Aircraft --- ANNUAL INSPECTION

OWNER'S INSPECTION REPORT

MASTER DATA LOG

Aircraft Registration and Documentation
Owner Registration Information:
N-Number / 1234A / Make /
Belchfire
/ Model / 55543
Serial / 987-65432 / Category /
Norm/Util
/ Owner / Doofus Q Tinkerputter
Address / 1234 Any St. / (leave blank) / Phone-work / 555.123.1324
City /
Anwhere
/ State /
AN
/ Phone-home / 555.321.9876
Email / / Zip / 98765-1234 / Phone-cell / 555.987.6543
Documentation Check:
Cockpit Data Plate / Airworthiness Certificate / Registration
Equipment List / Weight & Balance / Logbooks & Last Annual
Cockpit Placards / Instrument Markings / Fuselage Data Plate
AD's Checked through:
Aircraft Time In Service
Tach/Hobbs Reading: / Airframe Total Time:
Engine Total Time: / Engine Time Since Major Overhaul:
Propeller Total Time: / Prop Time Since Major O’haul:
Time Since Last Annual: / Transponder Check Date:
ELT Battery Replacement Due:
Airframe Inspection
Left Wing
Aileron Attach & Cables / Flap Attach & Cables / Structure & Covering / Strut
Strut Attach Fittings / Fuel Tank Placards / Fuel Tank Leaks / Fuel Tank Vent
Pitot Tube / Stall Warning / Aileron Trim System

Right Wing

Aileron Attach & Cables / Flap Attach & Cables / Structure & Covering / Strut
Strut Attach Fittings / Fuel Tank Placards / Fuel Tank Leaks / Fuel Tank Vent
Pitot Tube / Stall Warning / Aileron Trim System

Forward Fuselage

Static Port / Radio Cooling Vent / Fuselage Skin / Windshield
Engine Cowling / Cowl Flaps

Aft Fuselage

Horizontal Stabilizer / Elevator Attach & Cables / Elevator Trim / Doors & Hinges
Vertical Stabilizer / Rudder Attach & Cables / Rudder Trim

Landing Gear

Left Tire & Wheel / Left Brake / Left Brake Hydraulic Line / Left Hydraulic Reservoir
Right Tire & Wheel / Right Brake / Right Brake Hydraulic Line / Right Hydraulic Reservoir
Nose Tire & Wheel / Shock Strut / Shimmy Dampener / Nosewheel Steering Mechanism

Electrical System

Battery / Switches / Circuit Breakers or Fuses / Instrument Lights
Courtesy & Map Lights / Navigation (position) Lights / Strobe or Rotating Beacon / Landing Light(s)
Alternator & Regulator / Starter / Bonding & Shielding / Wiring
Equipment List
VFR Instruments & Equipment
Airspeed / Altimeter / Magnetic Compass / Seat Belts
Seats & Rails / Flight Controls / Shoulder Harnesses / ELT

Engine Instruments & Equipment

Tachometer / Manifold Pressure / Oil Pressure / Oil Temperature
Cylinder Head Temperature / Exhaust Gas Temperature / Fuel Quantity (each tank) / Fuel Pressure

IFR Instruments & Equipment

Turn Coordinator / Directional Gyro / Artificial Horizon / Clock
Vacuum Gauge / Vacuum Pump & Filters

Avionics

Com Radio(s) / VOR/LOC Radio(s) / Audio Panel or Intercom / Marker Beacon
DME / ADF / Glide Slope / Aux 2-way
AM-FM / Mic & Phone Jacks / Antennas

Miscellaneous Systems

Fire Extinguisher / Oxygen System / Cabin Ventilation / Cabin Heat

Engine Inspection

Compression

#1 / #2 / #3 / #4 / #5 / #6
Spark Plugs
#1 Top / #2 / #3 / #4 / #5 / #6
#1 Bottom / #2 / #3 / #4 / #5 / #6
Ignition System
Mag Timing Left / Mag Timing Right / Harness

Lubrication System

Change Oil / Check Screen or Filter / Leaks / Dipstick Security
Fuel System
Tank Quick Drains / Fuel Lines / Tank Selector / Vents (Wing & Cap) / Gascu-lator Screen / Air Filter
Carb Heat Control / Throttle Control / Mixture Control / Carb Venturi / Carb Heat Box

Propeller

Blades / Hub / Spinner / Safety Stripe / Rear Dull Paint
Miscellaneous
Exhaust System / Heater Muffs / Hot Air Ducting Hoses / Baffles / Engine Mounts

Miscellaneous Remarks

Inspections Performed As Noted Above
Owner Signature: / Date:
Jim Weir 2261417 A&P IA / Date:

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