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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