General Administration of Civil Aviation of China CAAC MAJOR REPAIR AND MODIFICATION (Airframe, Powerplant, Propeller and Appliance） | Beijing, P.R. China (100710) 155 Dongsi Street West Fax: 86-10-64030987 | |||||||||||||||||||||||
1. Aircraft | Maker | Model | ||||||||||||||||||||||
Serial No. 比尾巴ppt | Nationality & Registration No. | |||||||||||||||||||||||
2.Owner | Name | heartbroken | Address | |||||||||||||||||||||
3．Unit Identification Airframe□ Powerplant□ Propeller□ Appliance□ | ||||||||||||||||||||||||
Unit | Maker | Model | 文江学海 Serial No. | Type | ||||||||||||||||||||
Repair | Modification | |||||||||||||||||||||||
4．Conformity Statement | ||||||||||||||||||||||||
Name and address of Agency | Kind of Agency | Agency’s certificate No. | ||||||||||||||||||||||
□ | CAAC Authorized Mechanic | |||||||||||||||||||||||
□ | CAAC Certified Organization | |||||||||||||||||||||||
□ | Manufacturer | |||||||||||||||||||||||
□ | Manufacturer Authorized Organization | |||||||||||||||||||||||
I certify that the repair and/or modification made to unit(s) identified in item 3 above and described in item 6 of this from have been made in accordance with requirements of CCAR of P.R.C. and that the information furnished herein is true and correct to the best of my acknowledge. | ||||||||||||||||||||||||
Date: | Signature of authorized individual: | |||||||||||||||||||||||
5．Approval for return to rvice | ||||||||||||||||||||||||
Pursuant to the authority given to persons specified below, the unit identified in item 3 was inspected in the manner prescribed by the minister of CAAC and is Approved□ Rejected□
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Date of approval or rejection: | Signature of Authorized individual: | |||||||||||||||||||||||
Note：Weight and balance of operating limitation changes shall be entered in the appropriate aircraft record. A modification must be compatible with all previous modification to assure continued conformity with the applicable airworthiness requirements. |
6．Description of work accomplished (applied technical standard and/or document in repair operation. Any other hidden malfunction found and corrected result in shop repairing and final test data sheet sh道德感all be included.) |
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