gaca_gov_sa · regulation · processed · 2 chunks
GACA الطبيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] STATEMENT OF REGULATIONS COMPLIANCE OF (GACAR PART 137) <table><tr><td>No</td><td colspan="2">Data Description</td><td colspan="2">Information(Information to be filled with by the Applicant/Owner/Operator)</td></tr><tr><td>1.0</td><td colspan="2">DETAILS OF APPLICANT/OWNER/OPERATOR</td><td colspan="2"></td></tr><tr><td>1.1</td><td colspan="2">Full name of Applicant/Owner/Water Aerodrome Operator</td><td colspan="2"></td></tr><tr><td>1.2</td><td colspan="2">Address of Applicant/Owner/Water Aerodrome Operator</td><td colspan="2"></td></tr><tr><td>1.3</td><td colspan="2">Name and Location of the Water Aerodrome</td><td colspan="2"></td></tr><tr><td rowspan="2">1.4</td><td rowspan="2" colspan="2">Telephone and Email of Applicant/Owner/Water Aerodrome Operator</td><td>Tel/Mobile</td><td></td></tr><tr><td>Email</td><td></td></tr><tr><td rowspan="3">1.5</td><td rowspan="3" colspan="2">Name, Telephone and Email of the Focal Point of the Applicant/Owner/Water Aerodrome Operator</td><td>Name</td><td></td></tr><tr><td>Tel/Mobile</td><td></td></tr><tr><td>Email</td><td></td></tr></table> <table><tr><td>No</td><td>GACAR Reference</td><td>GACAR Part 137 Description</td><td>Statement Of Compliance</td><td>Tick Mark (X) (1) Or (2)</td><td>Remarks/Write Sub Part, if Not Applicable</td></tr><tr><td>1</td><td>GACAR 137 (Compliance)</td><td>GACAR 137 Sub Part A, B, C, D, E, F, G, H, I, J, K, L, M, N and Appendix from A to N.</td><td>We hereby certify that we have read all provisions and requirements of GACAR Part 137 and its Subparts and Appendices. This water aerodrome complies/will comply with all the applicable regulations of GACAR Part 137.</td><td><img></td><td></td></tr><tr><td colspan="5">Or</td><td></td></tr><tr><td>2</td><td>GACAR 137 (Non-Compliance)</td><td>GACAR 137 Sub Part A, B, C, D, E, F, G, H, I, J, K, L, M, N and Appendix from A to N.</td><td>We hereby certify that we have read all provisions and requirements of GACAR Part 137 and its Subparts and Appendices. There are some non-compliances of the regulations, and the list of all such non-compliances with mitigation measures, residual risk assessment and corrective action plan are provided in List of Non-Compliances of GACAR Part 137 (Form: ASD-F137-203) as attached.</td><td><img></td><td></td></tr><tr><td colspan="6">We hereby certify that the forgoing information are correct in every respect and no relevant information has been withheld</td></tr><tr><td colspan="3">Applicant/Owner/Accountable Executive Name</td><td colspan="3">Signature</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr><tr><td colspan="3">Position</td><td colspan="3">Date</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr></table> GACA-AVSES-AGA-F044 Rev: 2, Date: 11 Sep 25 Page 1 of 1