Station C - First Aid - Point C-1
For use of this form, see USAIC Pam 350-6. The proponent is USAIS, DOTD.
Candidate's Name______________Rank________Unit_________________
TASK 1: PERFORM MOUTH-TO-MOUTH RESUSCITATION.
EIB TEST SCORE SHEET Station J - M16 Rifle/M4 Carbine - Point J-1
For_use of this form, see USAIC Pam 35O~6, the proponent is USAIS, DOTD.
CANDIDATE'S NAME RANK UNIT
TASK 1: PERFORM FUNCTION CHECK.
TASK 2: LOAD AN M16A1 OR M16A2 RIFLE/M4 CARBJ NE.
TASK 3: CORRECT MALFUNCTIONS ON AN M16A1 OR M16A2 RIFLE/M4 CARBINE.
TASK 4: UNLOAD AN M16A1 OR M16A2 RIFLE/M4 CARBINE.
PERFORMANCE MEASURES PASS FAIL
1. Performed function check (in sequence.)
2. Loaded MI6AI or M16A2 rifle/M4 Carbine.
a. Pointed the muzzle in a safe direction.
b. Cocked the bolt to the rear, returned the charging handle to forward position, and placed the
selector in SAFE position.
c. Checked the chamber to ensure it is clear.
d. Inserted the magazine and pushed upward until the magazine catch engaged the magazine.
e. Tapped upward on the bottom of the magazine.
f. Depressed the upper portion of the bolt catch.
g. Tapped the forward assist to ensure that the bolt was fully locked.
h. Placed the selector lever in the SAFE position, closing the ejection port cover if the rifle is not to
be fired immediately.
3. Performed immediate action.
a. Slapped upward on the magazine to make sure it was fully seated.
b. Pulled the charging handle to the rear, observed the ejection of the case or cartridge, and
checked the chamber for obstruction.
c. Released the charging handle to feed a new round into chamber.
d. Tapped the forward assist.
e. Attempted to fire the weapon.
4. Unloaded and cleared the rifle.
a. Pointed the rifle muzzle in a safe position.
b. Removed the magazine from the rifle.
c. Placed the selector lever on SAFE.
d. Locked the bolt open/pulled the charging hadle rearward/returned the charging handle to the
forward position.
e. Removed any ammunition from the receiver and chamber.
f. Pressed the upper portion of the bolt catch, allowing the bolt to go forward.
g. Pulled the trigger to release the pressure on the firing pin spring. _______ _______
5. Completed performance measures 2 through 4 within 30 seconds.
CHECK: PASS______ FAIL______
REASON(S) FOR FAILURE
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__________________________________________________
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SCORER'S SIGNATURE________________DATE________________
Is this a retest? YES______NO______
FB FORM 20-5-R, 17 JAN 97