Airplane Survey Questionnaire Template

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AIRPLANE QUESTIONNAIRE
Name:
Grade:
CAPID:
Unit:
Date:
Check Pilot:
Grade:
CAPID:
Score:
Type/Model Aircraft:
Complete this open book questionnaire using the Flight Manual/Pilot's Operating Handbook. If a question or
part of a question is not applicable, write in NA. The check pilot will review and grade the questionnaire.
Minimum passing score is 80%. The completed questionnaire will be filed in the pilot's flight records.
1. Approved fuel grades and colors are:
2. Location/capacity of each fuel tank is:
3. Total usable fuel under all flight conditions is
gallons.
4. Endurance at 75% power, 7,500-foot MSL, with a 1-hour reserve is
hours.
5. What make and grade oil is used?
Winter:
Summer:
6. Oil capacity is
quarts. Minimum oil quantity for take off is
quarts.
7. Minimum oil pressure is
psi. Maximum oil pressure is
.
8. Maximum oil temperature is
degrees (F or C)
.
9. Magnetos are checked at
RPM. RPM drop should not exceed
RPM on
either magneto or
RPM differential between magnetos.
10. Maximum RPM and MP for takeoff are
and
in/Hg.
11. Maximum gross takeoff weight is
pounds. Empty weight is
pounds.
Useful load is
pounds. Maximum landing weight is
pounds.
12. Baggage compartment locations/weights are:
13. Give the IAS at maximum gross weight for:
a. Va (maneuvering speed).
e. Vx (best angle of climb, sea level).
b. Vso (stall, landing config, power. off).
f. Vmc (minimum control speed – multi-
engine only).
c. Vs1 (stall, cruise config, power. off).
d. Vy (best rate of climb, sea level).
g. Best glide speed.
14. Give the immediate action/memory items for:
a.
Engine failure immediately after takeoff.
b.
Fire during cranking and engine fails to start.
c.
Engine fire in flight.
d.
Electrical fire in flight.
CAPF 5Q–AIRPLANE, APR 14
OPR/ROUTING: DOV
Previous Editions Will Not Be Used

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