Practical Test Preparation Worksheets

Commercial Pilot ASEL and AMEL

Revision 3

Revisions

Revision Date Description 0 06/12/2018 Initial issue.

1 10/12/18

Updated formatting to include applicable ACS skill element next to form number in lower left-hand corner of each sheet.

Updated Form CA-I-A-2 to include Part 141 certification requirements. Updated references to AC 61-65 from revision G to revision H. Updated references to 14 CFR §61.129 to amendment 61-142.

2 03/10/2019

Added table of contents and page numbers for each form.

Added Form CA-B-1 (Practical Test Information).

Revamped Form CA-I-D-2 (Cross-Country Risk Analysis).

3 01/16/20

Changed title from “Checkride Prep Sheets” to “Practical Test Preparation Worksheets.”

Changed revision numbering system from A, B, C… to 1, 2, 3…

Aligned forms with that of Private Pilot including incorporating hyperlinks into the table of contents, updating Form CA-I-D-4 to reflect ICAO format, and removing automatic calculations from Form CA-I-F-1.

REVISIONS

www.answerstotheacs.com REV 3

Introduction This packet consists of multiple forms intended to guide applicants in preparation and organization for the practical test in accordance with the Airman Certification Standards. The forms contained herein are mostly self-explanatory, however, complete guidance on their use before and during the practical test are provided in the Answers to the ACS Commercial Pilot ASEL and AMEL e-book. For details, visit www.answerstotheacs.com.

INTRODUCTION

www.answerstotheacs.com REV 3

Form CA-B-1: Practical Test Information .................................................................... 1

Form CA-I-A-1: Master Checklist ................................................................................ 2

Form CA-I-A-2: Logbook Audit ................................................................................... 3

Form CA-I-B-1: Inspections ........................................................................................ 7

Form CA-I-C-1: Weather Log ..................................................................................... 8

Form CA-I-D-1: Navigation Log .................................................................................. 9

Form CA-I-D-2: Cross-Country Risk Analysis ............................................................ 10

Form CA-I-D-3: Flight Plan ......................................................................................... 11

Form CA-I-F-1: Weight and Balance .......................................................................... 12

Form CA-I-G-1: Systems Prep Sheets ....................................................................... 13

Form CA-I-H-1: Personal Minimums .......................................................................... 24

Form CA-I-H-2: Fitness For Flight .............................................................................. 25

TABLE OF CONTENTS

www.answerstotheacs.com REV 3

EXAMINER INFORMATION NAME PHONE NUMBER FEE

CASH ONLY

PRACTICAL TEST INFORMATION DATE TIME LOCATION AIRPLANE MAKE & MODEL

TYPE TEST

PRIVATE ASEL

INSTRUMENT AIRPLANE

COMMERCIAL ASEL

COMMERCIAL AMEL

OVERALL SCENARIO

CROSS-COUNTRY ASSIGNMENT

DEPARTURE:

DESTINATION:

REMARKS:

WEIGHT AND BALANCE INFORMATION LOAD DESCRIPTION WEIGHT

PASSENGER 1

PASSENGER 2

PASSENGER 3

PASSENGER 4

PASSENGER 5

BAGGAGE

IACRA INFORMATION USERNAME PASSWORD FTN

KNOWLEDGE TEST SUBJECTS (INCORRECT ANSWERS) ACS Code DESCRIPTION

PRACTICAL TEST INFORMATION

FORM CA-B-1 REV 3 www.answerstotheacs.com 1

Airplane Maintenance Records Airframe logbook (tabbed) Powerplant logbook (both engines if multiengine) Propeller logbook (both engines if multiengine)

Personal Documents Photo ID (at least 18 years of age) Pilot Certificate (at least private pilot) Current medical certificate or BasicMed qualification Original Knowledge Test Report Pilot logbook (tabbed) Completed 8710-1 form or IACRA 141 Graduation Certificate (if applicable) 141 Training Record (if applicable)

Equipment, Publications, & Payment View-limiting device Current VFR sectional chart (paper or electronic) Current Chart Supplement (paper or electronic) Flight computer (manual or electronic) Examiner’s fee

Airplane Performance Data (Marked Copies) Takeoff performance chart or graph Accelerate-stop performance chart or graph (if applicable) Accelerate-go performance chart or graph (if applicable) Climb performance chart or graph Single engine climb performance chart or graph (if applicable) Cruise performance chart or graph Descent performance chart or graph (if applicable) Landing performance chart or graph Loading table or graph (if applicable) CG graph

Answers to the ACS Checkride Prep Sheets (This Document) All forms completed

If Retaking or Resuming Practical Test Notice of disapproval or letter of discontinuance Updated 8710-1 form or IACRA

MASTER CHECKLIST

FORM CA-I-A-1 REV 3 www.answerstotheacs.com 2

LOGBOOK AUDIT

FORM CA-I-A-2 REV 3 (CA.I.A.S1) www.answerstotheacs.com

Part 61 Aeronautical Experience Airplane Single Engine Land Requirement Req’d Logged Flight Time Aircraft

Total Flight Time All1 250 hrs Total Flight Time Powered2 100 hrs

Total Flight Time Airplanes 50 hrs PIC All 100 hrs

PIC Airplanes 50 hrs PIC Cross-Country All 50 hrs

PIC Cross-Country Airplanes 10 hrs Commercial Flight Training All3 20 hrs

Instrument Training All3 10 hrs Instrument Training ASE 5 hrs

Complex Flight Training ASEL or AMEL4 10 hrs 2-Hr Day X/Country ASE 2 hrs 2-Hr Night X/Country ASE 2 hrs Checkride Preparation ASE 3 hrs

Solo or Supervised PIC ASE 10 hrs Long X/Country ASE NA Night VFR ASE 5 hrs

Night T/O’s & Ldgs ASE 10 Ground Training

Aeronautical Knowledge Ground Training (If Applicable) (61.125(a)) Areas of Operation Ground Training (61.127(a))

Endorsements Complex Airplane Endorsement (AC 61-65H A.68) Prepared for the knowledge test (AC 61-65H A.34) Prerequisites for practical test (AC 61-65H A.1) Review of knowledge test deficiencies (AC 61-65H A.2) Prepared for the practical test (AC 61-65H A.35) Retesting After Failure (AC 61-65H A.73) (If Retaking)

1 Up to 50 hours may be performed in an FFS or FTD representative of a single engine airplane. 2 Powered aircraft include all aircraft except gliders & balloons. 3 May be in any aircraft or FFS, FTD, or ATD. 4 May be in a single or multiengine land airplane for commercial ASEL only.

Current as of 14 CFR §61.125 Amdt. Orig, §61.127 Amdt. 61-124, & §61.129 Amdt. 61-142

3

LOGBOOK AUDIT

FORM CA-I-A-2 REV 3 (CA.I.A.S1) www.answerstotheacs.com

Part 61 Aeronautical Experience Airplane Multiengine Land Requirement Req’d Logged Flight Time Aircraft

Total Flight Time All1 250 hrs Total Flight Time Powered2 100 hrs

Total Flight Time Airplanes 50 hrs PIC All 100 hrs

PIC Airplanes 50 hrs PIC Cross-Country All 50 hrs

PIC Cross-Country Airplanes 10 hrs Commercial Flight Training All3 20 hrs

Instrument Training All3 10 hrs Instrument Training AME 5 hrs

Complex Flight Training AMEL 10 hrs 2-Hr Day X/Country AME 2 hrs 2-Hr Night X/Country AME 2 hrs Checkride Preparation AME 3 hrs

Solo or Supervised PIC AME 10 hrs Long X/Country AME NA Night VFR AME 5 hrs

Night T/O’s & Ldgs AME 10 Ground Training

Aeronautical Knowledge Ground Training (If Applicable) (61.125(a)) Areas of Operation Ground Training (61.127(a))

Endorsements Complex Airplane Endorsement (AC 61-65H A.68) Prepared for the knowledge test (AC 61-65H A.34) Prerequisites for practical test (AC 61-65H A.1) Review of knowledge test deficiencies (AC 61-65H A.2) Prepared for the practical test (AC 61-65H A.35) Retesting After Failure (AC 61-65H A.73) (If Retaking)

1 Up to 50 hours may be performed in an FFS or FTD representative of a multiengine airplane. 2 Powered aircraft include all aircraft except gliders & balloons. 3 May be in any aircraft or FFS, FTD, or ATD.

Current as of 14 CFR §61.125 Amdt. Orig, §61.127 Amdt. 61-124, & §61.129 Amdt. 61-142

4

LOGBOOK AUDIT

FORM CA-I-A-2 REV 3 (CA.I.A.S1) www.answerstotheacs.com

Part 141 Aeronautical Experience Airplane Single Engine Land Requirement Req’d Logged Flight Time Aircraft

Total Flight Time All 190 hrs Total Training Time All1 120 hrs Commercial Flight Training All 55 hrs

Instrument Training All2 10 hrs Instrument Training ASE 5 hrs

Complex/TAA Flight Training ASEL or AMEL3 10 hrs 2-Hr Day X/Country ASE 2 hrs 2-Hr Night X/Country ASE 2 hrs Checkride Preparation ASE 3 hrs

Solo or Supervised PIC ASE 10 hrs Long X/Country ASE NA Night VFR ASE 5 hrs

Night T/O’s & Ldgs ASE 10 Leftover Training Time All4 55 hrs

Ground Training Requirement Req’d Logged

Aeronautical Knowledge Training 35 hrs Endorsements

Complex Airplane Endorsement (AC 61-65H A.68) Prepared for the knowledge test (AC 61-65H A.34) Prerequisites for practical test (AC 61-65H A.1) Review of knowledge test deficiencies (AC 61-65H A.2) Prepared for the practical test (AC 61-65H A.35) Retesting After Failure (AC 61-65H A.73) (If Retaking)

1 May be in any aircraft within limitations of course approval or FFS or FTD (see note 4). 2 May be in any aircraft within limitations of course approval or FFS, FTD, or ATD. 3 May be in a single or multiengine land airplane for commercial ASEL only. 4 May be in any aircraft within limitations of course approval or FFS or FTD. FFS time limited to 36 hours & FTD time limited to 24 hours.

Current as of 14 CFR §141 Appendix D Amdt. 141-18

5

LOGBOOK AUDIT

FORM CA-I-A-2 REV 3 (CA.I.A.S1) www.answerstotheacs.com

Part 141 Aeronautical Experience Airplane Multiengine Land Requirement Req’d Logged Flight Time Aircraft

Total Flight Time All 190 hrs Total Training Time All1 120 hrs Commercial Flight Training All 55 hrs

Instrument Training All2 10 hrs Instrument Training ASE 5 hrs

Complex/TAA Flight Training AMEL 10 hrs 2-Hr Day X/Country AME 2 hrs 2-Hr Night X/Country AME 2 hrs Checkride Preparation AME 3 hrs

Solo or Supervised PIC AME 10 hrs Long X/Country AME NA Night VFR AME 5 hrs

Night T/O’s & Ldgs AME 10 Leftover Training Time All3 55 hrs

Ground Training Requirement Req’d Logged

Aeronautical Knowledge Training 35 hrs Endorsements

Complex Airplane Endorsement (AC 61-65H A.68) Prepared for the knowledge test (AC 61-65H A.34) Prerequisites for practical test (AC 61-65H A.1) Review of knowledge test deficiencies (AC 61-65H A.2) Prepared for the practical test (AC 61-65H A.35) Retesting After Failure (AC 61-65H A.73) (If Retaking)

1 May be in any aircraft within limitations of course approval or FFS or FTD (see note 4). 2 May be in any aircraft within limitations of course approval or FFS, FTD, or ATD. 3 May be in any aircraft within limitations of course approval or FFS or FTD. FFS time limited to 36 hours & FTD time limited to 24 hours.

Current as of 14 CFR §141 Appendix D Amdt. 141-18

6

INSPECTIONS

FORM CA-I-B-1 REV 3 (CA.I.B.S2) www.answerstotheacs.com

Inspections Inspection Time Limit Date Performed Expires

Annual Inspection 12 Calendar Months

Transponder Inspection1 24 Calendar Months

ELT Inspection1 12 Calendar Months

ELT Battery Replacement1 -

Airworthiness Limitations (complied with)

Airworthiness Directives (up to date)

1 If applicable

Progressive Inspections (If Applicable) Phase Time Limit Date Performed Expires

Note: Altimeter inspection, static system inspection, and VOR check not required for VFR flight. Additionally, 100-hour inspection not required for a practical test.

7

WEATHER LOG

FORM CA-I-C-1 REV A (CA.I.C.S1) www.answerstotheacs.com

VFR Weather Log Synopsis:

Adverse Conditions:

Departure Destination Enroute

Cur

rent

Wx

Time Wind Vis Wx Sky

Temp Alt

Fore

cast

Wx Time

Wind Vis Wx Sky

Win

ds A

loft ALT

NO

TAM

s

Departure:

Enroute:

Arrival:

8

NAVIGATION LOG

FORM CA-I-D-1 REV 3 (CA.I.D.S3) www.answerstotheacs.com

Preflight Planning In-Flight

Departure Destination Tail Takeoff Dist Landing Dist Accel/Stp Dist

Time to Climb Climb FFlow Resv Fuel Dept Time SE Climb Climb Power

Fuel to Climb Cruise FFlow Fuel Req’d Planned ETA Fuel Onboard Cruise Power

ALT Wind MV CRS HDG Dist Spd Time Fuel Checkpoint

Time Fuel Course

ATA

ETE ETA

ACT

Est

FOD CRS OFF SET

Dist HDG ALT Dir Mag

Var TC TH Leg TAS Leg Leg Leg Next Leg

Temp Vel MC MH Tot GS Tot Tot Error Dest Diff Prev Est

Rem Cor

9

PILO

T

RISKS

RISK ASSESSMENT

LIKELIHOOD IMPROBABLE REMOTE LIKELY PROBABLE

RISK LEVEL LOW SERIOUS HIGH HIGH RISK MITIGATION MEASURES

AIRC

RAFT

RISKS

RISK ASSESSMENT

LIKELIHOOD IMPROBABLE REMOTE LIKELY PROBABLE

RISK LEVEL LOW SERIOUS HIGH HIGH RISK MITIGATION MEASURES

ENVI

RON

MEN

T

RISKS

RISK ASSESSMENT

LIKELIHOOD IMPROBABLE REMOTE LIKELY PROBABLE

RISK LEVEL LOW SERIOUS HIGH HIGH RISK MITIGATION MEASURES

EXTE

RNAL

PRE

SSU

RES

RISKS

RISK ASSESSMENT

LIKELIHOOD IMPROBABLE REMOTE LIKELY PROBABLE

RISK LEVEL LOW SERIOUS HIGH HIGH RISK MITIGATION MEASURES

CROSS-COUNTRY RISK ANALYSIS

FORM CA-I-D-2 REV 3 (CA.I.D.S1) www.answerstotheacs.com 10

3 MESSAGE TYPE

<=(FPL 7 AIRCRAFT IDENTIFICATION 8 FLIGHT RULES TYPE OF FLIGHT

<=

9 NUMBER TYPE OF AIRCRAFT WAKE TURBULENCE CAT.

/ 10 EQUIPMENT

/ <= 13 DEPARTURE AERODROME TIME

<= 15 CRUISING SPEED LEVEL ROUTE

<= 16 DESTINATION AERODROME

TOTAL EET

HR MIN ALTN AERODROME 2ND ALTN AERODROME

<= 18 OTHER INFORMATION

<= SUPPLEMENTARY INFORMATION (NOT TO BE TRANSMITTED IN FPL MESSAGES)

19

E/ ENDURANCE

HR MIN PERSONS ON BOARD

P/

EMERGENCY RADIO

R/ UHF VHF ELT

SURVIVAL EQUIPMENT

/ POLAR DESERT MARITIME JUNGLE

JACKETS

/ LIGHT FLUORES UHF VHF

D /

DINGHIES NUMBER CAPACITY COVER COLOR

<=

A/ AIRCRAFT COLOR AND MARKINGS

N / REMARKS

<= C/

PILOT-IN-COMMAND )<=

FL U VP D M J

U V E

C

FLIGHT PLAN

FORM PA-I-D-3 REV C (PA.I.D.S3) www.answerstotheacs.com 11

WEIGHT AND BALANCE

FORM CA-I-F-1 REV A (CA.I.F.S1) www.answerstotheacs.com

Item Limit Weight Arm Moment Empty Weight

Front Baggage (Disregard if not Applicable)

Pilot & Front Passenger

Middle Row Passengers (Disregard if not Applicable)

Aft Row Passengers

Aft Baggage

Zero-Fuel Weight

Ramp Fuel

Gal

Ramp Weight

Ramp CG

Taxi Fuel Burn

Gal

Takeoff Weight

Takeoff CG

Enroute Fuel Burn

Gal

Landing Weight

Landing CG

12

AIRPLANE INFORMATION MAKE & MODEL SERIAL NUMBER REGISTRATION

CA.I.G.K1a: Primary Flight Controls and Trim

Operating Mechanism

� Cable � Push/Pull Rods

� Combination specify:

Rudder

� Conventional � Ruddervator � Twin Rudder

Rudder/Aileron Interconnect? � Yes � No

Pitch Control

� Elevator � Stabilator

Pitch Down Force

� None � Down Spring � Bobweight

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 13

CA.I.G.K1b: Secondary Flight Controls

Pitch Trim

� Trim Tab � Anti-Servo Trim Tab � Adjustable Stabilizer

Roll Trim

� None � Ground-Adjustable Tab

Servo Trim Tab

Yaw Trim

� None � Ground-Adjustable Tab � Bungee System

Anti-Servo Trim Tab

Flap Type

� Slotted � Plain � Split

Flap Control System

� Manual � Electric

Flap Actuating System

� Mechanical � Electric � Hydraulic

Speed Brakes?

Yes No

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 14

PA.I.G.K1c: Powerplant and Propeller

Engine Make and Model specify:

Rated Horsepower specify:

Number of Cylinders specify:

Engine Type

� Conventional Diesel

Engine Rotation

� Right � Left Counter Rotating (AMEL only)

Gearing

� Direct-Drive � Reduction Gearing

Induction System

� Normally Aspirated � Turbocharged

Fuel Metering System

� Carbureted � Fuel Injected (Bendix) � Fuel Injected (Continental)

Common Rail Direct Injection (Diesel)

Cylinder Configuration

� Horizontally Opposed � In-Line

Cooling System

� Air-Cooled � Liquid-Cooled

Adjustable Cowl Flaps? Yes No

Starting System

� Direct-Cranking Starter � Manual (Hand-Prop)

Auxiliary Starting System

� Impulse Coupling � Starter Vibrator (Shower of Sparks) Glow Plugs (Diesel)

Control System

� Conventional (Manual) � FADEC/ECU-Controlled

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 15

Turbocharger

System Type

Turbonormalized Ground-Boosted

Maximum Manifold Pressure? (specify)

Turbocharger Waste Gate Type

Fixed Waste Gate Manual/Coupled Waste Gate

Automatic Waste Gate

Turbocharger Automatic Controller

Absolute Pressure Controller

Variable Absolute Pressure Controller/Variable Pressure Controller

Sloped/Slope Controller

Pressure Ratio Controller

Rate Controller

Density & Differential Controller Combination

Turbocharger Intercooler? Yes No

Propeller

Type

Fixed Pitch Constant Speed (Single Engine Airplane)

Full-Feathering (Multiengine Airplane)

Maximum Start Latch RPM? (Multiengine Only) (specify)

Propeller Unfeathering Accumulator? (Multiengine Only)

Yes No

Propeller Synchronizer or Synchrophaser? (Multiengine Only)

Yes No

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 16

PA.I.G.K1d: Landing Gear

Type

Fixed Retractable

Configuration

Tricycle � Tailwheel

Nose Gear Structure

� Oleo-Pneumatic � Rubber Blocks

Main Gear Structure

� Oleo-Pneumatic � Rubber Blocks � Spring Steel Leg

Steering (Tricycle Configuration)

� Steerable Nosewheel � Free-Castering Nosewheel

Steering (Tailwheel Configuration)

� Pilot-Operated � Load-Operated (Steerable) � Free-Castering Tailwheel

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 17

Retractable Landing Gear

Gear Safe Lights

One-Light Configuration Three-Light Configuration EFIS

Gear Unsafe Light

Red Yellow

Mechanical or Visual Indicators? (specify)

Control and Actuating System

Electrically Controlled, Electrically Actuated

Electrically Controlled, Hydraulically Actuated

Manual System

Warning Horn

Minimum Throttle Position (specify)

Maximum Flap Position (specify)

Safety Switch

Squat Switch Airspeed Switch (specify airspeed)

Limitations

VLE (specify) VLO (specify)

Emergency Extension System

Hand Crank Hand Pump Gravity Freefall

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 18

EFIS

PA.I.G.K1e: Fuel, Oil, and Hydraulic

Fuel System

Total Fuel Quantity specify:

Usable Fuel Quantity specify:

Unusable Fuel Quantity specify:

Fuel Tanks specify:

Fuel System Type

� Gravity-Feed � Pump-Feed � High-Wing Fuel Injection

Crossfeed System Type (if multiengine)

Crossfeed-On Crossfeed-Off

Oil System

Maximum Oil Sump Capacity specify:

Minimum Recommended Oil Quantity specify:

Minimum Oil Quantity for Safe Flight specify:

Hydraulic System

Hydraulic Systems

� Brakes � Flaps � Landing Gear (if retractable)

Hydraulic Reservoir?

Yes � No

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 19

PA.I.G.K1f: Electrical

System Voltage

� 14 Volts � 28 Volts

Main Battery Voltage

� 12 Volts � 24 Volts

Power Generation

� Generator � Alternator

Voltage Regulation

� Voltage Regulator � Voltage Regulator & Overvoltage Relay

� ACU

Instruments

� Ammeter � Loadmeter � Voltmeter(s)

Busses specify:

Load Components (Check all that apply)

� Avionics � Flaps � Auxiliary Fuel Pump

� Ice Protection Systems � Stall Warning � Lights

� Starter � Select Instruments Landing Gear

Circuit Protection

� Circuit Breakers � Fuses

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 20

PA.I.G.K1g: Avionics

EFIS?

Yes � No

Navigation Radios

� VOR � Localizer � Glideslope

� Marker Beacon � GPS � None

Transponder

� Mode C � Mode S � ADS-B

ELT

� 121.5 � 406

Autopilot

Autopilot Installed?

� Yes specify model: � No

Axes of Control

� 1-Axis � 2-Axis � 3-Axis

Attitude Sensing

� Attitude-Based � Rate-Based

Traffic Alerting System

� TIS � TAS � TIS-B � None

Weather Avoidance System

� Satellite Weather � FIS-B Weather Radar

Terrain Alerting System?

Yes � No

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 21

PA.I.G.K1h: Pitot-Static, Vacuum/Pressure and Associated Flight Instruments

Pitot-Static System

System Type

� Conventional � EFIS (ADC)

Static Ports

� 1 � 2

Alternate Static � Yes � No

Pneumatic System

� Vacuum System � Pressure System � Venturi Tube System

PA.I.G.K1i: Environmental

Heating

� Exhaust Manifold Heater � Electric Heater Turbocharger Heater

Combustion Heater

Cooling

� Fresh Air Vents � Air Conditioning

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 22

PA.I.G.K1j: Deicing and Anti-Icing

Airframe

Pneumatic Deicing Boots “Weeping Wing”/TKS Heated Windshield

Fluid Windshield System Heated Stall Warning

Propeller

Prop Heat Fluid Anti-Icing System (TKS)

Intake

Carburetor Heat Alternate Air

Fuel

Heated Fuel Tank Vent

Pitot-Static

Pitot Heat

Yes No

Alternate Static

Yes No

PA.I.G.K1k: Water Rudders (Omitted)

PA.I.G.K1l: Oxygen System

Oxygen System Installed?

Yes � No

Tank Capacity specify:

SYSTEMS

FORM CA-I-G-1 REV 3 (CA.I.G.K1) www.answerstotheacs.com 23

PERSONAL MINIMUMS

FORM CA-I-H-1 REV 3 (CA.I.H.S2) www.answerstotheacs.com

Aircraft Tail

Number Make & Model

Max Xwind Component

Variable Baseline Corrected

Cei

ling

& V

is Minimum Ceiling

Minimum Visibility

Surf

ace

Win

d

Maximum Total Wind

Maximum Tailwind Component

Maximum Crosswind Component

Perf

orm

ance

Minimum Runway Length

Minimum Density Altitude

Maximum Terrain Elevation

Correction Factors

Factor Issue Correction

Pilot IMSAFE criteria or long time since last flown. +500 FT to ceiling

Aircraft Unfamiliar airplane or avionics. + ½ SM to visibility

Environment Unfamiliar airport, airspace, terrain, etc. +500 FT to runway length

External Pressure Deadlines from passengers or self. -5 KTS from winds

24

FITNESS FOR FLIGHT

FORM CA-I-H-2 REV 3 (CA.I.H.S2) www.answerstotheacs.com

Factor Evaluation

Illness

Fever? Yes No Congestion? Yes No

Any other symptoms?

Medication

List any medications currently being taken and if they are approved:

Stress

List any stressors or emotionally upsetting events:

Alcohol

Time since last alcoholic beverage?

Hung over? Yes No

BAC (if in doubt):

Fatigue Hours slept previous night:

Experiencing symptoms of fatigue? Yes No

Eating

Time since last meal:

Time since last water:

Experiencing symptoms of malnutrition or dehydration?

Yes No

25