038-foreign-fstds-qualification-acceptance-application-form-initial-and-renewal

gaca_gov_sa · form · processed · 2 chunks
document_type=form entity=format:application/pdf entity=language:ar language=en taxonomy_l1=transport taxonomy_l2=aviation taxonomy_l3=aircraft_certification validity=valid validity_confidence=0.6
GACA
العلوميه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
FOREIGN FSTDS QUALIFICATION ACCEPTANCE APPLICATION FORM (INITIAL/RENEWAL) AIRPLANE/HELICOPTER
<table><tr><td colspan="4">1. FSTD Operator Details</td></tr><tr><td colspan="2">Training Organization/Operator Name</td><td colspan="2"></td></tr><tr><td colspan="2">Competent Authority (ICAO Contracting State)</td><td colspan="2"></td></tr><tr><td colspan="2">Organization/Operator Address</td><td colspan="2"></td></tr><tr><td rowspan="2">Contact details</td><td>Name</td><td>Phone No.</td><td>Email</td></tr><tr><td></td><td></td><td></td></tr></table>
<table><tr><td colspan="4">2. Application</td></tr><tr><td colspan="4">The above FSTD organization requests the evaluation of its Flight Simulation Training Device for GACA Acceptance</td></tr><tr><td>□ Qualification Initial Acceptance</td><td colspan="3">□ Qualification Acceptance Renewal</td></tr><tr><td>Date</td><td colspan="3"></td></tr></table>
<table><tr><td colspan="2">3. FSTD Type Details</td></tr><tr><td>Type of FSTD</td><td>Type of FSTD (Airplane/Helicopter Type/Class) Qualification Level</td></tr><tr><td>Flight Simulator (FFS)</td><td>□ A □ B □ C □ D</td></tr><tr><td>Flight Training Device (FTD)</td><td>□ 1 □ 2</td></tr><tr><td>Flight and Navigation Procedure Trainer (FNPT)</td><td>□ I □ II □ II MCC</td></tr><tr><td>Basic Instrument Training Device (BITD)</td><td>□</td></tr><tr><td>Aviation Training Device (ATD)</td><td>□</td></tr><tr><td>Advanced Aviation Training Device (AATD)</td><td>□ 1 □ 2 □ 3 □ 4 □ 5 □ 6 □ 7</td></tr></table>
<table><tr><td colspan="2">4. FSTD Technical Details</td></tr><tr><td>FSTD qualification and Specification Certificate number</td><td></td></tr><tr><td>Qualification Certificate Expiry date</td><td></td></tr><tr><td>FSTD Manufacturer Name and Serial No.</td><td></td></tr><tr><td>Visual System</td><td></td></tr><tr><td>Primary Reference Document</td><td></td></tr></table>
<table><tr><td colspan="2">5. Visual Data Bases Details (If applicable)</td></tr><tr><td>No.</td><td>Aerodrome Visual ground segment runway</td></tr><tr><td>1</td><td></td></tr><tr><td>2</td><td></td></tr><tr><td>3</td><td></td></tr><tr><td>4</td><td></td></tr></table>
<table><tr><td colspan="2">6. Qualification Test Guide Details</td></tr><tr><td>Number of QTG&#x27;s run in last year</td><td></td></tr><tr><td>Number of marginal results(QTG)</td><td></td></tr><tr><td>Number of failures (QTG Number)</td><td></td></tr><tr><td>Number of QTG&#x27;s which is not run</td><td></td></tr></table>
<table><tr><td colspan="2">7. Manuals and Documentation (Current)</td></tr><tr><td>Manual / Documentation</td><td>Current Issue No. Approved/Accepted Date</td></tr><tr><td>Operations manual</td><td></td></tr><tr><td>Training manual</td><td></td></tr><tr><td>Quality manual</td><td></td></tr></table>
GACA-AVSES-OPS-F038
Rev: 3, Date: 15 Jun 25
Page 1 of 3

GACA
ال necesita تابع للطيران المدني
General Authority of Civil Aviation
[Non-Text]
FOREIGN FSTDS QUALIFICATION ACCEPTANCE APPLICATION FORM (INITIAL/RENEWAL) AIRPLANE/HELICOPTER
<table><tr><td>SMS manual, if applicable</td><td></td><td></td></tr><tr><td>FSTDs Manuals</td><td></td><td></td></tr><tr><td colspan="3">8. Quality System Details</td></tr><tr><td colspan="2">Quality management System approved by the Competent Authority</td><td></td></tr><tr><td colspan="2">Process and procedure in place for Audits/Inspection</td><td></td></tr><tr><td>Audits Scheduled</td><td></td><td></td></tr><tr><td>Audits completed/in progress</td><td></td><td></td></tr><tr><td>Scheduled Audits still to be commenced</td><td></td><td></td></tr></table>
<table><tr><td colspan="3">9. Accountable Manger/Head of Training Declaration</td></tr><tr><td colspan="3">• I certify that all the above information given is complete and correct</td></tr><tr><td>Name</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr></table>
<table><tr><td colspan="3">10. Evaluation Team</td></tr><tr><td>Name</td><td>Title</td><td>Department</td></tr><tr><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td></tr></table>
<table><tr><td colspan="4">11. FSTD Qualification Evaluation/Assessment Details</td></tr><tr><td>Date</td><td></td><td>Duration of flight time</td><td></td></tr><tr><td>Training Center Name</td><td></td><td>FSTD Level (Recommendation)</td><td></td></tr><tr><td>FSTD Type &amp; number</td><td></td><td>FSTD Documents</td><td>☐ SAT ☐ UNSAT</td></tr><tr><td>FSTD Airplane/Helicopter Type</td><td></td><td>FSTD Acceptance Evaluation/Assessment</td><td>☐ SAT ☐ UNSAT</td></tr><tr><td>Recommendations</td><td colspan="3"></td></tr></table>
<table><tr><td colspan="3">Remarks</td></tr><tr><td>Name of ASI/ Qualified Evaluator</td><td>Signature</td><td>Date</td></tr><tr><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td></tr></table>
GACA-AVSES-OPS-F038
Rev: 3, Date: 15 Jun 25
Page 2 of 3

GACA
الهييه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
FOREIGN FSTDS QUALIFICATION ACCEPTANCE APPLICATION FORM (INITIAL/RENEWAL) AIRPLANE/HELICOPTER
12. Supporting Documents
This application form
Copy of valid Foreign FSTD certificate/approval issued by ICAO Contracting State (Competent Authority)
Copy of valid Qualifications/Specifications certificate/approval issued by ICAO Contracting State (Competent Authority)
Copy of Quality Management System (QMS) manual approval (ICAO Contracting State (Competent Authority)
Copy of valid Foreign FSTD certificate/approval and valid Qualifications/Specifications issued by EASA and/or FAA, if applicable
FSTD Qualification Evaluation checklist
GACA-AVSES-OPS-F038
Rev: 3, Date: 15 Jun 25
Page 3 of 3