FLIGHT CHECK RECORD

Pilot Name (3 letter code): Date:

Pilot Licence No: Medical Date:

B737 C Series Q400 ____ Capt. F/O

Name of Examiner: Location: Block Time:
Examiner’s Authorization No. STD: Briefing Time:

Document Check: Type Rating ________________ Instrument Rating ____________ OPC

Valid till: __ / __ / _____ Valid till: __ / __ / _____ Valid till: __ / __ / _____

Type of Check: PC OPC Other ______________

Items to be checked (mandatory shaded) Items to be checked (mandatory shaded)

F P F P
(refer to EU-OPS App1 to 1.965 and EU-FCL App9) (refer to EU-OPS App1 to 1.965 and EU-FCL App9)
1. Flight preparation 3.7 Steep turns (45°)
1.1 Performance calculations 3.8 Stall/Upset recognition and recovery
1.3 Cockpit inspection 3.9 Instrument flight procedures
1.4 Before start & starting procedures/checks 3.9.1 Adherence to ATC instructions
1.5 Taxiing 3.9.2 Holding
1.6 Before take-off procedures/checks 3.9.3 ILS-approaches down to 200 FT:
2. Take-Offs 3.9.3.1 Manual / Raw data
2.1 Normal, different flaps settings 3.9.3.2 Manual / FD
2.2 Instrument LVTO (RVR _____ m) 3.9.3.3 Autopilot coupled
2.3 Cross wind take-off 3.9.3.4 Manual with OEI
2.4 Max take-off weight 3.9.4 Non-precision approach down to MDA/H
2.5 Engine Failure between V1 and V2 3.9.5 Circling approach
2.6 RTO before reaching V1 3.9.6 RNP APCH down to (………………..)
3. Manoeuvres / Procedures 4. Missed approach procedures
3.1 Turns 4.1 All engines from DH
3.4 Systems (select min 3 items) ↓ ↓ 4.2 Other missed approaches
3.4.0 Engine (if necessary propeller) 4.3 Manual go-around with OEI from DH
3.4.1 Pressurisation / Air-conditioning 4.4 Rejected landing at 50 FT and GA
3.4.2 Pitot / static 5. Landings
3.4.3 Fuel 5.1 Normal with transition to visual below DH
3.4.4 Electrical 5.2 Control jams or out-of-trim
3.4.5 Hydraulic 5.3 Cross wind landings
3.4.6 Flight controls 5.4 Abnormal flaps setting
3.4.7 Anti / de-icing 5.5 Landing with critical engine INOP
3.4.8 Autopilot / Flight director 6. Approaches down to < 200 FT (Cat 2 / 3)
3.4.9 Stall warning devices 6.1 RTO in min RVR
3.4.10 RA / GPWS / WXR / Transponder 6.2 ILS app down to applicable DH
3.4.11 Instruments / Navigation / FMS 6.3 Go-around on reaching DH
3.4.12 Landing gear / Brakes 6.4 Landings with visual reference at DH
3.4.13 Flaps/Slats 7. Company Procedures
3.4.14 APU 7.1 Knowledge and application of SOPs
3.6 Abnormal/Emergency (select min 3 items) ↓ ↓ 7.2 Crew coordination and call-outs
3.6.1 Fire drills 7.3 CRM/ TEM (see also opposite side)
3.6.2 Smoke control and removal 8. Other Qualifications
3.6.3 Engine failures / re-start 8.1 Right Seat Pilot
3.6.4 Fuel dumping 8.2 Cruise Relief Pilot
3.6.5 Windshear at take-off / landing 8.3 Others (…………………………………………..)
3.6.6 Emergency descent / Pressure loss
3.6.7 Pilot incapacitation
3.6.8 Emergency Evacuation
3.6.9 TCAS/ v7.1 event
3.6.10 EGPWS/TAWS manoeuvre
FINAL RESULT:

Passed (all items passed) Partial passed (1-5 items failed) Failed (more than 5 items failed)

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Effective from 24.11.2016 TRAINING FORM
FLIGHT CHECK RECORD
REMARKS / SUMMARY

CRM/TEM SKILLS ASSESSMENT

Categories Elements Remarks
Team building and maintaining
Considering others
CO-OPERATION
Supporting others
Conflict solving
Use of authority and assertiveness
LEADERSHIP & Maintaining standards
MANAGERIAL
SKILLS Planning and co-ordinating
Workload management
System awareness
SITUATION
Environmental awareness
AWARENESS
Anticipation
Problem definition/ diagnosis
DECISION Option generation
MAKING Risk assessment of option choice
Outcome review

AVERALL CRM/TEM SKILLS ASSESSMENT RESULTS:

Poor Acceptable Good Very Good

Pilot’s Examiner’s
Signature _____________________ Signature _____________________

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Effective from 24.11.2016 TRAINING FORM