Helipad Assessment (HPA)

Overall Helipad Status

HPA-YYYY-MM-DD-Pad#

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General Information

Inspector Name

FAIL

Date

Construction Crew

FAIL

Fire Number

FAIL

Helipad Number (for Title)

FAIL

Helipad Class

Pad Coordinates (lat,lon) — DDM below

DDM: —

Elevation (ft)

N/A

Structure & Materials

Cribbing / Anchor (enter C or A)

FAIL

Deck Width (ft)

FAIL

Stringers Secured

FAIL

Anchor Posts Used

FAIL

Heel to Light Toe (in)

N/A

Heel to Medium Toe (in)

N/A

Width of Heel Log(s) (in)

N/A

Skid Logs Marked

FAIL

Tree Species

Heel Log Diameter (in) — min 8"

FAIL

Landing Deck Logs Clean

FAIL

All other log Diameter (in)

N/A

Signs of Decay

FAIL

Spikes Used

FAIL

Skid Logs Secured to Ground (class 1/2 optional)

N/A

Site Information

Best Possible Site

FAIL

Opening Diameter (ft)

N/A

Danger Tree Assessment Done

FAIL

Wind Indicators Present

FAIL

Site Clear and Clean

FAIL

Approach/Departure Degrees

N/A

Crew Paths Marked

FAIL

Helipad Numbered

FAIL

Tolerance Measurements

Enter distance (ft) and drop (in). Slope is auto-calculated. **≥ 5% = FAIL**.

Lateral (Class 1/2)

Lateral - Heel: Distance (ft)

N/A

Drop (in)

Lateral - Toe (Light): Distance (ft)

N/A

Drop (in)

Lateral - Toe (Medium): Distance (ft)

N/A

Drop (in)

Longitudinal

Class 1/2 use Heel->Light & Heel->Medium. Class 3/4 use Front-to-Back left/right.

Heel->Toe (Light) Distance (ft)

N/A

Drop (in)

Heel->Toe (Medium) Distance (ft)

N/A

Drop (in)

Twist (Class 1/2)

Twist Heel vs Toe (Light) Distance (ft)

N/A

Drop (in)

Twist Heel vs Toe (Medium) Distance (ft)

N/A

Drop (in)

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Inspector Notes

Pilot (fillable in PDF)

Pilot Name

Call Sign

Pilot Signature (optional inspector-supplied)

Photos

Results

Fails: 0 • Upgrades: 0

Deficiencies (Fail)

Upgrades Required

Report (read-only)

Report Title (auto)

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