Page 2
Verification of Checks and repairs
ENERGY XC
Serial number:
………………………
.
……………
First check by ICARO / date:
…
.
…………………
…………………………
.
Name/ Stamp
Check (C)
Repair (R)
Which repair/ Check?
Check valid until?
Performed by/ date
Check (C)
Repair (R)
Which repair/ Check?
Check valid until?
Performed by/ date
Check (C)
Repair (R)
Which repair/ Check?
Check valid until?
Performed by/ date
Check (C)
Repair (R)
Which repair/ Check?
Check valid until?
Performed by/ date