Fueler - Missing Fuel Cap Survey Form

Fueler - Missing Fuel Cap Survey Form

Airport Fueling Operators are asked to relay any information they may have on aircraft fuel caps that are found missing from aircraft on arrival. This information will be used to determine if fuel caps need to be redesigned to prevent them from falling off of aircraft while in flight or on the ground. By researching this information on a national level we hope to identify any trends, if they exist, and develop solutions, if needed. This survey data will be compiled and used as justification for further research if a concern is identified.

Please take a moment and fill out the web-based survey form below.
I appreciate your comments and suggestions.
Send any photos to Fuel Cap Web Site

Click on the "Fuel Cap Example Photos" hyperlink prior to taking the survey for a few photos and descriptions of fuel caps found to date. This may help with your identification of fuel caps in the table below.

Category	Record Information Below
Important information for the Survey	Please fill out all information as completely as possible!
Airport Name or code
Airline Name
Flight Number
City Flight Arrived from
Aircraft Number
Aircraft Type
Gate
Date
Time
Your Name
Name of your Company
What Fuel Cap Manufacturer and fuel cap part # was used to replace this missing cap?	See this fuel cap description page for information on fuel caps

What is your job function?

Other:

Enter your comments, or any other information, reference the missing fuel cap in the space provided below:
Include any additional information such as location of the fueling port on the aircraft,
who noted the cap was missing, any markings, the condition of the fuel cap port and
surrounding wing areas (i.e.... damaged, broken pieces, lanyard missing)

If desired, tell us how to get in touch with you:

Name
E-mail
Tel
FAX

Please contact me as soon as possible regarding this matter.

Copyright © 2004 Dave, Student, Embry-Riddle Aeronautical University. All rights reserved. Revised: 10/07/07.

Copyright © 2004
Dave, Student, Embry-Riddle Aeronautical University. All rights reserved.
Revised: 10/07/07.