Critical identification data for aircraft and both damaged and replacement powerplants. All fields are essential for traceability and regulatory compliance.
Aircraft Registration/Tail Number
Aircraft Manufacturer and Model
Engine Position Affected
Engine #1 (Port/Left)
Engine #2 (Starboard/Right)
Engine #3 (Port/Left - Trijet)
Engine #4 (Starboard/Right - Quadjet)
Damaged Engine Serial Number
Damaged Engine Total Flight Hours
Damaged Engine Total Cycles
Replacement Engine Serial Number
Replacement Engine Total Flight Hours
Replacement Engine Total Cycles
Engine Type/Model (Both Units)
Date/Time of Bird Strike Incident (UTC)
Flight Number at Time of Incident
Flight Phase When Strike Occurred
Takeoff Roll
Initial Climb
Cruise
Approach
Landing Roll
Ground/Taxi
Pilot Incident Report Summary
Maintenance Lead Name and License Number
Assigned Inspector Name and License Number
Maintenance Facility/Hangar Code
Comprehensive documentation of foreign object damage assessment. Borescope inspection must cover all engine modules per manufacturer guidelines. All findings must be recorded with precise locations and measurements.
Bird Strike Details - Species/Size and Impact Location
Was the engine shut down immediately post-strike?
Time elapsed between strike and shutdown (seconds)
Explain operational necessity for continued operation and monitoring parameters
Post-incident boroscopic inspection performed within 24 hours?
Inspection Date/Time (UTC)
Justification for inspection delay and risk mitigation measures
Borescope Equipment Serial Number and Last Calibration Date
Fan Section Assessment (Station 0-2): Inspect all fan blades, spinner, and inlet guide vanes for impact damage, cracks, or deformation.
Fan Blade Damage Classification
No visible damage
Minor nicks/dents within limits
Major dents requiring blend repair
Cracks - blade replacement required
Severe deformation - multiple blades affected
Metallic debris detected in fan section?
Debris description, quantity, and exact location found
Fan Section Detailed Findings and Measurements
Compressor Section Assessment (Station 3-9): Inspect all compressor stages for foreign object damage, blade tip clearance, and axial/radial blade play.
Compressor Stage Damage Summary
No Damage | Minor (<5% blade count) | Moderate (5-15% blade count) | Severe (>15% blade count) | Unserviceable | |
|---|---|---|---|---|---|
LPC Stage 1-3 | |||||
LPC Stage 4-6 | |||||
HPC Stage 7-9 |
Compressor blade tip rub detected?
Describe location, severity, and estimated material loss
Combustion Section Assessment (Station 10-11): Inspect combustion liners, fuel nozzles, and transition ducts for burning, cracking, or foreign object impact.
Combustion Section Condition
Normal
Abnormal coloration
Liner cracks present
Fuel nozzle damage
FOD damage evident
Turbine Section Assessment (Station 12-15): Inspect all turbine stages for blade condition, tip clearance, and thermal damage.
Turbine Blade Condition Assessment
Serviceable | Minor coating loss | Tip curl/deformation | Crack indications | Unserviceable | |
|---|---|---|---|---|---|
HPT Stage 1 blades | |||||
HPT Stage 2 blades | |||||
LPT Stage 1 blades | |||||
LPT Stage 2-5 blades |
Oil contamination with metallic particles detected?
Particle size, quantity, and suspected source location
Vibration survey performed post-incident?
Maximum vibration value recorded (units)
Summary of Unserviceable Components Requiring Replacement
Does damage exceed allowable limits per manufacturer AMM?
Engineering evaluation reference number and summary of repair assessment
Upload Borescope Images and Video Files (All findings must be documented)
I confirm that borescope inspection covers all mandatory zones per engine manufacturer maintenance manual
Verification of replacement engine airworthiness status and comprehensive installation checklist. All torque values must be recorded and within specified limits.
Replacement engine received with valid maintenance release certificate?
Explain airworthiness verification process and reference documents
Replacement Engine Last Shop Visit Date
Engine Shop Visit Workscope Number
All mandatory service bulletins and airworthiness directives complied with on replacement engine?
List outstanding ADs/SBs and mitigation plan
Replacement Engine QEC Kit Part Number and Serial Number
Pre-installation engine preservation status verified satisfactory?
Describe preservation deficiencies and corrective actions
Installation Torque Verification: All critical fasteners must be torqued using calibrated equipment. Record actual values and tool calibration dates.
Critical Fastener Torque Log
Fastener Location/Part Number | Torque Wrench ID/Serial | Wrench Cal Due Date | Specified Torque Value | Actual Torque Applied | Torque Within Tolerance? | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Engine Mount Forward Bolt #1 | TW-001 | 8/15/2025 | 450 | 448 | Yes | |
2 | Engine Mount Aft Bolt #2 | TW-001 | 8/15/2025 | 450 | 452 | Yes | |
3 | Pylon Attach Bolt #3 | TW-002 | 9/1/2025 | 380 | 381 | Yes | |
4 | |||||||
5 | |||||||
6 | |||||||
7 | |||||||
8 | |||||||
9 | |||||||
10 |
I confirm all torque wrenches used were within calibration date and torque values recorded
Engine System Connections Verified (Select all completed)
Engine mounts and pylon structural attachment
Fuel supply and return lines (leak-checked)
Hydraulic pump and lines (pressure tested)
Electrical harnesses and connectors
Bleed air ducts and pre-cooler connections
Engine fire detection loops
Thrust reverser hydraulic/actuator systems
Engine cowling and access panels
Drain mast and vent lines
FADEC data link cables
Engine oil system serviced with correct type and quantity?
Explain oil servicing discrepancy
Oil Type and Part Number Used
Engine fuel system purged of air and contamination?
Describe fuel system contamination and corrective actions
Thrust reverser actuation test performed successfully?
Describe reverser test failures and corrective actions
Engine installed with required witness/inspector present?
Justify absence of required inspection and reference approved procedure
Upload Installation Photographs (Minimum: 4 sides, pylon interface, critical connections)
I certify that replacement engine installation complies with all applicable airworthiness requirements and manufacturer specifications
Comprehensive ground run-up to verify engine performance and recalibrate integrated aircraft systems. All parameters must be within manufacturer-specified limits before flight release.
Ground Run-Up Test Date/Time (UTC)
Ground Run-Up Test Engineer Name and License
Ground Run-Up Type Performed
Static Run (Chocks On)
Taxi Run (Low Speed)
High-Speed Taxi
Full Power Static
Ambient Temperature and Pressure Altitude
Pre-run leak check performed and passed?
Describe leaks found and corrective actions
Engine Performance Parameters - Record all values at stabilized conditions
Engine Run-Up Parameter Log
Power Setting | N1 (%) | N2 (%) | EGT (°C) | Oil Pressure (psi) | Vibration (units) | Within Limits? | ||
|---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | ||
1 | Ground Idle | 22 | 58 | 420 | 45 | 0.2 | Yes | |
2 | Takeoff Power | 98 | 101 | 890 | 65 | 0.8 | Yes | |
3 | Max Continuous | 95 | 98 | 860 | 62 | 0.7 | Yes | |
4 | ||||||||
5 | ||||||||
6 | ||||||||
7 | ||||||||
8 | ||||||||
9 | ||||||||
10 |
Engine reached rated takeoff thrust without anomalies?
Describe performance shortfall or anomalies
Thrust reverser deployment and stowage functions normally?
Describe reverser malfunction during run-up
Autothrottle system calibration required post-installation?
Describe autothrottle rigging adjustments made
FADEC software version compatible and all sensors reading correctly?
List FADEC discrepancies and corrective actions
Aircraft Systems Requiring Recalibration (Select all that apply)
Engine indicating system (EIS)
Full Authority Digital Engine Control (FADEC)
Autothrottle system
Flight Management System (FMS) performance database
Electronic Flight Instrument System (EFIS) displays
Central Maintenance Computer (CMC)
Aircraft weight and balance system
None - all systems auto-calibrated
Engine bleed air system provides proper pressure and temperature?
Describe bleed air system deficiencies
All engine instruments reading correctly on flight deck?
List instrument discrepancies
Engine vibration within acceptable limits at all power settings?
Describe vibration characteristics and suspected causes
Engine oil system functions normally with no leaks?
Describe oil system anomalies
Upload Ground Run-Up Data File (Digital engine monitor dump)
I confirm ground run-up was performed per manufacturer test procedures and all parameters are within limits
Final verification and airworthiness certification by authorized maintenance inspector. This section confirms all required maintenance actions have been completed satisfactorily and the aircraft is safe for return to service.
All sections of this form completed in full?
Identify incomplete sections and justification
All mandatory inspections and tests performed and passed?
List any outstanding items and risk assessment
Replacement engine logbook entries completed?
Describe logbook status
Aircraft maintenance logbook entry completed with correct references?
Explain logbook entry status
Weight and balance updated for new engine serial number?
Describe W&B update status
Is a test flight required before return to commercial service?
Test flight profile and specific checks to be performed
Any operational limitations or monitoring requirements imposed?
Detail all operational limitations and monitoring intervals
Clearance Recommendation
Approved for immediate return to service
Approved with operational limitations
Approved pending test flight
Not approved - additional work required
Inspector Comments and Additional Notes
Chief Maintenance Inspector Name
Inspector Authorization/License Number
Inspector Clearance Date/Time (UTC)
Chief Maintenance Inspector Digital Signature
I certify that I have personally reviewed all documentation, inspections, and test results, and that the engine replacement has been accomplished in accordance with approved maintenance data and airworthiness requirements. The aircraft is approved for return to service subject to any limitations noted above.
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