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Transport Canada S60077 Forni One - Airstream · 1. Approving Civil Aviation Authority/Country 2....

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1. Approving Civil Aviation Authority/Country 2. AUTHORIZED RELEASE CERTIFICATE Forni One 3. Form tracking No. Transport Canada S60077 4. Organization Name and Address !5. Work Order/Contract/Invoice Aviation Representatives Inc, 6245 Danville Rd. Mississauga Ont. LST 2H7 Tel (905) 790-0244 Fax (905) 790-3957 www.av-reps.com W59491 6. Item 7. Description 8. Part No. 9. Qty. 10. SeriaVBatch No. 11. Status/Work 1 UPPER TORQUE LINK 10135-501 1 DCL-A234 OVERHAULED 12. Remarks OVERHAULED in accordance with Messier-Dowty CMM 32-10-07 at Rev. 11 dated May 23/14. CSN: 19,789 CSO: 0 Full details held on Work Order W59491. Customer RefR216472. Certifies that the work specified in block 11/12 was carried out in accordance with EASA-145 and with respect to that work the aircraft component is considered ready for release to service under EASA Part 145 approval Certificate# EASA.145.7105 (Prwvlously Form 24-0078) Ix] CAR 571.10 Maintenance Release. (i] Other regulations specified in Block 12. Certifies that unless otherwise specified in Block 12, the work identified in Block 11 and described in Block 12, has been performed in compliance with the Canadian Aviation Regulations. 14c. Approved Organization Number AMO 55-00 14e. Date (dd/mmm/yyyy) Mike Milojevic 06-NOV-2014 nportant: Sae notas INST ALLER RESPONSIBILITIES Th16 certificate does not consbtute authority to install Installers 'Mlrkmg m a::cordance with the nat10nal regulabons of a country olher lhct' that specified m Block 1, must ensure lhat their regulat:ons recognize cerbficabons from the country specified Statements m blocks 13a or 14a clo not consbtute mstallabon certdicabon In all cases, the technical record for the arcralt must contain Ill 1r1stallabon certlficabon issued m a:cordMc:e wdh the applicable nal:IOOal regulal:lons before the arcraft may be flown
Transcript

1. Approving Civil Aviation Authority/Country 2. AUTHORIZED RELEASE CERTIFICATE

Forni One

3. Form tracking No.

Transport Canada S60077

4. Organization Name and Address !5. Work Order/Contract/Invoice

Aviation Representatives Inc, 6245 Danville Rd. Mississauga Ont. LST 2H7 Tel (905) 790-0244 Fax (905) 790-3957 www.av-reps.com W59491

6. Item 7. Description 8. Part No. 9. Qty. 10. SeriaVBatch No. 11. Status/Work

1 UPPER TORQUE LINK 10135-501 1 DCL-A234 OVERHAULED

12. Remarks

OVERHAULED in accordance with Messier-Dowty CMM 32-10-07 at Rev. 11 dated May 23/14. CSN: 19,789 CSO: 0 Full details held on Work Order W59491. Customer RefR216472. Certifies that the work specified in block 11/12 was carried out in accordance with EASA-145 and with respect to that work the aircraft component is considered ready for release to service under EASA Part 145 approval Certificate# EASA.145.7105

(Prwvlously Form 24-0078)

Ix] CAR 571.10 Maintenance Release.

(i] Other regulations specified in Block 12.

Certifies that unless otherwise specified in Block 12, the work identified in Block 11 and described in Block 12, has been performed in compliance with the Canadian Aviation Regulations.

14c. Approved Organization Number

AMO 55-00

14e. Date (dd/mmm/yyyy)

Mike Milojevic 06-NOV-2014

nportant: Sae notas

INST ALLER RESPONSIBILITIES

Th16 certificate does not consbtute authority to install

Installers 'Mlrkmg m a::cordance with the nat10nal regulabons of a country olher lhct' that specified m Block 1, must ensure lhat their regulat:ons recognize cerbficabons from the country specified

Statements m blocks 13a or 14a clo not consbtute mstallabon certdicabon In all cases, the technical record for the arcralt must contain Ill 1r1stallabon certlficabon issued m a:cordMc:e wdh the applicable nal:IOOal regulal:lons before the arcraft may be flown

Work Order Scope and Traveler Page: 1 of 6

Aviation Representatives Inc. Work Order #: W59491

PN: 10135-501

Qty: 1

Descr: UPPER TORQUE LINK

Make:

Customer: 3 Points Aviation Code: PA9

I Serial Numbers: DCL-A234,

!Task: 3-TEARDOWN RESULTS

TEARDOWN / INSPECTION FINDINGS

Instructions Incoming Teardown

1- Provide detailed teardown I fault findings below.

2- Check applicable standard faults:

3- Technicians Training Log reviewed and updated

Lockwire Missing 11&_ Dirty/Contaminated J Rec'd Dissassembled hl1&._ Incorrectly Shimmed ~

Seals & B/U's Worn NII\ Internal Corrosion / --

Bearings Worn IJ/f\ Bushings Worn ./ Sealant Missing M Chrome Damaged ~

I Print Flntllngs or DlscrepancleS Here:

Station:

Model:

Site:

Parts Missing

Time: 2 34.03 PM Date Printed: 9/10/2014

Reg:

TECH s1 SEP 1 2 2014

TECH Sy SEP 12 2014

TECHS I SEP 1 2 2014 ~ff\

Incorrectly Adjusted ~

Motor Burned

Paint Damaged

Plating Worn

Work Order Scope and Traveler Aviation Representatives Inc. Work Order #: W59491

PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

Serial Numbers: DCL-A234;

I Task: 4-SERVICE BULLETINS

Descr: UPPER TORQUE LINK

Make:

Code: PA9

DETAILAPPLICABLE S.B.'s &AD's

Instructions S.B's & A.D's

Station:

Model:

Site:

1- List recommended/ applicable Service Bulletins & Airworthiness Directives:

2- Detail Service Bulletins / Airworthiness Directives carried out:

I Print Findings or Discrepancies Here:

. ; f I I : • I ... I •, ... • t I t , .. .

\ ,

, I

Page: 2 of 5.

Time: 2:34:03 PM Date Printed: 9/10/2014

Reg:

' 'J f ' •

Work Order Scope and Traveler Aviation Representatives Inc. Work Order#: W59491

PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

Serial Numbers: DCL-A234;

!Task: 4-SERVICE BULLETINS

Descr: UPPER TORQUE LINK

Make:

Code: PA9

DETAIL APPLICABLE S.B.'s &AD's

Instructions S.B's & A.D's

Station:

Model:

Site:

1- List recommended / applicable Service Bulletins & Airworthiness Directives:

2- Detail Service Bulletins /.Airworthiness Directives carried out:

Print Findings or Discrepancies Here:

• J • • ' ·1 J • -~ • I .. ' l '

\ ,

.. • • J •

Page: 2 of~

Time: 2:34:03 PM Date Printed: 9/10/2014

Reg:

a.

. .. , .,,

Work Order Scope and Traveler Aviation Representatives Inc. Work Order#: W59491

PN: 10135-501

Qty: 1

Descr: UPPER TORQUE LINK

Make:

Station:

Model: Customer: 3 Points Aviation Code: PA9

Serial Numbers: DCL-A234;

Task: 7-0UTSIDE SERVICES

OUTSIDE SERVICES REQ'D

Instructions Outside Services A - Check applicable outside service.

1- NOT : LPI / (QTY Jt ) MPl,J/4 (QTY~ ) EDDY_ (QTY

,.· z~ 9:AP. ~LA:i;~ ,i_ (QTY 5

3- MACHIN.ING / (QTY -'\

) Detail 1t- ~J~(n , 1 LJ Nk f/N1o1Yt- so'\ (.OC.L- "~~)

) Detail 1 llN\.;.75 r • i. eoB.eS:

Site:

5- CHROME _ (QTY , · )Detail ___________ _

6- OTHER _ (QTY ) Detail _ ___________ _

Outside Services Completed & Approved ~ ate ___EEl 2 7 2P.!__ Print Findings or Discrepancies Here:

Q.C.

Q.C.

Page: 3 of 6

Time: 2:34:03 PM Date Printed: 9/10/2014

Reg:

-----£&2: I s,

Work Order Scope and Traveler Page: 4 of 6

~-------------------------------------:Tl=m-e-:-=2-=347 ,0"'3=pM-

Aviation Representatives Inc. Date Printed: 911012014

Work Order#: W59491 PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

I Serial Numbers: DCL-A234,

I Task: a-CORRECTIVE ACTION

Deacr: UPPER TORQUE LINK

Make:

Code: PA9

· UNIT ASSEMBLY/PRODUCTION

Instructions Assembly & Production Details 1- Unit Dissassembled, Cleaned & Inspected.

2- Fits & Clearances carried out.

' . . 3- Outside Serv1ces Completed

4- Install parts as required, per attached parts lists. ,

5- Assemble per CMM.

Station:

Model:

Site:

6- Finsih1ng per CMM; Alod1ne as Req'd __ Prime & Paint J Sealant Applied _L_

Reg:

TECH S'f SEP ' 1 10,4

TECH .S. '/ SEP 1 2 2014

TE NOV O 3 2014

~~ NOV O 4 2014 65-oo

7- Test & Adjust Per CMM T~

~EC~orrectiveAction Completed (Check 1): Overhaul I Repair_ Inspect/Test_ Modify_(i)1::v 4 5 ZOU.

I Print Findings or Discrepancies Here: I

Page: 4 of 6 Work Order Scope and Traveler 1-A-v-ia_t_i_o_n_R_e_p_r_e_s_e_n_ta_t_i_v_e_s_I_n_c_. ______ _:_ _____________ TI_m_•_:_2_·34--o-3-PM-

oate Printed: 9/10/2014 Work Order#: W59491

PN· 10135-501

Qty: 1

Customer: 3 Points Aviation

I Serial Numbers: DCL-A234,

I Task: a-CORRECTIVE ACTION

Descr: UPPER TORQUE LINK

Maka:

Code: PA9

. UNIT ASSEMBLY/PRODUCTION

instructions Assembly & Pro,duction Details 1- Urnt Dissassembled, Cleaned & Inspected.

2- Fits & Clearances carried out

3- OutJ1da Se~t:es Completed

4- Install parts as required, per attached parts lists. •

5- Assemble per CMM.

Station:

Modal:

Sita:

6- FInsIhing per CMM, Alodme as Req'd __ Prime & Paint J Sealant Applied _j_ 7- Test & Adjust Per CMM

8- Corrective Action Completed (Check 1) TECH

!Print Findings or Discrepancies Here:

Reg:

TECH S'f SEP , l toi4

TECH.s.y SEP 12 2014

NOV OJ 2014

NOV O 4 2014

Work Order Scope and Traveler ·Aviation Representatives Inc. Work Order#: W59491

PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

Serial Numbers: DCL-A234;

I Task: 9-FINAL TESTING

Descr: UPPER TORQUE LINK

Make:

Code: PA9

TEST/INSPECTION & APPROVAL

Instructions Q.C. Test & Inspection

1- Final Test carried out per CMM / ATP.

Station:

Model:

Site:

2- Final lnspection·carried out. /

3- Approved for recertification as : Overhaul ~epair _ Inspect/ Test_ Modify_

4- Date W.O. Completed _ N_O_V _0_6_ZO_l4 _

_IPrfrit Findings or Discrepancies Here:

Page: 5 of 6

Time: 2:34:04 P M Date Printed: 9/1 0/2014

Reg:

NOVO 5 2014

NOVO 5 201'

NOV O 6 2014

Work Order Scope and Traveler

Aviation Representatives Inc. Work Order#: W59491

PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

Sertal Numbers: DCL-A234;

'',,\.

Descr: UPPER TORQUE LINK

Make:

Code: PA9

Station:

Model:

Site:

Page: 6 of 6

Time: 2·34 04 PM . Date Printed: 9/10/2014

Reg:

Work Order Scope and Traveler Aviation Representatives Inc. Work Order#: W59491

PN: 10135-501

Qty: 1

Customer: 3 Points Aviation

Serial Numbers: DCL-A234,

Descr: UPPER TORQUE LINK

Make:

Code: PA9

Statlon:

Model:

Site:

Page: 6 of 6

Time: 2:34·04 PM Date Printed: 9/10/2014

Reg:

.

~~ Aviation Representatives Inc . Work Order

' 6245 Danville Rd Work Order #: W59491 Mississauga, On L5T 207

Canada. www.av-reps.com Date Printed: 9110/2014

~ Ph: (905) 790-0244, Fax: (905) 790-3957 Time: 2·33 33 PM

Page: 1

To: Ship To: ATTN: Clayton Coleman 3 Points Aviation 3 Points Aviation 1375 Almco Blvd 229 Conception Bay Hwy Units 7 & 8 Conception Bay South, NLAlW 301 Mississauga, ON L4W 1B5 Canada Canada

Ref#: R216472 Phone #:(905)6026145 Fax#: (519) 268- 7047 Emall: [email protected] Code:PA9 Site: PN: 10135-501 Descr: UPPER TORQUE LINK

Qty: 1 Station: Maka: Modal: Mfg: None

TSN: UNK TSO: UNK TSR: UNK CSN: 19769 CSO: UNK CSR: UNK

Entry Date: 9/10/2014 Need Data: 10/3/2014 Compl. Date: Warranty: No Container:

Serial Numbers: DCL-A234;

Task Description Status Seq Std Days Task Total 1-CUSTOMER COMMENTS Completed 1 1 $ 0 00

Notes: .,- OVERHAUL.

2-RECEIVING COMMENTS Completed 2 1 $000

Notes: NO SHIPPING DAMAGE NOTED.

Instructions '

Description: LIBRARY

MANUAL# 455 ATA# 32-10-07 MFR. MESS,IER-DOWTY REV: 11 DATED 23-MAY-14

~\C.1\) (l.E, s ON flU:)

~, '

Date W.O. Completed : N9V O 6 2q14 Parts Total: $ 0.00

Labor Total: $0 00

~~~ Misc. Total: $000 a.c Approval o 0 ::i:> ~w

• ,..,

-ho~edSlgna/d'~~~

Total: $000

V // (/

Form created with Quantum Control(tm) technology. Product Licensed to· Av1at1on RepresentatlVBS Inc.

Order Date: 5/11/2015

Ship Date: O

Sales Order: S331780

Customer#: UCA

To:

3 Points Aviation Urnt 7&8 1375 /i.imco Bou!evanj M1ss1ssauga, ON L.:tW 1B5, Canada

i : , I I : I

Terms: NET 30

Cust. PO#: 0-88266

FOB:YYZ

Buyer.MICHAEL HOPKINS

AWB:

: I/

Weight:

# of Boxes:

Ship Log#:0

TAX ID/EIN: 141695580

VAT#:

Ship To: COMMUTAIR

Packinn Slin Invoice #: 1145269

Invoice Date: 5/11/2015

Time: 1 55 05 PM

#ofltems: 1

Page: 1

Ship Via: FEDEX P1

Ship Via Acc:356770102

Ship Order: 8619

Shipment:

COMMUTAIR COMMUTAIR 240 Valley Rd South Burlington , VT 05403 USA

ATT: THOMAS ALLEN 14821 YONGE DRIVE JACKSONVILLE, FL 32218

Ph: 802-951-2500 Fax: 802-951-2525

Item Part Number/Description

1 10135-501 TORQUE LINK MLG

HS# 8803200000

Shipped BackOrd CD

0

Serial #: DCL-A-234 OH

Loc/Whse 06A05 MISSISSAUGA

Traceable To DAC AVIATION INTERNATIONAL

Cert Agency AV-REPS"F1.TD·oc

HST # 8557 42904

PLEASE SEND ALL PAYMENTS or INVOICES TO 229 CONCEPTION BAY HIGHWAY CONCEPTION BAY SOUTH. NL A1W3H1

MINIMUM PO IS$ 150 00

Cost Plus Exchange Core 1s repa1red/mod1fied to the same mod level/condlt1on as the unit that was shipped to the customer

Flat Rate Exchange Overhaul/Repair covers parts

and repair as required per CMM Parts and labor

required outside the Overhaul/Repair work scope as

per the CMM may require additional charges

I hereby certify that the aircraft parts descnbed herem were acquired from a source of supply that 1s

Unit Price UOM Total Amt

consistent with the conditions under which 3 Points Av1at1on d1stnbutors approval No 1-04 has bee,, 1------------------1

granted by Transport Canada

1) To the best of our knowledge, the matenal or part(s) were __ or were not~ subJect to

conditions of extreme stress, heat or environment (check one)

(1 e maJor engine/aircraft failure, accident, fire or warehouse fire) / 2) To the best of our knowledge, the matenal or parts(s) were __ or wer~ obtained from

the US Government or m1htary services ( check one) ,.,':I'? A \

~ ! 9 ' --~ ~~:i----- ~/

Authorized Signature.

Form created with Quantum Control(tm) technology Product Licensed to 3 Points Av1at,on

3 PTS PACKING SLIP ISSUE 29 MAY 2014


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