EQUIPMENT INSPECTION AND MAINTENANCE W ORKSHEET
For use of this form, see DA PAM 738, 780, and 738-751: the proponent agency is DCSLOG
2. NOMENCLATURE AND MODEL
262d QM BN
6. TYPE INSPECTION
COLUMN A - Enter TM Item Number
COLUMN d - Show corrective action for deficiency or
shortcoming listed in Column c.
COLUMN B - Enter the applicable condition status symbol.
COLUMN e - Individual ascertaining completed corrective
COLUMN C - Enter deficiencies and shortcomings.
action initial in this column.
"X" - Indicates a deficiency in the equipment that places it in an
DIAGONAL "(/)" - Indicates a materiel defect other than a
deficiency which must be corrected to increase efficiency or
to make the item completely serviceable.
CIRCLED "X" - Indicates a deficiency; however, the equipment
may be operated under specific limitations as directed by
LAST NAME, INITIAL IN BLACK, BLUE-BLACK INK, OR
higher authority or as prescribed locally, until corrective
PENCIL - indicates that a completely satisfactory condition
action can be accomplished.
HORIZONTAL DASH "(-)" - Indicates that the 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 MW O has not been accomplished.
ALL INSPECTIONS AND EQUIPMENT CONDITIONS RECORDED ON THIS FORM HAVE BEEN DETERMINED
IN ACCORDANCE W ITH DIAGNOSTIC PROCEDURES AND STANDARDS IN THE TM CITED HEREON.
8a. SIGNATURE (Person performing
9a. SIGNATURE (Maintenance
P. Moynihan PFC
DEFICIENCIES AND SHORTCOMINGS
ENGINE OIL LOW
ADDED 1 QT
ADDED 3 GALLONS
HAIRLINE CRACK IN ENGINE HOUSING
LOOSE BATTERY CABLES
DA FORM 2404, APR 79
Edition of 1 Jan 64, which will be used
Figure 4-3. DA Form 2404 (Equipment Inspection and Maintenance Worksheet).