ENGINE GROUND RUN CHECK OUT FORM

Request for EGR Checkout (To be completed by Senior Foreman & Above)
To: Manager Quality From: Senior Foreman & above

Name / Designation / Signature

Date of Request:
Details / Particulars of Authorisation Holder (AH) Being Checked-out
Name:
Staff No:
Licence / Authorisation No:
Division / Dept.
Date Appointed as LAE:
Date Last Authorisation
Issued:
EGR Authorisations Held:
(State if Idle / Full Power
Authorisation is held)
EGR Checkout (Tick either (A) or (B) below)
(A) Simulator (B) Checkout on aircraft
Date of
Date of course:
checkout:
Aircraft /
Details of Checkout: engine
Aircraft /
combination:
engine
Aircraft
combination:
registration:
Power Level Idle Full
Engine Pre-Start Check Engine Run Data Recording #
Engine Limits Briefing Special Tests/Others #:
Normal Shutdown Remarks :
Procedures Performed:
Post Engine Shutdown Check __________________________________
Emergency Procedure Briefing
Emergency Shutdown Drill __________________________________

Results of checkout Satisfactory Unsatisfactory

Checked Out By: Appropriate EGR Authorisation Held:
(State if Idle / Full Power* Authorisation is held)

Name / Designation / Signature

Person being checked out MUST be a practicing LAE for at least 6 months, and holding a current
Note 1:
Licence or Authorisation for the type of engine being run.
Person conducting check out MUST have a Licence or Authorisation, and Ground Run Authorisation
Note 2:
for the type of Engine being run.
Note 3: Only one engine type EGR Authorisation will be granted per application.
# Optional
* Delete as Applicable
Tick Box as Applicable

ECQ 002U