Aircraft Conformity Worksheet

8/20/2019 Aircraft Conformity Worksheet

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Department of Transportation

Federal Aviation Administration

Anchorage Flight Standards District Office

Ph. 907-271-2000 Formdate May 6, 2014 FAX 907-271-2098

ADDING AN AIRCRAFT TO AIR CARRIER OPERATIONS

Dear Applicant:To add an aircraft to an air carrier operation the certificate holder mut complete the follo!in" four tep.

1 Decide the #ind of operation $ou intend !ith the aircraft and prepare a !ritten tatement ho!in" that theaircraft and it e%uipment conform to the re%uirement of FA& 1'(.2()a*+ includin" re"itration+ currentair!orthine certification+ identification+ and current air!orth$ condition. The certificate holder mut aloho! that it meet the re%uirement for all intended operation.

2 ,e OST Forms 4507 and 6410 to initiate or update $our Air arrier &e"itration !ith FAA Headqarters!Air Trans"ortation Division AFS#$60! %00 &nde"endence Avene S'! 'ashington! D( $05)1* &e"iterand identif$ each aircraft ued and #eep the re"itration current.For lan# form "o to. http://www.faa.gov/about/oice_org/headquarters_oices/avs/oices/afs/afs200/branches/afs260/exemptions/

See FSIMS 8900.1 Volume 2 Chapter 2 Sections 1 and 2: go to http://fsims.faa.gov/P!"esu#ts.aspx$mode%&'oo(!ontents .

' Pro/ide copie of the document prepared in tep 1 and 2 to the FD and recei/e peration pecificationPara"raph D8( and an$ other peration pecification that ma$ e re%uired )ee elo!*.

ompl$ !ith FA& 1'(.3')a*)'* $ addin" the aircraft+ includin" the #ind of operation authori4ed for theaircraft+ to $our official control-litin" of aircraft ued or a/ailale for ue in air carrier operation.

The attached document+ Notice of Intent to Add an Aircraft and Aircraft Compliance Statement for FAR 135Operations, !ill help $ou accomplih tep 1 and '. The$ pro/ide a mean to document compliance and pro/idethe information !e need to iue all necear$ peration pecification.

TH+ &,FO-.AT&O, -+/+ST+D &, TH+S+ FO-.S &S -+/&-+D* 5ou ma$ ue an$ method that

pro/ide complete and accurate information. 6o!e/er+ the form pro/ided here "i/e $ou an or"ani4ed mean to pro/ide the FD the information it need to iue the appropriate peration pecification.

A((-A( &S &.2O-TA,T3 The Director of .aintenance hould complete the document in conultation!ith the Director of O"erations. The Director of .aintenance hould i"n the tatement on pa"e -1 i"nif$in"complete and accurate technical information. onult !ith %ualified pecialit a needed for pecial operation orpecial mean of na/i"ation. Technical errors or omissions can case nnecessar delas to com"letion of the"roect*

The S(H+D+ OF ++,TS on pa"e 1-1 lit the e/ent that ma$ relate to addin" the aircraft to $our 1'(operation. f $ou chedule thoe e/ent on thi form+ !e !ill e ale to determine our ailit$ to meet $ourepectation and chedule our reource. e !ill contact $ou if there are chedulin" difficultie.

e hope $ou find thee form ueful in helpin" $ou determine aircraft eli"iilit$ and a a !a$ to appl$ for certain#ind of operation. Pleae let u #no! if $ou ha/e an$ %uetion or u""etion.

incerel$+

The Anchorage FSDO

&,ST-(T&O,S3 Thee form are dei"ned for manual or on#screen fill-in. For on-creen fill-in+ ue TA and 6FT-TA and the moue tona/i"ate for!ard and ac# throu"h the form. e u""et that $ou print acop$ for reference !hile !or#in" on the document on $our computer. ealo recommend a/in" the document !ith a ne! name efore $ou tart!or#in" on it to preer/e the lan# ori"inal. Print the completed cop$+i"n+ and end it to u.

PLEASE DO NOT RETURN THIS PAGE TO THE FSDO

Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'Formdate

http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/afs/afs200/branches/afs260/exemptions/http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/afs/afs200/branches/afs260/exemptions/http://fsims.faa.gov/PICResults.aspx?mode=EBookContentshttp://www.faa.gov/about/office_org/headquarters_offices/avs/offices/afs/afs200/branches/afs260/exemptions/http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/afs/afs200/branches/afs260/exemptions/http://fsims.faa.gov/PICResults.aspx?mode=EBookContents


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(O,T+,TS

S+(T&O, 1 ,OT&(+ OF &,T+,T TO ADD A, A&-(-AFT################################################## 1#1

1.1 OPERATOR AN AIRCRAFT INFOR!ATION"""""""""""""""""""""""""""""""""""""""""""""""""""""""""1"1

1.# OC$!ENTS RE%$IRE AT S$&!ISSION OF T'IS NOTICE""""""""""""""""""""""""""""""""""1"1

1.3 SC'E$(E OF E)ENTS""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""1"1

1.* CONTACT INFOR!ATION"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""1"1

S+(T&O, $ -+/+ST FO- O2+-AT&O,S S2+(&F&(AT&O,S FO- TH&S A&-(-AFT#############$#1

#.1 INTENE +INS OF OPERATIONS""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#"1

#.# AIRCRAFT OPERATIONS"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#"1

#.3 AREAS OF OPERATION"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#"1

#.* PART C TER!INA( AREA OPERATIONS""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#"1

#.5 PART !AINTENANCE PRO-RA!"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#"1

#. SPECIA( OPERATIONS SPECIFICA TIONS FOR 'E(ICOPTERS"""""""""""""""""""""""""""""""#"1#./ AITIONA( RE%$IRE AIRCRAFT INFOR!ATION""""""""""""""""""""""""""""""""""""""""""""#01

#. !AINTENANCE 'ISTOR2"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#01

#. PRI!AR2 !AINTENANCE &ASE""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#01

#.14 !AOR A(TERATIONS"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#01

#.11 PRESS$RE C2(INERS AN SP'ERS""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""#01

S+(T&O, 8 A&-(-AFT (O.2&A,(+ STAT+.+,T FO- 185 O2+-AT&O,S#######################8#1

3.1 A(( AIRCRAFT"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" 3"1

3.# RNA) AN E6TENE O)ER7ATER OPERATIONS"""""""""""""""""""""""""""""""""""""""""""""""3"1

3.3 T$R&INE"PO7ERE, T$R&OET, AN8OR TEN"OR"!ORE PASSEN-ER AIRCRAFT."""3"1

S+(T&O, 4 FA- 185 A&-'O-TH&,+SS (H+(9&ST########################################################4#1

PLEASE DO NOT RETURN THIS PAGE TO THE FSDO

Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'


3/14

,OT+3 These forms are designed for on#screen fill#in* To navigate throgh the forms se TA: ;do ;"=*

se the "age "?domitted > ;signatre=3 Title3 Date3

Page )Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'

Formdate


4/14

SECTION , RE-!EST FOR OPERATIONS SPECIFICATIONSFOR THIS AIRCRAFT

2.1INTENDED KINDSOF OPERATIONS:

)ar7o O%y8Ne+er Pa&&e%7er&9

Ma=$m(m Pa&&e%7er Seat$%7 Capacit. Day O%y Day*N$7!t

CES NO CES NO CES NO

2.2 AIRCRAFTOPERATIONS

INSTR!CTIONS 1/ If .ou 0ant an operation described belo0 c'ec2 t'e bo3 to t'e left of its description/

DocumentRe4uirements

Procedures

Trainin5+S2ill

,/ T'en loo2 to see if a appears to t'e ri5't of t'e operation under 6Procedures7

and+or 6Trainin5+S2ill7 and re&ise .our operatin5 procedures and trainin5 manual andprepare to s'o0 proficienc. as indicated/ T'e FSDO 0ill pro&ide an. 5uidance .oure4uest/

OPSSRef+Par

,/$/1 PART A 8ENERA#

CRE9

)o%d('t 'erta$% FAR 1/ o-erat$o%& $% a''orda%'e $t! 3$7!t a%d re&t t$me$m$tat$o%& (%der 14 )FR Se't$o%& 1/261 t!ro(7! 1/2B/

A0//

Ma5e arra%7eme%t& $t! tra$%$%7 'e%ter& a%d ot!er or7a%$at$o%& 3or'ert$3$'ate !oder tra$%$%7 $% a''orda%'e $t! 14 )FR Se't$o% 1//24I3 a--$'ae, -ro+$de t!e FAR 142 Tra$%$%7 )e%ter $%3ormat$o% eo oratta'! a $&t $t! t!e $%d$'ated $%3ormat$o%

A0/1

Name )ert$3$'ate%(mer

Addre&& )o(r&e %ame8&9

U&e a% a--ro+ed 'om-(ter;a&ed 3$7!t )re re'ord5ee-$%7 &y&tem 3or FAR1/ o-erat$o%&

A02

U&e a% a(to-$ot $% $e( o3 a &e'o%d;$%;'omma%d Pro+$de t!e 3oo$%7

Autopilot "a2e+"odel + / Date Installed /

Pea&e 3(r%$&! a 'o-y :co&er pa5e onl.9 o3 t!e F$7!t Ma%(a S(--eme%tt!at $de%t$3$e& t!e a$r'ra3t a%d t!e a(to-$ot

U%e&& t!e a(to-$ot $& a$r'ra3t ma%(3a't(rer $%&taed, -ea&e 3(r%$&! a 'o-yo3 t!e FAA Form //B &!o$%7 t!e $%&taat$o% data

A01

ICIN8

)o%d('t a -reta5eo33 'o%tam$%at$o% '!e'5 d(r$%7 7ro(%d $'$%7 'o%d$t$o%& 3or Part 1/ O-erator&

A041

)o%d('t Part 1/ a$r-a%e o-erat$o%& $t!o(t a de$'$%7*a%t$;$'$%7 -ro'ed(re A042

Determ$%e 7ro(%d $'$%7 'o%d$t$o%& 3or t!e -(r-o&e o3 3$7!t (&$%7 a%a--ro+ed de$'$%7*a%t$;$'$%7 -ro'ed(re IA )FR Se't$o% 1/22B898/9

A02/

SPECIA#OPERA;TIONS

)o%d('t a$r-a%e a$r am(a%'e o-erat$o%& Part 1/ A024

)o%d('t La%d a%d Hod S!ort O-erat$o%& 8LAHSO9 at de&$7%ated a$r-ort&a%d &-e'$3$ed r(%ay 'o%3$7(rat$o%& a& $de%t$3$ed y A$r Tra33$' Ser+$'e& $%Not$'e B11011, A--e%d$= 1

A02B

)o%d('t S$%7e E%7$%e IFR 8SEIFR9 Pa&&e%7er;)arry$%7 O-erat$o%& U%der)FR Part 1/

A046

)o%d('t &-e'$a e% ro(te IFR o-erat$o%& $% )a&& G a$r&-a'e A014

Pa7e ) Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'

Formdate


5/14

SECTION , RE-!EST FOR OPERATIONS SPECIFICATIONSFOR THIS AIRCRAFT :continued<

,/, AIRCRAFTOPERATIONS contn!"#

INSTR!CTIONS 1/ If .ou 0ant an operation described belo0 c'ec2 t'e bo3 to t'e left of itsdescription/


ProceduresTrainin5+S2ill



OPSSRef Par

,/$/, PART ) ENRO!TE

IFR e% ro(te o-erat$o%& 0/2

)a&& INa+$;7at$o%

U&$%7 a% area %a+$7at$o% &y&tem 'ert$3$ed (%der o%eor more o3 t!e 3oo$%7 Ad+$&ory )$r'(ar& A) 0;4A, 20;101), 20;121A, 20;1/0A, 20;1/

Complete Section/$/1 AREA or #on5Ran5e NA( S.stems=For t'ese OperationsSpecifications

0/4

I% t!e US )a&& A a$r&-a'e (&$%7 a% area or o%7;ra%7e %a+$7at$o% &y&tem

0/

)a&& IINa+$;7at$o%

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)o%d('t o-erat$o%& $% )e%tra Ea&t Pa'$3$' 8)EP9a$r&-a'e

0/B

)o%d('t o-erat$o%& $% Nort! Pa'$3$' 8NOPA)9a$r&-a'e

0/

)o%d('t o-erat$o%& $% Nort! Ata%t$' m$%$m(m%a+$7at$o% -er3orma%'e &-e'$3$'at$o%& 8NAT*MNPS9a$r&-a'e

0/

)o%d('t o-erat$o%& $% area& o3 ma7%et$' (%re$a$$ty 040

)o%d('t (&$%7 &$%7e o%7;ra%7e %a+$7at$o% &y&tem8S;LRNS9

04

)o%d('t e=te%ded o+erater o-erat$o%& (&$%7 a &$%7e o%7;ra%7e'omm(%$'at$o% &y&tem 8S;LR)S9

)om-ete Se't$o% /46 Lo%7;Ra%7e )omm(%$'at$o%& Sy&tem8&9 8LR)S9 Fort!e&e O-erat$o%& S-e'$3$'at$o%&

04

RSM)o%d('t o-erat$o%& $% red('ed +ert$'a &e-arat$o% m$%$m(m 8RSM9

a$r&-a'e

046

2.$ AREAS OFOPERATION

Operations Outside t'e Conti5uous !nited States/

:If .es please list eac' countr. and oceanic area of operation<

>es No )?*?

+nter B,o change to :50C if a""ro"riate

Pa7e 2 Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'


6/14


2.% PART CTERMINAL AREAOPERATIONS



Procedures

Trainin5+S2ill


and+or 6Trainin5+S2ill7 and re&ise .our operatin5 procedures and trainin5 manualand prepare to s'o0 proficienc. as indicated/ T'e FSDO 0ill pro&ide an. 5uidance.ou re4uest/

OPSSRefPa

)o%d('t term$%a $%&tr(me%t o-erat$o%& (&$%7 &-e'$3$' -ro'ed(re& a%d

a%d$%7 m$%$ma 3or a$r-a%e&

)0)o%d('t a&$' I%&tr(me%t A--roa'! -ro'ed(re a(t!or$at$o%& J aa$r-ort&

)0

)o%d('t &tra$7!t;$% )ate7ory I a--roa'! -ro'ed(re& ot!er t!a% ILS, MLS,or GPS $t! &-e'$3$' IFR a%d$%7 m$%$m(m& 3or a$r-a%e& at a a$r-ort&

)0

)o%d('t IFR a--roa'! -ro'ed(re& (&$%7 &-e'$a IFR a%d$%7 m$%$m(m&3or a$r-a%e&

)0

U&e IFR Ta5eo33 M$%$m(m&, FAR 1/ A$r-a%e O-erat$o%& ; A A$r-ort& )0

)o%d('t 3ore$7% term$%a $%&tr(me%t -ro'ed(re& $t! &-e'$a re&tr$'t$o%&3or a$r-a%e&

)0

RNA

)o%d('t a$r-a%e o-erat$o%& (&$%7 -($&!ed RNA 8OR*DME9$%&tr(me%t a--roa'! -ro'ed(re& $t! a% area %a+$7at$o% &y&temComplete Section /$/1 AREA or #on5 Ran5e NA( S.stems= Fort'ese Operations Specifications

)06

)o%d('t %o%&'!ed(ed -a&&e%7er a%d*or a;'ar7o, &-e'$a term$%a areaIFR a$r-a%e o-erat$o%& $% )a&& G a$r&-a'e a%d at a$r-ort& $t!o(t a%o-erat$%7 'o%tro toer

)06

U&e -oer-a%t re+er&$%7 &y&tem& 3or rearard ta=$ $% &-e'$3$' a$r-a%eo-erat$o%&

)06

)o%d('t t(roKet a$r-a%e o-erat$o%& $t! ta$$%d 'om-o%e%t& $% e='e&&o3 10 5%ot& (t %ot to e='eed 1 5%ot&

)06

)o%d('t t(roKet a$r-a%e ta5eo33 o-erat$o%& $t! ta$$%d 'om-o%e%t& o310 5%ot& or e&&

)06

E%7a7e t!e a(to-$ot a3ter ta5eo33 a%d $%$t$a '$m at a% at$t(de oert!a% &-e'$3$ed 3or e% ro(te o-erat$o%& y T$te 14 )FR Se't$o% 1// 8a9

)0B

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)0B

NA

)o%d('t IFR a$r-a%e a--roa'! -ro'ed(re& (&$%7 +ert$'a %a+$7at$o%8NA9 (t$$$%7 a -($&!ed MDA a& a DA8H


7/14


2.& PART DMAINTENANCEPRO'RAM



Procedures

Trainin5+S2ill

,/ T'en loo2 to see if a appears to t'e ri5't of t'e operation under

6Procedures7 and+or 6Trainin5+S2ill7 and re&ise .our operatin5 procedures andtrainin5 manual and prepare to s'o0 proficienc. as indicated/ T'e FSDO 0illpro&ide an. 5uidance .ou re4uest/

OPSSRef Par

CA"P1*/$11:a


8/14


2.(

SPECIALOPERATIONSSPECIFICATIONS FORHELICOPTERS



Procedures

Trainin5+S2ill



OPSSRef Par

U&e A% A--ro+ed Se'(r$ty Pro7ram I% He$'o-ter O-erat$o%& 8to De-a%e PA@

$% &ter$e area&9 A01

)o%d('t !e$'o-ter a$r am(a%'e o-erat$o%& $% a''orda%'e $t! )FR 14 Part1/

A02

)o%d('t !e$'o-ter %$7!t +$&$o% 7o77e o-erat$o%& A0

U&e a% a--ro+ed ma$%te%a%'e -ro7ram 3or $t& !e$'o-ter %$7!t +$&$o% 7o77eo-erat$o%&

D0

U&e a$r'ra3t $t! %$%e or e&& -a&&e%7er &eat& $t! t!e add$t$o%a ma$%te%a%'ere?($reme%t& o3 14 )FR Se't$o% 1/421 a--$'ae 3or rotor'ra3t o-erat$o%&

D10

)o%d('t term$%a 3$7!t o-erat$o%& (%der $%&tr(me%t 3$7!t r(e& ; !e$'o-ter H10

)o%d('t o-erat$o%& (&$%7 a&$' $%&tr(me%t a--roa'! -ro'ed(re& 3or !e$'o-ter& H10

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H10

)o%d('t IFR !e$'o-ter e% ro(te de&'e%t 8HEDA9 -ro'ed(re& H10

U&e ater%ate a$r-ort IFR eat!er m$%$m(m& ; !e$'o-ter H10

)o%d('t !e$'o-ter o-erat$o%& (&$%7 &ta%dard ta5eo33 m$%$m(m& (%der Part 1/ H10

U&e &-e'$a re&tr$'t$o%& 3or 3ore$7% term$%a $%&tr(me%t -ro'ed(re& ; !e $'o-ter H10

)o%d('t !e$'o-ter )ate7ory II o-erat$o%& H10

)o%d('t !e$'o-ter )ate7ory III o-erat$o%& H10

U&e 3$7!t 'o%tro 7($da%'e &y&tem& 3or a$r'ra3t a(tomat$' a%d$%7 o-erat$o%& ;!e$'o-ter

H11

U&e ma%(ay 3o% 3$7!t 'o%tro 7($da%'e &y&tem& 'ert$3$ed 3or a$r'ra3t a%d$%7o-erat$o%& ; !e$'o-ter

H11

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H11

U&e &-e'$a a$r-ort a(t!or$at$o%&, $m$tat$o%&, a%d -ro+$&$o%& ; !e$'o-ter H11

)o%d('t !e$'o-ter o-erat$o%& (&$%7 oer t!a% &ta%dard ta5eo33 m$%$m(m&(%der Part 1/

H11

)o%d('t !e$'o-ter )ate7ory I, ILS, MLS, or GLS a--roa'! -ro'ed(re& $t!&-e'$3$' IFR a%d$%7 m$%$m(m&

H11

)o%d('t !e$'o-ter '$r'e;to;a%d ma%e(+er& (&$%7 IFR )ate7ory I a%d$%7m$%$m(m&

H11

)o%d('t !e$'o-ter 'o%ta't a--roa'!e& (&$%7 IFR )ate7ory I a%d$%7 m$%$m(m& H11

)o%d('t &-e'$a %o% )FR Part B $%&tr(me%t a--roa'! or de-art(re rotor'ra3to-erat$o%& &-e'$3$ed 3or t!e 3oo$%7 a$r-ort&

H12

Pa7e , Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'


9/14


NOTICE PART N$!&ERS AN OC$!ENT N$!&ERS !$ST &E CO!P(ETE AN ACC$RATE.

2.) ADDITIONALREQUIRED AIRCRAFTINFORMATION

For O"erations nder2art 185*411;a=;1=Onl;B,ine#or#ess

O"erationsC=

AIRCRAFT = E%ter t!e A$r'ra3t ma$%te%a%'e-($'at$o%

8$de%t$3$'at$o% or -art%(mer9 !ere

A$r'ra3t Ma$%te%a%'eMa%(a

Re+$&$o% Le+e

Date

ITEMMa5e Mode

Ma$%te%a%'e*O+er!a(Do'(me%t ID or Part

N(mer 8Read Note 19

T$me I% Ser+$'eDo'(me%t ID or Part

N(mer 8Read Note 29

TIME;IN;SERI)EINTERAL

EN8INE8Le3t or S$%7eE%7$%e9

EN8INE8R$7!t $3 a--$'ae9

PROPE##ER:#eft or Sin5leEn5ine<

PROPE##ER8R$7!t $3 a--$'ae9

PROPE##ER8O(ERNOR8Le3t or S$%7eE%7$%e9

PROPE##ER8O(ERNOR8R$7!t $3 a--$'ae9

PRI"AR>8O(ERNOR

O(ERSPEED8O(ERNOR

NOTE 1 Pea&e e%ter t!e e=a't %ame a%d $de%t$3$'at$o% or -art %(mer o3 t!e -($'at$o%8&9, $%'(d$%7 re+$&$o% e+e, (%der!$'! t!e $tem $ e ma$%ta$%ed 8%ormay t!e&e are t!e a$r3rame a%d t!e e%7$%e, -ro-eer, a%d 7o+er%or &er+$'e ma%(a&9

NOTE 2 Pea&e $de%t$3y t!e ma%(3a't(rer


10/14


2.12 MA,OR ALTERATIONS A+C "a2e+"odel

Re5istration N

&ST A .AO- AT+-AT&O,S THAT (--+,T A22 TO TH+ A&-(-AFTEse additional co"ies of this "age as needed*

DATE bloc2

Instructions For Continued Air0ort'iness

Appl.:>es or No<

Field Appro&al

in )loc2 :>es or No<

Fli5't "anual SupplementRe4uired

:>es or No< )rief Description of t'e "aor Alteration

2.13 PRESSURE C+LINDERS AND SPHERES

ist all 2ressre (linders and S"heres installed as Aircraft +qi"ment

2lease refer to FAA Order %)00*1! olme 8! (ha"ter 57! Section 1 for details*

Part Number Description or

Part Name

"anufacturers "aintenanceDocument

Applicable limitations and pro&isionsincludin5 current due dates/

Pa7e - Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'


11/14

SECTION AIRCRAFT CO"P#IANCE STATE"ENT FOR 1* OPERATIONS

3.1 ALL AIRCRAFT A+C "a2e+"odel

Re5istration N INSTR!CTIONS FOR SECTION =

♦ Please refer to FAR 1* Subpart C Aircraft and E4uipment and Far @1 as applicable for t'e specific re4uirements of t'e items

listed belo0

♦ C'ec2 t'e bo3 ne3t to t'e item to indicate t'at it meets t'e re4uirements of t'e rule/

♦ Pro&ide all additional information indicated/

/1/18eneralre4uirements

1/14/

8a9 For ea'! $tem $%$t$aed, t!e a--$'a%t 'ert$3$e& t!at t!e e?($-me%t meet& t!e a--$'ae Federa A+$at$o%Re7(at$o%& I%d$'ate $tem& t!at do %ot a--y y "NA#

89 A e?($-me%t %ot or$7$%ay $%&taed y t!e a$r'ra3t ma%(3a't(rer meet& FAA a--ro+ed data &!o% y FAForm8&9 //B !$'! are $&ted $% Se't$o% 212 o3 t!$& 3orm a%d are a+a$ae 3or $%&-e't$o% y t!e FSDO

/1/$ATC Transponders

8'9 AT)Tra%&-o%der

Ma5e Mode Date I%&taed

1

2

/1/E4uipmentre4uirements=8eneral

1/144L$&t a -ortae ee'tro%$' de+$'e& $%te%ded to e (&ed y t!e F$7!t )re

1/14B D(a 'o%tro& are $%&taed

1/14

8a9 At$meter8&9 Se%&$t$+e adK(&tae 3or arometr$' -re&&(re89 )ar(retor Heat*De$'e or Pre&&(re )ar(retor Ater%ate a$r &o(r'e

8'9 For T(roKet a$r-a%e& T!$rd art$3$'$a !or$o% $%&taed a''ord$%7 to FAR 121/08K9

/1/1?Performancere4uirements=

1/11 A$r'ra3t o-erated o+er;t!e;to- or $% IFR 'o%d$t$o%&

1/1/ La%d a$r'ra3t o-erated o+er ater

/1/1,Empt. 0ei5't andcenter of 5ra&it.=

1/1)(rre%'y re?($reme%t

For multien5ine aircraft= Date #ast 9ei5'ed= /

/1/1Emer5enc.E4uipment

1/1

FIRE EBTIN8!ISHERSMa5e*Mode "aintenance Document Aircraft #ocation

1

,

120

898129

APPRO(ED PERSONA# F#OATATION 8EAR Note= T'is e4uipment is re4uired for operations in coastal areas/ It need not meet 1*/1

Ma5eMode

NoI%&taed

one for eac' sea

120BEmer5enc. #ocator Transmitter Ma5e*Mode

E#TT.pe

TSONumber

//*O3.5en E4uipment

1/1B "eets all re4uirements

//Passen5er carr.in5under (FR at ni5'tor (FR o&er;t'e;topconditions

1/1

8a9 Gyro&'o-$' Rate;o3;T(r% $%d$'ator

89 S$- &5$d $%d$'ator

8'9 Gyro&'o-$' a%5;a%d;-$t'! $%d$'ator

8d9 Gyro&'o-$' d$re't$o% $%d$'ator

8e9 Ge%erator& meet$%7 FAR &-e'$3$'at$o

839 For N$7!t F$7!t A(t!or$at$o%

A%t$ 'o$&$o% $7!t &y&tem

I%&tr(me%t $7!t&

2 D )e 3a&!$7!t or e?($+ae%t

//(FR Radio andna&i5ationale4uipment

1/161

"a2e+"odel "a2e+"odelHF

)OM 1// !

S-a'$%7DME 1

OR 1 FMIm(%$ty

ADF 1

Pa"e 1

Note T!e term "FAR# $% t!$& do'(me%t mea%& "14 )FR Part# *+ar**a--&*'o%+er&$o%*tm-*&'rat'!./*220//21do'Formdate


12/14

/1 A## AIRCRAFT :continued<A+C "a2e+"odel

Re5istration N

//1?Passen5ers !nderIFR

1/16/

8a9 ert$'a &-eed $%d$'ator

89 Free a$r tem-erat(re $%d$'ator

8'9 Heated -$tot t(e 3or ea'! a$r&-eed $%d$'ator

8d9 Gyro&'o-$' -oer &o(r'e $%d$'ator or -oer3a$(re ar%$%7 $%d$'ator

8e9 Ater%ate &tat$' &o(r'eSee Order /401a '!7 1, a-- 14, -ar /4;/1 3or e='e-t$o%&

839 S$%7e;E%7$%e a$r'ra3t8Ge%erator*oad 'om$%at$o% a& &-e'$3$ed9

879 M(t$;e%7$%e a$r'ra3t8to 7e%erator& oaded a& &-e'$3$ed9

8!9 To $%de-e%de%t &o(r'e& o3 e%er7y a& &-e'$3$to -oer 7yro&'o-$' $%&tr(me%t&

//11Radio andNa&i5ationalE4uipment= IFROperations

1/16

Ma5e*Mode to m$'ro-!o%e&

Mar5er ea'o% Re'e$+er to !ead&et& or

o%e !ead&et a%d o%e &-ea5er

HF )OM 2 // !S-a'$%7

OR NA 2 FMIm(%$ty

3.4 RNAV AND E-TENDED OVERATER OPERATIONS

/$/1AREA or #on5Ran5e NA(S.stems=

1/16

Radio and na&i5ational e4uipment for E3tended O&er0ater Operation Aut'oriation "a2e+"odel SENSORS ;; INDICATE A## APPRO(ED FOR

1

< .

Datentalled .

F$7!t Ma%a7eme%t Sy&tem orNA Ma%a7eme%t Sy&tem

Lora% ) GPS INS*IRS

OTHERSHORT;RANGE RNA(

OR*DME or DME*DME;FMS

E%ro(te*Term$%a

No%;Pre'$&$o% A--roa'!e&

Remote*O'ea%$'

RNP TCPE8&9T$me L$m$t&

RNA

NA

,

< .

Datentalled .


Lora% ) GPS INS*IRSOTHER

SHORT;RANGE RNA( OR*DME or

DME*DME;FMS

E%ro(te*Term$%a


Remote*O'ea%$'


RNA

NA

< .

Date

ntalled .


Lora% ) GPS INS*IRSOTHER

SHORT;RANGE RNA( OR*DME or DME*DME;FMS

E%ro(te*Term$%a


Remote*O'ea%$'


RNA

NA

/$/#on5;Ran5eCommunicationsS.stem:s< :#RCS<

"a2e+"odel #RCS T.pe Date Insta

1 < . HF SAT+CO" DATA#ING OTHER

, < . HF SAT+CO" DATA#ING OTHER

< . HF SAT+CO" DATA#ING OTHER

/$/1?Air0ort'iness andOperatin5#imitations

For eac' item listed abo&e in sections /$/1 and /$/ pro&ide t'e follo0in5=

)o-$e& o3 t!e -ort$o%& o3 t!e $%&taat$o% a--ro+a do'(me%t& 8or$7$%a E?($-me%t L$&t or FAA Form //B9 a

F$7!t Ma%(a S(--eme%t& t!at &!o t!e ma5e a%d mode o3 t!e e?($-me%t a%d a--ro+a 3or t!e re?(e&teo-erat$o% )o%ta't t!e FSDO $3 t!ere are a%y ?(e&t$o%&

/$/11Emer5enc.e4uipmentE3tended o&er0ater operations

1/16B

8a9 T!e 3oo$%7 are 'o%&-$'(o(&y mar5ed a%d ea&$y a''e&&$e to t!e o''(-a%t& $3 d$t'!$%7 o''(r&Ma5e*Mode Ma$%te%a%'e Do'(me%t ID

L$3e Pre&er+er $t! L$7!t 3or ea'!o''(-a%t

*

L$3e ra3t& a& &-e'$3$ed $%1/16B89 8'9 *

Formdate


13/14

2+AS+ (O.2+T+ TH&S 2A+ O, &F A22&(A:+*

3.$ TURBINE/POERED0 TURBO,ET0 ANDOR TEN/OR/MORE PASSEN'ER AIRCRAFT.A+C "a2e+"odel

Re5istration N

/*/1

Pro&in5 TestFli5'ts

1/14 NOT RE-!IRED RE-!IRED

Pro+$%7 te&t -a% $& &'!ed(ed o% -a7e 1;1

Pro+$%7 te&t& are &'!ed(ed o% -a7e 1;1 Re?(e&t 3or de+$at$o% $& &'!ed(ed o% -a7e 1;1

/*/,AdditionalE4uipmentRe4uirements

1/10 Public address and cre0member interp'one s.stems

Ma5e*Mode*Ser$e& Date I%&ta

1/11 )o'5-$t o$'e Re'order&

1/118d9 D(a Head&et&*oom M$'&

1/12 F$7!t Re'order&

1/1/ Gro(%d Pro=$m$ty ar%$%7 Sy&tem

1/14Terra$% Aare%e&& ar%$%7Sy&tem 8TAS9

Class A Class )

1/1 P$tot !eat $%d$'at$o% &y&tem&

/*/11AdditionalAir0ort'inessRe4uirements

1/16

:a< For a lar5e airplanes 8more t!a% 12,00 -o(%d&, ma=$m(m 'ert$3$'ated ta5eo33 e$7!t9T!e a$r'ra3t

$& a 'omm(ter 'ate7ory a$r-a%e, ormeet& t!e add$t$o%a re?($reme%t& o3 FAR 12121/ t!ro(7! 1212/, a%d 121/0B:SEE NOTE<

:b< For Reciprocatin5;en5ine airplanes 'o%3$7(red 3or ten;or;more -a&&e%7er& orFor Turbopropeller;po0ered Small Airplanes 'o%3$7(red 3or ten;or;more -a&&e%7er&=

meet& a a--$'ae 'o%d$t$o%& &-e'$3$ed $% 1/1689 :SEE NOTE<

NOTE= Applicants must attac' a conformit. statement s'o0in5 compliance 0it' aadditional rules indicated in t'e applicable para5rap' abo&e

:c< For a ten;or;more small a$r-a%e&

&tate t!e ma=$m(m Passen5er seatin5 confi5uration:d< Car5o or ba55a5e compartments= All transport cate5or. airplanes t.pe certificated

after anuar. 1 1@*/ea'! 'a&& ) or D 'ar7o 'om-artme%t& $& %ot 7reater t!a% 200 '($' 3t $% +o(me, or meet& a a--$'ae 'o%d$t$o%& &-e'$3$ed $% t!$& 1/168d9

1/1B0 "aterials for compartment interiors

1/1B1 S'oulder 'arness installation at fli5't cre0member stations

1/1B/

"a2e+"odel+ SeriesDate

InstalledAirborne t'understormdetection e4uipmentre4uirements

1/1B

Airborne 0eat'er radare4uipment re4uirements

1/1BBEmer5enc. e4uipment re4uirements for aircraft 'a&in5a passen5er seatin5 confi5uration of more t'an 1@ passen5ers

1/10Traffic Alert and CollisionA&oidance S.stem

T)AS I T)AS IIT)AS II So3tare er&$o% B or !$7!erQ Ce& No

Formdate


14/14

SECTION $ FAR 1* AIR9ORTHINESS CHECG#IST

'e sggest o se this chec@list freqentl and es"eciall >efore "resenting the aircraft to theFAA for ins"ection or >efore an FAA chec@ ride*

A+C "a2e and "odel Re5istration N

(H+(9 TH+ :OG TO &,D&(AT+ (O.2&A,(+

INSPECTION ITE"

)!e'5 $3 t!e $tem meet& a a--$'ae FAR Re?($reme%t&

)ERTIFI)ATES AND REGISTRATION

T!e Re7$&trat$o% )ert$3$'ate $& o% oard a%d '(rre%t

T!e A$rort!$%e&& )ert$3$'ate $& o% oard a%d '(rre%t

T!e Rad$o Stat$o% L$'e%&e $& o% oard a%d '(rre%t

OPERATING LIMITATIONS

FAA A--ro+ed A$r'ra3t F$7!t Ma%(a 8AFM9 or P$ot& O-erat$%7Ha%doo5 $& '(rre%t, 'om-ete, a%d $% &er+$'eae 'o%d$t$o%

AFM 'o%ta$%& F$7!t Ma%(a S(--eme%t& t!at are '(rre%t a%da--$'ae to t!e $%&taed A(to-$ot*F$7!t D$re'tor, Na+$7at$o%e?($-me%t, a%d ot!er $%&taed e?($-me%t to !$'! a F$7!t

Ma%(a &(--eme%t a--$e&

A 3$7!t de'5 -a'ard& re?($red y t!e Ty-e )ert$3$'ate or t!e AFM are &e'(re a%d readae

T!e 3$7!t de'5 'o%ta$%& a o-erat$%7 ma%(a& a%d*or -a'ard&re?($red y T), ST), or FAA Form //B&

A &$t'!e&, '$r'($t rea5er&, 'o%tro&, et', are -ro-ery aeed

AFM 'o%ta$%& '(rre%t e$7!t a%d aa%'e data, a%d a o&oetee$7!t a%d aa%'e data $& &(-er&eded or, 3or a$r'ra3t %otre?($r$%7 a% AFM, t!e '(rre%t e$7!t a%d aa%'e a%d e?($-me%t$&t $& $% t!e a$r'ra3t

AFM 'o%ta$%& a '(rre%t a%d 'om-ete e?($-me%t $&t

For m(t$e%7$%e a$r'ra3t, t!e AFM 'o%ta$%& a e$7!$%7 re'ord&!o$%7 t!e a$r'ra3t a& e$7!ed $t!$% t!e a&t t!ree year&T!e re'ord $%'(de& a% e?($-me%t $&t, !$'! de&'r$e& t!e

a--ro+ed a$r'ra3t 'o%3$7(rat$o% at t!e t$me o3 e$7!$%7 T!ee$7!$%7 re'ord !a& t!e &$7%at(re a%d 'ert$3$'ate %(mer o3 t!e-er&o% or a7e%'y do$%7 t!e or5 a%d t!e date o3 'om-et$o%

AIR )ARRIER OPERATIONS DO)UMENTS

A$r'ra3t Ma$%te%a%'e Lo7 814 )FR 1/69 'o%ta$%& %o o-e%Me'!a%$'a Irre7(ar$t$e&

M$%$m(m E?($-me%t L$&t $& o% oard a%d '(rre%t

A$r )arr$er O-erat$o%& Ma%(a $& o% oard a%d )(rre%t

De3erred Ma$%te%a%'e Lo7 'o%ta$%& %o $tem& de3erred eyo%dt!e t$me aoed $% t!e MEL

PASSENGER SAFETC

A $%ter%a 'a$% -a'ard& re?($red y t!e Ty-e )ert$3$'ate or t!e AFM are &e'(re a%d readae

Pa&&e%7er r$e3$%7 )ard& meet 14 )FR 1/ Re?($reme%t&

INSPECTION ITE"

)!e'5 $3 t!e $tem meet& a a--$'ae FAR Re?($reme%t&

Re?($red emer7e%'y e?($-me%t $& o% oard, -ro-ery &toed,a%d $%&-e'ted

GENERAL AIRORTHINESS

T!e a$r'ra3t !a& t!e -ro-er e?($-me%t a%d a--ro+ado'(me%tat$o% re?($red y 14 )FR 1/ S(;Part ) Ae?($-me%t $& o-erat$%7 -ro-ery

A e=ter%a -a'ard&, re?($red y t!e Ty-e )ert$3$'ate or t!e

AFM, are &e'(re a%d readae

A 'o 3a&te%er&, &'re&, et', are &e'(re

A%te%%a& are 3ree 3rom ero&$o%

ADF Se%&e a%te%%a $& (%der &-r$%7 te%&$o%

A &tat$' $'5& $%&taed, %o%e ro5e% e='e-t a& aoed (%derMEL No o%d$%7 &tra-& ro5e%

T!e a$r'ra3t Ma5e, Mode a%d Ser$a N(mer data are o% t!eo(t&$de o3 t!e 3(&ea7e

A $%&tr(me%t&, &y&tem& a%d e?($-me%t are o-erat$%7 -ro-eryt!e a$r'ra3t $& a$rort!y a%d e7a to 3y

A$r'ra3t 'om-$e& $t! $t>& ty-e 'ert$3$'at$o% a&$& 8T)9 to $%'(de'om3orm$ty to a%y ST) or aterat$o% a%d $& $% 'o%d$t$o% 3or &a3eo-erat$o%

MAINTENAN)E RE)ORDS

T!e ma$%te%a%'e re'ord& &!o t!at a a$rort!$%e&& $%&-e't$o%&are '(rre%t $%'(d$%7, A%%(a*100 !r or Pro7rammed I%&-e't$o%,

At$meter, E%'oder, Stat$' Sy&tem, AT) Tra%&-o%der, et'

A re?($red ma$%te%a%'e, $%'(d$%7 ma$%te%a%'e o3 $3e $m$ted$tem&, $& '(rre%t

T!e ma$%te%a%'e re'ord& $%'(de a% A$rort!$%e&& D$re't$+e8AD9 L$&t$%7 &!o$%7 t!at a AD& are 'om-$ed $t! $%'(d$%7Re'(rr$%7 AD& T!e $&t$%7 m(&t 'om-y $t! FAR 141B8a98$98+9

T!e ma$%te%a%'e re'ord& $%'(de e%try 3or 'om-et$o% o3 t!$&'o%3orm$ty $%&-e't$o% "T!$& a$r'ra3t a%d $t& e?($-me%t 'o%3orm&to t!e re?($reme%t& o3 14 )FR Part 1/2, $%'(d$%7re7$&trat$o%, '(rre%t a$rort!$%e&& 'ert$3$'at$o%, $de%t$3$'at$o%, a%d'(rre%t a$rort!y 'o%d$t$o% 3or o-erat$o% o% Part 1/ )ert$3$'ate..............# E%try m(&t $%'(de date, a$r'ra3t tota t$me,

&$7%at(re, 'ert$3$'ate ty-e a%d %(mer

I 'ert$3y t!at, to t!e e&t o3 my 5%oed7e, t!e $%3ormat$o% 'o%ta$%ed $% t!$& re-ort $& 'om-ete a%d a''(rate

Director of .aintenance Date

Pa"e 1

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