EQUIPMENT INSPECTION AND MAINTENANCE WORKSHEET
For use of this form, see DA PAM 750-8; the proponent agency is DCS, G-4.
2. NOMENCLATURE AND MODEL
(Enter UNIT / LOCATION)
6. TYPE INSPECTION
(Enter Container ISO Number)
Show corrective action for deficiency or
Enter TM item number.
shortcoming listed in Column c.
Enter the applicable condition status symbol.
Individual ascertaining completed corrective
Enter deficiencies and shortcomings.
action initial in this column.
Indicates a deficiency in the equipment that places
Indicates a material defect other
it in an inoperable status.
than a deficiency which must be corrected to increase
efficiency or to make the item completely serviceable.
Indicates a deficiency, however, the
equipment may be operated under specific limitations as
LAST NAME INITIAL IN BLACK, BLUE-BLACK INK,
directed by higher authority or as prescribed locally, until
OR PENCIL - Indicates that a completely satisfactory
corrective action can be accomplished.
HORIZONTAL DASH "(-)"
Indicates that a required
FOR AIRCRAFT - Status symbols will be recorded in red.
inspection, component replacement, maintenance operation
check, or test flight is due but has not been accomplished,
or an overdue MWO has not been accomplished.
ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED
IN ACCORDANCE WITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.
8a. SIGNATURE (Person(s) performing inspection)
DEFICIENCIES AND SHORTCOMINGS
CSC RECERTIFICATION. NO REPAIRS
Asset Type (i.e. 22G1):
Next Inspection Date (Month/Year):
Manufacturer Serial Number:
Manufacturer Date / Year Built:
SERVICEABLE FOR IMDG / NON IMDG
DD Form 2282 Appiled
(Circle Inspected Type)
Certified Inspectors Signature / Date =====>
Print Certified Inspectors Name ======>
PREVIOUS EDITIONS ARE OBSOLETE.
APD LC v1.00ES
DA FORM 2404, FEB 2011