gaca_gov_sa · form · processed · 5 chunks
GACA الطبيه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHECKLIST FOR AIRWORTHINESS CERTIFICATE <table><tr><td colspan="10">(PHYSICAL INSPECTION CHECKLIST)</td></tr><tr><td colspan="2">Registration Mark</td><td></td><td>Make</td><td></td><td>Model</td><td></td><td colspan="2">Serial No.</td><td colspan="2"></td></tr><tr><td colspan="2"></td><td colspan="4">Item</td><td colspan="3">To be filled by the applicant</td><td colspan="2">GACA Use</td></tr><tr><td></td><td>☐</td><td>Initial Issue</td><td></td><td>☐</td><td>Renewal</td><td>N/A</td><td>SAT</td><td>UNSAT</td><td>SAT</td><td>UNSAT</td></tr><tr><td>1</td><td colspan="5">Ensure that A/C is powered, air condition provided, flight controls are fully extended, Cargo/LG doors are open, aircraft exterior and interior is clean and steps provided</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td colspan="11">Flight Deck Inspection</td></tr><tr><td>2</td><td colspan="5">Comply with A/C maintenance logbooks audit, ensure that discrepancies are rectified IAW applicable manuals, check MELs, CDL & NEF for proper sign-off and I.A.W the applicable manual.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>3</td><td colspan="5">Check for availability/update of MEL book, Cockpit Checklist, Airplane Flight Manual (or equivalents manuals)Weight and Balance Manual, Emergency Equipment Chart and Magnetic Compass correction Card</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>4</td><td colspan="5">Check for condition and security of cockpit windows, sunshade, cockpit seats, Harnesses, metal buckles, cushions and ensure TSO are available</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>5</td><td colspan="5">Check operation of No Smoking, Safety Belt signs, Emergency Lights, cockpit Voice Recorders, flight recorder, VOR, IFR equipment and ATC Transponder.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>6</td><td colspan="5">Check all emergency and Survival equipment for expiration, condition and correct stowage IAW the aircraft emergency equipment chart (cockpit and passengers cabin)</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>7</td><td colspan="5">Check availability of spare bulbs and fuses and all required Marking/placards</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td colspan="11">Aircraft Interior Inspection</td></tr><tr><td>8</td><td colspan="5">Check PAX & FLT ATTEND seats, safety belts for condition and TSO are available</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>9</td><td colspan="5">Check Galley for correct operation, leaks and security.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>10</td><td colspan="5">Check passenger safety briefing cards for availability and update for aircraft type.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>11</td><td colspan="5">Check lavatories for condition and operation. Check lavatories' built-in fire extinguishers for availability and expiration dates</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>12</td><td colspan="5">Ensure all required Marking/placards are properly installed and legible.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td colspan="11">Aircraft Exterior Inspection</td></tr><tr><td>13</td><td colspan="5">Ensure required markings and placards are properly installed and legible.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>14</td><td colspan="5">Check fuselage, engines, wings, LDG/WW and lights for condition, Ops and security</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>15</td><td colspan="5">Ensure any dents/damages have been correctly assessed (within limit) and documented in the aircraft logbook and the applicable buckles & dents chart.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>16</td><td colspan="5">Check cargo compartments for condition and integrity including ceiling lights, smoke detectors and fire extinguisher for expiration and operation of cargo loading system.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>17</td><td colspan="5">Ensure all inspection findings are entered in the logbook and rectified I.A.W the applicable Operator's Manuals.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11">CERTIFICATION</td></tr><tr><td colspan="11">This section must be signed 24 hours prior to the scheduled inspection date.</td></tr><tr><td colspan="11">I HEREBY CERTIFY THAT:The above information is true and all open defects and MEL items have been addressed.</td></tr><tr><td>Name</td><td colspan="4"></td><td>Title</td><td colspan="6"></td></tr><tr><td>Signature</td><td colspan="4"></td><td>Date</td><td colspan="6"></td></tr><tr><td colspan="4">Name of Organization (AMO/Manufacturer)</td><td colspan="8"></td></tr></table> GACA-AVSES-AIR-F016 Rev: 5, Date: 24 Aug 25 Page 1 of 3 GACA المنيه العامه للطيران المدني General Authority of Civil Aviation CHECKLIST FOR AIRWORTHINESS CERTIFICATE <table><tr><td colspan="9">(AIRCRAFT DOCUMENTATION)</td></tr><tr><td colspan="2">Registration Mark</td><td>Make</td><td>Model</td><td colspan="2"></td><td colspan="2">Serial No.</td><td></td></tr><tr><td></td><td colspan="4">Item</td><td colspan="3">To be filled by the applicant</td><td>GACA Use</td></tr><tr><td></td><td>☐ Initial Issue</td><td>☐</td><td>Renewal</td><td>N/A</td><td>SAT</td><td>UNSAT</td><td>SAT</td><td>UNSAT</td></tr><tr><td>1</td><td colspan="3">A Transmittal Letter from Aircraft Owner/Operator or Representative.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>2</td><td colspan="3">Application for Certificate of Airworthiness</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>3</td><td colspan="3">Official receipt showing payment of Certificate of Airworthiness Fee.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>4</td><td colspan="3">Current Saudi Arabian Aircraft Certificate of Registration Marks.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>5</td><td colspan="3">Current Saudi Arabian Aircraft Radio License.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>6</td><td colspan="3">Copy of Export Certificate of Airworthiness from All Exporting Countries Must show continuity back to the Country of Manufacture. (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>7</td><td colspan="3">Check aircraft Identification Plate (Should be in accordance with GACAR 45.25) aircraft registration must be included.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>8</td><td colspan="3">Check aircraft Identification Data (Should be in accordance with GACAR 45.27).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>9</td><td colspan="3">Check for conformity to Type Certificate Data Sheets; Airplane, Rotorcraft, Engine, Propeller (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>10</td><td colspan="3">Statement of Conformity or other similar document (if applicable).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>11</td><td colspan="3">List of STCs incorporated on Aircraft (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>12</td><td colspan="3">Verify that all Major Repairs/alterations are approved, and or Equivalent completed) (GACAR 91.457).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>13</td><td colspan="3">Current status of Life Limited parts of Airframe, Engine, Propeller, Rotor and Appliance</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>14</td><td colspan="3">Current status of applicable FAA & the State of Design ADs for Aircraft, Engine, Propeller, Rotor, and Appliance (GACAR 91.457). (applicable and non-applicable ADs recorded). Last FAA AD Biweekly Listing number Recorded. Only applicable ADs recorded in the applicable Logbooks.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>15</td><td colspan="3">List that shows compliance with Mandatory Service Bulletins and foreign ADs (if Applicable) (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>16</td><td colspan="3">Total Time in Service of The Airframe, each Engine, each Propeller, each Rotor, and APU is recorded (GACAR 91.457).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>17</td><td colspan="3">Current Inspection status of the Aircraft, including the time since last Inspection is recorded</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>18</td><td colspan="3">Time since last overhaul of all items installed on the aircraft which are required to be overhauled on a specific time basis (GACAR 91.457). (a) (2) (i). Owner/operator to provide a statement that confirms compliance.</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>19</td><td colspan="3">Status of Current Aircraft Inspection Program. Submit Copy of Inspection Program to GACA (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>20</td><td colspan="3">Selection of Inspection Program. On File</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>21</td><td colspan="3">Current Weight and Balance data</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>22</td><td colspan="3">Current status of aircraft Equipment List (For initial issuance only).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>23</td><td colspan="3">Cargo conversion approved (if applicable).</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr><tr><td>24</td><td colspan="3">Noise limits compliance (GACAR 91.503) (if applicable)</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td><td>☐</td></tr></table> CERTIFICATION This section must be signed 5 days prior to the scheduled inspection date. I HEREBY CERTIFY THAT: a. The above information is true. b. All documentation of the aircraft is complete, and in accordance with applicable regulations. c. All applicable ADs and GACA Directives have been complied with. d. All applicable ADs of previous State of Registry have been complied with (Applicable for issuance only). e. All applicable Mandatory Service Bulletins/Service Letters etc. have been complied with. GACA-AVSES-AIR-F016 Rev: 5, Date: 24 Aug 25 Page 2 of 3 GACA اللغه العامه للطيران المدني General Authority of Civil Aviation [Non-Text] CHECKLIST FOR AIRWORTHINESS CERTIFICATE f. All Life limited and overhaul items are within applicable limits. g. All scheduled Maintenance has been carried out. h. All open defects and MEL items have been addressed. i. The above aircraft conforms to its Type Certificate, and is in a condition for safe operation. j. The aircraft engine (s) and/or Propeller (s) installed on the aircraft conform to applicable Type Certificate, and are in a condition for safe operation. k. All equipment including Emergency equipment are installed in accordance with respective regulations, and are serviceable <table><tr><td>Name</td><td colspan="2"></td><td>Title</td><td colspan="2"></td></tr><tr><td>Signature</td><td colspan="2"></td><td>Date</td><td colspan="2"></td></tr><tr><td colspan="2">Name of Organization (AMO/Manufacturer)</td><td colspan="4"></td></tr></table> FOR GACA USE This aircraft and its documentation have been inspected and found to be satisfactory for the purpose of a recommendation for initial issuance / renewal of the certificate of airworthiness. <table><tr><td>Inspector Name</td><td></td><td>Signature</td><td></td><td>Date</td><td></td></tr></table> GACA-AVSES-AIR-F016 Rev: 5, Date: 24 Aug 25 Page 3 of 3