PA Dept of Conservation & Natural Resources



| | |Check Appropriate Box: |

|PA Dept. of Conservation & Natural Resources |Name of Contractor: | |

|Bureau of Forestry | |Airplane | |

| |      | | |

|Aircraft Description & Inspection |Mailing Address:  | |

|Form |       |Air tanker | |

| | City, State, Zip:   | |

| |       |Helicopter | |

|Instruction: Complete Answers by Checking Yes, No or Filling in Information. |

|Aircraft Description and Information |

|Aircraft Make & Model |Category |F.A.A. Reg |Year |Cruise IAS (MPH or KTS) |

|      |      |N      |      |      |

|      |      |      |      |      |

|Basic Empty Weight |Fuel (HH+MM) |Max. Cert. Takeoff Weight |Date of Last Annual Insp. |Accident History |

|      |

| |Total Hours |TSOH (hrs) |Gear |No. of Engines |Tank Capacity |

|1. Airframe | | | | | |

| |      |      |Fixed | |Ret. |

| | |      |      |      |      |

| |Hours since 100 hour |Number 1 (L) |Number 2 (R) |Number 3 |Number 4 |

| |Inspection | | | | |

| | |      |      |      |      |

|3. Propellers |Hours since Overhaul |Number 1 (L) |Number 2 (R) |Number 3 |Number 4 |

| | |      |      |      |      |

|4. Instruments |Normal Eng. Inst. |Fuel Qty. Ind. |Stall Warning |Airspeed Indicator |Clock |

| |yes | |no | |yes |

| |yes | |no | |yes |

| |yes | |no | |yes |

| |      |      |      |      |      |

| |Restraints |Cabin |Cockpit |First Aid Kit |Eng. Fire Ext. |

| |      |      |      |      |      |

| |Cabin Fire Ext. |Placards |Brakes |Survival Kit |ELT Battery Date |

| |      |      |      |      |      |

|6. Elec. System |Elec. Sys. (VDC) |APU |Battery Type |Ammeter |GPU Elec. Port |

| |      |yes | |no | |

| |yes | |no | |yes |

| |yes | |no |

| |yes | |no |

| |yes | |no | |

| |yes |

| |      |

| | |

|Information Provided and Attested to by: | |Date: | |

|(Signature Required) |      | |      |

1 Jan 2009 Edition BoF Aircraft Description & Approval Form 09

-----------------------

[pic]

................
................

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

Google Online Preview   Download