UFC 4-390-01
23 July 2003
Facility _________________________
Date _________
_____
Maintenance
_____ Repair
_____ Design Change
(requires Cert Board
approval)
Caution: Verify system is NOT pressurized/powered prior to
starting work and that the system CAN NOT be
pressurized/electrified during work!
Short description of why work was performed:
List parts repaired/replaced:
State tests performed (type of test, item tested, pressures and
result):
Craftsman performing work __________________Sign/date: __________
Supervisor's approval of work ______________Sign/date: __________
Figure C.1
Maintenance Log Outline
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