TCM TopCareTM Health Checklist Form
Inspecting Agency: __________________ Date: _____________
Inspecting Mechanic: ________________ Aviator Services Member #: _____________
Aircraft Owner: ____________________
Aircraft Make/Model: ________________ Aircraft Serial #: _____________
Aircraft Year: ______________________ Registration #: _____________
Engine Model: _____________________ Engine Serial #: _____________
Engine Hours: Time Since Major O/H: _______ Time Since Top O/H: _____________
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1. Differential Compression Check Record Readings
1a. Master Orifice
Reading................................................................... ______________
1b. Record Differential Compression Values for Each Cylinder
........... #1 ______________
#2 ______________
#3 ______________
#4 ______________
#5 ______________
#6 ______________
2. Cylinder Bore Inspection Check each item to indicate Inspection Results for Each Cylinder
2a-Normal Wear 2b-Light Rust 2c-Heavy Rust
2d-Heavy Wear 2e-Scoring
Cylinder #1 ..... __
__
__
__
__
Cylinder #2 ..... __
__
__
__
__
Cylinder #3 ..... __
__
__
__
__
Cylinder #4 ..... __
__
__
__
__
Cylinder #5 ..... __
__
__
__
__
Cylinder #6 ..... __
__
__
__
__
3. Oil Consumption Trend Monitoring Record Information
3a. Record Oil Consumption - One (1) Quart
Every.................................. _________ Hours
3b. Type of Oil Used
............................................................................
______________
3c. Record the Number of Quarts
Added................................................ ______________
3d. Record Oil Change Interval
............................................................. _________ Hours
3e. Sump Oil Strained and Filter Contents examined and Found to be
..... __ Clean
__ Light Material
__ Heavy Material
4. Oil Analysis Trend Monitoring Check each Item as Applicable
4a. Oil Analysis Profile Established
........................................................ __ Yes __
No
4b. Latest Oil Analysis Indicates
............................................................ __ Normal Trend
__ Abnormal Trend
4c. Oil Analysis Sampling Initiated
......................................................... __ Yes
__ No
Oil Analysis Lab Used
_____________________________________________
5. Baffle Condition Inspection Check each Item as Applicable
5a. Baffles in Good Condition, Correct
Position and Proper Contact ................................ ___
5b. Replaced or Repaired Baffles
................................................................................. ___
5c. Inter-Cylinder Baffles Installed Properly
................................................................... ___
5d. Holes and Cracks Sealed
...................................................................................... ___
5e. Cooling / Heating Duct Condition Correct or Repair
................................................... ___
6. Induction System Examination Check each Item as Applicable
6a. Air Filter Clean and Properly
Installed ..................................................................... ___
6b. Air Box Inspected and Repaired as Required
........................................................... ___
6c. Alternate Air Door Sealing and Functioning Properly
................................................ ___
7. Cowling Inspection and Cowl Flap Operation Check each Item as Applicable
7a. No Restriction in Cowling Inlet,
Outlet or Cooling Fins ............................................. ___
7b. Proper Cowl Flap Rigging and Operation Verified
...................................................... ___
8. Ignition System Inspection Check each Item as Applicable
8a. Magneto to Engine Timing Set at
............ _______ Left and ______ Right Degrees BTDC
8b. Spark Plugs Cleaned, Gapped, Tested and Replaced as Necessary
......................... ___
8c. Ignition Harness Inspected for Damage and Leads Replaced as
Necessary ............... ___
9. Fuel System Setup Check each Item as Applicable
9a. Idle Unmetered Fuel Pump Pressure Set
at ............................ _____ PSI at _____ RPM
Idle Fuel Mixture RPM Rise at Idle
Cutoff = 25/50 RPM .......................................... ___
Full Throttle Metered Fuel Set at
............................. _____ GPS/LBS-HR at _____ RPM
10. Aircraft Engine Gage Verification Check each Item as Applicable
10a. Verified Accuracy of Tach, MP, Fuel Flow, CHT and EGT Gages ........................... ___
11. Flight Test Check each Item as Applicable
Flight Test performed and all parameters within spec .................................................... ___
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If Cylinder Repair or Replacement was Required Due to Results
of the Preceding Inspections,
Indicate below:
Low Compression Rust Scored
Oil Consumption Other
Cylinder #1 ........................
__
__ __
__
__
Cylinder #2 ........................
__
__ __
__
__
Cylinder #3 ........................
__
__ __
__
__
Cylinder #4 ........................
__
__ __
__
__
Cylinder #5 ........................
__
__ __
__
__
Cylinder #6 ........................
__
__ __
__
__
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Comments: _____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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I hereby certify that I have performed the
TopCare Health Check and any of the items identified above that required repair,
replacement or verification have been
repaired, replaced or verified. I also understand that TCM requires submission of this
form for purposes of proof of accomplishment
for warranty and that TCM bears no responsibility for the review or action
on the actual details of this checklist form.
Mechanic's Signature: __________________________________ Date: _____________________
| ISSUED | REVISED | ![]() |
PAGE NO | REVISION | ||||
| MO | DAY | YEAR | MO | DAY | YEAR | 27 OF 28 | ||
| 02 | 17 | 97 | PO Box 90, Mobile, AL 36601 334-438-3411 | SID 97-2 | ||||
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