Aircraft Refueling Checklist Form
Complete the Aircraft Refueling Checklist Form to accurately record and verify all steps of an aircraft refueling operation.
Aircraft Identifier (Tail Number/Registration)
*
Airline or Operator
*
Refueling Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Refueling Time
*
Hour Minutes
AM
PM
AM/PM Option
Fuel Type
*
Please Select
Jet A-1
Jet A
Avgas 100LL
Other
Requested Fuel Quantity (liters or gallons)
*
Actual Fuel Quantity Delivered (liters or gallons)
*
Refueling Location (Gate/Stand/Position)
*
Pre-Refuel Safety Checklist (select all completed)
*
Aircraft properly grounded
Fire extinguisher available
No smoking signs posted
Fuel truck brake set
Fuel hose inspected for leaks
Post-Refuel Completion Status
*
Completed - No Issues
Completed - Minor Issues (Specify Below)
Completed - Major Issues (Specify Below)
Remarks / Notes
Submit Refueling Record
Should be Empty: