037-checklist-for- lsa-certificate-of-airworthiness

gaca_gov_sa · form · processed · 5 chunks

GACA
المنيه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
CHECKLIST FOR LSA CERTIFICATE OF AIRWORTHINESS
<table><tr><td colspan="8">AIRCRAFT INFORMATION</td></tr><tr><td>Registration Mark</td><td>Aircraft Make</td><td>Aircraft Model</td><td>Aircraft S/N</td><td colspan="4">Reason</td></tr><tr><td></td><td></td><td></td><td></td><td>□</td><td>Initial Issue</td><td>□</td><td>Renewal</td></tr><tr><td colspan="8">Aircraft Owner / Operator</td></tr><tr><td rowspan="2" colspan="2">Aircraft Documentation</td><td rowspan="2"></td><td rowspan="2"></td><td colspan="2">Applicant</td><td colspan="2">GACA Use</td></tr><tr><td>N/A</td><td>SAT</td><td>UNSAT</td><td>SAT</td></tr><tr><td>1</td><td colspan="2">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="2">Application for Certificate of Airworthiness</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>3</td><td colspan="2">Official receipt showing payment of LSA Certificate of Airworthiness Fee.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>4</td><td colspan="2">Check aircraft Identification Data Plate (Should be in accordance with GACAR 45.25 &amp; GACAR 45.27)</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>5</td><td colspan="2">Statement of Conformity (GACA form 8130-9) or another similar document (if applicable)</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>6</td><td colspan="2">Verify that all Major Repairs/Alterations are approved (GACA Form 8320-1, and or Equivalent completed) (GACAR 91.457).</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>7</td><td colspan="2">Current status of Life Limited parts of Airframe, Engine, Propeller</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>8</td><td colspan="2">Current status of applicable FAA &amp; the State of Design ADs for Aircraft, Engine, Propeller, (GACAR 91.457).</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>9</td><td colspan="2">List that shows compliance with Mandatory Service Bulletins (if Applicable) (For initial issuance only).</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>10</td><td colspan="2">Total Time in Service of Aircraft, Engine and Propeller is recorded (GACAR 91.457).</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>11</td><td colspan="2">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>12</td><td colspan="2">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>13</td><td colspan="2">Current Weight and Balance data</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>14</td><td colspan="2">Current status of aircraft Equipment List (For initial issuance only).</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr></table>
APPLICANT CERTIFICATION
<table><tr><td>I hereby certify that the above information is true, and all documentation of the aircraft is complete, and in accordance with applicable regulations.</td></tr><tr><td>Name Title Date Signature Name of Org. AMO/Manufacturer</td></tr><tr><td></td></tr></table>
FOR GACA AIR USE
<table><tr><td colspan="8">The documentation on the above-mentioned aircraft has been reviewed and found to be satisfactory for the purpose of a recommendation for initial issuance / renewal of the certificate of airworthiness.</td></tr><tr><td>Inspector&#x27;s Name</td><td>Title</td><td colspan="3">Signature</td><td colspan="3">Date</td></tr><tr><td></td><td></td><td colspan="3"></td><td colspan="3"></td></tr><tr><td rowspan="2" colspan="2">Physical Inspection</td><td colspan="3">Applicant</td><td colspan="3">GACA</td></tr><tr><td>N/A</td><td>SAT</td><td>UNSAT</td><td>SAT</td><td>UNSAT</td><td></td></tr><tr><td>1</td><td colspan="2">Comply with A/C maintenance logbooks audit, ensure that discrepancies are rectified IAW applicable manuals</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>2</td><td colspan="2">Check for availability/update of Airplane Flight Manual (or equivalents manuals)</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>3</td><td colspan="2">Check the condition and security of windows, doors, sunshade, seats, harnesses and ensure TSO are available.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>4</td><td colspan="2">Check operation of VFR equipment and ATC Transponder.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>5</td><td colspan="2">Check the fire extinguisher, First Aid Kit and ELT for expiration, condition and correct stowage.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>6</td><td colspan="2">Ensure required markings and placards are properly installed and legible.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>7</td><td colspan="2">Check fuselage, engines, propeller, wings and lights for condition and security.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>8</td><td colspan="2">Ensure any dents/damages have been correctly assessed (within limit) and documented in the aircraft logbook.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td>9</td><td colspan="2">Ensure all inspection findings are entered into the logbook and rectified I.A.W the applicable Operator&#x27;s Manuals.</td><td>□</td><td>□</td><td>□</td><td>□</td><td>□</td></tr><tr><td colspan="8">APPLICANT CERTIFICATION</td></tr><tr><td colspan="8">I hereby certify that the above information is true, and all open defects have been addressed. The above aircraft conforms to its Type Certificate and is in a condition for safe operation. The aircraft engines (s) and/or Propeller (s) installed on the aircraft conform to the applicable Type Certificate and are in a condition for safe operation. All equipment is installed in accordance with the respective regulations and is serviceable.</td></tr><tr><td>Name</td><td>Title</td><td>Date</td><td colspan="2">Signature</td><td colspan="3">Name of Org. AMO/Manufacturer</td></tr><tr><td></td><td></td><td></td><td colspan="2"></td><td colspan="3"></td></tr><tr><td colspan="8">FOR GACA AIR USE</td></tr><tr><td colspan="8">The above-mentioned Aircraft have been Inspected and found to be satisfactory for the purpose of a recommendation for initial issuance / renewal of the certificate of airworthiness.</td></tr><tr><td>Inspector&#x27;s Name</td><td></td><td>Title</td><td colspan="2">Signature</td><td colspan="3">Date</td></tr><tr><td></td><td></td><td></td><td colspan="2"></td><td colspan="3"></td></tr></table>
GACA-AVSES-AIR-F037
Rev: 6, Date: 20 Apr 25
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