Fiche Matricule d`Equipment / Component Log Card

Fiche Matricule d'Equipment / Component Log Card
No de Nomenclature
Designation du Composant
Serial Number
Section/Reference Number
Description
Identification du Materiel / Identification of Component
N de Serie
Part Number
Manufacturer
1
Constructeur
Marche ou Command / Contract No
Organisme Emettuer / Issued by
Date
Related Assembly
No Construzione
Reference No
Ensemble de Rattachement
2
A
B
C
Matériel Neuf / New
Signature / Unterschrift / Firma
Date Livrais
Date Delivered
Date Mise en Ser
Installation
Garantie / Life Guaranties
Signature
Date
Stockage
Shelf
Date
Matériel Réparé ou Révisé / After Reconditioning
Signature
Matériel Réparé ou Révisé / After Reconditioning
Date
Utilisation
In Use
Timbre / Stamp
Timbre / Stamp
Timbre / Stamp
Inspection et Controle / Inspection and Test Certificate
3
Certified that this equipment has been inspected and tested and is fit for service. Complete anti-corrosion
treatment has been carried out in accordance with the contract referred.
A
Nom / Name
Nom / Name
Inspector IC at:
B
Inspector IC at:
C
Nom / Name
Inspector IC at:
4
Neuf /New
Rep
Renseignements Particuliers / Remarks
Nature / Type
Rep
5
Observations / Remarks
Entretien Majeur et RG / Reconditioning
Fonctionnement
Life Consumed
Date Fin Troy
Date Completed
Organe. Reparateur
Repair Unit
9
Instructions Speciales Appliquees / SI's
Date
No
Date
No
8
Date
Instructions Techniques Speciales Appliquees / STI's
No
Date
No
Date
No
7
Remarques
Date
No
No
Date
Remarques
Modifications Appliques / Modifications Embodied
No
Remarques
Date
PPQ = 50
(Revised Jan 90)
du/of:
Fiche/Card No:
6
MOD Form 735
Fiche Matricule d'Equipment / Component Log Card
10
Limites de Fonctionnement
Authorized Life
Avant RG
Avant Entretien Mineur
Type
Units
11
Formation
Unit
Date de
Mouvement
Transfer Date
Section/ Reference
Periodicite Entretien Mineur
Periodic Maintenance
Equipment
Coefficient d'Utilisation
Coefficient
Support
Mutations et Utilisations Successives / Transfers, Installations, Repairs & Replacements
Fonctionnement
Positions
Motif du Mouvement et Travaux Effectues
Life Consumed
Location
Authority for Transfer, Nature of Fault
Parteil
Total
Support
Installed
and Work Details
Item Part
Item
Installation
Description
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Serial Number
Work
Order No
Location