Maintenance Records 11 - Attachment 11 - Supplemental Type

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DEPAlTMEM OF lRANSP0KlATrOlr FEDERAL AVIATION ADMlNlSlRAflON Fona Appr08.cd Budgef Bureau N o 04-ROGO I M A J O R REPAIR A N D ALTERATION. FOR FAA USE ONLY OFFICE IDENTIFICATION MAKE MODEL A'RCRAFT AMERICAN EUROCOPTER SERIAL N O AS35ODIASTAR NATIONALITY AND REGlSTRAJlQN MARK 1604 NAME (As shown m regrshutron certrficrrte) 'N360GE ADDRESS (As shorn an regrslmhon certrfimtej OWNER ISLAND EC$PWRESS.HELICOPTEFS, WC. 1175QUEENSWAYHWY. LONG BEACH CA 9080; 3. FOR FAA USE ONLY 4. UNIT IDENTIFICATION UNIT MAKE I 5. TYPE AIR LE AI N TO M DL OE AIRFRAME I I S RA N EI L O P (As dercrrbed m rtem 1 av b) o e I I POWERPLANT 1 I I I I 6 CONFORMITY STATEMENT A AGENCY'S NAME AND ADDRESS B KIND OF AGENCY C CERTIFICATE NO TIMOTHY A CRUISE, ------ --- ----------- ---LONG X BEACH. CA 90806 I I QmF'C*rED MECHALIC F RI N C R II A D MC A I O EG E TFC E E H NC SAI N T TO I 1I C S I I A E P P 1 E TFC T D E A P ~UNUFACTURER I ------- D I cerrlfy that t h e repair andfor alterarron made to the unlt(r) ldentlfied r rtem 4 above and described on the reverse o r n atrachrncnu hereto have been madc In accordancc wrch the requlremenb of Paa 43 of the U S Federal Avzatron Regulatlons and chat the rnformatlon furnrshed herern IS true and correct t o the best of my knowledge :DATE SIGNATURE OF AUTHORIZED INDNIDUA! 01/18/2001 7. APPROVAL FOB RETURN TO SERVICE 4 Purrurnt t u the authority Stven persons sppcrlied h l u w , the unrt ~dentrfiedm Item the A h l n t s n a r u r of the Federal Avlarton Admlnrsrratrun and IS APPROVED F A A FLT STANDARDS a r s anspecred tn the maonor prpscrrbed by REJECTED OWER (5pccrfyJ BY I S' CO N IE I R F A A D SG E EI N E x REPAIR STATION I S E TO AUTHORI~TION NPCI N C N DA OEPAPIMENT A A I N O T A SO T I SE T R F R NP R NP C O OF AR R F I C AT DATE OF APPROVAL OR REJECTION CERTIFICATE OR DESIGNATION N O 01 /I m1 0 -------- FAA Fonn 337 17-07) u5 Government ~ n n t ~ n o mrce ~ ~ - ~ 7 2 - 6 4 6 1 : 4 1 (8320) NOTICE Weight and balance or operating limifafion changes shall be entered in the appropriate aircfaff record. An alteration must be compatible with all previous affera€ions f assure continued conformity with the applicable o airworffiiness requirements. 8. DESCRIPTION OF WORK ACCOMPLISHED (If more space is required, attach addifional sheets. Identify wifh a i m l ? nationality and regisfmtion mark and date work completed-) N67GE OU18R001 AI(3T.T. 2108.5 S.B.01.00.12 (NREVERSE) TYPE CERTIFlCATEDATA SHEET#H9EU I REMOVED: 1 ENGINE, TURBOMECA ARRIEL 1B S/N 758 ) 2) TAIL ROTOR LONG DRIVE SHAFT ASSY. 3 F(=UCONTROL CAB= ) 4) GOV. CONTROL CABLE 5) ENGINE TO M G ~ DRIVE SHAFT AND SPINED COUPLING . 6 ENGINE FRONT SUPPORT TUBE ) 73 TORQUE METER GUAGE 8 TURBINETEMPGUAGE ) 9) START GEN. 10) AFT ENGINE FIREWALL AND FAIRING 11) ENGINE FUELINPUTHOSE 12) ENGINE OIL INPUT HOSE 13) ENGINE OIL OUTPUT HOSE 14) ENGINE FUELDRAIN LINE TO TOP OF FUEL TANK MODIFIED: 1 RELOCATE ENGINEMOUNTSON DECK TO EXISTING FWD. POSITION ) 2) RELAICATE WIRING CONNECTIONS AS INDICATED IN S.B.01.00.12(IN REVERSE) 3) REMOVE BUBBLE FROM FWD. DRIVE SIFLAlT COWL AND INSTALL HEAT SHIELD 4) CHANGE OIL COOLER AND LUBRICATION SYSTEMROUTING ACCORDING TO S.B.O~ .00.12(1~ REVERSE) 5 CFbWGE ENGINE OIL TANK LOCATION AND ROUTING TO FACILlTATE FULL ITOW CHIP DETECTOR ) 6 FWD- FIREWALL ACCESS HOLES A S INDICATED IN S.B.01.00.12 (INREVERSE) ) D CHANGE ENGINE COWL INL.ETSCREENAND BLANKWG PLATE LOCATIONS 8 CALIBRATE EXISTING TURBINETEMP. GUAGE HARNESS ) I INSTALL: 1 ENGBE, HONEYWEU LTSlOl600A3 S/N LE43456ce ) 2) TAIL ROTOR LONG DRIVE SHAFT 3) FCU CONTROL CABLE 4) GOV. CONTROL CABLE 5 ENGINE TO MGB. DRIVE SHAFT AND SPLZNED COUPLING ) 6) ENGINE FRONT SUPPORT TUBE 7 TORQUE MEzER WAGE ) 8 TURBINE TEMP- GUAGE ) 9 START GEN. ) 10) AFT. ENGINE FlREWALL 77) ENGrnFUELINF'uT ROSE 12) ENGINE OIL INPUT HOSE 13) ENGINE OIL OUTPUT HOSE 14) 3- OIL COOLER AS INDICATED IN S.B.01.00.12 (NR) I E 75) APPROPRIATE I N S T R . PANEL MAEKINGS 16) APPROPRIATEFLIGHT MANUAL CHANGE ADDITIONAL SHEETS ARE ATTACHED ~ADDIIIONAL SHEETS ARE ArrACHED NOTICE Weight andbalance or operating limitation changes shall be enfered in the appropriate aircraff record. An alferationmust be compatible with all previous alterations t assure continued conformity with the applicable o airworthiness requiremenfs. 8. D E S C m O N OF WORK ACCOMPLISHED (Ifmore space is required, attach additional sheets. Identify with aircraff nationality and regisfiation mark and dafe work completed-) N67GE 0U18/2001 A/C T.T.2108.5 SB.01.00.12(INREVERSE) TYPE CERTIFICATEDATA SHEET#H9EU REFERENCEMATERIAL: 1) MANUFACTURES SERVICEBTJLL,ITEN 01.00.12 (INREVERSE) 2 TYPE CERTIFICATEDATA SHEET # WEU ) 3 M A N U F A ~ MAINTENANCE MANUALS AND OTHER PUBLICATIONS ) S MEIGHT AND BALANW 1) REFER TO AnACHED FORM "B" FOR PHYSICAL WIEGHING WlTH EVERGREEN SCALES S/N 1009-4C NET WIEGRT C.G. MOMENT fl ADDITIONAL SHEETS ARE ATTACHED .. ... . HEIGHT AND BALANCE 12-87 Page 1 7 '00~ WE1 GHT AND BALANCE- 7 FORMS Form 8 WEIGHING SHEET -. " * < f h 5072 mm (199.68 i n ) Corn~lated by : 1 J a c k i n g point Date : 'oistance of each point f r o m the.aircraft cent?el ine : 3 9 8 . 5 mn ( 1 5 . 6 8 i n ) . .. i. " . . ....-.. : -. . 12 -87 Page 16 *OO* ~NITED STATES OF AMERICA D E P A R T M E N T O'F TRANSPORTATION-FEDERAL A V I A T I O N A D M I N I S T R A T i O N . N67GE 5. A U T ~ O R I T Y STANDARD AIRWORTHINESS CERTIFICATE. +.-c---=.~,rC - 1 NATIONALITY AND REGISTRATION MARKS SERIAL -4. CATEGORY NonnaL and certifies 0 This airworthiness dote of issuance, therefor, to be in comprehensive Avktion, Exceptions: tho t, as of the to the type certificate of the applicable International Civil w 6. TERMS AND COHDlTlOHS Unless sooner surrendered, this airworthiness certificat performed in accordonce aircraft i s registered in th DATE of ISSUANCE established ainfe;once, by the Administrator, and alterotians are ions, as appropriate, and the OESlGNATtON NUMBER R 07/26/85 . ANCE WITH APPLICABLE FEDERAL AVIATION REGULATIONS. Any alteration, reprodudiorl/or misuse of this ~ e r i i f i M @ ~ m h ~ * 6 i punishable b y a fine not exceeding $1.000, or imprisonment not exceeding 3 years, or both. THIS CERTIFICATE MUST BE DISPLAYED IN THE AIRCRAFT IN ACCORD- FAA Form 81[lb-2 r l r - r ; , ~ F ~ R M F F Z I FAA v ~nnu 12=3 A.le . --.a --- --.-- -- - . . - - I

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