ANNUAL/100 HOUR INSPECTION CHECKLIST

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1 ANNUAL/100 HOUR INSPECTION CHECKLIST Applicability: The Balloon Works, FireFly & Galaxy Models (TC A14SO and TC A10NM) Qualification: Inspection must be carried out by an inspector who is approved by the FAA to inspect the particular type of balloon. Documentation: The aircraft logbook must be present for all inspections. The number of flight hours, any repairs or modifications made since the last inspection, should be correct and up to date. REG#: MAKE/MODEL#: _ SYSTEM SERIAL#: OWNER: WORK ORDER # ENVELOPE MODEL & S/N: TOTAL TIME: CARRIAGE MODEL & S/N: #1 BURNER MODEL & S/N: #2 BURNER MODEL & S/N: TANK #1 P/N & S/N TANK #4 P/N & S/N TANK #2 P/N & S/N TANK #5 P/N & S/N TANK #3 P/N & S/N TANK #6 P/N & S/N ALTIMETER P/N & S/N VARIOMETER P/N & S/N PYROMETER P/N & S/N INSPECTED IAW FIREFLY BALLOONS REPAIR AND MAINTENANCE MANUAL REVISION#: AIRWORTHINESS DIRECTIVES AND SERVICE BULLETINS CHECKED: BIWEEKLY AD#: DATE:_ INSPECTION PERFORMED BY: This balloon system found to be in AIRWORTHY / UNAIRWORTHY (circle one) condition. DOCUMENTS & REQUIRED EQUIPMENT: A. FAA CERTIFICATE OF AIRWORTHINESS - Present, displayed, in good condition B. FAA REGISTRATION CERTIFICATE REGISTERED OWNER: Present EXPIRATION DATE: C. FLIGHT MANUAL - Present and correct for model. Appropriate Flight Manual Supplements and STCs present. D. AIRCRAFT LOGBOOK - Component part and serial numbers correspond to AIRCRAFT SERIAL NUMBER RECORD. Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-1 of 6

2 ENVELOPE A. IDENTIFICATION: Data Plate: Present (located on top girdle), legible, numbers match logbook N-Numbers: Present, legible, match each other, match logbook GORE: PANEL: GORE: PANEL: B. FABRIC STRENGTH: GRAB test in warp and fill directions (40lbf. polyester/30lbf. Nylon (178N polyester / 133N Nylon)) IAW ICA, Section 6 2 places within 180cm of top girdle GORE: PANEL: COLOR: GORE: PANEL: COLOR: 2 places on the valve GORE: PANEL: COLOR: GORE: PANEL: COLOR: 2 places below the equator GORE: PANEL: COLOR: GORE: PANEL: COLOR: C. TELETEMP TEMPERATURE RECORDING STRIP: Inspect for presence and record max temp reached. If 300 F(149 C) is tripped, leave in place and add a new indicator IAW ICA Section 5. Valve center cap Gore Seam S/N Tab# _ Temp S/N Tab# _ Temp D. TEMPERATURE SENSOR Wire (if installed) securely stitched in place FlyTec Transmitter (if installed): - Pocket securely stitched in place on gore seam - Velcro wire holder inside envelope secure - Wire hole not torn, burnt or elongated E. FABRIC INTEGRITY (TO INCLUDE VALVE FABRIC) GORE BY GORE INSPECTION: Holes, tears or areas of damaged fabric beyond limits outlined in ICA Section 6 Signs that fabric has been overheated (glassy, crinkled, stiff, shriveled, heat curled, and discoloration) Stitching Integrity (type/location, broken stitches) Integrity of previous repairs (IAW ICA Sections 4 and 5) F. GIRDLES - Inspect for integrity, stitching, and fabric overlap margin Top Girdle Bottom Girdle Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-2 of 6

3 G. LOAD CORDS - Inspect load cords for obvious damage, secure stitching and proper routing. Secure Stitch at Top Girdle Secure Stitch at Bottom Girdle (as appropriate see ICA Section 5) Eye-splice tacks, top and bottom 15 cm (5.9 ) minimum splice length at top tie ring H. TOP TIE RING - Inspect for distortion, cracks, nicks, burrs, etc. I. CROWN LINE - Condition, security, free of excessive knots, handles for security, attaching thong J. ENVELOPE ATTACHMENTS - Proper and secure attachment of: Skirt Ties Guide Ring Anchors Anchor Loops Rotation vent attachments (internal) K. SUSPENSION CABLES Kevlon Cables & Lashing (fraying, sheath/kevlon intact, previous repairs) Wood Toggles (cracks, chips, security) Metal cables (fraying, kinks, overheating, broken strands, metal toggle and nicopress intact & secure) Carabineers (burrs, nicks, condition) Suspension cable/load cord interface (secure, safetied as appropriate see ICA Section 5) L. SKIRT - Security, condition, proper attachment, band intact and not damaged M. VALVE COMPONENTS Velcro tabs (both on valve and top girdle) present, stitching intact, clean and free of debris, good holding force Small Forged Steel Rings (integrity, distortion, cracks, burrs, corrosion) Centering cords (integrity, knots tight, fraying, stitching to valve edge). Pull test by hand to approx. 10 lbf. (44.5 N) Perimeter cord and Perimeter loops (integrity, knots tight, fraying) Jumpers (integrity, knots tight, fraying) Bridle cords (integrity, knots tight, fraying) Valve Line Assembly Old Style w/ steel top half (Integrity, fraying, signs of heat damage, steel band/joint intact, ½ (1.3 cm) rope free of excessive knots, attaching thong on bottom end, eye splice & nicopress sleeve for security and sharp edges) Valve Line Assembly New Style w/ Kevlon top half [integrity, fraying, signs of heat damage, ½ (1.3 cm ) rope free of excessive knots, attaching thong on bottom end, eye splices for security] Guide Line Assembly (Attachment, location, ring or pulley integrity) Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-3 of 6

4 CARRIAGE A. ID PLATE (located on the tie plate on underside of carriage) Present, legible, numbers match logbook NOTE: S/N may be burned into underside of floor only. B. FLOOR ASSEMBLY Plywood Floor (integrity top and bottom, cracks, delamination, wear around fuel tanks) Wood Runners (integrity, cracks, chips, condition of hardware and security) Tie Plate Hardware (integrity) C. FRAME AND WICKER integrity, security, cracks, breaks, holes D. CORNER PANELS - Inspect for security and integrity. Tighten as necessary. E. SUSPENSION ROPES Abrasion, condition, position, length, integrity, max allowable damage IAW ICA Section 6, interference with fuel lines and carriage structure Retainers (integrity) F. BURNER SUPPORT Plastic covers (damage which might affect rope strength) Toggle Loop Lashing (integrity, shrinking of eye diameter) Thimbles for carabineer envelope attachment (burrs, nicks, security) Lynch Pins or attaching bolts and Securing Bands (security, condition, operation of lynch pins, corrosion) Square Pins, Bolt and Fasteners, Rattan Structure (security, condition) G. FUEL CYLINDER STRAPS - Integrity, no less than 80% of cross section intact, buckles, rings, snaps or clips for corrosion and general condition H. CARRIAGE PADDING - Condition keeping in mind pilot and passenger safety/comfort I. HANDLES - Condition and security Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-4 of 6

5 INSTRUMENTS A. GENERAL - Operational, serial numbers match log book B. TEMPERATURE INDICATOR - Correct ambient temperature within +/-10 F (5.5 C), Batteries replaced and wiring secure (if applicable). C. ALTIMETER TEST +/- 100 ft (30.5 M). at current barometric pressure, Batteries replaced (if applicable) D. RATE-OF-CLIMB - Operational, Zeroed _ E. TS TEMPERATURE GUAGE - Inspected IAW ICA Section 6 FUEL SYSTEM A. FUEL SYSTEM Close inspection for integrity, worn spots or abrasions on hoses, interference from tanks or any part of carriage structure, damage to fittings and connectors, as well as leaks. B. FUEL HOSES Replacement Due Date: Wear or abrasion spots, leaks, kinking, or too tight bend radii, interference from tank collars or carriage structure REPLACEMENT OF FUEL HOSES IS MANDATORY AFTER NINE (9) YEARS IN SERVICE. (See Service Bulletin B-24) C. PILOT LIGHT VALVE AND PRESSURE REGULATOR - Leaks, correct operation D. FUEL PRESSURE GAUGE - Reads correctly when line is pressurized, within 5% of 0 when line is drained E. PRESSURE RELIEF VALVES - Life limitation of 10 years from installation date. (See Service Bulletin B-24) F. FUEL CYLINDERS Visible damage, valves, fittings undamaged, dust cap on pressure relief director. DCM Electri-shield, if fitted, intact with target decal readable. Check cylinders for DOT Requalification Requirements (See Service Bulletin B-24) Record certification and replacement due dates: TANK #1 CERT PRV TANK #2 CERT PRV TANK #3 CERT PRV TANK #4 CERT PRV TANK #5 CERT PRV TANK #6 CERT PRV G. FUEL CYLINDER GAUGES - Operational, readable, indicating correctly H. FIRE SUPPRESSION SYSTEM - If fitted, gauge indicating sufficient pressure, tank secure, lines and fittings secure. Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-5 of 6

6 BURNER(S) A. BURNER VISUAL #1 #2 Can/Coils (integrity, cracks, holes, dents, corrosion) Joints/connections (security, leaks) Pilot light tubes (aligned, secure) Aspirator (in position, secure, open) Handle for security (T3-017 only) Replace O ring in REGO Valves, setscrew locked 10 in/lb.(1.1 N-M), cotter pin in trigger, torque specs for bonnet. SEE AD # , ICA Section 6 and TCDS A14SO and A10NM. B. OPERATIONAL CHECK #1 #2 (F1 Mirage only) Check for leaks in the baseplate seam using a soapy water or window cleaner solution while pilot lights are lit Pilot Lights (Blue flame, inner cone extended at least 3/8 (1 cm) over tube ends, will not blow out.) Main Jets (Positive ignition, thin flame shape, No flame extending through coils) Trigger Valve (Positive action, no leaks) Connections/Joints (leaks) Fire2 (Valve operates properly, Alignment proper with no flame extending outside of can, Positive ignition and burning.) INFLATION CHECK (To be done at the discretion of the Inspector) A. VALVE - Proper fit around girdle, centered B. VALVE LINE - Greater than 5ft (1.5 M) of slack C. CROWN LINE - Greater than 3ft (0.9 M) of slack D. FUEL SYSTEM - Fuel Flow from each tank, Check pressure drop with burner operating E. BOTTOM GIRDLE AND SKIRT - Orientation, level to ground, no pulling Revision 1.0 APPENDIX A ANNUAL/100 HOUR INSPECTION CHECKLIST A-6 of 6

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