Dear Colleague: IFALPA is in the process of gathering data for the study of the compliance with ICAO Standards and Recommended Practices. We would appreciate your completion of this form Please return it to your Member Association.
 
DATE
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NAME(optional)
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FLIGHT NO
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FROM
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TO
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EN-ROUTE NAVIGATION : Unserviceable Navigation Aids

NO
FIR
NAV AID Ident/freq
VOR / DME / NDB
Published by NOTAM
       
YES
NO
1
2
3
4
5
 

EN-ROUTE COMMUNICATIONS:
NO
GND Stn
Call Sign
Waypoint
Freq
Time (HF)
Congestion
Freq in use for gnd - gnd coms
Readability
       
Low
Med
High
Yes
No
0
1
2
3
4
5
1
2
3
4
5
6
7
8
9
10
0 – no contact, 1 - unreadable, 2 – readable now & then, 3 – readable but with difficulty, 4- readable, 5 – perfectly readable
 

APPROACH/AERODROME COMMUNICATION
N/A
Good
Acceptable
Poor*
A
Approach communications
B
Aerodrome Communication (including Tower)
C
Congestion due frequency sharing (appr-twr/twr-gnd)

* please specify in Any Other Comments box at the bottom
 

APPROACH AND LANDING – Runway Used

A
 Type of approach executed:
ILZ
LLZ DME
VOR DME
VOR
NDB
Circling
Visual
B
 Was Radar Service provided:
YES
NO
N/A
C
 Quality of Radar Service provided:
Good
Acceptable
Poor
D
 Quality of Appr. Nav Aids used:
Good
Acceptable
Poor
E
 Unserviceable aids / services published by NOTAM?
YES
NO*
N/A
F*
 Please specify which u/s Navaids were not NOTAMed
 

LIGHTING
A
 Was approach lighting
Serviceable
Unserviceable
Partly Ser.
NA(Daylight)
B
 Was VASI/PAPI serviceable / reliable
YES
NO
Not installed
C
 Were threshold lights: serviceable/partly serv/unserv/not appl
Serviceable
Unserviceable
Partly Ser.
NA(Daylight)
D
 Were r/w edge lights: servic/partly serv/unserviceable/not appl
Serviceable
Unserviceable
Partly Ser.
NA(Daylight)
E
 Was taxiway lighting adequate?
YES
NO
NA(Daylight)
F
 Was apron lighting adequate?
YES
NO
NA(Daylight)
G
 In case any of the above were unserviceable or only partly serviceable, was this fact published by NOTAM?
YES
NO
NA
 

RUNWAY CHARACTERISTICS (R/W )

A
 Condition
Smooth
Rough
Damaged
B
 Slippery when wet
YES
NO
N/A (Dry conditions)
C
 Surface State? HEAVY rubber accretion in TDZ
YES
NO
D
 Were surface markings clear?
YES
NO
 

METEOROLOGICAL INFORMATION
A
 Was valid forecast (TAF) available at departure airport?
YES
NO
  
B
 Was weather information readily available upon first contact with destin. ATC?
YES
NO
  
C
 Was weather information recent, if not pse specify
YES
NO
  
D
 Was weather information accurate, if not pse specify
YES
NO
  
E
 If ATIS published was it available
YES
NO
NA
F
 If ATIS provided, was it accurate, if not pse specify
YES
NO
NA
   
 

HAZARDS / SECURITY
A
 Were airport manoeuvring areas secure of animals/humans0?
YES
NO
  
B
 Was there a significant bird/wildlife hazard?
YES
NO
  
C
 Do you consider airport security
Good
Satisfactory
Poor

If unable to assess this yourself, on any of the above, please include your agents’ opinion:

NOTAMS (Were NOTAMS factually correct and up to date, if not pse specify)

COMMENT ON ENGLISH LANGUAGE USED ON R/T

ANY OTHER COMMENTS