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Add Aircraft to Air Carrier Operations - DOC by bud19087

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									                                                            Department of Transportation
                                                      Federal Aviation Administration
                               Richmond Flight Standards District Office
                                        Richmond International Airport, Virginia 23250-2415
 Ph. 804-222-7494                                   RIC FSDO Form F022, Revision 8, March 12, 2009                         FAX 804-222-4843

                      HOW TO ADD AN AIRCRAFT TO AIR CARRIER OPERATIONS
Dear Applicant:
To add an aircraft to an air carrier operation the certificate holder must complete the following steps.
1 CHOOSE OPERATIONS: Choose the kinds of operations, areas of operation, and maintenance (and/or Inspection)
    programs you want for the aircraft. Contact the Certificate Holding District Office (CHDO) for guidance as needed—the
    checklist in SECTION 3 lists the possible operations.
2 CONFIRM AIRCRAFT COMPLIANCE: Be sure that the aircraft will meet all performance and equipment
    requirements described in 14 CFR Parts 91 and 135, and in Operations Specifications related to the proposed aircraft
    operations. The checklist in SECTION 4 is designed to help with this.
3 APPLY: In a letter to the CHDO request Operations Specifications to add the aircraft, and to permit the proposed
    operations, areas of operation, and maintenance/inspection programs (see letter example next page). Include training,
    operations, and maintenance/inspection program revisions as needed to support the operations determined in step 1
    above. Include a statement (see SECTION 4 & SECTION 5) that the aircraft complies with all applicable rules and
    provide supporting documents that show compliance as determined in step 2 above.
4 RECEIVE VALIDATION, ACCEPTANCE, AND APPROVAL: Obtain CHDO approval and acceptance of revised
    operations, training, and maintenance programs and procedures. If necessary, plan for validation of aircraft compliance,
    operations, training and maintenance programs, and personnel proficiency.
5 REGISTER ECONOMIC DATA: You must register your Air Carrier and identify each aircraft used and keep the
    registration current. Send OST Forms 4507 and 6410 to: FAA Hdqtrs, Air Transportation Division AFS-260, 800
    Independence Avenue SW, Washington, DC 20591. For blank forms and guidance information go to
    http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/afs/afs200/branches/afs260/exemptions/.
6 COMPLETE ENVIRONMENTAL COMPLIANCE: Send the CHDO a completed National Environmental Policy
    Act (NEPA) form (see Page 2-1). We forward this for Regional Approval, so do not delay sending it.
7 RECEIVE OPERATIONS SPECIFICATIONS: We will approve Ops Specs Paragraph D085, and any other required
    Paragraphs once the above steps are completed.
8 UPDATE AIRCRAFT LISTING: Comply with §135.63(a)(3) by adding the aircraft, including the kinds of operations
    authorized for the aircraft, to your official control listing of aircraft used or available for use in air carrier operations.
ATTACHMENTS: The sample application letter and the attachments—Request to Add an Aircraft, Request for
Operations Specifications, and Aircraft Compliance Statement for FAR 135 Operations, may help you accomplish steps 1
through 4 above. They provide an organized method to document compliance and provide the information we need to
approve the aircraft and operations you request.
THE INFORMATION YOU PROVIDE in these attachments is needed to issue the appropriate Operations Specifications.
However, the attachments are not mandatory. You may use any method that provides complete and accurate information.
ACCURACY IS IMPORTANT: Personnel experienced with the aircraft make and model and the operations proposed
should prepare these documents and sign the statement on page 5-1 signifying complete and accurate technical information.
Technical errors or omissions will delay completion of the project.
The SCHEDULE OF EVENTS on page 1-1 lists the events that may relate to adding the aircraft to your 135 operations. If
you schedule those events on this form, we will be able to determine our ability to meet your expectations and schedule our
resources. We will contact you if there are scheduling difficulties.
We hope you find these forms useful in helping you determine aircraft eligibility and as a way to apply for certain kinds of
operations. Please let us know if you have any questions or suggestions.
Sincerely,                                                  INSTRUCTIONS: These documents are designed for manual or on-screen fill-in.
                                                            For on-screen fill-in, use TAB and SHIFT-TAB and the mouse to navigate forward
                                                            and back through the forms. We suggest that you print a copy for reference while
                                                            working on the document on your computer. We also recommend saving the
The Richmond FSDO                                           document with a new name before you start working on it to preserve the original in
                                                            case you need to start over. Print the completed copy, sign, and send it to us.

ALWAYS USE THE the latest version of this document. Find it at http://www.faa.gov/about/office_org/field_offices/fsdo/ric/local_more/
                                                  PLEASE DO NOT RETURN THIS PAGE TO THE FSDO

Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                        RIC FSDO Form F022, Revision 8, March 12, 2009
                   [EXAMPLE: INSERT COMPANY LETTERHEAD, NAME AND ADDRESS]
[Insert Date]

[Mr. Ms] [name], Principal Maintenance Inspector
Federal Aviation Administration
Richmond Flight Standards District Office
5707 Huntsman Road, Suite 100
Richmond International Airport, Virginia 23250-2415

Dear [Mr. / Ms.] [Last name of the Principal Maintenance Inspector]:
This is to apply for amended Operations Specifications (OPSS), Paragraph D085, [if new make/model aircraft insert “and
A003” else hit DELETE] to add [insert the aircraft make, model, series] registration number [insert the registration
number including N] to our air carrier operation. Please see the following attachments for the details of this application.
Attachment Section 1 provides:
           Additional information about the aircraft
           Our Schedule of Events for the activity needed to add the aircraft to our fleet
           Names and contact information for personnel assigned to this project.
Attachment Section 2 is the National Environmental Policy Act (NEPA) Requirement Form; please forward this to your
Regional Office for approval.
Attachment Section 3 is an OPSS A004 checklist we marked to show the OPSS to be added or revised to allow the
operations we propose with this aircraft. The section also includes supporting information about the aircraft and its
capabilities. The attached documents and the Schedule of Events speak to the written procedures, training, and
demonstrations of proficiency, required by the OPSS we need.
Documents to be Approved: We include and request your approval of the documents checked below related to this
project.
          Minimum Equipment List (MEL) (mandatory attachment if an MEL will be used)
          Approved Aircraft Inspection Program (AAIP) (optional, but a mandatory attachment if an AAIP will be used)
          Continuous Airworthiness Maintenance Program (CAMP) (mandatory attachment for 10-or-more-passenger
          aircraft operations, optional for nine-or-less)
          RVSM Operations, Training, and Maintenance Programs (mandatory attachment(s) for aircraft operated
          between FL290 and FL410 inclusive—see §91.180)
          Procedures to conduct a pretakeoff contamination check during ground icing conditions (If not included,
          Operations Specifications A041 may be delayed.)
          Deviation request (mandatory attachment if a deviation is required, e.g., reduction in proving test flight time)
          Training program revision (mandatory if any training is required to add the aircraft/operation)
Documents to be Accepted: We include and submit for your review and acceptance of the documents checked below.
         Aircraft Lease [Mandatory attachment if the Air Carrier is not the legal owner of the aircraft, Ref. 135.25(b)]
         Revision [insert revision number] to the Operations Manual (mandatory for any change to the MEL or other Part
         135 Operations document)
         Attachment Section 4: Aircraft Compliance Statement and supporting documents
         Attachment Section 5: Airworthiness Checklist and inspection statement showing the aircraft is ready for
         operations under 14 CFR Part 135
         Proof of DOT Economic Registration (insurance) (mandatory attachment for first aircraft, provide within 30
         days after adding any additional aircraft)
         The data required by Section 3.7 REQUIRED MAINTENANCE & INSPECTION DATA
Please contact the persons indicated in Attachment Section 1 for any question concerning this application. Please let us
know immediately if you are not able to accommodate our schedule of events.
Sincerely,

[insert name and title]

Attachments
NOTE:           These forms are designed for on-screen fill-in. To navigate through the forms use TAB (down) and Shift-Tab (up). Use
                the page up/down and the mouse to skip large areas.

                                                                                                                              Check if this is an
SECTION 1                  REQUEST TO ADD AN AIRCRAFT                                                                         UPDATE/REVISION
                         Operator’s
                                                                                                                      Certificate
                         Legal
                                                                                                                       Number
                         Name
                         Registered Owner
                         Enter exactly as shown on the
                         registration certificate
1.1                      (see NOTE below)
         OPERATOR
         AND                           Address
         AIRCRAFT
         INFORMATI
         ON                        City/state/Zip

                                  Aircraft Make                    Complete Model Number                  Serial No                 Registration Number
                                                                                                                                        N
                                         The Aircraft will be based at (airport Designator)
                             The maintenance records will be based at (airport Designator)

  NOTE: The registered aircraft owner name must be identical to the certificate holder’s legal name or the applicant must provide a copy
           of a lease or other agreement that shows how she or he will control the operation and maintenance of the aircraft. SEE
           §135.25(b) & FAA Order 8900.1, VOL 3 CHAP 13, Section 2: Information for Air Carrier Lease Agreements.

                                                                                               PHASE 4 DEMONSTRATION & INSPECTION
                                       PHASE 3 DOCUMENT COMPLIANCE                         All documents must be approved or accepted before this phase
                                                                              PLANNED
                                                                                                                                                PLANNED
                                                 EVENT                       SUBMISSION                      EVENT                               DATE(S)
                                                                                DATE

                         Deviation Request
                                                                                              Pilot training
                         (For Proving Test flights)
                                                                                              Maintenance training
                         Pilot Training Program/revision
                                                                                              [10-or More 135.411(a)(2)]
1.2                      Maintenance Training Program
         SCHEDULE                                                                             FAA Conformity Inspection
         OF EVENTS
                         [10-or More 135.411(a)(2)]
If an event or item is   Plan for Proving Test or Validation                                  Proving Test Flights
applicable please
enter your estimated     Final Compliance Statement                                           Proficiency/Flight Checks
date otherwise leave
blank.                   Insurance Registration with AFS-                                     Validation Test Flights
                         260, using OST Forms 4507 and
                         6410 (see cover letter)                                              Other:
                         NOTE: After initial certification, the date may
                         be up to 30 days after adding an additional                          Other:
                         aircraft
                                                                                                             PROPOSED COMPLETION DATE
                                       PHASE 5 FAA CERTIFICATION and/or OPS SPECS


                                                            NAME                                 Phone & EMAIL ADDRESS

                                                                                                    Phone:

                         Director of
                                                                                                    EMAIL:
                         Maintenance

1.3                                                                                                    FAX
         CONTACT
         INFORMATI
         ON                                                                                         Phone:

                         Director of                                                                EMAIL:
                         Operations


                                                                                                       FAX




                                                                       Page 1-1
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                       RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 2                  ENVIRONMENTAL IMPACT

 National Environmental Policy Act (NEPA) Requirement Form


                                   FAA Order 1050.1E, Appendix A, Section 14

The following information is required to complete the analysis for NEPA
Requirements for adding aircraft to an Air Carrier Certificate:

 1. Operator Name:
 2. Type of Aircraft (M/M/S) involved:
 3. N Number of Aircraft involved:                                                  N
 4. Home base of aircraft:
 5. Anticipated Air Carrier Operations of
    Aircraft:
         a.      Hours per month:
         b.      Flights per month:
         c.      What percentage of operations
                 will occur between…                               0700-2200        % 2200-0700                        %

Complete and submit this NEPA Requirement Form to the FSDO along with the
Adding an Aircraft to Air Carrier Operations Package.

The FSDO will send the above information to the Regional Office for analysis.
Once completed, the Regional Office will return the report to the FSDO to retain
in the Operator’s Certification File.
The FSDO cannot issue Operations Specifications without the completed report
from the Regional Office.




                                                            Page 2-1
Note: The term “FAR” in this document means “14 CFR Part”
                                                                               RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                  REQUEST FOR OPERATIONS SPECIFICATIONS
                           FOR THIS AIRCRAFT
                                             Cargo Only                  Maximum Passenger
INTENDED                                 (Never Passengers)               Seating Capacity            Day Only                 Day/Night
KINDS
OF                                            YES     NO                                              YES    NO                YES       NO
OPERATIONS:


NOTE: SKIP THIS OPS SPECS CHECKLIST IF YOU WANT THE CHDO TO HELP YOU DECIDE THESE
        QUESTIONS—Go to Page 3–5 to continue
Instructions: Check the paragraphs that must be added or revised for your proposed use of the new aircraft. Review the
contents of the Operations Specifications paragraph (we will provide these on your request). Provide the written procedures
and the training needed and be able to demonstrate proficiency as required in the paragraph. Provide the supporting data as
needed


                  OPS SPECS CHECKLIST




                                                                                                                                       Procedures
                                                                                                                         Proficiency
                                                                                                             Requires




                                                                                                                           Requires




                                                                                                                                         Requires
                                                                                                              Training
                                                                                                               Special




                                                                                                                            Special




                                                                                                                                           Special
                  IMPORTANT: Check only items that apply to the aircraft currently




                                                                                                                                           Written
                                                                                                                              Check
         Para




                  being added to the certificate and only if you need New Or Revised
                  Operations Specifications
AUTO    A001      Issuance and Applicability
AUTO    A002      Definitions and Abbreviations
AUTO    A003      Aircraft Authorization
AUTO    A004      Summary of Special Authorizations and Limitations
        A005      Exemptions and Deviations
AUTO    A006      Management Personnel
AUTO    A007      Other Designated Persons
AUTO    A008      Operational Control
AUTO    A009      Airport Aeronautical Data
AUTO    A010      Aeronautical Weather Data
        A011      Approved Carry-On Baggage Program                                                              YES                       YES
        A013      Part 135 Operations Without Certain Emergency Equipment                                                                  YES
        A014      Special En Route IFR Operations in Class G Airspace                                                       YES
        A015      Autopilot in Lieu of Required Second-in-Command                                                           YES
        A017      Approved Security Program for Helicopter Operations                                            YES        YES            YES
        A018      Scheduled Passenger Helicopter Operations                                                      YES        YES            YES
        A019      Automotive Gasoline as Aircraft Fuel                                                           YES        YES            YES
        A020      Airplane Operations Without Instrument Rated Pilots                                            YES        YES            YES
        A021      Helicopter Emergency Medical Services (HEMS) Operations                                        YES        YES            YES
        A022      Approved Exit Seat Program                                                                     YES        YES            YES
        A023      Authorization to Use an Approved Procedure for Determining Operations During Ground
                                                                                                                 YES                       YES
                  Icing Conditions
        A024      Air Ambulance Operations-Airplane                                                              YES        YES            YES
        A025      Electronic Recordkeeping System                                                                YES        YES            YES
        A027      Land and Hold Short Operations                                                                 YES                       YES
        A028      Aircraft Wet Lease Arrangements                                                                                          YES
        A029      Aircraft Interchange Arrangements                                                              YES        YES            YES
        A031      Outsourced Training                                                                                                      YES
        A032      Adoption of Flight Crewmember Flight Time Limitation Rules to Establish Flight Attendant
                                                                                                                                           YES
                  Duty & Flight Time Limitations & Rest Restrictions
        A033      Title 14 CFR Section 135.265 Flight and Rest Time Requirements for Certain Part 135
                                                                                                                 YES        YES            YES
                  Operations
        A034      Advanced Qualification Program                                                                 YES        YES            YES
        A037      Basic 14 CFR Part 135 Operator - Commuter and On-Demand Operations                                        YES            YES
        A038      Basic 14 CFR Part 135 Operator - On-Demand Operations Only                                                YES            YES
        A039      Single Pilot-in-Command Operator                                                                          YES            YES
        A040      Single Pilot Operator                                                                                     YES            YES
        A041      Authorization for 14 CFR Part 135 Airplane Operators to Conduct a Pretakeoff
                                                                                                                            YES            YES
                  Contamination Check
        A042      Authorization for Operations Without a Deicing/Anti-icing Procedure When Ground Icing
                                                                                                                                           YES
                  Conditions Do Not Exist.
        A046      Single Engine IFR (SEIFR) Passenger-Carrying Operations Under CFR Part 135                     YES        YES            YES
        A050      Helicopter Night Vision Goggle Operations (HNVGO)                                              YES        YES            YES
        A052      Automatic Dependent Surveillance-Broadcast (ADS-B)                                             YES        YES            YES
        A055      Carriage of Hazardous Materials (HazMat)                                                       YES        YES            YES
        A056      Controller-Pilot Data Link Communications (CPDLC)                                              YES        YES            YES

                                                                  Page 3–1
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                 RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                  REQUEST FOR OPERATIONS SPECIFICATIONS
                           FOR THIS AIRCRAFT (continued)
                  OPS SPECS CHECKLIST




                                                                                                                                     Procedures
                                                                                                                       Proficiency
                                                                                                           Requires




                                                                                                                         Requires




                                                                                                                                       Requires
                                                                                                            Training
                                                                                                             Special




                                                                                                                          Special




                                                                                                                                         Special
                  IMPORTANT: Check only items that apply to the aircraft currently




                                                                                                                                         Written
                                                                                                                            Check
         Para
                  being added to the certificate and only if you need New Or Revised
                  Operations Specifications
        A057      Eligible On-Demand Operations 14 CFR Section 135.4.                                        YES          YES           YES
        A061      Use of Electronic Flight Bag                                                               YES          YES           YES
        A096      Actual Weight Program For All Aircraft                                                     YES          YES           YES
        A097      Small Cabin Aircraft Passenger and Baggage Weight Program                                  YES          YES           YES
        A098      Medium Cabin Aircraft Passenger and Baggage Weight Program                                 YES          YES           YES
        A099      Large Cabin Aircraft Passenger and Baggage Weight Program                                  YES          YES           YES
        A348      Verification of Personnel for Access to Flightdeck                                         YES                        YES
        A395      Operator-Approved Minimum Equipment List                                                   YES                        YES
        A447      Emergency Airworthiness Directives (EAD) Notification Requirements                                                    YES
        A449      Antidrug and Alcohol Misuse Prevention Program                                             YES                        YES
        A501      Liability Insurance Suspension for Seasonal Operations                                                                YES
        A502      Air Carrier Merger and/or Acquisition                                                      YES                        YES
        A520      Special Federal Aviation Regulation (SFAR) No. 77 Approval                                 YES          YES           YES
        A529      Special Authorization for Emergency Operations to Support Regional Disaster Recovery       YES                        YES
        A530      Special Federal Aviation Regulation (SFAR) No. 77 Approval for Operations Conducted
                                                                                                             YES                        YES
                  Under Contract to U.S. Transportation Command or Air Mobility Command
        B029      Driftdown or Fuel Dumping for CFR Terrain Clearance Requirements                           YES          YES           YES
        B030      IFR Navigation Using GPS/WAAS RNAV Systems                                                 YES          YES           YES
AUTO    B031      Areas of En Route Operation
        B032      En Route Limitations and Provisions                                                                     YES
        B034      IFR Class I Terminal and En Route Navigation Using Area Navigation Systems                 YES          YES           YES
        B035      Class I Navigation in the U.S. Class A Airspace Using Area or Long-Range Navigation
                                                                                                             YES          YES           YES
                  Systems
        B036      Class II Navigation Using Multiple Long-Range Navigation Systems (LRNS)                    YES          YES           YES
        B037      Operations in Central East Pacific (CEP) Airspace                                          YES          YES           YES
        B038      Operations in North Pacific (NOPAC) Airspace                                               YES          YES           YES
        B039      Operations in North Atlantic Minimum Navigation Performance Specifications
                                                                                                             YES          YES           YES
                  (NAT/MNPS) Airspace
        B040      Operations in Areas of Magnetic Unreliability.                                             YES          YES           YES
        B045      Extended Overwater Operations Using a Single Long-Range Communication System               YES          YES           YES
        B046      Operations in Reduced Vertical Separation Minimum (RVSM) Airspace                          YES          YES           YES
        B047      Authorized to Conduct Class II Navigation Using a Flight Navigator                         YES          YES           YES
        B048      Air Tour Operations Below 1,500 Feet AGL in the State of Hawaii                            YES          YES           YES
        B049      Operations in the Grand Canyon National Park Special Flight Rules Area (GCNP-SFRA)         YES          YES           YES
        B050      Authorized Areas of En Route Operations, Limitations, and Provisions
        B054      Class II Navigation Using Single Long-Range Navigation System (S-LRNS)                     YES          YES           YES
        B057      National Parks Air Tour Management Operations-Under 14 CFR Part 136                        YES          YES           YES
        B059      Canadian MNPS Airspace                                                                     YES          YES           YES
        C049      Destination Airport Analysis Program                                                       YES          YES           YES
        C051      Terminal Instrument Procedures                                                             YES          YES           YES
        C052      Basic Instrument Approach Procedure Authorizations - All Airports                                       YES
        C053      Straight-In Category I Approach Procedures Other Than ILS, MLS, or GLS and IFR
                                                                                                                          YES
                  Landing Minimums - All Airports
        C054      Special Limitations and Provisions for Instrument Approach Procedures and IFR Landing
                                                                                                                          YES           YES
                  Minimums
        C055      Alternate Airport IFR Weather Minimums                                                                  YES           YES
        C057      IFR Takeoff Minimums, 14 CFR Part 135 Airplane Operations - All Airports                                YES
        C058      Special Restrictions for Foreign Terminal Instrument Procedures                                         YES           YES
        C059      Category II Instrument Approach and Landing Operations                                     YES          YES           YES
        C060      Category III Instrument Approach and Landing Operations                                    YES          YES           YES
        C061      Flight Control Guidance Systems for Automatic Landing Operations Other Than
                                                                                                             YES          YES           YES
                  Categories II and III
        C062      Manually Flown Flight Control Guidance System Certified for Landing Operations Other
                                                                                                             YES          YES           YES
                  Than Categories II and III
        C063      IFR RNAV 1 Departure Procedures (DP) and Standard Terminal Arrivals (STAR)                 YES          YES           YES
        C064      Terminal Area IFR Operations in Class G Airspace and at Airports Without an Operating
                                                                                                                          YES           YES
                  Control Tower--Nonscheduled Passenger and All-Cargo Operations
        C065      Powerback Operations with Airplanes                                                        YES          YES           YES
        C067      Special Authorizations, Provisions, and Limitations For Certain Airports                   YES          YES           YES
        C068      Noise Abatement Departure Profiles                                                         YES          YES           YES
        C070      Airports Authorized for Scheduled Operations                                               YES          YES           YES
        C071      Autopilot Engagement After Takeoff and During Initial Climb for Auto Flight Guidance
                                                                                                             YES          YES           YES
                  System (AFGS) Operations
        C072      Engine-Out Departure Procedures with Approved 10-Minute Takeoff Thrust Time Limits         YES          YES           YES
        C073      IFR Approach Procedures Using Vertical Navigation (VNAV)                                   YES          YES           YES

                                                                Page 3–2
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                               RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                  REQUEST FOR OPERATIONS SPECIFICATIONS
                           FOR THIS AIRCRAFT (continued)
                  OPS SPECS CHECKLIST




                                                                                                                                       Procedures
                                                                                                                         Proficiency
                                                                                                             Requires




                                                                                                                           Requires




                                                                                                                                         Requires
                                                                                                              Training
                                                                                                               Special




                                                                                                                            Special




                                                                                                                                           Special
                  IMPORTANT: Check only items that apply to the aircraft currently




                                                                                                                                           Written
                                                                                                                              Check
         Para
                  being added to the certificate and only if you need New Or Revised
                  Operations Specifications
        C074      Category I Precision Approach Procedures and IFR Landing Minima - All Airports                            YES           YES
        C075      Category I IFR Landing Minimums - Circle-to-Land Approach Maneuver                                        YES           YES
        C076      Category I IFR Landing Minimums - Contact Approaches                                                      YES           YES
        C077      Terminal Visual Flight Rules, Limitations, and Provisions                                                 YES           YES
        C079      IFR Lower than Standard Takeoff Minima, 14 CFR Part 135 Airplane Operations - U.S.
                                                                                                                            YES           YES
                  Civil Airports
        C080      Terminal Area IFR Operations in Class G Airspace and at Airports Without an Operating
                                                                                                                            YES           YES
                  Control Tower for Scheduled Passenger Operations
        C081      Special Non 14 CFR Part 97 Instrument Approach or Departure Procedures                                    YES           YES
        C358      Special Restrictions for "RNP-like" Foreign RNAV Terminal Instrument Procedures with
                                                                                                               YES          YES           YES
                  RNP Lines of Minima
        C359      Special Authorization For Certain Category II Operations at Specifically Approved
                                                                                                               YES          YES           YES
                  Facilities
        C382      Landing Performance Assessment At Time Of Arrival For Turbojet Operations                    YES          YES           YES
        C384      Required Navigation Performance (RNP) Procedures With Special Aircraft and Aircrew
                                                                                                               YES          YES           YES
                  Authorization Required (SAAAR)
        D072      Aircraft Maintenance - Continuous Airworthiness Maintenance Program (CAMP)
                                                                                                               YES          YES           YES
                  Authorization.
        D073      Approved Aircraft Inspection Program (AAIP)                                                  YES                        YES
        D074      Reliability Program Authorization: Entire Aircraft                                           YES          YES           YES
        D075      Reliability Program Authorization: Airframe, Powerplant, Systems or Selected Items           YES          YES           YES
        D076      Short-term Escalation Authorization                                                          YES          YES           YES
        D077      Maintenance Contractual Arrangement Authorization: For Entire Aircraft                                                  YES
        D078      Maintenance Contractual Arrangement Authorization: For Specific Maintenance                                             YES
        D079      Reliability Program Contractual Arrangement Authorization                                                               YES
        D080      Leased Aircraft Maintenance Program Authorizations: U.S.- Registered Aircraft                                           YES
        D082      Prorated Time Authorization                                                                                             YES
        D083      Short-Term Escalation Authorization for Borrowed Parts Subject to Overhaul
                                                                                                                                          YES
                  Requirements
        D084      Special Flight Permit with Continuous Authorization to Conduct Ferry Flights                 YES                        YES
        D085      Aircraft Listing
        D087      Maintenance Program Authorization for Leased Foreign- Registered Aircraft Operated by
                                                                                                                                          YES
                  U.S. Air Carriers
        D088      Maintenance Time Limitations Authorization                                                                              YES
        D089      Maintenance Time Limitations Section                                                                                    YES
        D090      Coordinating Agencies for Suppliers Evaluation (CASE)                                                                   YES
        D092      Maintenance Program Authorization for Airplanes Used for Operations in Designated
                                                                                                               YES                        YES
                  Reduced Vertical Separation Minimum (RVSM) Airspace
        D093      Helicopter Night Vision Goggle Operations (HNVGO) Maintenance Program                        YES          YES           YES
        D095      Minimum Equipment List (MEL) Authorization                                                   YES          YES           YES
        D101      Additional Maintenance Requirements - Aircraft Engine, Propeller, and Propeller Control
                  (Governor)
        D102      Additional Maintenance Requirements - Rotorcraft
        D103      Additional Maintenance Requirements - Single Engine IFR                                      YES                        YES
        D104      Additional Maintenance Requirements - Emergency Equipment
        D106      Aircraft in Long-Term Maintenance or Storage                                                                            YES
        D485      Aging Airplane Inspection and Records Review
        E096      Weight and Balance Control Procedures                                                        YES                        YES
        H100      Performance Requirements for Transport Category Large Helicopters                            YES          YES           YES
        H101      Terminal Instrument Procedures - Helicopter                                                               YES
        H102      Basic Instrument Approach Procedure Authorizations - All Airports                                         YES
        H103      Category I IFR Landing Minimums Other Than Airborne Radar Approaches - All Airports                       YES
        H104      Helicopter En Route Descent Areas                                                                         YES
        H105      Alternate Airport IFR Weather Minimums                                                                    YES           YES
        H106      IFR Standard Takeoff Minimums, Helicopter Operations                                                      YES           YES
        H107      Special Restrictions for Foreign Terminal Instrument Procedures
        H108      Category II Instrument Approach and Landing Operations                                       YES          YES           YES
        H109      Category III Instrument Approach and Landing Operations                                      YES          YES           YES
        H110      Flight Control Guidance Systems for Automatic Landing Operations Other Than
                                                                                                               YES          YES           YES
                  Categories II and III
        H111      Manually Flown Flight Control Guidance System Certified for Landing Operations Other
                                                                                                               YES          YES           YES
                  Than Categories II and III
        H112      Instrument Approach Operations Using an Area Navigation System                               YES          YES           YES
        H113      Special Terminal Area IFR Rotorcraft Operations in Class G Airspace--Nonscheduled
                                                                                                                            YES
                  Passenger and All-Cargo Operations

                                                                 Page 3–3
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                 RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                  REQUEST FOR OPERATIONS SPECIFICATIONS
                           FOR THIS AIRCRAFT (continued)
                  OPS SPECS CHECKLIST




                                                                                                                                      Procedures
                                                                                                                        Proficiency
                                                                                                            Requires




                                                                                                                          Requires




                                                                                                                                        Requires
                                                                                                             Training
                                                                                                              Special




                                                                                                                           Special




                                                                                                                                          Special
                  IMPORTANT: Check only items that apply to the aircraft currently




                                                                                                                                          Written
                                                                                                                             Check
         Para
                  being added to the certificate and only if you need New Or Revised
                  Operations Specifications
        H114      Special Helicopter Authorizations, Provisions, and Limitations into Certain Airports                     YES           YES
        H116      IFR Lower Than Standard Takeoff Minimums, Helicopter Operations                                          YES
        H117      Straight-in Category I Precision Instrument Approach Procedures - All Airports                           YES
        H118      Category I IFR Landing Minimums - Circle-to-Land Approach Maneuver                                       YES
        H119      Category I Contact Approach Procedures                                                                   YES
        H120      Airports Authorized for Scheduled Helicopter Operations                                                  YES
        H121      Special Terminal Area IFR Rotorcraft Operations in Class G Airspace--Scheduled
                                                                                                              YES          YES           YES
                  Passenger Operations
        H122      Special Non CFR Part 97 Instrument Approach or Departure Procedures for Rotorcraft
                                                                                                              YES          YES           YES
                  Operations




                                                                 Page 3–4
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                    REQUEST FOR OPERATIONS SPECIFICATIONS
                             FOR THIS AIRCRAFT (continued)

NOTICE: This information is for OPSS Part D.
        Part Numbers and Document Numbers must be Complete and Accurate.

                                                         AIRCRAFT :                      Aircraft
                                                                                    Maintenance                                       Read Note 1
                                                    Enter the Aircraft                   Manual
                                                      Manufacturer’s
                                                                                        Revision
                                            maintenance document                           Level
                                            identification number or
                                                  part number here:                            Date
                                                                                         Maintenance/Overhaul                Time In Service
                                                                                          Document ID or Part              Document ID or Part             TIME-IN-
                                                                    Make &                     Number                           Number                     SERVICE
                              ITEM                                  Model                     Read Note 1                     Read Note 2                 INTERVAL
3.1      ADDITIONAL           ENGINE
         REQUIRED             (Left or Single Engine)
         AIRCRAFT             ENGINE
         INFORMATION
                              (Right if applicable)
For Operations under Part
                              PROPELLER/ROTOR
135.411(a)(1) Only            (Left or Single
(“Nine-or-Less                Engine)
Operations”)                  PROPELLER/ROTOR
                              (Right if applicable)
                              PROPELLER
                              GOVERNOR
                              (Left or Single Engine)
                              PROPELLER
                              GOVERNOR
                              (Right if applicable)
                              PRIMARY
                              GOVERNOR
                              OVERSPEED
                              GOVERNOR

NOTE 1. Please enter the exact name, identification or part number, revision level, and date of the publication(s) under which the item will be maintained (normally
these are the airframe and the engine, propeller, and governor service manuals).

         Include a copy of the front page of each maintenance document and copies of relevant supporting records.

NOTE 2. Please identify the manufacturer's publication(s) by exact number and title that specify the overhaul /replacement time, or time-in-service interval for the
item. This is often a service bulletin.

         Include a copy of the front page of each maintenance document and copies of relevant supporting records.

                                                   Before this application, the aircraft was maintained and inspected under the following
                                                   maintenance and inspection programs: (Please check)
                                                      91.409(a)       Annual inspections
3.2      MAINTENANCE &                 Parts                                                                     91.409 (b)     100 Hour Inspections
         INSPECTION
                                     43 & 91          91.409(d)       Progressive Inspections
         HISTORY
                                                       (f1)   CAMP/CAIP [121 or 135.411(a)(2)                    (f3) Manufacturers Program
                                                      (f2)    AAIP [135.419]                                     (f4) Other Approved Program
                                                  Under our air carrier certificate, the aircraft will be inspected and maintained as indicated
                                                  below:
                                                         Part 135 411(a)(1) Maintained according to Parts 43 and 91 and inspected under (select one):
                                                                   91.409(a) Annual inspections and 91.409(b) 100 Hour Inspections
                                                                   91.409(d) Progressive Inspections
3.3      INTENDED (NEW)
                                                                   91.409 (f3) Manufacturers Program
         MAINTENANCE &              135.411
         INSPECTION                                                91.409 (f4) Other Approved Program
         PROGRAM                                                   135.419 Approved Aircraft Inspection Program (AAIP)

                                                     OR

                                                        Part 135.411(a)(2) Maintained according to a Continuous Airworthiness Maintenance Program
                                                        (includes inspections) (required for 10 or more pax aircraft)

                                  ESTIMATED TOTAL (Part 91 and 135) TAKE-OFFS PER MONTH
3.4      ANTICIPATED
         AIRCRAFT USE             ESTIMATED TOTAL (Part 91 and 135) FLIGHT HOURS PER MONTH

                                                                             Page 3–5
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                                   RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 3                         REQUEST FOR OPERATIONS SPECIFICATIONS
                                  FOR THIS AIRCRAFT (continued)

                                                                                                 A/C Make/Model
3.5          MAJOR ALTERATIONS
                                                                                                 Registration     N

§91.417(a)(2)(v) LIST ALL MAJOR ALTERATIONS THAT CURRENTLY APPLY TO THE AIRCRAFT;

                   Instructions For Continued Airworthiness
                             Field Approval
                                      Flight Manual Supplement
DATE                   Apply        in Block 3    Required
337 block 7         (Yes or No)    (Yes or No)   (Yes or No)      Brief Description of the Major Alteration




Use additional copies of this page as needed.

3.6          PRESSURE CYLINDERS AND SPHERES

List all Pressure Cylinders (including oxygen tanks) and spheres installed as aircraft equipment
                            Description or              Manufacturer’s Maintenance                Applicable limitations and provisions
Part Number
                            Part Name                           Document                              including current due dates.




Use additional copies of this page as needed.

3.7          REQUIRED MAINTENANCE & INSPECTION DATA

Refer to §91.417(a)(2): Provide the following information in any convenient format (current computer tracking
records may be acceptable if they provide the information indicated below):

      (i)    The total time in service of
               The Airframe,         Each Engine,              Each Propeller,   Each Rotor

      (ii)   The current Status of life-limited parts of each airframe, engine, propeller, rotor, and appliance

      (iii) The time since last overhaul of all items installed on the aircraft which are required to be overhauled on a specified time
            basis      NOTE: This includes all items that are required to be overhauled by the manufacturer of the item

      (iv) The current inspection status of the aircraft, including the time since the last inspection required by the inspection program
           underwhich the aircraft and its appliances are maintained. NOTE: This includes all appliances

      (v)    The current status of applicable airworthiness directives (AD) including, for each, the method of compliance, the AD
             number, and revision date. If the AD involves recurring action, the time and date when the next action is required.




                                                                            Page 3–6
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                         RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 4                  AIRCRAFT COMPLIANCE STATEMENT FOR 135 OPERATIONS
                                                                                         A/C Make/Model
4.1     ALL AIRCRAFT
                                                                                  Registration    N
INSTRUCTIONS FOR SECTION 4:
 Please refer to FAR 135 Subpart C, Aircraft and Equipment, and Far 91 as applicable, for the specific requirements of the items
    listed below
 Check the box next to the item to indicate that it meets the requirements of the rule.
 Provide all additional information indicated.
                                         (a) For each item marked  or recorded in any field, the applicant certifies that the equipment
                                         meets the applicable Federal Aviation Regulations. Indicate items that do not apply by “NA.”
General                                  (b) All required instruments and equipment not originally installed by the aircraft manufacturer
requirements                             have been approved as shown by FAA Form(s) 337 which are listed in Section 3.5 of this
                                         document and are available for inspection by the FSDO, and are in operable condition.
                                         (revised text to conform to the rule)
                       135.143                               Mode S     If not Mode S
                                          (c) ATC
                                                                        Date Installed          ATC Transponder Make & Model
                                         Transponder        Yes  No
                                                                               *
                                             #1
ATC Transponders                           #2
                                   * NOTICE: For 135 Operations, ATC Transponders installed after January 1, 1992, must be
                                              Mode S.
                                       Attach a list of all portable electronic devices intended to be used by the Flight Crew or enter
                       135.144
                                       “none”:
Equipment              135.147         Dual controls are installed
requirements:
General                                (a) Altimeter(s): Sensitive & adjustable for barometric pressure
                       135.149         (b)      Carburetor: Heat/Deice or          Pressure Carburetor: Alternate air source
                                       (c) For Turbojet airplanes: Third artificial horizon installed according to FAR 121.305(j)
Performance            135.181           Aircraft operated over-the-top or in IFR conditions
requirements:
                       135.183         Land aircraft operated over water.
Empty weight and                   Currency requirement
center of gravity:
                       135.185
                                                For multiengine aircraft: Date Last Weighed:         .
                                   FIRE EXTINGUISHERS
                                                   Make/Model                   Maintenance Document          Aircraft Location
                       135.155      1
                                    2
                                    3
                                   APPROVED PERSONAL FLOATATION GEAR
                                   (For operations beyond power-off gliding distance from shore)
Emergency                          Note: This equipment is required for operations in coastal areas; it need not meet 135.167
Equipment
                       91.205      Make/                                             Number
                       (b)(12)
                                                                                                              one for each seat
                                   Model:                                            Installed
                                                                          MAKE/MODEL:                        Shelf Life:
                                       PYROTECHNIC
                                       SIGNALING DEVICE
                                   Emergency Locator Transmitter
                       91.207      Make/                                               ELT                        TSO
                                   Model                                               Type                       Number
Oxygen Equipment       135.157          Meets all requirements Section 3.6 must list this equipment if this box is checked.




                                                                  Page 4-1
Note: The term “FAR” in this document means “14 CFR Part”                                      RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 4 AIRCRAFT COMPLIANCE STATEMENT FOR 135 OPERATIONS
          (continued)

                                                                                                     A/C Make/Model
4.1 ALL AIRCRAFT (continued)
                                                                                                     Registration            N

                                                                                                                   (e) Generators meeting FAR specifications
                                        (a) Gyroscopic Rate-of-Turn indicator
Passenger carrying                                                                                         (f) For Night Flight Authorization
under VFR at night                      (b) Slip skid indicator
or VFR over-the-top
                       135.159                                                                                     Anti collision light system
conditions
                                        (c) Gyroscopic bank-and-pitch indicator
                                                                                                                   Instrument lights
                                        (d) Gyroscopic direction indicator
                                                                                                                          2 "D-Cell” flashlight or equivalent

                                                                          Make/Model                                                          Make/Model
VFR Radio and                      VHF COM 1                                                   8.33 KHz Spacing*         DME 1
navigational           135.161
equipment
                                   VOR NAV 1                                                   FM Immunity*               ADF 1
                                                             *Required for certain operations Outside the U.S.
                                                                                                                           See below for other COM/NAV Equipment

                                                                                                                  (e) Alternate static source
                                                                                                                      See Order 8340.1a chg 81, app 14, par
                                                                                                                      34-31 for exceptions
                                        (a) Vertical speed indicator
                                        (b) Free air temperature indicator
                                                                                                                  (f) Single-Engine aircraft
                                                                                                                         (Generator/load combination as
Passengers Under                        (c) Heated pitot tube for each airspeed
IFR
                       135.163                                                                                           specified)
                                            indicator
                                                                                                                  (g) Multi-engine aircraft:
                                        (d) Gyroscopic power source indicator or                                      (two generators loaded as specified)
                                            power failure warning indicator
                                                                                                        (h) Two independent sources of energy as
                                                                                                             specified to power gyroscopic
                                                                                                             instruments
                                         Autopilot Make & Model                      Autopilot is capable of operating the aircraft controls to
AUTOPILOT              135.105                                                       maintain flight and maneuver it about the three axes:
                                                                                     Required for Ops Specs
                                                                   Make/Model
Radio and                                                                                                                          Two microphones
                                                                                                                    *
Navigational                       VHF COM 2                                                    8.33 KHz Spacing                   Marker Beacon Receiver
Equipment: IFR
                       135.165
                                                                                                              *                    Two headsets or
Operations                         VOR NAV 2                                                    FM Immunity
                                                        *
                                                                                                                                   One headset and one speaker
                                                            Required for certain operations Outside the U.S.




                                                                            Page 4-2
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                                        RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 4 AIRCRAFT COMPLIANCE STATEMENT FOR 135 OPERATIONS
          (continued)
4.2     RNAV AND EXTENDED OVERWATER OPERATIONS

                                   Radio and navigational equipment for Extended Overwater Operation Authorization
                                          Make/Model            INDICATE ALL SENSORS                                APPROVED FOR
                                                                  Flight Management                          WAAS
                                                                  System or
                                                                                                             Non-Precision Approaches
                                                                  NAV Management
                                                        .         System                                     Remote/Oceanic
                                                                  GPS       Loran C                          RNP TYPE(s)
                                   1      Date                                                                  Time Limits
                                          Installed               INS/IRS
                                                  .               OTHER                                      BRNAV                 PRNAV
                                                                  SHORT-RANGE RNAV                           VNAV                  Enroute
                                                                      VOR/DME or                                                   /Terminal
AREA or Long
Range NAV
                                                                      DME/DME-FMS
Systems:                                                          Flight Management                          WAAS
                                                                  System or
                                                                                                             Non-Precision Approaches
                                                                  NAV Management
                                                        .         System                                     Remote/Oceanic
                                                                  GPS       Loran C                          RNP TYPE(s)
                       135.165     2      Date                                                                  Time Limits
                                                                  INS/IRS
                                          Installed
                                                  .               OTHER                                      BRNAV                 PRNAV
                                                                  SHORT-RANGE RNAV                           VNAV                  Enroute
                                                                      VOR/DME or                                                   /Terminal
                                                                      DME/DME-FMS
                                   3      If a third navigation system is installed, please attach the information indicated above for that system

                                             Make/Model                                    LRCS Type                                   Date Installed

Long-Range                         1                                      HF      SAT/COM         DATALINK          OTHER
Communications
System(s) (LRCS)                   2                                      HF      SAT/COM         DATALINK          OTHER

                                   3                                      HF      SAT/COM         DATALINK          OTHER

                                   TO AVOID DELAYS IN APPROVAL, provide the following for each Navigation or LR
                                       Communication system listed above
Airworthiness and
Operating
                                           Copies of the portions of the installation approval documents (original Equipment
Limitations                                List or FAA Form 337) and
                                           Flight Manual Supplements that show the make and model of the equipment and
                                           approval for the requested operation. Contact the FSDO if there are any questions.
                                       (a) The following are
                                   conspicuously marked and easily
                                                                                          Make & Model                 Maintenance Document ID
                                   accessible to the occupants if
Emergency                          ditching occurs:
equipment
Extended overwater
                       135.167         Life Preserver with Light for each
operations                             occupant.
                                       Life rafts as specified in
                                       135.167(b) & (c).




                                                                     Page 4-3
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                      RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 4 AIRCRAFT COMPLIANCE STATEMENT FOR 135 OPERATIONS
          (continued)
      PLEASE COMPLETE THIS PAGE ONLY IF APPLICABLE
                                                                                                  A/C Make/Model
4.3     TURBINE-POWERED, TURBOJET, AND/OR TEN-OR-MORE PASSENGER AIRCRAFT
                                                                                                  Registration     N

                                                                                            Proving test plan is scheduled on page 1-1
Proving Test Flights   135.145            NOT REQUIRED                REQUIRED              Proving tests are scheduled on page 1-1
                                                                                            Request for deviation is scheduled on page 1-1
                       135.150              Public address and crewmember interphone systems
                                                                                                Make/Model/Series                      Date Installed

                       135.151              Cockpit Voice Recorders

Additional             135.151(d)           Dual Headsets with Boom Mics
Equipment
                       135.152              Flight Recorders
Requirements
                       135.153              Ground Proximity Warning System
                                            Terrain Awareness & Warning
                       135.154              System (TAWS)
                                                Class A         Class B
                       135.158              Pitot heat indication systems

                                    (a)     For all large airplanes (more than 12,500 pounds, maximum certificated takeoff weight):
                                            The aircraft
                                                  is a commuter category airplane, or
                                                 meets the additional requirements of FAR 121.213 through 121.283, and 121.307:
                                    (b)     For Reciprocating-engine airplanes configured for ten-or-more passengers or
                                            For Turbopropeller-powered Small Airplanes configured for ten-or-more passengers:
                       135.169                   meets all applicable conditions specified in 135.169(b)
                                            (c)   For all ten-or-more small airplanes
                                                  state the maximum Passenger seating configuration
                                    (d)     Cargo or baggage compartments: All transport category airplanes type certificated
                                            after January 1, 1958.
                                               each class C or D cargo compartments is not greater than 200 cubic ft in volume, or
                                               meets all applicable conditions specified in 135.169(d)
Additional             135.170              Materials for compartment interiors
Airworthiness
Requirements           135.171              Shoulder harness installation at flight crewmember stations
                                                                                                                                           Date
                                                                                           Make/Model/ Series
                                                                                                                                         Installed
                       135.173             Airborne thunderstorm
                                           detection equipment
                                           requirements
                       135.175             Airborne weather radar
                       .                   equipment requirements
                                           Emergency equipment requirements for aircraft having
                       135.177
                                           a passenger seating configuration of more than 19 passengers


                                           Traffic Alert and Collision
                       135.180
                                           Avoidance System                   TCAS I       TCAS II
                                                                            TCAS II Software Version 7 or higher?              Yes       No
                                          Aircraft was built to RVSM requirements as shown in the Type Certificate.
                                          Aircraft was modified to RVSM requirements under
RVSM
Requirements
                       91.180                  Service Bulletin          or STC           on (date)
                                                    A copy of the maintenance sign-off is included with this conformity statement.
                                                    The RVSM maintenance program is submitted for approval with this statement




                                                                      Page 4-4
Note: The term “FAR” in this document means “14 CFR Part”
                                                                                                      RIC FSDO Form F022, Revision 8, March 12, 2009
SECTION 5                  FAR 135 AIRWORTHINESS CHECKLIST
We suggest you use this checklist frequently and especially before presenting the aircraft to the
FAA for inspection or before an FAA check ride.
A/C Make and Model                                                                                              Registration   N
                                                     CHECK THE BOX TO INDICATE COMPLIANCE


INSPECTION ITEM                                                                 INSPECTION ITEM
    Check if the item meets all applicable FAR Requirements                        Check if the item meets all applicable FAR Requirements
CERTIFICATES AND REGISTRATION                                                   PASSENGER SAFETY
     The Registration Certificate is on board and current.                           All internal cabin placards required by the Type Certificate or
     The Airworthiness Certificate is on board and current.                          the AFM are secure and readable.

     The Radio Station License is on board and current.                              Passenger Briefing Cards meet 14 CFR 135 Requirements.

OPERATING LIMITATIONS                                                                Required emergency equipment is on board, properly stowed,
                                                                                     and inspected.
     FAA Approved Aircraft Flight Manual (AFM) or Pilots
     Operating Handbook is current, complete, and in serviceable
     condition.
     AFM contains Flight Manual Supplements that are current
     and applicable to the installed Autopilot/Flight Director,                 GENERAL AIRWORTHINESS
     Navigation equipment, and other installed equipment to which
     a Flight Manual supplement applies.                                             The aircraft has the proper equipment and approval
                                                                                     documentation required by 14 CFR 135 Subpart C.
     All flight deck placards required by the Type Certificate or the
     AFM are secure and readable.                                                    All external placards, required by the Type Certificate or the
                                                                                     AFM, are secure and readable.
     The flight deck contains all operating manuals and/or
     placards required by TC, STC, or FAA Form 337s.                                 All cowl fasteners, screws, etc., are secure.
     All switches, circuit breakers, controls, etc., are properly                    Antennas are free from erosion.
     labeled                                                                         ADF/HF Long-Wire antenna is under spring tension.
     AFM contains current weight and balance data, and all                           All static wicks installed, none broken except as deferred
     obsolete weight and balance data is superseded; or, for                         under an MEL. No bonding straps broken
     aircraft not requiring an AFM, the current weight and balance
     and equipment list is in the aircraft.                                          The aircraft Make, Model and Serial Number data are on the
                                                                                     outside of the fuselage.
     AFM contains a current and complete equipment list.
                                                                                     All instruments, systems, and equipment are operating
     For multiengine aircraft, the AFM contains a weighing record                    properly or deferred under an MEL; the aircraft is airworthy
     showing the aircraft was weighed within the last three years.                   and legal to fly.
     The record includes an equipment list, which describes the
     approved aircraft configuration at the time of weighing. The
     weighing record has the signature and certificate number of                MAINTENANCE RECORDS
     the person or agency doing the work and the date of
                                                                                     The maintenance records show that all airworthiness
     completion.
                                                                                     inspections are current including, Annual/100 hr or
                                                                                     Programmed Inspection, Altimeter, Encoder, Static System,
AIR CARRIER OPERATIONS DOCUMENTS                                                     ATC Transponder, etc.

     Aircraft Maintenance Log (14 CFR 135.65) contains no open                       All required maintenance, including maintenance of life-
     Mechanical Irregularities                                                       limited items, is current.

     Minimum Equipment List is on board and current.                                 The maintenance records include an Airworthiness Directive
                                                                                     (AD) Listing showing that all ADs are complied with including
     Air Carrier Operations Manual is on board and Current.                          Recurring ADs. The listing must comply with FAR
     Deferred Maintenance Log contains no items deferred                             91.417(a)(i)(v)
     beyond the time allowed in the MEL.



I certify that, to the best of my knowledge, the information contained in this report is complete and accurate.



                                     Director of Maintenance (or other title)                                                    Date




                                                                          Page 5-1
Note: The term “FAR” in this document means “14 CFR Part”                                               RIC FSDO Form F022, Revision 8, March 12, 2009

								
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