Aerodrome Low Visibility Assessment Form
Assess aerodrome conditions, operational readiness, restrictions, and required actions during low-visibility operations.
Aerodrome Conditions
Assessment Date/Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Aerodrome / Airport Name
*
Assessor Name or Role
*
Prevailing Visibility Range
*
Please Select
Greater than 5 km
3 to 5 km
1 to less than 3 km
500 m to less than 1 km
200 m to less than 500 m
Less than 200 m
Variable / Rapidly Changing
Weather / Precipitation Condition
*
Please Select
Clear
Fog
Mist
Haze
Rain
Drizzle
Snow
Sleet
Mixed Conditions
Other
Operational Readiness Assessment
Critical systems readiness assessment
*
Rows
Fully operational
Partially operational
Degraded
Unavailable
Not inspected
Runway lighting
1
2
3
4
5
Taxiway lighting
6
7
8
9
10
Approach lighting
11
12
13
14
15
Signage and markings visibility
16
17
18
19
20
ATC and ground coordination readiness
21
22
23
24
25
Navigation aid status
26
27
28
29
30
Notes on operational readiness
Overall operational readiness level
*
Please Select
Fully operational
Partially operational
Degraded
Unavailable
Not inspected
Systems requiring immediate attention
Runway lighting
Taxiway lighting
Approach lighting
Signage and markings
ATC and ground coordination
Navigation aids
Other
Assessed by
*
Restrictions and Actions
Current Low-Visibility Category / Operational Level
*
Please Select
Normal
Low Visibility Procedures
Restricted Operations
Suspended
Other
Overall Readiness
*
1
2
3
4
5
Active Restrictions or Closures
Required Follow-up Actions or Corrective Measures
*
Submit Assessment
Should be Empty: