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CA 1282 BIRD STRIKE REPORTING FORM

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					BIRDSTRIKE OCCURRENCE FORM - CA 1282 (Amended 02/2003)
To be completed on discovering evidence that a birdstrike has, or may have, occurred.
To be completed for all birdstrikes, whether or not damage has been caused.
Copies of this form should be sent as indicated at Note 1 below.

Aircraft Operator................................…………..              Precipitation:
Aircraft type & series.........................................      None            Fog            Rain              Sleet/Snow
Aircraft reg. ..............................………………….
Date (dd/mm/yy) ............/............/............               Bird Species/description (e.g. Herring gull, Woodpigeon)
Time (local) .........: ..........Hrs (24 hr)                        ................................................………………………….…...
                                                                     If you are not certain of the bird species, please send a copy
       Dawn         Day        Dusk           Night                  of this form and any remains (e.g. a wing, but even the
Aerodrome ...................................……………....               smallest of remains are useful) to: -
Runway in use .......................                                BIRDSTRIKE AVOIDANCE TEAM, CENTRAL SCIENCE
Height (agl) ........................... ft                          LABORATORY, SAND HUTTON, YORK YO41 1LZ, UK.

Speed (IAS) .....................…..kts                              Please mark the container “Bird remains”
Position (if en route) ...........................................   This identification service is provided free to UK aerodromes and
                                                                     aircraft operators.

Phase of Flight                                                      Bird remains sent for identification                        Yes               No
Taxi                             Descent
Take-off run                     Approach                            Number of birds
Climb                            Landing roll                               seen struck* (enter actual number if known)
En Route                         Ground checks                       1
                                                                     2-10
Part(s) of Aircraft                   Struck damaged*                11-100
                                        (describe)                   100+
Radome
Windshield                                                           Pilot warned of birds                                       Yes               No
Nose (if not one of the above)
Engine nos:                1                                         Note 1: Copies of this form should be submitted as soon as
                           2                                         practicable to the recipients shown below. (It is not necessary
                           3                                         to wait for confirmation of bird species.)
                           4
Propeller                                                            Aerodrome
Wing/rotor (inc high lift devices)                                   Aircraft Operator
                                                                     Civil Aviation Authority (address overleaf)
Fuselage
                                                                     Bird Strike Avoidance Team        (if identification required)
Landing Gear
Tail                                                                 Remarks and other relevant information*:
Lights
Other (specify*)

Effect on flight
None                             Returned
Aborted t/off                    Diverted
Other

Other Reports raised
Mandatory Occurrence Report (MOR)
Air Safety Report (ASR)
Other* (specify)
  Send to:
  Civil Aviation Authority                                           Reporter Details
  Aerodrome Standards Dept
  FREEPOST RCC1456                                                   Name....................................................................................
  Crawley RH6 0YR                                                    Employer ..............................................................................
  Fax No 01293 573971                                                Tel no .......................................         Date ............................
  Web site: www.caa.co.uk

				
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Description: CA 1282 BIRD STRIKE REPORTING FORM