a 3 - RotorLink

Transcription

a 3 - RotorLink

I
Controle drexemaiOn des modifications et des Services Bulletins
Modification and Service Bulletin checking
Unite
Numero
Nature de la modification
No
Type of modification
ou societe
d'execution
Performing
unit or
contractor
Date
d'execution
et tampon de
controle
1
Performing date
and
inspection stamp
Name
076199
EC
21/03/03
EY
Log card no
ANTIVIBREUR A RESSORT
VIBRATION ABSORBER ASSY
Denomination
Nomenclature OTAN
NATO Nomenclature
350A 31003306
Reference EC
076200
Fiche no
FICHE MATRICULE / LOG CARD *
EC Part number
Code OTAN fabricant
Reference fabricant
NATO manuf code
Manufacturer's Part number
Version
Configuration livraison
Version
Delivery configuration
Numero de serie
SD
Amendements
078
Amendments
Serial number
Fabricant
F0210
Type
EUROCOPTER
Supplier
350A
Type
2
Marche ou commande / Contract or order
Date
Reference
Reference
Date
Organisme emetteur
No ou lot
Issuing agency
Kit no
Fournisseur
Adresse
Contractor
Garantie
3
---
Date de
livraison
Materiel
Material
Date of
delivery
/
address
Guarantee
Date de
mise en
service
Duree garantie de
stockage
Duree Garantie
de fonctionnement
guaranteed storage period Service date Guarantee operation
Fab/Man
4
Renseignements particuliers
Annexe au tableau 4:
/
Special information
NON/NO
Inventaire des pieces a Duree de Vie:
NON/NO
Unite
ou societe
Date
Contractor
Date
EC
Version et
No Appareil
Aircraft
Version
and S/N
a3- o6
Nb de fiches :
Number of sheet
Transfer sheet
Operation
Support Partial Total
4'.083
3 :12 5
.
NON/NO
Support Partiel Total
0
21/03/03
ftS
Ec
Attestation/ Certif
Fonctionnement
Nb de pages :
Number of pages
Inventory of lifed components
Fiche Matricule de Transfert:
Nb de pages :
Number of pages
Appendix to table 4
Oil
Fab / manuf
Recept / Receipt
Destockage
depraservation
V.P / periodic
overhaul
Montage
Fitting
Limite de fonctionnement
Limite de vie
Operating limit
Life limit
* Rayer la mention inutile
* Delete as necessary
' ,3a
..sT
Positions successives et operations d'entretien et de remise
n etat mineures et majeures
350A 31003306
Successive status and minor / major maintenance and o verhaul operations
Unite ou
societe
Date
Contractor
Date
Foncti onnement / Opera tions
Unite/Uni ty:EN HE URES
Unite/Un ity: EN C CIES
Total
Partiel
Support
Aircraft Versior
and S/N
Version et
No Appareil
(
...
•• ...........
SD 078
Motif du mouvement (code symptomes) - Travaux effectues - Pieces
changees
Reason for transfert (code and symptomes) - Accomplished work replaced parts
Positions successives avant livraison avion - voir recto tableau 5
Successive status before A/C delivery- see front of page of table 5
0
,
0
0
HISTORICAL SERVICE RECORD
10000 0-Vale
PHI, Inc.
P.O. BOX 90808
RETIRES: (
(MAUL:
LAFAYETTE, LA 70509-0808
INSP: r t, uy
C. If OS 1/1101
•-■nr.-1PART NUMBER: 350 PI ..1--1 - 12- cl D- CLA
COMPONENT NAME:
SERIAL NUMBER:
MA I N RoTO r
r'v
-040M=5 9. 13 0.0i
RINS:
DATE OF MANUFACTURE:
INSTALLATION DATA
DATE
INSTALLED
ON
COMPONENT TIME
NC W I I5 IA L
, (42%
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CYC.
T.S.O.
-
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T.S.I.
September 12, 2006
COMPONENT TIMES
A/C Nig 13 AE
T•T• 41q8‘•17.
T.T. 1-11 q13. I 1
T.S.O.
NC
CYC.
cYc. 15414 14 .
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NC
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REMOVED AT
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T.S.I.
PAGE I OF 2
TECHNICAL DIRECTIVES AND HISTORY OF OVERHAUL
DIRECTIVE NUMBER
COMPLIANCE
IF APPLICABLE
DATE
WORK COMPLETED
REC.
FR.
P.O.
P.S.
DATE
BY
DATE
W.O. #
iUs Oa° 115-
cC)C)-7
Removed From Loofaer Tnat\ls P/N 350A37-000l-l-o
Serie_d_ No. rr ■ -Ingo IT -119R:12_ TD
ircrari
K15BloAc.
Pil 952-HS11-0011
•
J '
V. 3
Re_a3i
Ziozpptex,c4
January 12, 2006
PAGE 2 OF 2
WO
PETROLEUM HELICOPTERS, INC.
:NGINEERING
REPORT
P. 0. BOX 90808
ENGINEERING
REPORT
LAFAYETTE, LA 70509
COMPLETE SECTIONS APPROPRIATE TO HELICOPTER MODEL
AIRCRAFT TIME RECORD
(ENTER IN HOURS AND MINUTES)
- OTAL
-
3 724; 5-0
HRS. TO DATE
HOURS FLOWN TODAY
—
'0TAL
TYPE (OR)
CUSTOMER
PILOT'S NAME & EMPLOYEE NO.
F'f
2-
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/
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2 I-
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NO.
TIME
ENG. STARTS
#2
#1
TAKE
OFFS
tf-
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?2
7
ENGINE POWER CHECK
1
#2
#1
:GT/TOT/ITT
Air Speed
II/NG
Decel
Time
'orque
High Lifts
Low Lifts
OAT
■ Ititude
Daily Total RIN
(Computed From Applicable Model Formulas)
Engine/s Rinsed & Dried
DC Reading
Signature
ITEMS REQUIRING DAILY COMPLIANCE
MAINTENANCE PERFORMED
DISCREPANCIES OR OTHER COMMENTS
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ILY PREFLIGHT CHECK MADE IN ACCORDANCE WITH GUIDE IN FRONT OF
GBOOK BEFORE THE FIRST FLIGHT OF THIS DAY. AIRCRAFT DEEMED
WORTHY AND SATISFACTORY FOR OPERATIONAL FLIGHT.
AIRCRAFT
,
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MODEL
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7 , -
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SIGNATURE
CERTIFICATE NO.
DATE:
MO.
6
DAY
2
YR 40A111
Comp Category: AS-350B2
Comp ID: MRS-413
Part Desc: SHAFT, MAIN ROTOR
Work Unit
Part No — Part Desc. — Part Serial
MR SHAFT AS350 RT
350A37-1290-04-Shaft, Main Rotor-M5220
SB 05.00.32 6YR CORROSION IN
350A37-1290-04-Shaft, Main Rotor-M5220,./
CompMaint-CompStatus.rpt
Printed On:
Comp. ST:
Component Status Report
Part No.: 350A37-1290-04
Pos
Comp TT: 4,798.19
PHI, Inc.
Wednesday, Aug 01, 2007 08:42AM
Comp Serial#:
Service Life
Usage
Date
90000 CF-RTR
-INS
T.T
TC
15,644.20
M5220
TS-IN/OH
CS-IN/OH
Due at
Units CompHr. Date
74,355.80
06/02/1 1
6Y
Page No:
l of 1
Controle d'execution des modifications et des Services Bulletins
Unite
Nunero
ou societe
No
d'execution
Performing
unit or
contractor
Fiche no
Date
d'execution
et tampon de
controle
1
Performing date
and
inspection stamp
Name
MAT ROTOR PRINCIPAL
MAIN ROTOR SHAFT
Denomination
01
Log card no
(\Iv ex-ifouns
.
S) P itkie)
Nomenclature OTAN
NATO Nomenclature
350A 37000402
Reference EC
EC Part number
Code OTAN fabricant
071222
Reference fabricant
NATO manuf code
073118
076129
Version
Numero de serie
076145
M
350A37000402 M
Version
Amendements
1751
Amendments
Serial number
Fabricant
076150
Type
EUROCOPTER
Supplier
076152
F0210
350A
Type
2
076161
Marche ou coinmande / Contract or order
Date
Reference
076163
Reference
Date
Organisme emetteur
No ou lot
076169
Issuing agency
Kit no
Fournisseur
Adresse
076176
Contractor
076179
3
Garantie
076181
Materiel
076182
Material
076183
Date de
livraison
Date of
delivery
/
address
Guarantee
Date de
mise en
service
Duree garantie de
stockage
Duree Garantie
de fonctionnement
Fab/Man
076188
076196
4
/
Special information
076201
076213
NON/NO
076224
EC
21/03/03
EY
'S
' Y
Unite
ou societe
Date
Contractor
Date
EC
Version et
No Appareil
Aircraft
Version
and S/N
c.
03-0
NON/NO
Nb de fiches :
Number of sheet
Operation
0
21/03/03
AS .3. o 83
--.S4Z5
Nb de pages :
Number of pages
Transfer sheet
Attestation/ Certif
Fonctionnement
OUI/YES
MO
Nb de pages :
Number of pages
Appendix to table 4
014
Fab / manuf
Recept / Receipt
Destockage
depreservation
V.P / periodic
overhaul
Montage
Fitting I'll
.
3,
Limite de vie
Operating limit
Life limit
■
Delete as necessary
03
r-5
1
Positions successives et operations d'entretien et de remise en etat
ineures et majeures
Successive status and minor / major maintenance and overhaul perations
Unite ou
societe
Date
Contractor
Date
Fonctionnement
Version at
No Appareil Unite/Unity: EN HEURES
Aircraft Version
and S/N
350A 37000402
M 1751
/ Operations
changees
Unite/Unity:EN CYCLES
Support Partial
Total
Support
Partial
Total
Support Partial
Total
Support
Partial
Total
•111
INVENTAIRE DES COMPOSANTS
INVENTORY OF COMPONENTS
DESIGNATION ENSEMBLE
REFERENCE ENSEMBLE
ASSEMBLY REFERENCE
ASSEMBLY DESIGNATION
MAT ROTOR PRINCIPAL
NO DE SERIE
VERSION
SERIAL NUMBER
VERSION
350A 37000402
M
COMPOSANTS
PAGE 01
POSE
INSTALLATION (*)
POSE
DESIGNATION
INSTALLATION
00000
//////
NON-ROTATING SWASHPL
S
00000
//////
-
350A37100308
2003/03
00000
//////
SWASHPLATE, ROTATING
S
00000
//////
350A37111925
2003/03
00000
//////
DRIVE ADAPTER , SCIS
S
00000
//////
350A37112602
2003/03
00000
//////
LINK, SCISSORS UPPER
S
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//////
350A37112602
2003/03
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//////
LINK, SCISSORS UPPER
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350A37112702
2003/03
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//////
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2003/03
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//////
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2003/03
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//////
BRANCHE DE COMPAS SU
BRANCHE DE COMPAS IN
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VIS DE FIXATION ETOI
STAR TO MAST ATTACHM
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4
REMPLACEMENTS
ENTRAINEUR DE COMPAS
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2
Version
PLATEAU CYCLIQUE TOU
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5
Asemblynurofces
7- Version
ECHANGES
(*)
2003/03
1321
3
7
PLATEAU CYCLIQUE FIX
1513
1
COMPONENTS
REFERENCE
350A37100207
1751
1- Date de pose - Date of installation
2- Numero de serie - Serial number
3- Heures de fonctionnement du composants
Operating time of component
4- Heures de fonctionnement de l'ensemble
Operating time of assembly
5- NB cycles du composant
6- NIC
Component
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number
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//////
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- Serial number
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MAT ROTOR PRINCIPAL
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VERSION
350A 37000402
M
COMP 0 SANT S
POSE
DESIGNATION
INSTALLATION
2003/03
350A37124420
57381
2003/03
350A37124420
57394
2003/03
350A37124420
57395
ECHANGES
(*)
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//////
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2003/03
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2003/03
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0
ASSEMBLY REFERENCE
NO DE SERIE
SERIAL NUMBER
POSE
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,
REFERENCE ENSEMBLE
PAGE 02
■
1
information
11 4
IN
OF COMPONENTS
MAT ROTOR PRINCIPAL
M
350A 37000402
COMPOSANTS
POSE
DESIGNATION
INSTALLATION
2003/03
PAGE 03 FIN
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COMPONENTS
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NO DE SERIE
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INCORPORATED
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COMPONENT NAME:
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PART NUMBER:
INSP:
SERIAL NUMBER:
RINS:
INSTALLED
ON
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PAGE! OF 2
DIRECTIVE NUMBER
COMPLIANCE
IF APPLICABLE
DATE
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June 21,1999
DATE
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PETROLEUM
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June 21, 1999
PAGE 1 OF 2
DIRECTIVE NUMBER
COMPLIANCE
IF APPLICABLE
DATE
WORK COMPLETED
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Numero de serie
M
Amendements
3988
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F0210
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2
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350A
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Reference
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Kit no
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350A32012000 M
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6702
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Date
Reference
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COMPLIANCE FORM
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R-E-C.,0 1-N6g
NOTIFICATION OF COMPLIANCE IS REQUIRED BEFORE
• PHI 915 COMPLIANCE 002
-
-
-
REV. 01/13/2006
PETROLEUM
HELICOPTERS
INCORPORATED
RETIRES:
COMPONENT NAME:
O'HAUL:
PART NUMBER:
INSP:
P.O. BOX 90808
b tirs
3660
SERIAL NUMBER:
INSTALLED
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---- 6/ —
T.S.I.
June 21, 1999
REASON FOR REMOVAL
PAGE 1 OF 2
•
DIRECTIVE NUMBER
COMPLIANCE
IF APPLICABLE
DATE
WORK COMPLETED
REC.
W.O.
FR.
Id 'di
P.O.
P.S.
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DATE
BY
DATE
1A-la -0',3@ctc -ti b1(41)
41=1111■•■••••■
P111-952-11S12-0111 REV. I
June 21,1999
PAGE 2 OF 2
FOTO-02Q B - Page 2 vet
Positions successives et operations cfentretien et de remise en etat mineures et inajeures
J
Successive locations and wino Ytintiur maintenance wid overhaul operations
•apinandertnlvhde EinhaaNtellen. Ilanpipralant:en and Grandaherholanvn
IMMIIIM
i
Ou
Fonctionnement
sociate
Date
Version et
!V Appareil
(*rator: 0r
Date
Atrennt Verslon
Suppott
and W
I 4,port
l'enion 4: S-NI: tie!
Hunt,. Ara mberi
nauulmppe
Unite
Einheir odes
Firma
Draw on
Unite i llia t / Einkeit:
Pattie)
Unite i
Total
Motif du mouvement (code symptomes) - Travaux effectuis - Pieces changees
/opera/king/Be klmeit
Reason for transter ni.).le and sly nqoloan.) • Ancvntpfished mirk - Replaced parts
Ein -- odes Awbunkrund -- Durchgefithrte Arbelien -- Ausgeweeltsdte Tette
ra./Eatteh:
Support
Partiel
Support
Ted
Goa oil
Rounruppo
Total
Positions successives avant livraison apparel! - Voir recto tableau 5
Total
57te•esst ► foranont bepre Air irlis..7), - See front Palen has Inimarr 5
Aufelnanderfekende Einbaindellen yew liallychrnither - Liejerunk. Siehe Vordeneke To belie Nr.5
Gninnnt
Ted
rsi 5 & Fe
I
F070.029 B - Page
motto. utoor de4 .i,,;,^rvke Iluantn ckwl:Ng
PriilvermerA such Darehjiihrung von ,indtrungen and Service BitlIelitts
Numero
No
FN. \•rr
5
Date
I '$.nal
va or
IAuWe
Fin/cell oiler
Firma
&Mint
FAG
Date d'execution et
Unite ou
societe d'execution tampon de connate
PerfOrmtvg date
Pe tiortniEg lot:: or
taNkrhou mono
contra:1yr
Datum .111' Vithrtia '0
EeMitrit and
Kontrollstempel
otter Firma
Type qrao,immiim
.1rt der Anderunk
Unite
ou
societe
Version et
N° Apparel!
Atriedji ;Wake.,
and Sle
Vershm A S-Nr
de, lielwehraubers.
Fiche n'
tFICHE MATRICULE i LOG CARD t. GEILITELAUFKARTE ' lov can; u- 1
Lid. Sr.
Fonctionnement
e lived:kw, Bestrielmzen
Support
Smoot
Eautrappe
04/04
Partiel Total
1;411
Pao:al
Ted Ge‘anO
Attestation
c eritc,:,/tkve
Beiehebvivente
FAG
16 I
Fah Arfaiv / flerstethr
0 h ;tempt; Nerept ' Afinah me
DexinekagelDepre.sereamm
Lagerahrhan
V.1. Prelate Oterkend
Periedi%che Invneknan
* /),14^11' a% Pet
Identification du materiel
Material kit:milled lion
Jenomination
.,i
,,„,,Bezeiehnunt Roulement / Bearing
Keintzeielmung der Geratev
!ornenclature OTAN
Aro oorscarlature i NATO rersoriornsonstmmer 704A33651206
seference EC
C part number; EC Telleitennzeichen
593733
eference fabricant
Code OTAN fabricant
D2456
tinaniwiterer'a Pao nund,er i llenaellerielleAenn;ek ken
NA 10 .110/4 4 o,ofc i NATO nersted,eirtnle
onfiguration de livraison
Version
kl'verr (on flonation ; LeyerAnnilveration
4:r.t:,n1 / ;'erkfeet
4umaro de eerie
An iendements
R/NA2425
. ertll nu.winr I Serien .\'r
An:en:newt!, i Aim/Nap.
Fabricant
Type
:tiiqeter ' Ileroe#er FAG
F.,2,,,, 'bp
riferenc Marche ou commande
Coo Inn i f ' Order
I "vim oiler Auftraje
Date
tereov.,Agitrap-Nr.
Diner /Dimon
pA
organisme emetteur
N' du lot
ii.A.:,,,x ./,,,,Ay, .4 v.ar.srz eher
Kit e' .!...m -A
N
1! ourois:-,eur
MI e 5se
,v:rd, t,t Lidera%
ldie i . / Aniehrifl
Garantie
1417t runty
Gamitik
Date de
Durk. garantie de stockage Date de mice en
Duree Garantie
Warranted Atords:e perfoi
Materiel
livraison
service
de fonctionnement
tnrandez;eit bd. lawmen;
,':',1‘;;;;;Nod liale ,,f ‘teR;er:y.Vert lee dale
if'■ir..alikAI o,oirat:on ivnixt
GermLtelerdaoun
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InInvrietwahordron
Granniiezen Ind Heine*
;la Elfar ller
_»
.tipa NI Ogotinalion
Vow:Mere Vermerke
1
Annexe au tableau 4 :
otriinon '
Nb de page 11
m,,,.,iaLT :e., tabl...• 4.' Annum; In OW Tube& 4
rrs/v, lev:Nein
,''h a I page.‘ Anwhaeneo
liwentaire des pieces a Duree de Vie :
orrifnon *
Nb de page 11
knrivor,.- qr-md , oxpomon i t in-zeichniv der Lebenudamerteile
'm oo leuWein
Nb 4p:tee.% /An:Rh/Seinen
Fiche Matricule de Transfert :
orriin Oft *
Nb de fiche 1/
;ranger A lea , GeenteingOarre fde den Tramiel'
yen.,Xv) --SVdein
3:1, ori thoil .' Ai:ohl *grim
1 .
7.
Irrunite de fonctionnement
i.pc:dt:vgirw: . lintlruzults.Oke ElOriehizen
Mont:ate 1;n:w ' Widest,.
* Raynr la rnenti,Dli inutile
*fie he-serivetree lithrteliel •rtettf4Votirnr-op-2Vircriorrrrw-rrnitrtirnrfo-firgfrisirarie-trrtrrrGrrttt --
r•
:Vi•htzutrellenties strelehest
Limite d‘:. vie
I ilv limit . 7.e1;enAdnuet
' c.
1 Controle d'execution des modifications et des Services Bulletins
FICHE MATRICULE
•
Unite
Numero
d'execution
No
ou societe
Performing
unit or
contractor
Date
d'execution
et tampon de
controle
1
Performing date
and
inspection stamp
Name
073118
21/03/03
EY
NATO Nomenclature
•
350A 32040000
EC Part number
Code OTAN fabricant
Reference fabricant
NATO manuf code
350A32040000 M
Version
Numero de serie
M
Amendements
3174
Amendments
Serial number
Fabricant
F0210
Version
ey
01
Nomenclature OTAN
F0210
Log card no
POMPE A HUILE
OIL PUMP
Denomination
Reference EC
EC
Fiche no
*
/ LOG CARD
Type
EUROCOPTER
Supplier
350A
Type
2
Reference
Date
Reference
Date
Organisme emetteur
No ou lot
Issuing agency
Kit no
Fournisseur
Adresse
Contractor
Garantie
3
Date de
livraison
Materiel
Material
Date of
delivery
/
address
Guarantee
Duree garantie de
stockage
Date de
mise en
service
guaranteed storage period
Service date Guarantee operation
Duree Garantie
de fonctionnement
Fab/Man
•
41
/
Special information
NON/NO
Appendix to table 4
Number of pages
NON/NO
5
Unite
ou societ
Date
Contractorr
Date
EC
Version et
No Appareil
Aircraft
Version
and S/N
Attestation/ Certif
Fonctionnement
-o
Number of sheet
0
312,c
Nb de fiches :
Operation
21/03/03
OS
NON/NO
Transfer sheet
AS3S-083
Lc_
Nb de pages :
Number of pages
Nb de pages :
0'1-
(s/t
Fab / manuf
Recept / Receipt
Destockage
depreservation
V.P / periodic
overhau
Mon tage
Fitt
Fitting
Limite de vie
Operating limit
Life limit
0
•
•
-
I
A•
350A 32040000
Successive status and minor major maintenance and overhaul operations
Unite ou
societe
Date
Contractor
Date
Fonctionnement / Operations
Version et
Aircraft Version
and S/N
Support Partiel
Support Partial
M 3174
chantiees
Total
Support
Partiel
Total
Total
Support
Partial
Total
Petroleum
Helicopters Inc.
1
Petroleum Helicopters,
Inc
2001 SE Evangeline Thruway
Lafayette Louisiana USA
Component Tag
Serviceable
PART S
350A33-2030-00
PART DESC
SERIAL #
SPIDER ASSEMBLY, T/R P/C, SEE REMARKS
MA1910
!111111111111011111111111111111111111111111111111111111111111111111111111111
13:
OBJECT TYPE
COMPONENT 0
1111111111111111111111111111111111
SN:
TSI
TSN
Component
TRD 2699
-
999.4
i
(
REF. DOC. #
REF. DOC. TYPE
TSO
DATE
5 C• L(
CURRENT CONDITION
1
Goods Receipt
11/03/2005
GORC-030936-2005
Serviceable
REMOVAL DETAILS
COMP. REPLACEMENT S
REASON S
BASE
REMOVED BY
REMOVAL DATE & TIME
REMOVAL TYPE
REMOVAL CONDITION
REMARKS
AIRCRAFT REG #
TOTAL FH
____,...
.
NHA PART #
NHA SERIAL S
POSITION CODE
,....
Only one section, "A" or "B" is to be filled out in it's entirety. Section "A" will be used by the repair station
— - ---- -- - -- Settion '114-wilf be used by certified Mecilanies,-Maintenance Release
Ref. Doc.# GORC-030936-2005
A
The aircra
are, aircraft engine, . •
er, or
aplliance identifi ,
. was re. • -4 in accordance with
current regulations of the ,
. Aviation Administratin
and is approved f.
to serve e work order for
pertinent
Mechanic:
Inspector:
.
Approved Repair Station No. IIEER.
Mechanic:
g
_..,
__
'ficamiki---
Approves' for return to service in accordance with
FAR 65.81, FAR 65.85, or FAR 65.87
Cert. Type:
Serviceable
GENERATED
ON
11/03/2005
09$$48$511
mm/dd/yyyy
PAGE
HI-124SSMInSS
See accompanying paperwork for serviceability information.
Refer to packing slip via Ref. Doc. # shown above.
INSTALLATION INFORMATION. RETURN TO RECORDS.
A/C t
S/N
?S
T.T. 6 2-7(
Date 1 fl 3
1
OF
1
Unite
ou societt
d'execution
Performing
unit or
contractor
Numero
N°
FICHE MATRICULE /
Date
&execution
et tampon de contrele
Performing date and
inspection stamp
. . .
. .
.
V
"
Denomination
Name
Fiche n°
LOG CARDS
-
•
I
II
Log Card II °
...3...
I
Material Identification
,,,
fr,ATCAU of Com-UW(3E ARRCege
Nomenclature OTAN
NATO Nomenclature
(
ReMrence EC
EC Part number
Pt 1
5c5 A 5 3
✓
CH Ft iuCy€ cl'i OeR -TN c. REAR
AD30, (3c)
Reference Fabricant
Configuration de livraison
•
Numero de serie
il
Code OTAN fabricant R) ,9 t o
NATO Many . code
Version
Amendements
Serial number
Amendments
Type
TYPE
C-7( )InG-5P-T-C- Q
Marche ou commande
Reference
2,1 1
Reference
F jdg 42_
Organisme emetteur OEM
Contract or order
Date
J602_ 102_
Date
A
N° ou lot
Issuing agency
Kit n°
Fournlsseur
Adresssig
N.ecArtian
Contrator
Materiel
Date de
livraison
Material
Date of delirwry
Address
14P,
7Q 14()1Ai
e., ro v
Guarantee
Garantie
I
Version
pt j alo
Fabricant
Supplier
-
,
Duree
* garantie de stockage
Guaranteed storage period
Date de liaise
en service
Duree Garantie
de fonctionnement
Service date
Guarantee operation period
Fab/Man
•
51 ouUnite
societe
Contractor
Date
Date
Aircraft Version
Support
Partiel
Total
and S/N
Support
Partial
Total
,
32CD
Appendix to table 4 '
Inventaire des pieces a Duree de Vie :
otknon•
yes/no
oui/nose
yes/no
Number of pages
optt/non•
Nb de fiche 1/—
Transfer
yes/no
Number of pages
log Card
I*1 ,
li
Fab/ManztfRecept/Receip
-000-Destockage/Depreservation
VP/Periodic Overhaul
115A 5t311.3
EC.
CPR 1812 B
A0/0 3
3782-
o"
mon,a,,,„ing
,
Nb de page 1/—
Number of pages ,
Nb de page 1/-ef-
Fiche Matricule de Transfert :
Attestation/Certifl
Fonctionnement
Op&ation
Version et
N° Appareil
NC-Ari.i gryte OS 1
Special information
Limite de vie
Operating limit
Life limit
• Rayer la mention inutile
Delete as necessary
Successive status and minor/major maintenance and overhaul operations
Unite ou
societe
Version et
N° Appareil
Date
Date
Contractor
P Vaar
AELLC
10/25/05
Y 1L;T-rt-
Id 30 05 0
-
-
Support
Partiel
Total
Support
Partiel
Total
Support
Partial
Total
Support
Partial
Total
3
CRS VY1R575K
9 fri
TSR 0.0
580E-37,15 4'21: (')
fgFiLl '‘iln 9' AM",
TSN
Ts,--%—
11.
I
999.4
91: A9
-
S/N MA 1910
Reason for transfer (code and symptoms) - Accontplisbed storks - Replaced parts
and SAV
2.
-
Motif du mouvement (code symptomes) - Travaux effectues - Pieces changees
Unite " nril
Aircraft Version
/9615o
57
I At ° e ,y
Fonctionnement/Operancm
Unite / l'iiit
350A33 2030 00
—
Positions successives avant livraison avion - Voir recto tableau 5
Successive status before A/C delivery-See front page of table 5
9--17 tdecA)
ig=ro-k-/ .-, '/'/7
INSPECTED ANWREPAIRED IN ACCORDAN
9X,',. -' - -- -
.‘41
NUAL,
MRV, WO# W104087, SERVICEABLE.
r,,
AmtA
0,
J .
I 1 64- fl ipa.it"?(I N-rtm C ,..( VC or i-e e' It' . DI 5(70 -2.0t5 P15: S36 415'13 o r, /14'2 R
111.5icti)ed-Vo r)
350 OVERHAUL
1- Date de pose
-
0
R
A TINA() ry---. CAP
a
aa) A 33 ,')30 Cr)
A33 C61. (A.10
)( r.N (= rk rr
POSE
INSTALLATION
-
(""
2o D'6
!
ip
S-
i."
''''
rx--)
VERSION
VERSION
flo:m. ::t enztl eof cycles
6-
1
3
2
4
7
li
- Version
tl 14- J.,,lo
7- Version
COMPONENTS
COMPOSANTS
REFERENCE
DESIGNATION
0:31-1
AR
REFERENCE ENSEMBLE NO DE SERIE
SERIAL NUMBER
ASSEMBLY REFERENCE
POSE
INSTALLATION (*)
.0
PAGE 01 FIN
ECHANGES
REHPLACENENTS
(*)
(11-NA")
I
rCr3
AM
PAW
.,...
Renseignoments particuliers
Special information
(*)
10/05
00000
///////
2116
999.4
Vitt
///////
414 !"41Y
,:
1.
2.
Approving National Aviation
'
,
Authority/Country:
AUTHORIZED RELEASE CERTIFICATE
FAA/UNITED STATES
DCR0502967
FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG
5. Work Order / Contract /
Invoice:
4. Organization Name and Address
American Eurocopter LLC
2701 Forum Drive, Grand Prairie Texas
75052-7099
W104087
6. Item
7. Description
8. Part Number
9. Eligibility
1
PITCH CHANGE SPIDER
350A33-2030-00
H9EU
13. Remarks:
-i
i1
10. Qty
11. Serial Number
12. Status / Work
MA 1910
Repaired
1
Maintenance Release statement: American Eurocopter LLC certifies that the part or component identified herein has been Repaired, in accordance with
Eurocopter Manual: MRV Revision: 9 and has determined that this part or component herein is airworthy as stated in block 19 dated: Oct/25/2005.
TSN: 999.4
1.
3. System Tracking Ref No:
e it Msden
TSR: 0.0
TSO: N/A
tried above were manufactured in conformity to:
19.
V 14 CFR 43.9 Return to Service
N/A
❑ Other regulation specified in Block 13
Certifies that unless otherwise specified in Mock 13, the work identified in
Block 12 and described in Block 13 was accomplished in accordance with Title
14, Code of Federal Regulations, part 43 and in respect to that work, the items
are approved for return to service.
Approved design data and are in a co edition for safe operation.
Non-approved design data specified ii Block 13.
15. Authori2ed Signature:
Cycles:
16. Approval/Authorization No.
20. Authorized Signature:
21. Certificate Number:
rI
VY1R575K
g>if-i'll
[
17. Name (Typed or Printed)
i
-
18. Date:
22. Name (Typed or Printed)
i,
J
Frank Slack
23. Date:
Oct/25/2005
User/Installer Responsibilities
It is important that the existance of this document alone does not automatically constitute authority to install the parUcomponent/assembly.
Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified in Block
1, it is essential that the user/installer ensures that his/her airworthiness authority accepts parts/components/assemblies from the airworthiness authority of the country specified in Block
1.
Statements in Blocks 14 and 19 do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in accordance with the
national regulations by the user/installer before the aircraft may be flown.
FAA Form 8130-3 (6-01)
* Installer must cross check eligibility with applicable technical data.
NSN: 0052-00-012-9005
)
'tpr.vUT1°-rT\U_P
v
4.
Tue 05,,7/05 11:35
PROG: wo/list/wosumry
USER: u2324
AM
Work Order Class: ECF WARR Number: W104087
Issue Date: 09/26/05
Revision:
efer"
Location: AECR Customer:
Created By: u2171 - Juan Rojas
Aircraft TSN:
91,775-
Component S/N:
14811451 11 7/42
1 1 4/).
Last Modified By: u2324 - Oliver Bernal
Aircraft Cycles:
P/N: 350A33-2030-00
PAGE 1
WOSUMRY
DB: Prod
Work Order Summary Repo.,c
•
.4/9-
Aircraft Model: AS350B3
SPIDER ASSY, PITCH CHANGE
TSN:
5'7574fi:/TSR:
4:1'
Serial Num: 3782
Quantity to Produce:
TSO:
!Y:41-- Total Cycles:
Date Needed: 10/26/05
1.0
,4/d
Mfg Date:
4:0,p
/ /22g
Instructions:
INSPECT AND REPAIR AS REQUIRED IAW MRV
REASON: T/R SPIDER WORN BEYOND LIMITS
WO Class changed from to ECF WARR
by u2171 on 09/26/05
REASON: WORN BEYOND LIMITS
MMIR# 00021B
RCVG# 05804312
RMA# R056817
ECF WARR TT: 999.4
INSPECTED AND REPAIRED IN ACCORDANCE WITH 350 OVERHAUL MANUAL, MRV, SERVICEABLE.
I hereby certify that the repair, overhaul, or modification of this unit, as identified on its permanent work order file, has been
done in accordance with current regulations of the Federal Aviation Administration and manufacturers' recommendations. This unit
is approved for return to service. Pertinent details are on file at this repair station under authorization # W104087 and a
copy supplied to the customer.
Repair Station No. VY1R575K
Signature:
6ate:
10/25/05
Note: No other work is to be performed other than those items listed on this work order. If safety of flight items are
discovered, contact writer so proper authorization can be obtained prior to performance of additional work.
•
J1
•
Contrede d'execution des modifications et des Services Bulletins
Numero
Nature de La modification
N°
. Type of modification
Fiche n° 4
FICHE MATRICULE / LOG CARD*
Unite
ou societe
d'execution
Date
d'execution
et tampon de controle
Performing
unit or
contractor
Performing date and
inspection stamp
lj
Log cirri n°
.11aterial Identification
TA
Nomenclature OTAN TG S .
Reference EC
3S-0 A 33 0200 . c6
Denomination
Name
04 ‘85 LI,
NATO Nomenclature
g5k-(4
al 3.A.,1
04
EC Part number
900.5
flECACt1 201E. 03 /
•
Reference Fabricant
Code OTAN fabricant Co
NATO Manif code
Configuration de livraison
Version
Numero de serie
Serial number
Fabricant
supp/ier
2-lo
l'ersion
r.1 R A63
Arnendements
Amendments
Type
El.)000PTE -
Marche ou corntnande
Reference
.-1 I rj 0212_
Reference
TYPE
Contract or order
Date
Date
.
Organisme emetteur
Or
Issuing agency
F
oO
mU
trr
alliS
to r SeUr
r r E CA ett
MA
Materiel
Date de
livraison
Material
Date of delivery
102.10?_
N° ou lot
Kit n°
Adresse.)0p 41,
Qo PE
Garantie
s--16
Address
46, -N_A_, Au Q5601
Guarantee
Du 'ree garatitie de stockage
Guaranteed storage period
Date de mise
en service
Duree Garantie
de fonctionnement
Service date
Guarantee operation period
Fab/Man
•
.Special information
o)d/non•
Appendix to table 4
yes/no
Number of pages
Inventaire des pieces a Duree de Vie :
oui/tirin•
Nb de page 1/
Inventory of lifed compinents
1,,,,es/nn,o,
s/
Number of pages
Fiche Matricide de Transfer[ :
olpi/non*
Nb de fiche V—
Transfer log Card
_LI
•
Fonctionnement
Number
Attestation/Cern':
Unite
ou societe
Date
Version et
N° Appareil
Contractor
Date
Aircraft Version
Support
Partiel
Total
and 5/N
.cupport
Partial
Total
Operation
C co
1
'
.
tie- cfpfizokaSp,co 6
r
Fah/MannfRec ept/Rec op
Destockage/Depreserration
as3 ,083
Ec:.
CPR 1812 B
03-03
31.25
V:P/Periodic Overhaul
o it
0H
m„„,„,,F„,,
,,
,,,
ve.,:,..
Nb de page 1/—
Limite de vie
Operating limit
Life limit
Rayer la mention inutile
Delete as necessary
qt pages
Positions successives et operations d'entretien et de remise en Etat mineures et majeures
5
Successive status and minor/major maintenance and overhaul operations
Unite ou
societe
Contractor
Date
Date
Version et
N° Appareil
Aircraft Version
and S/N I
Fonctionnement/Operation
Motif du mouvement (code symptomes) - Travaux effectues - Pieces changees
Reason for transfer (code and symptoms) - Accomplished works - Replaced parts
Unite ' Una :
Unite / Unit
Support
Partiel
Total
Support
Partiel
Total
Support
Partial
Total
Support
Partial
Total
Positions successives avant livraison avion - Voir recto tableau 5
Successive status before A/C delivery - See front page of table
5
•
•
•
1- Date de pose
Serial number
2- Numero de serie
NO DE SERIE
VERSION
SERIAL NUMBER
VERSION
REFERENCE ENSEMBLE
ASSEMBLY REFERENCE
REFERENCE
POSE
DESIGNATION
INSTALLATION
35-0 A 33 ,Aoco . 2-I
03 I 2)co,?) o co
660
.
Lg60 _A ✓
6 co
3so R '35 Jec-).1. 2s.4
0 3 /,c03
6 op
6 co
o CO
L -fatil
6 OD
C; C'r )
03 1 Qco3
6 co
0 oc)
CA IL-Fez_
-i--3s-0 R 33 ,_)02_0.,1
HA 026(2 i 0 co
03 1 cD3 o co
0 co
a co
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