APPLICATION FOR EXTENDED OPERATIONS (ETOPS) OPERATIONAL APPROVAL

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APPLICATION FOR EXTENDED OPERATIONS (ETOPS) OPERATIONAL APPROVAL This form is to be used for applicants seeking Extended Diversion Time Operational (EDTO) approval in accordance with OTAR Part 121.275. As guidance material is still being developed for EDTO, the BCAA is accepting the processes involved in the granting of ETOPS approval as an acceptable Alternative Means of Compliance. Applicants are strongly advised to read the 'ETOPS Notes for Completion' before completing the form. Please complete the form in BLOCK CAPITALS using black or dark blue ink. This form is designed to elicit all the required information from those operators requiring ETOPS operations approvals. The completed form and supporting documentation should be submitted to the Flight Operations Section of the Bermuda Civil Aviation Authority at the address listed in the 'Notes for Completion'. Section I Page 1 Operator/Airframe Details Completion mandatory Section II Page 2 ETOPS Notes For Completion Section III Page 2 Signature Block Completion mandatory Section IV Pages 3 to 7 Operator's ETOPS Operations Manual Matrix Completion mandatory SECTION I OPERATOR/AIRFRAME DETAILS 1 Applicant Details - required for all Approval requests Please give the official name and business or trading name(s), address, mailing address, e-mail address and contact telephone/fax numbers of the applicant. Note: For AOC holders - company name, AOC number and e-mail address will suffice. 2 Aircraft Details - required for all Approval requests Aeroplane type(s), series and registration mark(s). Aeroplane Type Aeroplane Series Registration

SECTION II ETOPS NOTES FOR COMPLETION 1 Applicability Extended Operations (ETOPS/EDTO) applies to operators wishing to use twin-engined aircraft more than 60 minutes' flying time from a suitable diversion aerodrome. Such routes could be long ocean crossings, polar routes or routes where there are limited diversions available, e.g. trans-siberia. The requirements for Operator Approval to carry out ETOPS (Acceptable Means of Compliance) are laid out in OTAR Part 121.275 under the EDTO regulations. Further guidance can be sourced in EASA AMC 20-6 and in UK CAA CAP 789. ETOPS/EDTO is a major process, which will involve all aspects of a company's operation. It is therefore strongly recommended that the BCAA be contacted before submitting an application. It is likely that MNPS, RVSM and RNP-10 approval will also be required. 2 Operator's ETOPS Operations Manual Matrix Section IV of this application form is the Operator's ETOPS/EDTO Operations Manual Matrix. All applicants should complete Column 4 of this matrix in full. If more than one type of aircraft/fleet is included in a single application a completed matrix should be included for each aircraft/fleet. Failure to complete the ETOPS/EDTO Operations Manual Matrix may result in a delay in processing your application. 3 Documents to be included with the application Copies of all documents referred to in Column 4 of the Operator's ETOPS/EDTO Operations Manual Matrix should be included when returning the completed application form to the BCAA. Original documents should not be sent, photocopies are sufficient. Do not send complete manuals, only the relevant sections/pages will be required. The issue of an ETOPS approval will incur a charge. Details of charges can be found in the BCAA Fee Schedule (www.bcaa.bm). Failure to include all relevant documentation and the correct fee may result in a delay in processing your application. 4 Submissions and Enquiries Address for submissions: Bermuda Civil Aviation Authority (BCAA) P.O. Box HM 1017 Hamilton HM DX Bermuda Contact details for enquiries about ETOPS: Tel: +1 441 293 1640 Fax: +1 441 293 2417 E-mail: dcafltops@gov.bm SECTION III SIGNATURE BLOCK Signature:... Name (BLOCK LETTERS):... Appointment:... Date:... Please note that a minimum of 120 working days will normally be required to process and issue an ETOPS approval - if data is missing or omitted the process may take considerably longer. Page 2 of 7

SECTION IV APPLICANT'S ETOPS SUBMISSIONS MATRIX Please complete your review of your Operations Manual. The ETOPS flight operations minimum requirements are given in the table below. Enter the Operations Manual references in the last column and return the matrix, together with photocopies of the relevant pages of the Operations Manual, to the address given in paragraph 4 of Section II. Operations Manual Subjects Requirements Operator's Operations Manual Part A General Documents/regulations used in compiling ETOPS Manual/Procedures. Brief description of ETOPS. Definitions. Criteria. Approval. Qualifications. Training (Initial and Recurrent) and Checking. ETOPS Authorisation. OTAR Part 121 EU-OPS EASA AMC 20-6 FAA AC 120-42B Extended Operations. Adequate aerodrome. Approved one-engine inoperative cruise speed. Threshold distance/time. Adequate ETOPS en-route alternate. Equal time points. Rule distance/time. ETOPS segment. ETOPS significant system. Maximum approved diversion time. Dispatch. Company AOC defined operating area. List of certified aircraft types/engine combinations. Approved diversion time. Crew qualifications. ETOPS qualified dispatcher personnel. ETOPS qualified operations staff. ETOPS qualified maintenance personnel. Flight crew training and Operations Manuals. Flight crew currency requirements. Commander's responsibilities. Statement to show when ETOPS are allowed. Page 3 of 7

Part A General (continued) Part B Type Specific ETOPS Flight Preparation and Planning. Flight Crew Procedures. Type-related ETOPS Operations. Type-specific Planning Requirements. Aircraft serviceability and MEL. Communication and navigation facilities. Critical fuel scenario. Critical fuel reserve. ETOPS alternate aerodrome selection. ETOPS alternate planning minima. Pre-dispatch and post-dispatch weather minima. Computerised flight plan. Delayed dispatch. Maintenance check (pre-departure service check). Verification flights. Crew responsibilities. Flight documentation/chart handling. Fuel management. Weather monitoring. Change of routing. Diversion decision-making. Icing. Crew workload management. Identification of ETOPS aeroplanes. Types of ETOPS operations that are approved. Placards and limitations. One-engine inoperative speed. ETOPS Fuel Planning. Including critical fuel scenario. MEL/CDL. ETOPS-specific MEL/CDL items. Aeroplane Systems. Non-normal Procedures. Performance data. Aerodrome technical differences, navigation fit, communications fit. Navigation failures. Action to be taken on ETOPS-significant system failure. Low fuel scenario. Crew incapacitation. Page 4 of 7

Part C Route and Aerodrome Instructions Part D Training ETOPS Areas and Routes. Ground, Simulator and Line Training. Approved area of operation. ETOPS en-route alternates. Performance restrictions and weather minima for en-route alternates. Meteorological facilities/information. Low altitude cruise information. Route minimum diversion altitudes. MSA restrictions. Route-specific oxygen requirements. General: ETOPS overview. ETOPS regulations. ETOPS type design approval. Definitions. Approved one-engine inoperative speed. Maximum approved diversion time. Operator's approved diversion time. ETOPS area of operation. ETOPS routes. ETOPS alternate aerodromes and weather minima. Navigation systems accuracy, limitations and operating procedures. Meteorological facilities and information. In-flight monitoring and procedures. Computerised flight plan. Charts and position plotting. Equal time point. Critical fuel. Page 5 of 7

Part D Training (continued) Normal procedures: Flight planning and dispatch. ETOPS fuel requirements. Route alternate selection - weather minima. MEL - equipment-specific. ETOPS service check and technical log. Pre-flight FMS set-up. Flight performance progress monitoring. Flight management, navigation and communication systems. Aeroplane system monitoring. Weather monitoring. In-flight fuel management (to include independent cross-checking of fuel quantity). Non-normal procedures: Diversion procedures and diversion 'decisionmaking'. Navigation and communication systems, including appropriate flight management devices in degraded modes. Fuel management with degraded systems. Procedures for single and multiple failures in flight affecting ETOPS sector entry and diversion decisions. Operating on standby power. Operational restrictions associated with system failures including any applicable MEL considerations. Page 6 of 7

Part D Training (continued) ETOPS Simulator Training and Line Flying Under Supervision. Flight Operations Staff and Dispatchers. Pilots conversion course. Annual refresher course. Outline of training syllabus to include: ETOPS regulations. Operational approval. Aeroplane performance. Diversion procedures. Area of operation. Fuel requirements. Dispatch considerations: MEL, CDL, weather minima and alternate airports. Delayed dispatch. Documentation. Any Further Comments to Support Your Application: Page 7 of 7