APPLICATION TO REGISTER A HELICOPTER FOR COMMERCIAL AIR TRANSPORT OPERATIONS
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- Dulcie Parsons
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1 . Operator: Operator: O No.: ontact person: Phone:. Helicopter ata: Manufacturer: Type esignation: Type of engine(s): Year of manufacture / first o: Serial No (If available) Icetra No.: Registration: PS MPS MTOM (Kg/Lbs) MLGM (Kg/Lbs): MZFW (Kg/Lbs): ate of last weighing: / Selcal ode Mode S: ELT codes: nnex 16 Noise certification. Intended operation: rea of Operation Iceland = IS Iceland/Greenland = ISGR rctic = 1 ntarctic = 2 Europe North = 3 Europe South = 4 Europe East = 5 Worldwide = WW Mid East = 6 sia = 7 Pacific = 8 North merica = 9 aribbean = 10 S merica = 11 N tlantic = 12 frica = 13 Type of Operation Passenger 1 argo 2 HEMS 3 erial Work 3 (please specify):. Flight Training evice: New Flight Simulation Training evice (FST) needed for Helicopter? Yes No If yes, complete and submit form FOS-002 "pplication for ST user approval" o Helicopter and FST have onfiguration ifferences? Yes No If yes, complete form FR-014 "Flight Training evice / Helicopter onfigurarion ifferences List. Page 1
2 E. Special uthorisations/approvals applied for (specify relevant data, values or notes in fields as applicable): PRT-SP: SUPRT - PN Operations RNP 2 RNP 4 RNP 10 RNP PH RNP 0,3 RNP R PH RNP 0,3-0,1 PRT-SP: SUPRT - MNPS NT MNPS -RNV / RNV 5 P-RNV / RNP 1 PRT-SP: SUPRT - RVSM RVSM PRT-SP: SUPRT E - LVO LVTO RVR (<400m): RVR 150m or 125m T II RVR/H minima: T III RVR/H minima: T III RVR/H minima: PRT-SP: SUPRT G - GR ata Link ommunication PL / ST omm PL / VHF omm FNS 1/ L/P (M 20-09) -TIS (M 20-10) S S PRT-SP: SUPRT H - NVIS NVIS PRT-SP: SUPRT I - HOIST OPERTIONS NVIS PRT-SP: SUPRT J - HEMS HEMS EF lass (Specify) GR Note: Special uthorisations require a separate application to be submitted and approved by IETR before authorisation is granted. Page 2
3 F. Supplemental Type ertificates (ST s) Note: List of ST s as a separate document is also acceptable provided all information specified in table are included. No ST's or Modification have been incorporated. List of incorporated ST s (1) ST reference: (2) escription FM Supplem ent (3) MEL Supplem ent ES pproval Reference ES pproval ate Note Yes N/ Yes N/ Notes: (1) ST reference number (e.g. ST S5656-T) (2) Short description of modification (e.g. Installation of cabin interior) (3) See ST cover sheet or equivalent for availability of FM Supplement Page 3
4 G. ocuments to be provided to IETR (as applicable) ocument: Revision status: ate of revision: Notes: * Required Helicopter Flight Manual * Operations Manual Part Operations Manual Part * Operations Manual Part Helicopter QRH * abin Manual MMEL * MEL * LOP* Emergency Equipment Layout * Passenger Safety riefing ard * opy of loadsheet for Helicopter* PN Operations - Form FR-041 NVIGTION or FR-035 RNP PPROH MNPS - Form FR-041 NVIGTION PPROVLS RVSM - Form FR-041 NVIGTION PPROVLS LVO - Form FR-040 PPLITION FOR LOW VISIILITY OPERTIONS GR: - Submit a letter and revised pages from relevant OM Parts and Training records. EF - Form FR-036 PPLITION FOR ELETRONI FLIGHT G/PE OPERTIONL PPROVL pplication for Noise ertificate * Helicopter Radio License * List of Manuals and ocuments on board (specify rev. status / doc. number and date) * List of Service ulletins applicable to Helicopter * List of Modifications applicable to Helicopter * Page 4
5 H. Insturments, ata, Equipment - ompliance List (PRT-T / SUPRT ) Introduction Operators are required to comply with the instruments and communication requirements of ES IR OPS. Each shall demonstrate, from the available airplane records (manufacturers and subsequent modifications), how compliance with applicable requirements are achieved for each individual airplane that he operates. This compliance List is derived from 2012 / NNEX IV / PRT-T / SUPRT ompletion of form The operator shall verify what instruments and equipment is installed by completing relevant parts of this form. Refer to the actual regulation for details of each requirement. If the requirement is not satisfied through the TS, mark "No" in column "" and provide further details of compliance in the relevant field on the form (, or ) / NNEX IV / PRT-T / SUPRT ertificate ata Sheet (TS) publications (Service ulletins, Indicate S number escripe T.IE.H.100 Instruments and equipment general T.IE.H.105 Minimum equipment for flight T.IE.H.115 Operating lights T.IE.H.125 Operations under VFR by day flight and navigational instruments and associated equipment Page 5
6 2012 / NNEX IV / PRT-T / SUPRT ertificate ata Sheet (TS) publications (Service ulletins, escripe Indicate S number T.IE.H.130 Operations under IFR or at night flight and navigational instruments and associated equipment T.IE.H.135 dditional equipment for single-pilot operation under IFR T.IE.H.145 Radio altimeters T.IE.H.160 irborne weather detecting equipment T.IE.H.165 dditional equipment for operations in icing conditions at night T.IE.H.170 Flight crew interphone system T.IE.H.175 rew member interphone system T.IE.H.180 Public address system T.IE.H.185 ockpit voice recorder T.IE.H.190 Flight data recorder T.IE.H.195 ata link recording Page 6
7 2012 / NNEX IV / PRT-T / SUPRT ertificate ata Sheet (TS) publications (Service ulletins, Indicate S number escripe T.IE.H.200 Flight data and cockpit voice combination recorder T.IE.H.205 Seats, seat safety belts, restraint systems and child restraint devices T.IE.H.210 Fasten seat belt and no smoking signs T.IE.H.220 First-aid kit T.IE..230 First-aid oxygen T.IE..235 Supplemental oxygen pressurised aeroplanes T.IE.H.240 Supplemental oxygen non-pressurised helicopters T.IE..245 rew protective breathing equipment T.IE.H.250 Hand fire extinguishers T.IE.H.260 Marking of break-in points T.IE.H.270 Megaphones Page 7
8 2012 / NNEX IV / PRT-T / SUPRT ertificate ata Sheet (TS) publications (Service ulletins, Indicate S number escripe T.IE.H.275 Emergency lighting and marking T.IE.H.280 Emergency locator transmitter T.IE.H.290 Life-jackets T.IE.H.295 rew survival suits T.IE.H.300 Life-rafts, survival ELTs and survival equipment on extended overwater flights T.IE.H.305 Survival equipment T.IE.H.310 dditional requirements for helicopters conducting offshore operations in a hostile sea area T.IE.H.315 certified for operating on water miscellaneous equipment. T.IE.H.320 ll helicopters on flights over water ditching T.IE.H.325 Headset Page 8
9 2012 / NNEX IV / PRT-T / SUPRT ertificate ata Sheet (TS) publications (Service ulletins, escripe Indicate S number T.IE.H.330 Radio communication equipment T.IE.H.335 udio selector panel T.IE.H.340 Radio equipment for operations under VFR over routes navigated by reference to visual landmarks T.IE.H.345 ommunication and navigation equipment for operations under IFR or under VFR over routes not navigated by reference to visual landmarks T.IE.H.350 Transponder pplicant s Statement I herewith confirm completeness and accuracy of this application and of the ir OPS / PRT-T ompliance Lists. (For official use only) IETR cceptance: Name of Nominated Person Operations : Signature ate: ate: I herewith confirm correctness of the ir OPS T.IE ompliance List. Signature: Name of Nominated Person Part-M : Signature ate: Page 9
APPLICATION TO REGISTER AN AIRCRAFT FOR COMMERCIAL AIR TRANSPORT OPERATIONS
. Operator: Operator: O No.: ontact person: Email: Phone:. ircraft ata: Manufacturer: Type esignation: Type of engine(s): Year of manufacture / first o: Serial No (If available) Icetra No.: Registration:
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