reporte de cilindros de oxigeno
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8/17/2019 Reporte de Cilindros de Oxigeno
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FECHA/ DATE:
MM MM AA YY
MM MM AA YYY DOT:___3AA____3HT
SATISFACTORIO / SATISFACTORY___________________________________________________
NO SATISFACTORIO / NOT SATISFACTORY___________________________________________
SATISFACTORIO / SATISFACTORY__________________________________________
NO SATISFACTORIO / NOT SATISFACTORY__________________________________
SATISFACTORIO / SATISFACTORY__________________________________________
NO SATISFACTORIO / NOT SATISFACTORY___________________________________
SATISFACTORIO / SATISFACTORY__________________________________________
NO SATISFACTORIO / NOT SATISFACTORY_________________________________
SATISFACTORIO / SATISFACTORY__________________________________________
NO SATISFACTORIO / NOT SATISFACTORY_________________________________
SATISFACTORIO / SATISFACTORY__________________________________________
NO SATISFACTORIO / NOT SATISFACTORY_________________________________
REPORTE DE INSPECCIÓN DE CILINDROS DE OXIGENOOXIGEN CYLINDER TEAR DOWN REPORT
CONVIASA-GACC-2004-1806 Rev. 8 ORDEN DE TRABAJO.WORK ORDER
CLIENTE / CUSTOMER :- CONVIASA
-- OTRO / OTHER _____________
N/P:P/N
MODELO:MODEL
VIDA LIMITE:HARD TIME
N/S:S/N
FABRICANTE:MANUFACTURER
DATA TÉCNICA A UTILIZAR: TECHNICAL DATA
REVISIN N!:MANUFACTURER
1. INSPECCIONPRELIMINAR PRELIMINARY
INSPECTION
FECHA DE LA ULTIMA PRUEBA HIDROSTATICALAST HYDROSTATIC TEST DATE:
FRECUENCIA DE PRUEBA HIDROSTAHYDROSTATIC TEST FRE
FECHA DE FAB. MF"DATE
PRESION INICIAL:______________PSIPRESSURE
CAUSA DE LA REMOCION:
REASON FORREMOVAL
CONDICIN DE REMOCION:
CONDITION AT TIME RECEIVED
INSPECCION VISUAL POR DA#OS OCULTOSVISUAL INSPECTION FOR
PHYSICAL DAMA"E
CONDICION DE LA VALVULA VALVECONDITION
TEST DE OLORODOR TEST
2. PROCEDIMIENTO DELLENADO CHAR"IN"
PROCEDURE
TEMP. FINAL DE LLENADO FINALFILLIN" TEMP______________!$
PRESION FINAL DE LLENADO:FINAL FILLIN" PRESS:_________________________________PSI
3. INSPECCION INAL FINAL INSPECTION
PRUEBA DE FU"ALEAK TEST
PRUEBA DE PUREZAPURITY TEST
PRUEBA DE HUMEDAD MOISTURE TEST
SERVICIABLE / SERVICEABLE%FORMA INAC &'-(()/FAA *'3(-3 O INAC )3-((' / FAA
33+,
REPARABLE / REPAIRABLE%FORMA AAV-"ACC-&(()-'*&,
RECHAZADO / REJECTEDAAV-"ACC-&(()-'*
OBSERVACIONES/REMARKS:____________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________
CERTIICO !"E EL E!"IPO IDENTIICADO EN ESTA ORDEN DE TRA#A$O %A SIDO INSPECCIONADO DE AC"ERDO A LOS RE!"ERIMIENTOS DE LAS REG"LACIONES AEDETERMINADO !"E ESTA AERONAVEGA#LE. THE UNDERSI"NED CERTIFIES THAINSPECTED ACCORDIN" TO THE CURRENT AERONAUTICAL RE"ULATION REUIREMENTS AND IT WAS FOUND IN SERVICIABLE CONDITION.
FIRMA DE MECANICO / LIC N!MECHANIC SI"NATURE
FIRMA DE INSPECTOR / SELLOINSPECTOR SI"NATURE / STAMP
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MECANICO / MECHANIC
MECANICO / MECHANIC
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MECANICO / MECHANIC
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MECANICO / MECHANIC
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INSPECTOR
MM MM AA YY
ICA/UENCY
INITIAL
%FORMA,
________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________
RON&"TICAS VIGENTES Y SE %A THE EUIPMENT MENTIONED ABOVE HAS BEEN
VENCIMIENTO DEL CILINDROCYLINDER DUE DATE