Www.csustan.edu



CALIFORNIA STATE UNIVERSITY, STANISLAUSUNMANNED AERIAL SYSTEMS (UAS) REVIEW COMMITTEEMSR 160 | (209) 667-3493 | orsp@csustan.eduFLIGHT OPERATIONS PROPOSAL APPLICANT INFORMATIONName of Primary Applicant and UAS/UAV Operator: FORMTEXT ?????Position of Primary Applicant (check one): FORMCHECKBOX Faculty FORMCHECKBOX Staff FORMCHECKBOX Administrator FORMCHECKBOX StudentIf Primary Applicant is a Student, list University Employee Sponsor: FORMTEXT ?????Name(s) of Other Applicant(s) and Operator(s): FORMTEXT ?????Contact Information of Primary ApplicantAddress:Street (Including Apt/Unit #) FORMTEXT ?????City FORMTEXT ?????State FORMTEXT ?????ZIP Code FORMTEXT ?????Phone: FORMTEXT ?????Email: FORMTEXT ?????CERTIFICATION AND SIGNATUREBy submitting this protocol I certify under the penalty of professional misconduct the attached statements are accurate and true. Primary Applicant Signature: FORMTEXT ???Date: FORMTEXT ???University Employee Sponsor Signature (if applicable): FORMTEXT ???Date: FORMTEXT ???FLIGHT OPERATIONS INFORMATIONNOTE: Each section MUST be completed. 1. Purpose, nature (research, instruction, other), and goals of the work to be undertaken.Click here to enter or paste text – this field will expand as required. There is no word/page limit.2. Need for a UAS or UAV.Click here to enter or paste text – this field will expand as required. There is no word/page limit.3. Type of vehicle(s)/equipment to be utilized and the manner in which it/they will be operated.Click here to enter or paste text – this field will expand as required. There is no word/page limit.4. Airworthiness of the proposed UAS/UAV.Click here to enter or paste text – this field will expand as required. There is no word/page limit.5. Training of involved personnel, including the pilot(s)/operator(s) and visual observers.Click here to enter or paste text – this field will expand as required. There is no word/page limit.6. Dates/schedule of activities to be undertaken.Click here to enter or paste text – this field will expand as required. There is no word/page limit.7. Locale(s) and flight plan for operations.Click here to enter or paste text – this field will expand as required. There is no word/page limit.8. In cases where a COA application is being sought for airspace over land not owned by the University, the request to the UAS Review Committee must include a letter of collaboration from each non-University party involved.Are you proposing flight in airspace over land not owned by the University? FORMCHECKBOX Yes FORMCHECKBOX NoIf YES, check here acknowledging that you have attached an appropriate letter of collaboration from each non-University party involved. FORMCHECKBOX 9. All forms of data (including imagery) to be collected.Click here to enter or paste text – this field will expand as required. There is no word/page limit.10. Provisions for security of the equipment, both during and outside of operation, and of any sensitive data collected.Click here to enter or paste text – this field will expand as required. There is no word/page limit.11. Sources and nature of financial support for the project, including expenses such as equipment and insurance.Click here to enter or paste text – this field will expand as required. There is no word/page limit.12. Communications plan for notifying campus police, local landowners, and police agencies, as appropriate, in the overflight radius of planned operations each time a UAS is flown.Click here to enter or paste text – this field will expand as required. There is no word/page limit.13. Written affirmation, in the case of a Public Use COA, that the UAS/UAV will be used only for noncommercial, research purposes.Click here to enter or paste text – this field will expand as required. There is no word/page limit. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download