Airport Fuel Cap Survey Form

Airport/Aircraft Fuel Cap Survey Form

Airport Operators are asked to relay any information they may have on aircraft fuel caps that are found on movement and non-movement areas. This survey is particularly concerned about fuel caps found on runways but will accept all information reported. 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	Location of Fuel Cap
Type of Fuel Cap/Color/Manufacturer#	On Runway	On Taxiway	On Ramp	In gate area	Safety Area	None found
J.C. Carter/Gray Model MS29525- 1 External Underwing Mounted
Shaw Aero Device/Gray Model MS29525-1 External Underwing Mounted
J.C. Carter /Red MS29526-2
Shaw Aero Device/Red MS29526-2
General Aviation Fuel Cap (if known)
Vehicle Fuel Cap
Unknown Type of fuel cap

What airport are you associated with? (Use either 3 letter code or full name)

What group are you associated with?

Other:

Manufacturer: (J.C. Carter, Shaw Aero Device, etc.)

Part Number: (examples: MS29525-1 or MS29526-2)

Serial Number: (sometimes on the reverse side of the cap)

Aircraft type (if known): (757, A300, DC-10, 747, A310, A320)

Carrier (if known): (Airline, Cargo, Charter, etc.)

Date and time fuel cap was found ?

(example: 12/06/04 1600L (L for local time, Z for Zulu)

What runway was the fuel cap removed from?

(example: 18R centerline near TWY S3 intersection)

What taxiway was the fuel cap removed from?

(example: TWY P and TWY S intersection)

Enter your comments or any other data reference the fuel cap in the space provided below:
Include any other numbers, additional location information, who found the cap, markings, the condition of the fuel cap
(i.e.... damaged, broken, lanyard missing), or any information stamped or printed on the reverse side of the fuel cap)

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: 07/24/2010

Copyright © 2004
Dave, Student, Embry-Riddle Aeronautical University. All rights reserved.
Revised: 07/24/2010