOG BOOK

First Aid Kit present? Y REGISTRATION
Fastened down? N In book? Y
Any outdated items? N If yes, dispose of them Current? Y
Tool Kit present? Y PROOF OF INSURANCE
Fastened down? N In book? Y
Survival Kit present? Y Current? Y
Any outdated items? N If yes, dispose of them CAPF 73
Fire Extinguisher Y In book? Y
Fastened down? Y X Y
Charged? Y Signed for monthly tire check? Y
X✘
MISSION READY? Yes No Inspected by:
Major Dan Metcalf
IF this vehicle is released for use after failing the initial inspection, it SHALL be released only after IC signs release below!!!
I release the above named vehicle for use under the condition, that "I take responsibility for releasing it from its
'grounded status'. I realize that in doing so I take full responsibility for its use on this mission."
Incident Commander's Signature
KSWG Form 32 LOCAL REPRODUCTION AUTHORIZED REVIEWED 1 OCT 08