72
ULLETIN COMPLIANCE RECORD ALTIMETER & STATIC SYSTEM CHECKS F.A. R. 91 .170 AUTHORIZED SIGNATURE CERTIFICATE NO.
ULLETIN COMPLIANCE RECORD ALTIMETER & STATIC SYSTEM CHECKSF.A. R. 91 .170
AUTHORIZED SIGNATURECERTIFICATE NO.
MANUFACTURER
ALTIMETER & STATIC SYSTEM CHECKSF.A. R. 91 .170
CHATTANooGA AERo sElutcE'lnc.
APPROVED BY:ACENCY CERT N(I t0tAt
ilMtr rfl rll^rlilrI
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l*n'7 )'2AT + 15'cI€sr Irr <nl I
INDTT'B{cs-TESr t
Pr (rt) I 25.ooo t\
mm 10,fi)oo0
l0,m JtA 35,0myxt //[I ,rc,00OI-) L2,000
r{.moJmo {5,lno
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zloo l' 15,000
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60,fit03000 r l('
7!.mo Tt000
20,000
!.,ffi m.(m5m0 ^)7- Q'4
;TEM CHECKS) RADIO & ELECTRONIC CHECKS
MAINTENANCE RELEASE
The aircraft, airframe, aircraft engine, propetter,orapptiance identified above was repaired and inspected inaccordance Hith current Regutations of the FederaIAviation Administration and is approved for return toservice. Pertinent detaits of the repair are on fite at
a/
Attantic Aero, Inc. FAA
IYPI OT i FRROR OR i NEXT CHECKCHI'CK I RI SULTS I DUL
EQUIPMENICHECKED
TFrr'l onfn,^,7- ATC TIi) arun r.\
RADIO ELECTRONIC CHECKS
)Nlc CHECKS
MAINTENANCE RECORDF.A.R.43.9
loRrrs
Fexr cHrcrDUE \cn,
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------- ACENCY & CERTIFICATE NO.wonx pinFonMED/RETURNED To !il':J-o'i8i*'"'"gf B[I^=.[jPBE--- ciEcKEP BY:
srcNniunr - cERl' No'Efc-" Qt' F, t^: I
tt'*'Ftt;f'/ u''ntf - Ev
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INSPECTION RECORDF.A.R. 43.11 - 91.217
DATE STATUS & PANCY LISTSIGNATURE - CERT. NO. OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
7 4- rcraft And
tssued A ST4il DftP,DAirworthiness
ANCE RECORD\.R.43.9VORK PERFORMEDD DATA USED
Certificate. DatedTu ll 10, /18?
For B€ECH
^"/N--
APPFiI-)Vt.D iiLF-'/ii ll Sl-A.IlON 1l' 4"43
Irt J7-e)s-
AGENCY & CERTIFICATE NO'WORK PERFORMED/RETURNED TO
e
DATE AtR( ilAl I
tN \t lt\
/Utrt',lg
TECORD- 91.217rr.r srnius & DIscREPANcY LlsrAPPROVINGOR DISSAPPROVING AIRCRAFT FOR SERVICE
t' -[o
taIJ S ERVICE
# 4?t43
DATE
INSPECTION RECORDF.A. R. 43.11 - 91 .217
KIND OF TION - STATUS & DISCREPANCY LISISIGNATURE _ CERT, NO. OF PERSONAPPROVINGOR DISSAPPROVING AIRCRAFT FOR SERVICE
-xlk
AIRCRAFT TIMEIN SERVICE
o
TOTAT'II.ME IN SERVICE
INSPECTED. lN ACCORDANCE WITH AlNSpEcrroN Al!D, wAS o-ereRM[{Eo Tq B.E lN
AIR SERVICE, II,IC.APPROVED REPAIR STAIIUN #
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DATE
INSPECTION RECORDF.A. R. 43.11 - 91 .217
rION. STATUS & PANCY LISTSIGNATURE _ CERT. NO. OF PERSON APPROVINC OR DISSAPPROVING AIRCRAFT FOR SERVICE
[i:lC:c33, TCn:r?ssee 3742t
- ,- 4.- - n\/
y that this airciaft has been inspected inaccorcoa,ce
i-
/,-/,:I
r/ --r,^12t
()1r. y', '-
ln /1
condition.
-r-Z or *r Pr =',-\r"u5tt$Yl;:ffi
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"i .?uL1$J:'"ul"H i: "'iig
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lgtouz^N'oNrlvSll|IHSS 'v'v'l
:peu6tg
:Aq Palneqro^o4-02
Replacedby RS#N\fuse ass,
ffi i; tt NVf '",fpaqstlduoccv ullallng ectrrd;
om!tmt!F
,rrl:oulFN
:l lrl(l
N/ti
ON O/M
AIRCRAFT TIMEIN SERVICE
c*b)a l.
ION RECORD:t.11 - 9-t.217sli-<lrriru.sii.,,)r'r ( il()N STAT|S s;:;;;--
t{ \t tt\ tt It{\_ N IR(.RAFT TIMEIN SERVICE
INSPECTION RECORDF.A.R. 43.11 -91.217
\tOCr
4-02-() I l'J I ', /lt'l
lir'lrlaced allcrn,rlrrr ,,rrllr I ll, I lll,y l?S#NV2llO4',1, ,,r r I tt'r'rl ,rr,l,,lrt:;r'assembly ot r ,rrr l' trrtrrrl I r,
aeg # Nt1 /< ,
nspect
, .,, },,-:: Total timc ,'/ , i' ),
,e |,l llrr. lrrrl,e, t,,,,r ,,., ,,t., r,,, I ,'.1, I
l*, €rl rt,,,E I
lr
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conditi!nll.rl,I"'
t,
A/C Total I rrx. 'lq l I
Sisned 7, 1/ /-,At lirttf tr A' r ",
t 3712t
INSPECTION RECORDF. A. R. 43.11 - 91 .217
IAIRCRAFT TIME I KIND OF INSPECTION .. STATUS & DISCREPANCY LISTI ,ri uArb I rN seRvtcr I sTcNATURE - CERT. No. oF pERsoN AppRovtNG oR DrssAppRovrNc AIRcRAFT FoR sERVtcE
l/,
( lat
r rl
trl
i{|'rI'-
AIRCRAFT TIMEIN SERVICE
''i/',:rt y i f t" t- l',,rr l'fe,
( > > Ir,r, I
FAA t.;pair Station DX4R144Mcerti
quired by F.A.R and ras determined to be airuorthy
TECORD- 91.217rrl-- sraiu-s a orscnePANcY LlsrnppnoVrn-c on DtssAPPRovlNG AIRCRAFT FoR sERVlcE
I
'air Station DX4Rl/t4Mrrti
'1.
DATE
INSPECTION RECORDF. A. R. 43 .11 - 91 .217
AIRC'I nlro z o1/u1 / 9+ TACI{: 5+4.6 AFTT : 5++.6 i'erf ormedthis a/c 1n A/lV Beech service manual.annual inspr:ction on
Okd all ccntrols for proper rigging and iubd, ckd allcables for prop.r tension, ckd all struct. pointsr inspdalI hos-s, I j-nes, & wi-ring. Repacked all- wheel bearings,ckci tires, whee ls & brakcs f,or condition. Llkd and servlcedall fluid Ievels. Ckd SBs & Alls for compliance to date'Replaced propuLLcr spinner builkhead PN )5258 due tocracks new I,N lJ554U. Ilepla.ced propelLer Orring sgal PN
reinstallation. Replaced tail strobeA1611-1 during propflash tube assy -L'NPN lvjs29511-',5'J8. ALLmanual- ancl standardreturn this a/c totr'AA CriS.AD 93-2+-01
94-O1 -O3has bernG r-v*r'- (
to be in
A506. Replaced fue I cerp outside o rrinllswork periorrned in;\/'uv ]leech servict:pr:actice as listed in l"l\lt part 45 to
service. Ref er to ''tlOl/ '5'515 on f j- l ': thir;
Tqh t t
ry F.A.R and was dcbrmined to be airworthY
N/A due toNy'R due toinstal led.
airfrarne timesecluip. Slick mags
)
lrlr/\,rv.",t llly t t)rlrlrll();1.
It;rtt: +' 'l " ' I't '(
llrlr lrtrrlr / t r
N tr7erINSPECTION RECORDF.A.R. 43.11 -91.217
KINDOF INSPECTION STATUS& DISCREPANCY LISTSICNATURL _ CERT, NO. OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
/ "ber?
6-4,lC
*l;
lc'/2. ,1,u4q-/ - U
d o clos ttt Ur' ,L z 5-,
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at+, -+4Ac 5'o',l- o r{uu t t,t,t N,i,,,{s**rr-- Taya'lt
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:ORD.217\TUS & DISCREPANCY LIST)VINCOR DISSAPPROVINC AIRCRAFT FOR SERVICE
yt4eI z.afeo/t
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Fe {?g'ttre r'4
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lca'
INSPECTION RECORDr F.A.R.43.11 -91.217
KIND OF INSPECTION . STATUS & DISCREPANCY LISTSICNATURE _ CERT. NO OF PERSON APPROVINC OR DISSAPPROVING AIRCRAFT FOR SERVICE
AIRCRAFT TIMEIN SERVICE
t40, gl.z €q,z *2.-a:ret q-f €i lhn-s V"t'( 7 F,'l/cas
ue/{,)Hotn 4 fet nf soQ
'ok 7c..r'ectt eh5 (e ,4O z:0rta<o[a't,'c- *)01", vd ,r/. ? rzylq rlr,Lw,< i
)**^u4 ( *li(,L tf -rn /^ '8A z{77rr $alv wnrraa(,\t g(f, ja ad tc/nos ea ok ot.
I certify that rhis ATRCRAFT/ENGtNE,rrcPvwr€u ilI ll
ffi/AN ANNUALto b. ln airworthy condition
,trtoq . oal*.f,h, *, ( rto/,
INSPECTION RECORD. F.A.R. 43.11 -91.217DArF IAIRCRAFT TIME I klND oF lNsPEcrtoN .. srATUs & DtscREpANcy LtsT! \r I lN SERVICE I SICNATURL - cERr. NO. OF PERSON APPROVINC OR DtssAppROVtNG A|RCRAFT FOR sERVtcE
" r.1-"1i
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ltr/itppircers Fi!t:, $i. Y' i?irFFiA {'er? ', tN 3{'3^:
burlc$rlnd!f tlndds and lound boclj-f wifr FAR43. AooondrF
*X0lrurspondff*l rnd<e /nnd l_ltrt ggftE
INSPECTION RECORDF.A.R. 43.11 -91.217
& DISCREPANCY LISTOR DISSAPPROVING AIRCRAFT FOR SERVICE
l1 hPtL, (4/L
5t4)
B
'A
drlc.,lfimc
Florr';k. lA1g6a222
,tto b"t( fl-"llrztl ' -1-(+e(/-
,ca/ n4)(.14( E,ts
a(rac . s//,He Gore(*Lv'
r L tat' /{4,4 .7 ilz
D,;4
l1 hp^t L 70 | ccrtify that rhisinspccted in accordancc with
ALTIME ENGI
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ORD217,TUS & DISCREPANCY LISTVINGOR DISSAPPROVING AIRCRAFT FOR SERVICE
t rrrv 411 tr4t,a// /ana t i
oa,h a/tL/"qft
"20n-*(g T,i
I ccrtity that thlsin accordancc with
:ermincd to bc lnddc.,
! _-
INSPECTION RECORDF.A. R. 43.11 - 91 .217
+r\
DATE
t{tuMGarLra
d
AIRCRAFT T]MEIN SERVICE
KIND OF INSPECTION - STATUS & DISCREPANCY LISTSICNATURE J CERT. NO. OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
,ily'tAs €atoftlA,
Fnng z"tlnrl[t'a bf sttaft o^t
T fotl.,lo '(fi a 719 L,c{0
Flor.-rt. )A 196a222
N IRCRAFT TIMEIN SERVICE
INSPECTION RECORDF.A. R. 43.11 - 91 .217
KIND OF INSPECTION STATUS & DISCREPANCY LISTSICNATURE _ CERT. NO OF PERSON APPROVINCOR DISSAPPROVINC AIRCRAFT FOR SERVICE
__-_
\r,
iTgrt o'i?4(/1
,ltr-j-t'g,4x'Y5r Alonlcr tn'| , (x)4Rttril(
INSPECTION RECORDF. A. R. 43.11 - 91 .217
DArE lo'l*'!A[J,l'I'KIND OF INSPECTION STAIUS & DISCREPANCY LIST
SIGNATURE _ CERT, NO. OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
,2,,,(
Zo lp? ?7
5/
is
oi-f,,Zz
-----v,t I,f
Z
,','r11'r, t/// il
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a'l I ..9..,t" r,,y'tst,..2
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Its 47ttl? L4,t ltl
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a
AI
:ORD.217\TUS & DISCREPANCY LISTIVINCOR DISSAPPROVING AIRCRAFT FOR SERVICE
,h-f,,zz
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76. oI.t
2z-z-
I
INSPECTION RECORDF.A.R. 43.11 -91.217
DATE KIND OF INSPECTION. STATUS & DISCREPANCY LISTSICNATURE - CERT. NO, OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
lo{ry;auo/
, e41
Yt
AIRCRAFT TIMEIN SERVICE
5z fl* ,t,,Lgnoroe k 2ztlatza()z- upt-.zr{ { /&$t
>1raaa-t-S .
e"(42 E?a
-/,/- r /z-
INSPECTION RECORDF.A. R. 43.11 - 91 .217
AIRCRAFT TIMEIN SERVICE
KIND OF INSPECTION STATUS & DISCREPANCY LISTDATE SIGNATURE - CERT. NO. OF PERSON APPROVINC OR DISSAPPROVINC AIRCRAFT FOR SERVICE
I certify that
vna,? to be in airworthy condition
A
h'l rlJ, App?t()?rh hFl
lrqrrorrln-lY|fiitlrprhmr /t ortlbJ br7lrrl ll, A;t?lnhtr lotr
AP'NOVGrptrry I(
DI
*-n:lTiJ-?""'*l^,-.*I certify that thi
lrnrlneO to be in airworthy condition
INSPECTION RECORD
. oF PERSON OT"*ou,*.
ilFnT !f,o!
Dolo 2/4!'ryi,gi:ffi*;ml;:l-lT, HilJ*onJ lo"na oi'*"at'r'
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I
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PANCY LISTR DISSAPPROVING AIRCRAFT FOR SERVICE
'aect r42
( //ara o4oe*
9 /zl -dYA L// E7-? 3Z-
'rft12
fia>. cZ"4| 17't 4q2 7 761
INSPECTION RECORDF.A. R. 43.1 1 - 91 .217
l'.1 iw't-Y
i\|
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,,, \ \r:"-
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KIND OF INSPECTION . STATUS & DISCREPANCY LISISIGNATURE _ CERT. NO. OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
lnspection, and was
g^,.t ?tt^al 0ftotat Time 7Slgned
- 1Z 60 sx-
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lr
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4"4Z.oA.
ORD217,TUS & lff#t""t' lT
^rRcRAFr FoR SERVrcEvtNc oR
INSPECTION RECORDF.A. R. 43.1 1 - 91 .217
ffi&DlscREPANCYLlsrsrcNAruRE - cERr. uo. or'iiis."oi'r-n'pPti"Vtr.lcbR' DtssAPPRoAIRCRAFT TIME
IN SERVICE
,41 iC -t1' i,r /cc,
3
IN
FAA
av Pu<r
go:f gTJ:S'kffi";lH;"o"n dato
:3s'J:*ni;ffi1ff ii ffijEd'","d
INSPECTION RECORDF . A. R. 43 .11 - 91 .217
KIND OF INSPECTION STATUS &_ CERT. NO. OF PERSON APPROVINC OR DISSAPPROVINC AIRCRAFT FOR SERVICE
so I AcrullL-- 1"ryi. IALTMETERACTUALALTIMETER
FEADING
RDt75 & DISCREPANCY LISTCOR DISSAPPROVING AIRCRAFT FOR SERVICE
Date Zl?l l9z
INSPECTION RECORDF.A.R. 43.11 - 91.217
KIND OF INSPECTION - STATUS & DISCREPANCY LISTSTGNATURE _ CERT. NO. OF PERSON APPROVINC OR DISSAPPROVING AIRCRAFT FOR SERVICE
AIRCRAFT TIMEIN SERVICE
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INSPECTION RECORDF.A.R. 43.11 -91.217
TION - STATUS & DISCREPANCY LISTSIGNATURE - CERT. NO. OF PERSON APPROVINC OR DISSAPPROVING AIRCRAFT FOR SERVICE
ORD217r IJS & DISCREPANCY LISTVIN(; OR DISSAPPROVINC AIRCRAFT FOR SERVICE
Jar I
HANSEATISCHELUFTWERFT GMBH
2800 Bremen-Flughafen, Halle ELuftfahrttechn Betr -Nr l-A 37FAA-Fepairsraion Nr .181 - F
' : aC 66 Telefon (C4 2', t 1: 2C 93 - 5 rebx 2 44 535
Destgnatc" .72 z"z"'> ' '' *'? v, ), " -i ;-.- .>pari No: ii -.].j /lVanufaciu rer / Supplier
Manufact Date -3CShelf Lrfe o c- :' - -= :XC
Dare c'De '.
t!^^. . -tui \ TSO I_SNa--^. -1tg : -:
RCi-- ^::=--lnsoecl--
WORK PERFORMEDlnspecteo I rr:-= lOverhauled I '.'-l'-:Remarks
Work Order: LQrCERTIFICATE OF APPROVALThe work specified above has been carried out in accordance withcurrent regulations of the LBA/FAA ltem is approved for return toservice Pertinent details are on file,
H?n O
.',,) '/ -/.,1''t.. t-,(Date) (Slgnaturd of author. lnspector)
HeDarred L--l
Other L-l
l|| .ir T t .3 :r- T.Vla_-
!r-l':. Iv!
.q,,Ld, ry constjtute a uth oritf,f_fr1u_frfi];
[:],,li,ffit"DAirworrhino-- ^.--' ydifferen*han rh6 n;_.. ..the country tr rness
certifi.ali^^ rarts/
"rcr/rnsta,le y difterenthanrh. n;_... ..the country tr Inesi
- \-,,,'ue wrrn the nr.. certification. rartstnonal regulation
rt an
.,,c uountry
' ...,, ,ue wrr4 the r^., certification.ranona, regu,atjon
ll I tlltHt , rrllilltllli tllr lt it I
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1 UNITED STATES ,. FAA FORM 8130-3AIRWORTHINESS APPROVAL TAG
U.S. Department ol Transportation. Federal Aviation Administration
3 SVstem Trackrnq Flel No
I OrQiln zat onBlccS AIBCRAFT lNC. - BT.3 BOX 86, WELLSTON, OK 74881 - PHONE:405-2s8-2965. FAX: 405-258-3016
5 Work Order Conlracl or nvorce No
\t .o .11227 5; lr, n, 17. D, scilul,oil 18. Pa'l Numbe. | 9. I lgrbrl'ly' 110 OJart lyl11. Saral'Barr.l' Nurbe l2 Slalus/Work
t lRrcHr ELEVAToR 133-610000-612 I vnnrous I r lsu-zzts-t OVERHAULED13 I],NAK.THE COMPONENT IDENTIFIED ABOVE WAS REPAIRED AND INSPECTED IN
ACCORDANCE WITH CURRENT FEDEML AVIATION REGULATIONS AND IS APPROVED FORRETURN TO SERVICE. AD 89-05-02 N/A HAS ALUMINI]M FITTING. ROUGH BALANCED WITHSHOP TAB AND ROD. NO PAINT. NO STATIC WICKS. UNDERBALANCED AT 4.2 TO BEREBALANCED BEFORE INSTALLATION AND AFTER PAINT. REPLACED SKIN.rDted ltle parls musl be accompanted by matnlenance hElory tncludtng lolal ltme/lola ycles/lme stnce new
14 I New i Newly Overhauleda,,idrlri5 lhal ll)c new or newly overhauled pad(s) denlrlred above excepl as olherwrse specilied rn block I 3rrri(wrrc) nnfula(!!rcd nilccordarrcewlhFAAapproveddesrqndalaandaiBodhrnessNo fE: lf ( nse ol pads lo he erponed lhe specr:l requremenls ol lhe rmpodrnq counlry have been mel
19 Flelurn to Service in Accordance with FAR 43 ICedrlres lhal lhe work specilr€d n bkrk 1 3 lor rlhche.l) ahove was carred o!l n ac$rdrfce w lh FaAarMonhinessrequlalronsandrnrespecllolhewol{peiomcdlhepad(s) s(are)approvedlorrelLrtrr o
15 c l1d,ild I 16 tsAAAulhotrzal,Oa NO "'nn'#AecL tr\)< I ,i*$'[?;il'#"?
7 \.ilnn, , r'oprJ o, P ,rled) | 18. DatF 22. Name (ryped or Pr nted) GLEN A BiGiS ln o""3l3I l03
!\
(-
4l
DATE AIRCRAFT IIMEIN SERVICE
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'2 c,tJ -v 6 <6?
3Gron Adminislralion
8-2965' FAX: 405-258-30.1 6
IRED AND ]NSPECTED IN]LATIONS AND IS APPROVED FORII]M FITTING. ROUGH BALANCED W]THUNDERBALANCED AT 4.2 . TO BE
{T. REPLACED SKIN.
in Accordance with
^,r. \pp r'r" i il' oL h 1 r' r "lr. nFo' rr' va'' arr'pd' rl tr' "1' r ld' " ^'rl' F^A
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3 SVStem Track ng Flel No
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BLT_227 5_I
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INSPECTION RECORDF. A. R. 43.11 - 91 .217
DATE
a ou'-x (' -<(rP
AIRCRAFT TIMEIN SERVICE
KINDOF INSPECTION SIATUS& DISCREPANCYLISTSICNATURE _ CERT. NO OF PERSON APPROVING OR DISSAPPROVING AIRCRAFT FOR SERVICE
5.t l-+/l F 7 / /'/'t-t-- L
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ORD217TUS & DISCREPANCY LIST/INC OR DISSAPPROVINC AIRCRAFT FOR SERVICE
)rn and Auiomaticrequired by
cc g/ FI
lo conpiy
FOR:
Transport CanadaATITIIORIZED RELEASE CERTIFICATE
TCCI lJrn7E(YYM\1DD-X NN)
r Attntrrd nBrtrlrrl'n .rhr rid rildr(t,lINSIGHT INSTRUMENTS CORPORAIION599 INDUSTRIAL DRIVEFORT ERIE. ONTARIO CANAOA, L2A 5M1
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-----: -
INSPECTION RECORDF. A. R. 43.11 - 91 .217
,nNi i r rsrSICNATURE - CERT NO. OF PERSON APPROVI I'l'tl()vtN(' n lll( ll^t I I ()ll \l ll\ ll I
iJi-T,r l')'tr -)
!.207 reoulrements for:.iFll5 AlFi:Fl.Fjfirl0v,r'IRPLANT WAS lNSl)l ( ' ll l'
morc of iis battery usoful timehr crrrosicn anC
t5ti3 cl ccilit;ic ano ctasil senrcr cf :'-if;lcicnt signel radiatort
JiITH ATLA|{TIC AIi], INC.
Ss'otE edilRffit* FAA
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-aius * DTscREPANCY LtsrOVINGOR DISSAPPROVING AIRCRAFT FOR SERVICE
; v a,/,lo *-
HIS'.IRCRAFT/POVCERPLANT WAS INSPECTED
{siEcTtoi.t r"t'.tD wA$ cETERMit'lED To
{AREPAIF
System and Automatic Pressure
FAR 43, Appendix
91.4'13 u/ere Performoq this
franspcnCcr No. 2: Mcclcl iic. '- --
SiN '---AUTHORIZED STGNATURET A'''
rt<rf,n-t@Lr I rv}J!"r \?
\Alesl Si:i -' Llevorly Airport
f)anvers, Massachusotts, 01 923
CompanyTail#ComponentModel #Serial # (MakePart #LocationGomments
N rl-7oT-
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7 ao l,fz.f zt lo't-
Next DueCert #
1r;iii
776, 7/ i"/raz 7
t€S pFAEf.frnS ._i^cqrJry]Gt*TlO,r SfiTOiES
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FILTER ASS€TNELIES htTTEOPR€\E GT56g1NEoPRENE GASKET/ J'q e,p*AfZ cL ! t -Method of Gompllencc '-'1 ' "/ " ' ' '/ .z /rrrSfrrwgrHrutlrrrarrS / -- . --SBr - ' Data ?j*a2: b=ir --/'-';
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GompanyManufacturer BEECH AIRCRAFT CORP.ModelTail#Serial#Tach TimeTotal TimeA/C Cert. Date
F334N r r'7 oT'cEt!6f?4f' q7 4?'4 17,22'o t rytba4 /-[/'r1 ok
91-1 7 -01 lt,tzstslMethod of ComplianceSB#Signature
{r/ -07- tLHLEVr,TRiM.,:,TAB'..ACTUATORSI,"',.,",'.:i :: '
p,.,q sr? (zg w4 ? - 3 .12Date Next DueCert. #
91-18-19 lwzlrslMethod of ComplianceSB#Signature
FlESf,',SblOUtDER: HARNESSES;[,,: ;:' 1:,' ::::,:' :;'' : :;: ::::1:;:,
P,c.tt/, ret Lo5 Bdk q't(cllDate Nerct DueCert. #
91-20-08 rsisl€rMethod of ComplianceSB#Signature
FRESH,,A|R BIO Gf ,
PJ tr', are /. zDue
Cert. #
93-03-02 ffiffzresMethod of ComplianceSB#Signature
LORAN RECEIVER SYSTEMIrl /k KL^4 - ?3 r{oTDateCert. #
3:n9r1c//ezNeX Due
*g$.-24"0,t : : ollai/g4 FORWARF, RUDFER spAR/
Method of Compliance ry /e llauezez, tSB # Pqig rarSisnature 64VA?4{, Cert. #
,
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Method of Compliance
7
4tre.
WING FRONT SPAR INSPECTPfW
SB#Signature
,t /e 4)cueuez ) -F4t/a&e t*/€4bate br,r./ffNext Due
*-( cert' # Bl7r7a92zz.-97-14-15 oetoz/ez cABtN-stDE DooR
Method of ComplianceSB#Signature
f Compliance oyed#, b *neC
ry86-*t" lndicates Possrb/e Recuning lnspections TData Corporation
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INSTALLED EQUIPMENTITEM
ENGINE
ENGINE
PROPELTER
PROPELTER
ENGINE
ENGINE
PROPELLER
PROPETTE R
ENGINE
ENGINT
PROPE tLE R
PROPETLER
ENGINT
ENGINE
PROPETLE R
PROPELLER
MANUFACTURER'Ntt,tql. Ahil
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DATI
l. Removed #l Bendix/ICng KX-155 Nav/Comm, KR-87 ADF with indicator, KLN-90B with MSIAnnunciator switching unit and data loaderjack.
Installed Garmin GNS-530 GPSA.Iav/Comm, GDL-69A )04 Receiver and GTX-330 transponder in \l
accordance with manuf,acturer's ingallation manuals. STC's and AC43.l3-lB and 2A.
Accomplished altitude correspondence test in accordance with FAR 43 Appendix E, Paragraph ( c ).
Accomplishd pitot static leak test.
Accomplished ground test on all avionics and electrical systems and found no interference with new orexisting equiprnent.
Revised weight and balance and equipment list. For further details refer to FAA Form 337 filed with theaircraft rwords.
1
3.
4,
5.
6
SIGNATURE
North Atlantic Air, Inc.FAA Approved Repair StationNo. C85R585N
MAJ OR ALTERATIONSREGISTRATION SERIAL WORK ORDER TOTAL HOURS DATE
Nl5707 cE-1365 232474 1318.6 2/13lo7
With respect to the work performed, the aircraftidentified above is approled for retum to servile.Work order N o.'> j5,.t1 ff Darc: 2-- i \ u-7
APPKUVEU b I:AGENCY CERT. NO.
TIN COMPLIANCE RECORD
Y('LKn u r n o n r z ru r n o n r z r o s I c N A T U R E
CERTIFICATE NO.
ALTIMETER & STATIC SYSTEM CHECKSF.A.R. 91.411
-1:
+:
-!
ALTIMETER & STATIC SYSTEM CHECKSF.A.R. 91.411
OVED BY:ACENCY CERT. NO.
,<-*r
*t
RECHECKREQUIREDSERIAL NOMANUFACTURER
FAR 91.41i
RADIO & ELECTRONIC CHECKSBY:
AGENCY CERT. NO.
end
M CHECKS
\X AtI
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eof
nclione
CHECKED BY:SIGNATURE _ CERT. NO.
Fl
)
t
I
F
Altimeter and Static System TestI certifl'that the Altimeler and static Sletem tests and inspections, as requircdB-'- FAR 91.41 L In accorpance *'itb FAR 43, appendix E have bcen pertbrmed-Par- (a) Slatic Systcm ./Pllol "J j-r.., 1-3c::,, /';5,1 tested lo l, Kco-ptrr:rT-rcned6fi-.Par. (c) Integrared SS,stcm Ten
Rhoades Air Center, lnc.4770 Ra1'Boll Blvd. Columbus IN. 47203(8t2) 372-tEt9
rl
Transponder TestATC Transponder Tests and Inspections, as required b1' F.AR 91.413 in.Accordance u'ith FAR 43- appendix F- have been performed.
Sctial# 'i:lt Z-t 3t;Sentl# 6, t 3l'/
Work Order * I /J'1 Signarure
FAA Ccniticate # CRSJRAR33SFRhoades -Air Center. lnc.. 4'170 Ral' Iloll Blr d. Columbus IN. 47?03(8t2) 372-r819
RADIO & ELECTRONIC CHECKSEQUIPMENTCHECKEDi:: DATE ERROR OR
RESULTSXT CHECK
DUE
Reg. No: 46lJfTachHobbs: i'l'43-9\ltork Order: 9??
CHECKED BY:SIGNATURE _ CERT. NO,
Eagle Afionics, LLCd -:rJ,lrdr.erru SrColsrSu,r, lN{ -J0J/fJ.i) J.?.t--tI-00c E_s. 8E4F9/9S
A,C lr,take- 6c-<c hIr'IodeL FSiA$edal No: (.6 - l3f,t
I I Altirneter l\'Iodel:=l Altimeter i\'Iodel:
$eriel: int,'L,$eriel:
al Encoder N'fodtl; Serial: iqq').itl Encoder ltfodel: C Sedel:el TranqponderilIodel:al TransponderNlodel i(il 16y' Serial: A't 3 t+
I certi$ thst the altimeter, static, andaltitude reporting equipment s1'stem terts ardinspectiorrs t*quired b1' 14 CFR sE9l.+ t I heve beanpetformed and found to cmrrpll. *ith
cFR $434E and Fto Z 0 <FT,Date: !{ -l ? :.1'1
EsEh .4r'iooks.LLC C-RS. BEAS!I9E.
I ceni$ thatthe tests end inspections required by 14 CFR 5s9 1.413 1ran'.been perfonnEd end rriththc limits set in 14 CFn lUi Appendix F.Date: "l'l r7*Sisrerure: Ergle Alinrnics, E t"C C.R.S. $E.tF9:98.
RADIO & ELECTRONIC CHECKSDATE
CHECKED BY:SICNATURE _ CERT.
FRROR OR i Hexr cnecx
Altimeler Correction CardUUT ERR REF UUT
Rloadcs Air Ccntel lnc. 4770 Ral Botl Blvd. Columbus IN. 47103(81?) 372-1819
Signaturc
U9cIJJ;6zYllJ ^iEL:)i.. u_fi<vOoug>29CzolJ4U
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MAINTENANCE RECORDF.A. R. 43.9
ACENCY & CERTIFICATE NO.WORK PERFORMED/RETURNED TO AIRCRAFT TIM
tN SERVtctDATE OFCOMPLETION
'l' L"
ORDER
cBsR585N
:(
. (,*.-l
+-+-
LI
Thls ELT hn:r hao/ rrrqul
DESCRIPTION OF WORK PERFORMEDOR APPROVED DATA USED
,5 /.,ry /J.>1, ,fTL>L t J') t,'t?- c"r'-ttt'
cf c9nl:cli and crash sen8ot
/\,IAtNTENANCE RECORDF.A.R.43.9ECORD
, "*n(
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COBDANCE WITH
ORTHY
.t /eA;) oL
Hnc.tlcvacEnrtrrt;..--t"--..*' o* * iiE ili,
"E o,?j:Y * *ge4 DATE OF ACENCY & CERTIFICATE NO.
WORK PERFORMED/RETURNED TO SERVICEill)
,lu)L{
onoea #izJJ-TEPAIR STATION . c8sR585N
-
DESCRIPTION OF WORK PERFORMEDOR APPROVEDDATA USED
i/=/7 /L//J (,1t) 0,F-/,t:/
.50% cr noro c{ ii;
.Baileny' f:i coil-c5ion
Aoc€
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"E iqEe v)
5(J €cg :- 0)>,!au'-LoOl=It.F -E ileE {lh.<ln :
DESCRIPTION OF WORK PERFORMEDOR APPROVED DATA USED AIRCRAFT TIME
IN SERVICE
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r.A.K.4J.9DATE OF
COMPLETIONAGENCY&CERTIFI(NII N0
WORK PERFORMED/RETURNLD IO SEDATE OF
COMPLETION
5lza
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1,901 t
rifva 0hll rrrtIrrr duorilt1 rnsh
ia-tERrtrtcare No iD/RETURNED TO
MAINTENANCE RECORDF.A. R, 43.9
DATE OFCOMPLETION ACENCY & CERTIFICATE NO.
WORK PERFORMED/RETURNED TO SERVIC
(nErd4A
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AIRCRAFT TIMEIN SERVICE
DESCRIPTION OF WORK PERFORMEDOR APPROVEDDATA USED
ror cgnosio-n,and .T,PP:*P ilisiucrnor,r
FAAREPAIR STATIoN No. CB5B585N
MAINTENANCE RECORDF.A.R.43.9
DATE OFCOMPLETION
ACENCY & CERIIFICATE NO.WORK PERFORMED/RETURNED TO SE DATE OF
COMPLETI0
2taltlz
RECORDt.9ORMEDED
ACENCY & CERTIFICATE NO.WORK PERFORMED/RETURNED TO SE
MAINTENANCE RECORDF.A.R.43.9
DATE OFCOMPLETION AGENCY & CERTIFICATE NO.
WORK PERFORMED/RETURNED TO
Aircraft LogbookBonanza F33ATach: 1537.3 hrs.
April 10,2012S/N: CE-1365 N15707
Total Time: 1537.3 hrs.
I
cleaned & repacked wheel bearings. Lubricated hinges, controrpulleys, bellcranks and landing gear linkage. Conducted gearretraction & extension test (including manual emergency extension)- satisfactorily. complied with FAR 91 .2o7 D 1-4 ELT inspection -satisfactory. ELT battery due 6114. Complied with AD's (seeseparate AD compliance Report). serviced battery and installed"pigtail leads" for charger/maintainer.
I I certify that this aircraft has been inspected in accordance with anannual inspection per the Beechcraft service Manual and FAR 43Appendix "D" and was determined to be in an ainryorthy condition.
t A&P 2126136 tA
l=
AIRCRAFT TIMEIN SERVICE
DESCRIPTION OF WORK PERFORMEDOR APPROVED DATA USED'
GAA REFAIR STATION hIO. (n5fi585f{
DATE OFCOMPLETION
MAINTENANCE RECORDF.A.R.43.9
ACENCY & CERTIFICATE NO.WORK PERFORMED/RETURNED TO SER
EaeleAvionics. LLC C.RS 8EAR979B
N#: I 5707 Make:REECH Model: F33A S/N: CFI-|355 Aircraft Tinre: 1612.80
R&R KG l02A s/n 29559 DG overhauled by Central Florida Avionics & Instruments LLC. See8130-3 WIO 12205-3 datedS-2-L2. Ops check good.
l.lle aircrafl, airframe, or appliance identified above was repaired, and inspected in accordance wilh currenl Regulationsolthe Federal Aviation Agency and is approved for rehrnr to scrvice Pertinent details of the work accomplished are onfilo at this Repair Station under
W O. No : 50-l Dale:0811112012
ll r
t)Al( ()Ml'l
Rev Orig 2/10/12
liF ':,r - ---
ENANCE REC-OR5F.A.II.43.9
! OF WORK PERFORMEI)IHOVI D DATA I,SFT) ACtN(YnttilillltwoRK PERF()fiMt trlltl ll
nics. LLC C.RS 8EAR979B
/\,lotlcl; l;.ilA SrN: CE-l365 Aircrall Iirrrc
lcd b-y Ccntral Florida Avionics & Instrumcnts Lt,(, Sr.r,s chcck good.
END
MAINTENANCE RECORDF.A. R. 43.9
I
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)r rctunr 1o scrvice. Pertinent details ofthe work acoonrplishorl nr,, ,,rr
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DESCRIPTION OF WORK PERFORMEDOR APPROVED DATA USED
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ORD MAINTENANCE RECORDF.A. R. 43.9
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Approvlng Natlonal {vlatlorrAuthorlty/Country:
FAA/Unitcrl Slrrles
zatlon Name and Addrorr:
Descrlptlon:
Kll'- l'llllsll All{BI,OW
FAA ProductionCertificate No.8
19. E 14CFR43.9 R€turntoServlce I Othcr regulatlon spe<lfled In Block 13
u I ll(,ll)lllty: *
N/A
| '/\1,: I :;AlRWOtt il ilNr
14. Certlfles the ltems ldentlfled above were manulolltalh
Approved dcstgn data and are ln a <onrlltlsn hl lrfNon-approved deslgn data spcclfled ltr [hlll I I
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lllfi,iltIt',cl_llllr rr','l/tl
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It ls lmportantto understand that thorxlrlorrr r rrl thh tllrtr*., r rr
Where the user/installcr pcrlbrrrrs wrrrlt lrr rlltrlrll rrllh tlrspecificd in Block l.it iscsscrrlirrl lhll lhl tnl llrtrllrr rlrlr. r, r
courttry spccilicd in llkrck l.\accordlttcc wilh lhc tt:tliort:tl rtgrrlnllortr lrt lhr m.r r lrrrtrll, r I r ,r ,r, , , rlt rrr,rr lrr llonrr
AUTHOIII'I I) RELEASE CERTIFICATEf rl t,',, nt r(] r, ATRWORTHINESSAPPROVALTAG
j/b*o llr'fl 1{ rt ' I r'r', 111 r, tlt Corporation 9709 E.vr, lrtl, r KS 67201
fl I llc{*
ttr {lfil r .'
,'r AlrlrF,
22. Name (Typed or Prlnt€d)l
I lror /lrrrl nller Responsibilities,,r rl,'r. r,,l trulr,rrnll(rlly(onstltuteauthorltytolnstallthepart/component/assembly,,l r ';,rrl,rtl,rrrt ,'l ,rr trir rror lhirrrss nulhority dill'crcnt than thc airworthiness authority ofthe countryr 1,",,t,,r'rtlrlrrrrrrrrrthorilt,:rccc;rlsplrts/componcnts/assembliesfromtheairworthinessauthorityofthe
Certlfles that unlcss oth€rwlse specifld ln Block 13, the work identlfled ln Block 1
and descrlbed ln Block 13 was accompllshed ln accordance wlth Tltle 14 Code ofFederal Regulatlons, part 43 and ln r€pe<t to that worlgthe lt€ms are appfoved forreturn to serulce.
5. Work Order/Contract/lnvolceNumber:
0000180490-00001 011, Serial/BatchNumber:
20. Authorlzed Slgnature:
FAA forrn fl I |O I ((, O l) 'ltr'.1,rllrrl,rr't r I NSN:0052-00-01 2-9005
F.A. R. 43.9DESCRIPTION OF WORK PERFORMED
OR APPROVED DATA USED
tt,alllTr-\ralr^rMAINTENANCE RECORD
Aircraft LogbookBonanza F33ATach: 1660.2 hrs.
Cleaned & repacked wheel bearings. Replaced both brake caliperpiston o-rings and flushed & refilled brake fluid. Lubricated hinges,control pulleys, bellcranks and landing gear linkage. Conductedgear retraction & extension test (including manual emergencyextension) - satisfactorily. R&R tachometer following repair ofhourmeter function. Complied with FAR 91.207 D 1-4 ELTinspection - satisfactory. ELT battery due 6114. Complied withAD's (see separate AD Compliance Report).
I certify that this aircraft has been inspected in accordance with anannual inspection per the Beechcraft Service Manual and FAR 43
April 19,2013S/N: GE-1365 N15707
Total Time: 1660.2 hrs.
AGENCY & CERTIFICA IIWORK PERFORMED/RETURNI I)DATE OF
COMPLETION
Ir
t rllI\llrr I.\l I I t' tl
lr ',1 lr\ l' I
/(,'lt' I
Work Order
Kelley lnstruments, lnc.4131 May
Wichita, KS 67209-2838(316) 945-7171 . (800) 835-10s4 * Fax (316) 945-7386
No. 132351Date: 411112013
Part Name: Tachometer
Manufacturer: Castleberry
Customer Discrepancy:
F.A.A. C.R.S OP2RO65L
Part No. 3310-00052
PO No: -
Serial No: 5737
Customer: Michael Foushee
FIX HOUR METER - TACH WORKS PROPERLY
Work Status Repair O,e.raui & Cert F T. & C€rt{ tta 4 -a
Preliminary lnspection:hour meter inop
lnspeclor:
ln-Process lnspection:gears slipping on shaft secure
lnspector:
Hidden Damage lnspection:none
lnspector:
WorkPerformed:lnspected & repaired
Service Bulletins, Modifications:nla
Recorded Parts:
Qty Part Number0 nla
Description
WH FinattnspectionDate
Yes No /
.=d9N-(.)oQ=
APR I 6 2OBFinal I nspection (Certificated Repairman)
81 30-3 lssued
MAINTENANCE RECORDn<,r r.x vri.i I l{lll l( All N()
w()l{k I'l l{l ()llMl l)/lll ltrltNl l) l()\l ll\ll I_-AGENCY & CERTIFICATE NO. . ],
WORK PERFORMED/RETURNED TOSERVICI.',
April 19,2013I'I,l ET^T '/-S- lg
No. 132351Date: 4111120i3
\
5-7386
I No: 5737
Zpl-et nct -l
ftfs-,2 I.t z (1,
Form Tracking l"lumberN"de rcpdtedu Fotmdairc
13ts2273/NKE/N/B
Work Order / Contract / lnvorcebn de commande / Contrat / Fafute
31 47S00054
10. Serial No I N" s6ile 1 1. Status / Work I Etat / Travaux
14b. Authorised Signature ,,/ 14c. Certificate/Approval Ref No ./N" du CeftfflcaUAgrement
l4e Oirto (drl nuntr yyVv)/ Outo (ll rrrttntt unnn)
13c. Approval/Authorisation lrlumberNu m 6 ro d' ag rdmenAd' a utoris ati on
FR.21G.0100
14d Name / A/om'l3e Date (dd mmm yyyy) I Date (Ji mmm aaaa)
31 May 2013
L( r I l( )l,l (-;t tJt tr^l EL AVIATI(JhI L]IVILE
FRANCE
)rganisation Name an(l Arlrle'."Vom et Adresse r/e /'Olgrrlri srrre
tem / ,tenr 8, Part No. I N" de pllce-313-0
7.00-6161120
RenrarksRenrarqrres Norme(s) :TSOC62, ETSOC62
ETSOC62 Approval number: EASA.21 0.989
Certifies.that the items identified above were manufactured in conformity to :
Certifie que ies 6l4ments identlfifs cldessus ont 6td fabriques conformdment aux :i approved ciesign data ancj are in a conditiorr ior sale operation
donnees de conception approuvdes et sont en 6tat de tonctionner en toute s6curlt6J non-approved design data specified in block 12
donndes de conception non approuvOes spicifiies dans la case 12
Authorised SignatureS/gnature autorlsee
AUTHORISED RELIA$E C ERTIFICATECot tlllcat Llltlltllllr a Autt,, lri
EASA FONTU TFontrulaln I ilc I'EASA
MICHELIN - LPAVPlace des Qs111;1.Itrr lr,rrrx63040 CLERMON1 I I I(IIAND CEDEX 9FRANCE
14a. E Parl 1457k.5O Releate lo Setvtr r.Appr5>6atlon pour rcttrlse ott wrv/r:oSe,J6n Partle 146.A hO
l t-Jty / Qt6
'This document has been issued accotdtnq to Jn approved computer generated signature procedure''Ce docufi\ent a 6te 6mis selon une procddure.lpprouvee de signature 6lectronique
tJE
I I ( )ther reqrrlatiorr r,,pecifrecl in block 12At tltw tr\lllolnonlullrn rtrtl,'/!..irlpfr r:ase 12
Certilie/fuat unle:-,s otherwt.,e ryectlred rn blocl. l:' thr work t(lrnttlre(l ttt block ll attcl rlescttbecl in blockl2.,vlas accomphshed rn accorclancr wrth Part 145 arrtl in re3pect to tlrat work the items are consideredr4ady lor release to serviceCertlfie que, sauf lndlcatlon contralre spdclfl6e ed case 12, les travaux identitiis en case 11 et
145 et qu'au vu de ces travaux, lesd6crits en case 12 ont 6td rda//sds conformtment A la partiepiices sont considdrdes prdtes i la remise 5xt'seruice.
Name / /Vom
INaTALLER iEsPoNslBlLlTlES / F.spon8at/llrds d.,'&l,let ut/h.tzllat urlif€t€ does not automa!€lvconsthut authoritylo hstall lhe lem(slunqt rc @n.tlrP pasfot Cn.!n t'ano [email protected]'tnstattet t'(cs) h.n(t)
ty a.cepls tms irom the eiMnhins .ulhorly spsilied in block 1 .
notu6 d. navisrbllhE ecept les lten6 t€tl. pat l .tltonr, de navisabilit! t?'€ntionnae d.ns l. cae 1 ,
lh.aircran hay b. n@n
Ents natlonaux Dat I'
orm 1 lssue 2l Formulaire I cle I'EASA Edltlon 2
voler.
RECORDF.A. R. 43.9
DATE OF-F CoMPLETtON
tr',t*- Aircraft LogbookBonanza F33A S/N: GE-1365Tach: 1743.8 hrs.
April 11,2014Nls70T l
Total Time: 1743.8 hrs.
Cleaned & repacked wheel bearings. Lubricated hinges, controlpulleys & hinges, bellcranks and landing gear linkage. Conductedgear retraction & extension test (including manual emergency iextension) - satisfactorily. Complied with FAR 91 .207 D 14 ELT i
inspection - satisfactory. ELT battery due 6/14. Complied withAD's (see separate AD Compliance Report).
I certify that this aircraft has been inspected in accordance with anannual inspection per the Beechcraft Service Manual and FAR 43Appendix "D" and was determined to be in an ainryorthy condition.
A&P 2126136 lA
Airworthiness Directive Gompliance Report
rairNumber: N15707Prepared For:
Adam Clock4980 Somerset LaneColumbus, lN 47201
812-375-4520
aclock8880@hotmail com
Beechcraft Bonanza F33A
Continental 1O.520-BB (1 8)
McCauley 3A32C4OOC
Date of Report: 4:11-14
Prepared By:
BAKAircraft Service lnc.11952 West Youth Camp RoadColumbus, lN 47201
812-344-2965
michael.foushee@yahoo com
S/N: CE-1365
SiN: 830046-R
S/N:890169
re
Airframe
Engine
Propeller
NOTES
Recurring AD's:
76-07-12 Bendix lgnition Switch
07-08-04 Propeller Blade
Equipment Dates:
Static/XPDR Check
ELT Battery
Due: 1843.8 hrs
Due: Next annual or 1843.8 hrs.
Due: April, 2016
Due: June, 2014
Date
Tail #
Hours
4-11-14 Update 4 2O14-.O1B "
N15707 serial # cE-1365
Tach Tlme: 1743.8 hrs. TT: 1743.8 hrs. Enqine TSN: 588.4 hrs. TSPOH: 588.4 hrs.
Misc Adam Clock
AD # Subject Date / Hours Method of Rec Date / Hours Signature andCategory at Compliance Gompliance Next Due Number
71-2+10Airframe
Security Of ControlWheel
1537.3 hrs.4-10-12
N/A by Serial # Michael FqsfpeA&P 2126136 tA
72-11-02Airframe
Engine Fuellntemrption
1537.3 hrs.4-10-12
N/A by Serial# Michael FoustpeA&P 21261361A
73-1+O3Airframe
Landing GearShock Strut Piston
1537.3 hrs4-10-12
N/A by Serial# Michael FqrsteA&P 2126136 rA
74-0TO2Airframe
Landing GearShock Strut Piston
1537.3 hrs.4-10-'t2
N/A by Serial# Michad FouslrceA&P 2126136 tA
74-24-03Airframe
Strobe LightSystem
1537.3 hrs.4-10-12
N/A by Serial# Michad FqrsfieeA&P 2126136 tA
75-05-02Airframe
Engine Oil 1537.3 hrs.4-10-12
N/A by type of drain Yes N/A Mictrad FqrsleAEP 212615 !A
76-22-02Airframe
"Y'Type ShoulderHarnesses
1537.3 hrs.4-10-12
N/A by Serial# I$idsd For.sleAAP 212615 r
79-01-01Airframe
Screws ln ControlSystem
1537.3 hrs.+1U12
N/A by Serial# ltf#FqsleA&P 212ff$ lA
8+09-01Airframe
WindowEmergency Egress
1537.3 hrs.+1U12
N/A by Serial# fitdrd FcdeA&P 212fl5 n
87-18-06 R1
AirframeSeat ReclineActuator Handle
1537.3 hrs.+10-12
N/A by Serial# tfidFcdeA&P 212615 t
88-20-01Airframe
Firewall Material 1537.3 hrs.+1G-12
N/A by Serial# ff,dFodeAlP2t26r5lA
88-21-O2
AirframeSeat Tracks 1537-3 hrs
4-10-12N/A by Serial# fftEFqde
AtP zt2flS n91-17-01Airframe
Elevator Trim TabActuators
270.0 hrs.8-3-92
Complied with per SB-2399
fHFad-AtP A26l$ n
91-20-08Airframe
Fresh Air BlowerHousing
413.3 hrs.1-20-93
Complied with per SB-2380
fHFad=eAtP 2t2Ft$ n
93-03-02Airframe
Loran ReceiverSystem
1537.3 hrs.4-10-12
N/A by Serial# HFadueAIP 2r26t- n
93-24-03Airframe
Rudder FonruardSpar
904.6 hrs.4-27-OO
Complied with per SB-2333 - installed kit PN33-6001-1 Nn frrrlher
HFadaeAtP ZrDr- n
Rannrl Pranarar{ Rv Mic}rael Fnrrehca
Date 4-'11-14 Update # 2014-018
Tait # N1570T Seriat # CE-1365
Misc
Tach Tlme: 1743.8 hrs. TT: 1743.8 hrs. Engine TSN: 588.4 hrs. TSPOH: 588.4 hrs.
Adam Clock
AD#Category
Subject Date / Hours Method ofatGompliance Gompliance
Rec Date / Hours Sign*re ildNext Due t{unber
95-M-03Airframe
Wing Spar Frame 1537.3 hrs.4-'10-12
N/A by Serial# Yes N/A Mk$ad FotsteA&P 2126136 14
97-14-15Airframe
Cabin And UtilityDoor Handle
848.9 hrs.4-'t0-98
Complied with byOperational Test
Michad FrusheeA&P 21261S tA
01-08-08Airframe
V-Band ExhaustClamp
1001.4 hrs.2-27-02
N/A by installation Yes N/A Midad Fqrsl=eA&P 212615 lA
01-1 1 -03
AirframeBlower MotorCircuit
956.3 hrs.8-7-O1
Complied with per SB-U-3267 by instaling 1
amn CR t
Mto$ad FqsfeA&P 212615 n
01-2T10Airframe
Flap Flex Shaft 1001 .4 hrs.2-27-O2
N/A by Date Midad FasfeA8P212615n
07-08-08Airframe
Landing GearUplock Rollers
1537.3 hrs4-'10-12
N/A by Serial# Yes N/A
08-1 3-1 7
AirframeCircuit BreakerToggle Switch
1419.4 hrs.5-20-09
Complied with byinstallation of "newqfule" hreakers
ll#FqdeAtP zl2flS n
09-25-01Airframe
ShoulderHarnesses
1438.6 hrs.3-2-10
Complied with per SB-2394 - new washerinstalled
lEtd Fod-eAtP A2F!S n
70-14-O7
Engine
Fuel lnjectionPump
1 155.4 hrs.z26lu
N/A - engine is a TCMfactory reman enginemrnrrfaeirred tDNOA
fErdFofrAtP 2lS!S n
72-24-03Engine
Oil Filter Adapter 1 155.4 hrs.2t26tU
N/A - engine is a TCMfactory reman enginemanrrfaeftrred 2l26lM
Yes N/A HFo#AtP 2UD15 n
79-05-09Engine
Loss Of OilPressureI nr{icalinn
1 155.4 hrs.z26tu
NIA - engine is a TCMfactory reman enginemanufacJured 2l2AlM
HfuEAtP A2615 n
80-01-04Engine
Cylinder HolddownFlanges
1 155.4 hrs.2t26tU
N/A - engine is a TCMfactory reman enginemenrrfanlrrrad 2|2AIM
H*AtPaiDt- n
81-24-06,
Engine
Fuel Pump 1 155.4 hrs.2t26tM
N/A - engine is a TCMfactory reman enginemanrrfacJttrad ?l26lM
Yes N/A HF*AtP ZED!:5 n
86-13-04 R3
Engine
CylinderAssemblies
1 155.4 hrs.2t26lM
N/A - engine is a TCMfactory reman enginemanr rfaclr rred 2 12F'l0,4
Yes N/A HFEA|PZTDr:f n
87-14-02Engine
Starter AdapterShaftgear
1 155.4 hrs.a26l04
N/A - engine is a TCMfactory reman enginemanufacfirred 2l?6lM
HFGAtPzED't:5 n
88-03-06Engine
OilFilter 1155.4 hrs.2126l04
N/A - engine is a TCMfactory reman enginemanrrfanf rrad ?l24(\4
HF*AtP2Ern- n
Beech F33AAi rworth iness DirectiveGompliance Report
lRnad Fqrsl-eAEP 212615 n
Report Prepared By Michael Foushee Page2
Airworthins DirectiveGompliance Report
Date 4-11-"14 Update 6 2O14+O1B
Tait# N157OT seriar # CE-1365 "
Hours Tach Tlme: 1743.8 hrs. TT: 1743.8 hrs. Engine TSN: 588.4 hrs. TSPOH: 588.4 hrs.
Misc Adam Clock
AD # Subject Date / Hours Method of Rec Date / Hours Sigrlatre -dCategory at Compliance Compliance Next Due Hunber
88-17-03Engine
Starter AdapterShaftgear
1155.4 hrs.2t26t04
N/A - engine is a TCMfactory reman enginemanr rfacJr rrcd 2 126104
Midrd FqrsfeA&P 21261$ !A
91-19-03Engine
Engine Oil Filter 1155.4 hrs.2t26tM
N/A - engine is a TCMfactory reman engineman r rfacjr rred 2 126104
Midad FqrsfeA&P 212615 !A
93-1 0-02Engine
Cylinder ValveRetainer Key
1 155.4 hrs.a26l04
N/A - engine is a TCMfactory reman enginemanr rfacfr rred 2 126104
MidadFqrsleeA&P 21261$ n
9316-15Engine
Fuel Pump DriveShaft
1 155.4 hrs.2t26104
N/A - engine is a TCMfactory reman enginemanrrfacirred 2l26l()4
Mk$d FqrCeAEP 21261$ n
97-26-17Engine
CrankshaftManufacturingPrn.nss
1 155.4 hrs.2t26t04
N/A - engine is a TCMfactory reman enginemanrrfacJlrcd 2l)6lM
Yes N/A Itficfnd Fq.sl-eAEP 212615 n
98-17-11Engine
Nelson BalancingService
1155.4 hrs.2t26t04
N/A - engine is a TCMfactory reman enginemanrrfaclrrred 2DNnt
lildrd Fqd-eA&P 212fiS n
9$.19.01Engine
Crankshaft CheekCracks
1 155.4 hrs.2t26l04
N/A - engine is a TCMfactory reman enginemanrrfacJrrred 2D6lO4
lErdFqdeAtP 2r2$S n
oo-23-21Engine
Crankshafi 1 155.4 hrs.2t26lM
N/A - engine is a TCMfactory rerhan enginemanr rfaal, ,rar{ ) ItAliA
fHFodeAtP zl2Dtsn
04-08-10Engine
ECi ReciprocatingEngine Cylinders
1 155.4 hrs.2t26tM
N/A - engine is a TCMfactory reman enginemanr rfacJr rred ,l2ilnL
ft|14|Fr*AtP 212tl:5 n
07-M-19 R1
EngineSuperior Air PartsCylinderAecamhliac
1155.4 hrs.2t26104
N/A - engine is a TCMfactory reman enginemanrfacJrrred 2l28li4
ft|4|Fql-AIP zUDl:! N
0916-03Engine
(SAP) CastCylinderAssemhlies
1 155.4 hrs.2t26lM
N/A - engine is a TCMfactory reman enginemanr rfanJr rrcrl 2 l?F,1o,4
Yes N/A Elr-|Fo-lAtP ZU6'r5 n
09-1 9-07Engine
Cracked EQ3Cylinders
1537.3 hrs.+10-12
N/A by Serial# Yes N/A EclFr*AtP zrDr- n
10-11-O4Engine
Hydraulic ValveLifters
1438.6 hrs.3t2t10
N/A by Date of Mfgr. HFGAtP ZIIFII n
12-03-06Engine
AVStar Fuel ServoDiaphragm
1660.2 hrs.4-1 9-1 3
N/A - diaphragm notinstalled.
HF*AaP ZErirS n
03-13-17Propeller
Propeller BladeSeparation
1537.3 hrs.4-10-12
N/A - no work done byT&W Service
HF*AtPzrlbEt r
o5-14-11Propeller
SouthemCalifornia PropellerSenrice
1537.3 hrs.4-10-'12
N/A - no work done bySoCal Prop Service
EF*AtPzED'r5 n
Report Prepared By Michael Foushee Page 3
Beech F33AAirworth iness DirectiveGompliance Report
Dare 4-11-14 update a 2O14O1B
Tait# N15707 sedat# cE-1365 "
gou,= Tach rlme: 1743.8 hrs. TT: 1743.8 hrs. Engine TSN: 588.4 hrs. TSpoH: 5gg.4 hrs.
Misc Adam Clock
AD#Categery
Subjeci Dab/Hourc MethodofatCompliance Compliance
Rec Date / Hours Sigrratre -dNext Due llurE
0G24-07Propeller
Propeller BladeSeparation
1537.3 hrs.+10-12
N/A - no work done byCSE Aviation
ltfictrd Fq.sl-eA&P 212615 n
07-08-04Propeller
Propeller BladeSeparation
1743.8 hrs.4-11-14
Complied with byvisual inspection.
Yes Next annual or1843.8 hrs.
ltfii$ad FqrC-eAtP 212615 tA
7do7-12Appliance
Bendix SwitchesRepair OrRanlar=manl
1743.8 hrs.4-11-14
Complied with byOperational Test
Yes 1843.8 hrs. lliiJrdFcdeAEP21261SN
81-1t{)3Appliance
Brackeft Air FilterRetainerSmn/Gackale
1537.3 hrs.+10-12
Complied with byvisual inspection.
lficfrd FanC-eAEP212flSn
Report Prepared By Michael Foushee Page 4
