VLOGA za izdajo licence LAPL Helikopterji APPLICATION FORM for the issue of the LAPL Helicopters
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1 VLOGA z izdjo liene LAPL Helikopterji APPLICATION FORM for the issue of the LAPL Heliopters 1 OSEBNI PODATKI PERSONAL DATA Priimek kndidt(ke): Applint's lst nme: Dtum rojstv (dd/mm/yyyy): Držvljnstvo: Ntionlity: Nslov (uli, hišn številk, pošt, držv) Address (street, numer, postl ode, ity, stte) Telefonsk številk: Telephone Numer: Letlsk orgnizij: Nme of ATO: Ime kndidt(ke): First nme: Krj rojstv: Town of irth: Številk oseneg dokument: ID /Pssport Numer: Elektronski nslov: E-mil: 2 PODATKI O IMETNIKOVI LICENCI IN RATINGIH če ostjjo HOLDER S LICENCE AND RATINGS HELD if existed Orgn, ki je lieno/rting izdl Issuing Authority Vrst številk liene Type No. of Liene Vrst rtingov / dtum veljvnosti Type of Rtings / Expiry Dte 3 PRILOGE VLOGE ENCLOSURES OF THE APPLICATION FORM Kopijo veljvneg zdrvniškeg spričevl rzred»lapl«a opy of the vlid 2 ND lss medil ertifite En fotokopij veljvneg oseneg dokument A opy of the vlid ID Kopij potrdil o oprvljenem izpitu z teorijo LAPL(H) A opy of the LAPL(H) theory exm ertifite Ostlo (opiši) Other (desription) D/Yes D/Yes D/Yes Ne/No Ne/No Ne/No 4 PODPIS VLAGATELJA APPLICANT'S SINGATURE Krj in dtum: Ple nd Dte: Podpis kndidt: Applint's Signture: ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 1 od/of 6
2 5 ZAHTEVAN NALET ZA PRIDOBITEV LAPL(H) REQUESTED FLYING TIME FOR THE ISSUE OF A LAPL(H) Dtum oprvljeneg teoretičneg preverjnj Dte of ompletion of the theoretil exmintion Skupni nlet kot pilot helikopterj: Totl flight hours s heliopter pilot: Skupni nlet kot pilot helikopterj v čsu tečj: Totl flight hours s heliopter pilot during the ourse: Letenje z inštruktorjem s tipom helikopterj n kterem o poteklo preverjnje prktične usposoljenosti: Dul instrution in heliopter type on where the skill test will e done: Letenje z inštruktorjem, od teg: Dul flight instrution, of whih: Smostojno letenje pod ndzorom: Supervised solo flight time: Smostojni nvigijski preleti: Solo ross-ountry flight time: Dtum izvede let dljšeg od 80NM z enim pristnkom n letlišču, ki ni letlišče vzlet: Dte of 80 NM flight with full stop lndings t one erodromes different from the erodrome of deprture: Dtum preverjnj prktične usposoljenosti Dte of skill test flight Nlet Flying time Zhtevn nlet Requested flight time (dd/mm/yyyy) (dd/mm/yyyy) (dd/mm/yyyy) 6 IZJAVA ORGANIZACIJE ZA USPOSABLJANJE ATO DECLARATION Izjvljm, d so podtki nvedeni v tem dokumentu točni. I delre tht the informtion ontined in this doument is urte. Orgnizij z usposljnje: Št. odoritve orgnizije: Approved Trining orgniztion: Approvl ertifite No.: Dtum pričetk tečj: Dte ourse strted: Ime in priimek vodje usposljnj: The hed of trining nme: Krj in dtum: Lotion nd dte: Dtum zključk tečj: Dte ourse ended: Podpis vodje usposljnj: The hed of trining signture: ŽIG/STAMP ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 2 od/of 6
3 7 AMC2 FCL.125 of Prt FCL of Commission Regultion (EU) 1178/2011 ( 3th Nov 2011) Vsein preizkus prktične usposoljenosti z izdjo liene LAPL Helikopterji Content of the skill test for the issue of the LAPL Heliopters Upor kontrolnih seznmov helikopterj in prks doreg pilot (uprvljnje helikopterj s pomočjo zunnjih vizulnih orientirjev, postopki z preprečevnje zledenitve in rzledenitev, itd.) veljjo z vse sekije. DEL 1 SECTION 1 PREVERJANJA IN POSTOPKI PRED LETOM/PO LETU PRE-FLIGHT/POST-FLIGHT CHECKS AND PROCEDURES Use of heklist, irmnship, ontrol of heliopter y externl visul referene, nti-iing proedures, et, pplies in ll setions. Poznvnje helikopterj (npr. tehnični dnevnik, gorivo, ms in rvnotežje, zmogljivost) nčrtovnje let, dokumentij, NOTAM-i, vreme Heliopter knowledge, (e.g. tehnil log, fuel, mss nd lne, performne), Flight Plnning, NOTAMS, Wether Pregled/postopki pred letom, loirnje delov in njihov nmen Pre-flight inspetion /tion, lotion of prts nd purpose d e Pregled pilotske kine, postopki z zgon motorjev Cokpit inspetion, strting proedure Preverjnje komunikijske in nvigijske opreme, določitev in nstvitev frekven Communition nd nvigtion equipment heks, seleting nd setting frequenies Postopek pred vzletom in rdijsk zvez z ATC Pre-tke-off proedure nd ATC liison f Prkirnje, ugšnje motorjev in postopki po letu Prking, Shutdown nd Post-flight proedure DEL 2 SECTION 2 LEBDENJE, ZAHTEVNEJŠE UPRAVLJANJE IN OMEJENA OBMOČJA HOVER MANOEUVRES, ADVANCED HANDLING AND CONFINED AREAS Vzlet in pristnek (odlepitev in dotik tl) Tke-off nd lnding, (lift off nd touh down) d e f g h i j k l m n o p q Vožnj po tleh (tksirnje), tksirnje v ledenju Txi, hover txi Stionrno ledenje z čelnim, očnim in hrtnim vetrom Sttionry hover with hed/ross/til wind Orčnje med stionrnim ledenjem v levo in desno z 360 (orčnje n mestu) Sttionry hover turns, 360º left nd right (spot turns) Mnevri v ledenju v smeri nprej, nzj in očno Forwrd, sidewys nd kwrds hover mnoeuvring Simulirn odpoved motorj v ledenju Simulted engine filure from the hover Hitro ustvljnje v veter in z hrtnim vetrom Quik stops into nd downwind Zunj letliški pristnki in vzleti n teren z ngiom/neutrjen teren Sloping ground/unprepred sites lndings nd tke-offs Vzlet (rzlični profili) Tke-offs (vrious profiles) Vzlet s očnim in hrtnim vetrom (če je izvedljivo) Crosswind, downwind tke-off (if prtile) Vzlet z njvečjo vzletno mso (dejnsko li simulirno) Tke-off t mximum tke-off mss (tul or simulted) Prileti (rzlični profili) Approhes (vrious profiles) Vzleti in pristnki z omejeno močjo Limited power tke-off nd lnding Avtorotije (izprševle izere dve nlogi izmed: osnov (iz smer), z njvečjim doletom, z mjhno hitrostjo, li s 360 zvojem. Autorottions (FE to selet two items from - Bsi, rnge, low speed, nd 360 turns) Pristnek z vtorotoijo Autorottive lnding Postopek zsilneg pristnk z vrnitvijo v motorno letenje Prtie fored lnding with power reovery Preizkus moči, tehnik rnj prmetrov, tehnik pilotirnj med priletom in vzletom Power heks, reonnissne tehnique, pproh nd deprture tehnique ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 3 od/of 6
4 DEL 3 SECTION 3 d e f NAVIGACIJA - POSTOPKI NA RUTI NAVIGATION - EN ROUTE PROCEDURES Nvigij in orientij n rzličnih solutnih/reltivnih višinh let, rnje nvigijskih krt Nvigtion nd orienttion t vrious ltitudes/heights, mp reding Ndzor solutne/reltivne višine, hitrosti, kurz (smeri) let, opzovnje zrčneg prostor, nstvitev višinomer. Altitude/height, speed, heding ontrol, oservtion of irspe, ltimeter setting Spremljnje potek let, dnevnik polet, por goriv, vtonomij, predviden čs prihod, oen kot znos in ponovn vzpostvitev zdne poti, spremljnje instrumentov Monitoring of flight progress, flight log, fuel usge, endurne, ETA, ssessment of trk error nd reestlishment of orret trk, instrument monitoring Opzovnje vremenskih rzmer, nčrtovnje preusmeritve polet Oservtion of wether onditions, diversion plnning Izoginje trčenju (postopki opzovnj) Collision voidne (look-out proedures) Rdijsk zvez z ATC in upoštevnje predpisov ATC liison nd oservne of regultions DEL 4 SECTION 4 POSTOPKI IN MANEVRI FLIGHT PROCEDURES AND MANOEUVRES Vodorvni let, ndzor smeri, solutne/reltivne višine in hitrosti let (mnever s hitrostjo). Level flight, ontrol of heding, ltitude/height nd speed Zvoji v vzpenjnju in spuščnju z izhodi z določeno izhodno smeri Climing nd desending turns onto speified hedings 180º in 360º horizontlni zvoji z ngiom 30 Level turns withup to 30º nk, 180º to 360º left nd right DEL 5 SECTION 5 NEOBIČAJNI POSTOPKI IN POSTOPKI V SILI (simulirno kjer je primerno) ABNORMAL AND EMERGENCY PROCEDURES (simulted where pproprite) Opom (2); Izprševle FE izere 4 od nslednjih nlog: Note (2) The FE shll selet 4 items from the following: d e f g Okvr motorjev, vključno z okvro regultorj, zledenitev uplinjč/motorj, okvr oljneg sistem, kot je ustrezno Engine mlfuntions, inluding governor filure, ruretor/engine iing, oil system, s pproprite Okvr gorivneg sistem Fuel system mlfuntion Okvr električneg sistem Eletril system mlfuntion Okvr hidrvličneg sistem, vključno s prileti in pristnki rez hidrvlike, če je ustrezno Hydruli system mlfuntion, inluding pproh nd lnding without hydrulis, s pplile Okvr glvneg rotorj in/li sistem z urvnovešenje rekije vrtilneg moment (n simultorju li smo teoretično) Min rotor nd/or nti-torque system mlfuntion (FFS or disussion only) Postopek o požru, vključno s postopki z ovldovnje in odprvo dim, kot je ustrezno Fire drills, inluding smoke ontrol nd removl, s pplile Drugi neoičjni postopki in postopki v sili, kot so opisni v ustreznem helikopterskem priročniku Other norml nd emergeny proedures s outlined in pproprite flight mnul ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 4 od/of 6
5 AMC1 FCL.015(), AMC 1 to Appendix 7 of prt FCL Commission Regultion (EU) 1178/2011 ( 25th Nov 2011) FE Poročilo o preverjnju prktične usposoljenosti z izdjo liene LAPL(H) Applition nd report form for skill test for issue of LAPL(H) liene OSEBNI PODATKI KANDIDATA 8.0 APPLICANT'S PERSONAL DATA Kndidtovo ime: Applint 's lst nme: LAPL: A H B S Kndidtov priimek: Applint 's first nme: BPL: SPL: Singture of Applint: Podpis kndidt: PPL: A H As Vrst liene (če ostj): Type of liene held (if pplile): CPL: A H As Držv: Stte: IR: A H As 8.1 Podtki o letu Detils of the flight Tip helikopterj: Type of heliopter: Letlišče li vzletišče: Aerodrome or site: Čs vzlet : Tke-off time: [UTC] Registrij: Registrtion: Čs pristnk: Lnding time: [UTC] Čs let: Flight time: 8.2 REZULTAT PREIZKUSA RESULT OF THE TEST Podronosti preizkus: Skill test detils: Skupni čs let: Totl flight time: Kndidt je prktično preverjnje po delu:»p«oprvil,»f«ni oprvil,»/«preverjnje ni ilo izvedeno. The ndidte is setion of the test/hek:»p«pssed,»f«filed,»/«skill test ws not pplile. OPRAVIL PASSED Krj in dtum: Lotion nd dte: Številk poolstil izprševl: Exminer's ertifite numer: Podpis izprševl: Exminer's signture: 8.3 Opome: Remrks: NI OPRAVIL FAILED Rezultt po delih / Setion result: DELNO OPRAVIL PARTIAL PASSED Registrij simultorj/helikopterj: SIM or irrft registrtion: Vrst in številk liene: Type nd numer of liene held: Ime in priimek izprševl: Exminer's nme: Krj in dtum: Lotion nd dte: Številk poolstil izprševl: Exminer's ertifite numer: Podpis izprševl: Exminer's signture: Vrst in številk liene: Type nd numer of liene held: Ime(n) z velikimi črkmi: Nme(s) in pitl letters: ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 5 od/of 6
6 CAA 1 Opis oprvil ZAKLJUČNO POROČILO (izpolni poolščen ose Agenije z ivilno letlstvo) FINAL REPORT (ompleted y the uthorized person of Civil Avition Ageny) Kontrolni seznm postopkov pred izdjo liene Before liene issue proedures hek list Preveri»Vlogo«, d so predložene vse predpisne strni in priloge! Minimln strost kndidt ( 17 let / del FCL.100). Zdrvstven sposonost kndidt (zdrvniško spričevlo njmnj rzred»lapl«/ del MED.A.030(e) ) Preveri ustreznost letlske šole! Preveri ustreznost izprševl določi g ACL Uspešno zključeno teoretično preverjnje znnj glej prilogo: stndrdn olik spričevl. Če spričevlo ni izdl ACL, preveri vtentičnost! Preveri ustreznost vstopnih pogojev in upoštevnje kreditov (točk 5 te vloge)! Preveri ustreznost izvede in trjnje preverjnj (čs trjnj 90 minut z LAPL). Dokzilo o plčilu pristojine v skldu z enikom Agenije 2 Podpis, ko je ustrezno Opom / omejitev V skldu s Prilogo 1 Uredo komisije (EU) št. 1178/2011 Agenije z ivilno letlstvo izdj LAPL(H): In ordne with the Annex 1 of the Commission Regultion (EU) No. 1178/2011 the Civil Avition Ageny issuing the LAPL(H): Številk liene: Li Rting: Rting: Omejitve / opome: Limittions / Notes: Dtum izdje: Issuing dte: ŽIG/STAMP POSTOPEK VODIL-A ADMIN. ACTION WAS TAKEN BY PODPIS POOBLAŠČENE OSEBE SIGNATURE OF THE AUTHORIZED PERSON ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge 6 od/of 6
7 TE STRANI NE VSTAVLJAJ V OSEBNI DOSJE! / DO NOT ENTER THIS PAGE TO PERSONAL FILE! DOPUSTNA ODSTOPANJA PRI PREVERJANJU MED LETOM / FLIGHT TEST TOLERANCE Kndidt dokže usposoljenost z: () uprvljnje helikopterj v skldu z njegovimi omejitvmi; () tekoče in ntnčno izvjnje vseh mnevrov; () rzsodnost in doro pilotirnje; (d) uporo letlskeg znnj; (e) tk ndzor helikopterj, d uspešn izved postopkov li mnevrov v noenem trenutku ni dvomljiv; Uporljjo se nslednje omejitve, določene o upoštevnju turulentnih rzmer ter opertivnih znčilnosti in zmogljivosti uporljeneg letl. (1) Višin Height (i) oičjen let norml flight (ii) S simulijo večje odpovedi simulted mjor emergeny (iii) V ledenju z učinkom tl Hovering I.G.E flight (2) Hitrost Speed (i) pri vzletu in priletu tke-off nd pproh (ii) pri vseh drugih režimih let ll other flight regimes (3) Znos helikopterj v ledenju Ground drift (i) v ledenju po vzletu z učinkom tl T.O. hover I.G.E (ii) pri pristnku lnding ±150 ±200 ± ±15 The pplint shll demonstrte the ility to: () operte the heliopter within its limittions; () omplete ll mnoeuvres with smoothness nd ury; () exerise good judgement nd irmnship; (d) pply eronutil knowledge; (e) mintin ontrol of the heliopter t ll times in suh mnner tht the suessful outome of proedure or mnoeuvre is never in dout; The following limits shll pply, orreted to mke llowne for turulent onditions nd the hndling qulities nd performne of the eroplne used. čevljev feet čevljev feet čevljev feet vozlov knots vozlov knots čevljev ±3 feet rez premiknj v strn li nzj no sidewys or kwrds movement TE STRANI NE VSTAVLJAJ V OSEBNI DOSJE! / DO NOT ENTER THIS PAGE TO PERSONAL FILE! ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge i od/of ii
8 TE STRANI NE VSTAVLJAJ V OSEBNI DOSJE! / DO NOT ENTER THIS PAGE TO PERSONAL FILE! ATC DPATO DPBL FE LDP TDP T.O. POMEN SIMBOLOV IN OKRAJŠAV / THE MEANING OF THE SYMBOLS AND ABBREVIATIONS Kontrolor zrčneg promet Air Trffi Controller Nprej določen točk po vzletu Defined Point After Tke-off Nprej določen točk pred pristnkom Defined Point Before Lnding Izprševle v zrku Flight Exminer Točk odločitve pri pristnku Lnding Deision Point Točk odločitve pri vzletu Tke off Deision Point Vzlet Tke-off TE STRANI NE VSTAVLJAJ V OSEBNI DOSJE! / DO NOT ENTER THIS PAGE TO PERSONAL FILE! ACL-OBR: LAPL(H)-ISSUE, Rev. 00 / 8th April.2012 strn/pge ii od/of ii
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