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Ea¥PTRJR
MAINTENANCE & ENGINEERING
Approved MOE Forms List EGME 501 Chapter: 1.1
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Engine Non-Routine Card
1.No. : ……………………..
2.Customer:……………………………… 3.Work Order.:……………
4.BOW: ………………………………… 5.Work Package:…………………………….
6.Engine Model: …………………………… 7.Engine SN: ……..…………………………..
8.Generating Item:……………………… 9.Working station:………………………………
10.Contains Item CT / RII? 11.No. of attached pages: ……………
Yes No
12.Discrepancy
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13.issued by: 14.Signature: 15.Stamp: 16.Date:
17.Required Action
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Provisioning and components to be replaced
18.Item 19.Description 20.P/N off 21.QTY 22.S/N off 23.P/N on 24.S/N on
Estimated Man-hour and customer Acceptance
25.Estimated man-hour is: …………………………………………………………………………..
26.Customer acceptance Yes No
27.Issued by: 28.Signature: 29.Stamp: 30Date:
31.Work Carried Out
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Material Used
32.Item 33.Description 34.P/N 35.QTY
36.Issued by: 37.Signature: 38.Stamp: 39.Date:
Note: For any additional data, use attachments. Form 409E
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Issue: 1 Amendment: 0
Issue Date: June. 2012 Page 123 of 210