0 jl major repair and alteration - aso · install bob fields aerocesories inflatable door seal in...

0 Form Approved Jl Electronic Tracking Number OMB No. 2120-0020

MAJOR REPAIR AND ALTERATION 11/30/2007 U.S. Department For FAA Use Only of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration

INSTRUCTIONS: Print or type all entries. See Title 14 CFR §43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. §44701 ). Failure to report can result in a civil penalty for each such violation. (49 U.S. C. §46301(a))

Nationality and Registration Mark Serial No.

N146TA EA-176 1. Aircraft

Make Model I Series BEECH A36TC

Name (As shown on registration certificate) Address (As shown on registration certificate) VIDEOFAX, INC. 4245 Kemp Suite 810

2. Owner Wichita Falls, TEXAS

76308 USA

3. For FAA Use Only

4. Type 5. Unit Identification

Repair Alteration Unit Make Model Serial No.

D [XI AIRFRAME (As described in Item 1 above) .. D D POWERPLANT

D D PROPELLER

Type

D D APPLIANCE Manufacturer

6. Conformity Statement

A. Agency's Name and Address B. Kind of Agency

Select Avionics, LLC. U. S. Certified Mechanic I Manufacturer

1500 E. Industrial Blvd Ste 121 Foreign Certified Mechanic C. Certificate No.

McKinney, TX X Certified Repair Station RS # 5ECR951Y 75069 USA Certified Maintenance Organization Select Avionics

D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U. S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge.

Extended range fuel

0 Signa~:/Date of Authorizedu ,d;;, Jerry Huntley

per 14 CFR Part 43 App.B /7~ ...... 7/0 ~/f.../1 26-0ctober-2011

(/ / 7. Approval for RetLJ\n to)lervice

Pursuant to the authority given persons specified below, the unit identifiWin item 5 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ~ Approved D Rejected

FAA Fit. Standards Manufacturer Maintenance Organization I Persons Approved by Canadian Inspector Department of Transport

BY FAA Designee X Repair Station Inspection Authorization Other (Specify)

Certificate or Sig!/DateofAuthorized~ ~ Jerry Huntley Designation No. 3267153 /7' /_A "..h'"?J 26-0ctober-2011

FAA Form 337 (10-06) r(/ / , v

NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.

8. Description of Work Accomplished (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)

N146TA II Oct-26-2011

Nationality and Registration Mark Date 1. Removed the following equipment: King KY-196 COM P/N 064-1019-00 King KLN-908 GPS PIN 066-04031-1121 King KNS-80 RNAV P/N 066-4008-00 ACU PIN MD41-328 GPS Antenna P/N 071-01545-0200

Installed the following equipment: Garmin GA 35 WAAS Antenna P/N 013-00235-00 installed at F.S. 83 Garmin GTN-750 P/N 011-02282-00 installed at F.S. 53 Annunciator P/N MD41-1510 installed at F.S. 56 Blind Encoder PIN A30-9 installed at F.S. 49

Garmin GTN-750 is interfaced to the following existing equipment: Century Ill AutoPilot, Blind Encoder, King KMA-24 Audio Panel, King Kl-206 Indicator, Mid Continent MD41-1510 ACU and FS-450 Fuel Flow. Recomputed Weight and Balance and entered into aircraft records.

2. Garmin GTN-750 installation was done as per STC SA02019SE-D. All equipment installed as per Manufacturer's Instructions and in accordance with AC 43.13-1 B/2B. The following manuals were used for reference: Garmin GTN 750 installation manual PIN 190-01007 -A3 Rev. 3, May, 2011.

\ 3. All wiring meets requirements of AC 43.13-1 B chapter 11. Wiring was routed and secured as per AC 43.13-1 B chapter 11. Circuit protection was used as per AC 43.13-1 B chapter 11. Electrical load does not exceed limits as per AC 43.13-1 B chapter 11. Wiring also meets requirements of AC 43.13 -2B chapter 2. All installed equipment was checked for EMI interference as per AC 43.13-1 B chapter 11. All effected systems were tested accordingly to show compliance with 14 CFR 23.1301.

4. The following circuit protection was used for this installation; The following items were installed on the Avionics power bus located on the Co Pilot's sub panel: Garmin GTN-750 Com 1 installed using 5 AMP circuit breaker, Garmin GTN-750 GPS installed using 5 AMP circuit breaker.

5. FAA Approved flight manual supplement for the GTN-750 PIN 190-01 007-A2 Rev. 1, Mar, 2011 has been provided to the aircraft owner/operator and must be on board the aircraft for this installation.

6. Continued Airworthiness for this installation should be performed as per attached Instructions for Continued Airworthiness PIN 190-01007-A1 Rev. 1, Mar, 2011 for the GTN-i50 system-:- A copy has been provided-to the aircraft owner/operator for inclusion into the aircraft maintenance

. records. ---------------------------------------------------------------------END----------------------------------------------------------------------------------------

0 ADDITIONAL SHEETS ARE ATIACHED

FAA Form 337 (10-06)

,~ Form Approved

1

!Electronic Tracking Number OMB No.2120-0020

MAJOR REPAIR AND ALTERATION 11/30/2007

U.S. Department (Airframe, Powerplant, Propeller, or Appliance) For FAA Use Only

of Transportation

Federal Aviation Administration

INSTRUCTIONS: Print or type all entries. See Title CFR 43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 44701 ). Failure to report can result in a civil penalty for each such violation (49 U.S. C. 46301 (a)).

Nationality and Registration Mark Serial No. 1. Aircraft N146TA EA-176

Make Model I Series Beech A36TC

Name (As shown on registration certificate) Address (As shown on registration certificate) 2. Owner Asche Todd M Address PO Box 501

City Willmar State Minnesota Zip 56201-0501 Country United States

3. For FAA Use Only

4. Type ~~ \ 5. Unit Identification

Repair Alteration · ·Lin it Make Model Serial No.

D 0 AIRFRAME (As described in item 1 above)

D D -·

POWERPLANT

-~~\

D D PROPELLER

D D Type

APPLIANCE

Manufacturer

.::.:.~.

;. ',"\


A. Agency's Name and Address B. Kind of Agency Name Ronald G Olsen X U.S. Certificated Mechanic I Manufacturer

Address 1765 Budd Ave Foreign Certificated Mechanic C. Certificate No. City Maple Plain State Minnesota Certificated Repair Station 474723603 Zip 55359 Country United States Certificated Maintenance Organization

D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto have been madgjn accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished ti~rein is true and correct to the best of my knowledge.

Extended range fuel per D r Signature/Date of Authorized lndivid~ ~ 1!!:.--14 CFR Part 43 App. B 9/19/2008

7. Approval for Return To Service

Pursuant to the authority given persons specified below, the uniGaentified in item 5 was Qpected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ./ APPROVED REJECTED

FAA Fit. Slandards Manufacturer Maintenance Organization

I Person Appoved by Canadian

BY Inspector Department of Transport

FAA Designee.-:· ... Repair Station X Inspection Authorization Other (Specify)

Certificate or Designation No. Signature/Date of Authorized Individual

474723603 ~~ 9/19/2008 FAA Form 337 (10-06)

NOTiCE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.


I 9 /l<rfoc>Y I Nationality and Registration Mark Date

Install Bob Fields Aerocesories inflatable door seal in accordance with STC SA4180W and Drawing No. 3950 Revision Letter G dated Jan. 23 1987, and report DFA 310 Revision 2 Installation Instructions dated 2/26/1993. This installation was completed with the provisions in accordance with Bob Fields Aerocessories Service Bulletin No. BFA-001. This is an Alternative Means of Complience (AMOC) for AD 98-21-21 per FAA Memorandum Docket 98-CE-88-AD dated January 11, 1998. End .

. ,. ...

:·,

... ,

0 Additional Sheets Are Attatched

FAA Form 337 (10-06) Reproduced by Avantext, Inc.

~nlttd .Srntu of ~a

taepertmwt or 1:ren.sportetion -.:f.'edeml 2ttJietion £ldministretion

~upplcmcntal rm::npe [ertificatc . A~ SA4180WE

~~~~;~~Bob Fields Aerocessories

¥~Civil Air

a:...? .. /..<'io.1't<l-. *See Aircraft Speci:ication 3Al5 f~r complete certification basis.

tr7n.aJ,q;~-,;?f;M~~·~.-3Al5 · . · ..-ltak: Beech ,

~:H35 ,J35 ,K35 ,M35 ,N35 ,P35 ,535, V35, V35A, V35B ,35-33, 35-A33,35-B33,35-C33,35-C33A,E33,E33A,E33C,F33,F33A,F33C,G33,36;A36,A36TC ~~~y~~~-~~Insta11ation-of inflatable door seal in accordance

with FAA sealed Aerocessories Drawing No. 3950 dated Apri1'7, 1980, or later FAA approved revision.

:...z!n~.o~~-ru/~n.4.-: The approval of this change in type design applies to the basic aircraft of the specified model on,-y that.is otherwise unmodified. This approval should not be extended to other aircraft of this model on which other previously approved modifications are incorporated unless it 1s determined by the installer that the interrelationship between this change and any of those other previously approved modifications will introduce no adverse effect upon the airworthiness of that aircraft.

~-L~.iea4~&-A.o/0--'7~"'-~:~-~./-<M~/~..n,.Ar~....-z.!~l/.--,..,.u,;n. Vn-#··~' ... ._n/,/..u...,...:.

~~~.o-,...evk~~k..A-~.<dtdi~.b:y~·yU,,,:,..,t..,./,.,.tj/A..

c.- ·-A'.' ~~; . y~~~~u.n,

-~.4u-¥'~1.u6;""':0ctober 16, 1979

.05 ... t-. .,r~~:J une 30, 1980

Branch

(Titlt)

A'!)' alttraiion of this certificate is punishable ~Y a .fine of not exceeding S I ,000, or ,·mprisonmmt not excuding 3 ;•ear;, or both.

ThiJ ctrtificalt ~d)' bt /ramjtTrtd in arrord.on" wrt~ FAR 7(~;. Page 1 of 2 Pages 1M lo"' 8110-2 (10-68)

f'J Form Approved

MAJOR ~-EP~IR AND ALTERATION OMB No.2120-0020

U.S. Department .. (Airframe, Powerplant, Propeller, or Appliance) For FAA Use Only

of Transportation Office Identification Federal Aviation Administration

INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix 8, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49''U.S.C. 1421 ). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

1. Aircraft Make Model

Raytheon A36TC

Serial No. Nationality and Registration Mark EA-176 N146TA

2. Owner Name (As shown on registration certificate) Address (As shown on registration certificate)

Asche Todd M PO Box 501 Willmar, MN 56201-0501

3. For FAA Use Only I

- . -4. Unit Identification 5. Type

Unit Make Model Serial No. Repair Alteration

AIRFRAME (As described in item 1 above) X

POWERPLANT

PROPELLER

Type .. ,: APPLIANCE

Manufacturer

6. Conformity Statement \

A. Agency's Name and Address B. Kind of Agency C. Certificate No.

Ronald G Olsen X U.S. Certificated Mechanic 474723603 1765 Budd Ave Foreign Certificated Mechanic Maple Plain MN 55359

Certificated Repair Station .....

Manufacturer

D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge.

Date I Signature of Authorized Individual e 4/4/2007 . . (7/-£.....¢---~'/ ~---

7. Approval for Return To Service

Pursuant to the authority given persons specified below, the uniGaentified in item 4 was inspected in the rT)anner prescribed by the Administrator of the Federal Aviation Administration and is ./ APPROVED 0' REJECTED '

FAA Fit. Standards Manufacturer X Inspection Authorization Other (Specify) BY Inspector

FAA Designee Repair Station Person Appoved by Transport Canada Airworthiness Group

Date of Approval or Rejection Certificate or Designation No. Signature of Authori~-Hldividual

4/Jl./7,)..) (, 01 A2 .. /-<)/ , ..

4/4/2007 -·· -··- .

FAA Form 337 (12-88)

NOTICE Weight and balance or operating limitation changes shall be entered in the appropriatE? aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.


Install cooling air baffles in accordance with D'Shannon Products Installation Manual No DSP-IM95-2 revision 6, per STC SA368CA. No change in wieght and balance. End.

****************************** NOTHING FOLLOWS******************************

~- --- -- --· :----

0 Additional Sheets Are Attatched

Reproduced by Avantext. Inc. *U.S.GPO:l994-568-012/00019

I ~

© Copyrighted By 'l'SHANNON PRODUCTr

"PROPRIETARY" b ·. " ·· l?le-infonnatlon contained in or disclosed Y t~: llnftro ,;iHat~• of .Au•.ar~~, .

document is consideredp~ta¥~iffihtlltiiilrrz:ml1ifHrrln!inn -- ~ eor.ru:f: J\1Iiatian J'omini.efrlttiau ?roducts. This document an items and infor . . ~ . •. '·. .-.

nation contained or disclos. . r~ ~nmnta:l <(it nn.e tJler±tfi.ccr±z JSed, COpieS, Or reproduc WhO e ~ltrf."~ ., ~ J . ,hall ihe contents be revealed in any manner tr ~nv oerson unless written oermission is obtainFW ·

U'Shllllnon l'roducrs 13610 Gl~er Lane Lindstrom, MN 55045

SA368CH ~ermiSSIOn IS hereby QIVen TOf tne TOIIOWiflt aircraft and only valid when the signature ir the approval by is signed by Alia~ Pete_rsor · :a~d the return of the •eg1?t a rr t!:

'lalidated. Model Only~~~~~ Aircraft' C1 u .Nu . ber """'~~"*~~::..

. . . . · 3erial . - ~ -CGl ~M.J d • ./.«,.. r.,/~ ,;. ,dr {wr" llf"-N;,w _,t4.,. d-~~toMy_/l~r/ .-.;d\ ~c(~~~t::z~!e:%/i~~::2;t'_

· d~ ... -...s. -7"'-.~-.1' .C........- --.t.J ,d;. ..,,;..,..,.,.,d~ '7'"'':--.,.,.J.-. </')'l-....,.( 10?./:C.C. Civi I Air., ::ri?..,..,..,&-/.tM.-1. {See Ain:rafi Spc:~:ificatiuo No. 3A IS for complete certification basis.)

P~>Yl·~..Y.-.1. ..~ ... :;c~,. ..... ~ .; ~.4 .· 3A 15

,,pj,.,.

•/1{,('~.·

Raytheon Aircraft Compruty

SJ5, V35, V3.5i\, Y 3.5l:l, 35-C.33A, E33A, F33A E33C, f33C, 36, A36, A36TC. n.16TC

lnstall:uion·of cooling air ~fflM in accordance with D'Sha11non. f'.rod.uct.s' .lns~lhuion .M1111ual No. DSP-IM95-2, revision 6, d3tcd April 16, 2002, l,lr llltcr FA A IIJ'proved revisions.

' ~ .... "1

J. Compatibility of this de5ign change with previously approv~"tl niooifi~·~tli.m~ rmJ:~ ~~ -'!!l;;~i·ri~d by the inmd!cr

2. Aircraft specifications IIJ"C the Slime as listed on Airct11ff SJX.."Ciliclllilln Number .lA 1.~.

J. If the holder agreell to pennit another penon to use this certificate to alter rh:: >mxluct. the holder ~hall'give rh~ Q!hcr ocr.;on written ·cv\dcncc of that pc:nnission .

. J,T~ ,..,.....,0',...-k ,_,(a;. .l"'Yf""~~ ""'/"" ,..-/'..r.-1',;., .&~;. ;.;..,..s.-4 fr"' ~~~"'-.d,d' ~.-;,. u:. ;yp';...;: luU4if•

~,-< ~~~(',,I'~~;.;.-.... ~u- ~ ,.,«;.,....,.i.J.. ~u~ t.;. a. ,/;1,....?. • ..:-.w~ .... "';/a;. .~ ... ~«- .. ~.,;~:W> ....

Y~"¥~.·June23, 1995

(i'/£1t!)

(.

fJ ' ·Form Approved

MAJOR REPAIR AND ALTERATION OMB No.2120-0020

For FAA Use Only U.S. Depanmenl (Airframe, Powerplant, Propeller, or Appliance) of Transportation Office Identification Federal Aviation Administration

INSTRUC.TIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S. C. 1421 ). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

Make Model 1. Aircraft Raytheon A36TC

Serial No. Nationality and Registration Mark EA-176 N146TA

2. Owner Name (As shown on registration certificate) Address (As shown on registration certificate) Asche Todd M P.O. Box 501

Willmar, MN 56201

3. For FAA Use Only

.

4. Unit Identification 5. Type


AIRFRAME (As described in item 1 above) X

POWERPLANT "

I

PROPELLER

Type .. ~-,

APPLIANCE Manufacturer



Ronald G Olsen X U.S. Certificated Mechanic 474723603 1765 Budd Ave Foreign Certificated Mechanic Maple Plain MN 55359

Certificated Repair Station

Manufacturer


Date I Signature of Authorized lnd~ 12/26/2006

! ~./"l.fl 7. Approval for Return To Serv(ce

Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is G2J APPROVED d' REJECTED .

FAA Fit. Standards Manufacturer X Inspection Authorization Other (Specify) BY Inspector

Person Appoved by Transport .I

FAA Designee Repair Station Canada Airworthiness Group Date of Approval or Rejection Certificate or Designation No. ~e of Authorized Individual

12/26/2006 474723603 t/..-.!j --t:: FAA Form 337 (12-88)


50074-5 cover 1771-us14 latch 001-410000-21 nose grill 002-410019-37 fuselage Keel 002-410019-7 angle 002-41 0019-8 angle 002-410027-42 skin 002-410012-1 side Plate 002-410012-3 side plate 002-41 0026-1 bulkhead 002-41002602 bulkhead 002-410026-22 bulkhead 002-410027-7 angle 002-410027-8 angle 002-410014-5 pan-nose 002-410022-1 former 002-410022-2 former 002-41 0024-5 Ionge ron 002-410026-21 bulkhead 002-41 0026-6 bulkhead 002-41 0019-22 angle 36-400017-17 skin Bottom Fus 36-400017-19 skin Cabin Bot 36-400017-51 skin cabin LH 35-41 0330-15 keel Assembly 002-430044-11 frame 002-4100295-5 bracket 002-410029-6 bracket 35-8009-1 s NG. Boot Kit 36-820023-1 ng et Boot Kit --002-430009-:15 - -- -seal Assembly- ' 002-430009~121- ~

seaiAssmebly -002-430045~67 frame LH St 68 002-430039-55 channel 002-430026-25 rear Carry Thru 106-420012-3 zee Frame 002-430044-63 frame 002-430044-49 frame 002-430010-33 frame 002-440010-39 skin 107470-2U z stock 002-430037-20 channel RH 002-430037-19 channel LH 36-400013-4 frame lwr RH 35-41 0259-36 channel 36-430056-5 doubler Front :33-430056-5 doubler Front 002-430039-45 stringer 002-430038-73 skin 140-3607-001 kit 002-430038-73 skin Center · 36-430056-7 ' ft spar. doubler (2) 36-430056-8 doubler ft spar (2) 36-4004-5 fwr spar kit. 36-4004-7 aft spar kit 002-430012-13 frame 002-43007-11 angle 002-430009-106 stringer 002-430008-225 skin fus upper 002-430039-49 sringer fwd 002-430044-17 frame 002-430009-201 stringer 36-400011-1 stringer cabin 002-430026-26 rear spar reinf 002-430039-43 stringer 002-430039-27 stringer 36-4000 13-3 frame lwr blkh 36-400027 frame lwr fus 36-400013-4 frame lwr RH 002-43007 4-1 frame cabin door" 002-430008-71 skin 002-430043-17 gusset 002-430030-35 web rear spar 002-430039-53 angle 002-430039-133 channel 169-160005-21 spar 002-430045-67 frame lh blkd 002-430044-49 frame blkd 002-430044-5 frame rh lwr fus 002-430046-1 frame lh fus 002-430044-26 angle blkd ass~:m 002-430044-23 stiffner 002-430009-95 frame 002-430010-37 frame blkh sf 100 002-430039-69 angle 002-430044-17 frame 002-430043-9 gusset 002-430043-17 gusset 002-430039-27 stringer 002-430009-201 stringer 002-430008-225 skin fus uper 002-430057-17 hat section 002-430038-89 stringer 002-430038-90 stringer 002-430020-13 bracket assem 002-430037-21 keel fwd lh 002-430010-9 keel fwd rh 002-430010-23 angle lh fs 100 002-430038-39 channel pnl fus 002-440027-31 channel 002-430037-22 keel fwd rh 35-410330-20 angle keel assem 36-400013-3 frame lwr blkh -002-430037-19 channellh 002-430030-23 web fwd spar ct 002-430018-19 aft web front spar 002-432218-11 web front spar 002-430037-12 a11gle 002-430037-25 keel 002-40017-3 stringer 002-410024-14 longeron' 002-430038-41 channel fuse 00?-j 10030-125 lwr firewall - _00_?..:430038-41 chanr1eL. v·.

-- ---·- .. ---Removed and replaced the following parts to RH wing.

002-430038-73 skin center 000-110109-3 slin rh inbd le

Removed and replaced the following parts to LH wing.

'000-110015-5 skin ob le

.,.

••• •••••.,•••••••••••••••••••• NOTHING FOLLOWS ••••••••••••••••••••••••••••..; \o) w. © § 0 Vl w. ·~

' 1\r\\ JAN 0 5 2007 I l

Reproduced by Avantext, Inc.

UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION-FEDERAL AVIATION ADMINISTRATION

.. · ~ _STANDARD A I R W 0 R T~H IN E S S C E R Tl F.l CAT E -- -~- ~--·.:.._--::-.._

UTILITY

I. NATIONALITY AND 2. MANUFACTURER ANO~;;fODEL ~ -~ 3. AIRCRAFT SERIAL REGISTRATION MARKS ~. '- \, !'\ 'If/ ~~MBER

, BEECHt~IR~~FT C<;'RP. ij d: "~ N3804 7 A36~~ ~"\; ,~J~ · '- rp~l76

4. CATEGORY

5. AUTHORITY AND BASIS FOR ISSU~.NCE~ ~~~>\~~ ~ f?"'- ~\ ' This airworthiness certificate[is' is_~ued pursuant .... t~t~&- fedeiOI{A~iation A'ct!of\1958 and certifies that, as of the~

:, date of issuance, the oircraf;' ~o:' -y;hich issu~~/has.:::b4;~1insP.ected and fotJnd ~~~ co~form to the type certificate therefor, to be in conditio~-,1 .fdr'-sofe oper~tiOii"'fciOd).hc»r:oeen ~hOwn to meet/·~~~ requirements of the applicable I comprehensive and detoile~1 /airworthines~' c'6de/ asr~r:(i;i'ded Sy A.ln'e_x 8 to .:the Co_.nvention on lnternation?f Civil .

Aviali<;>n, except as noted _,~erein. _d r--' 6:::t.Q_\L\\__ . }~ Excephons: \~ d~ -=F~~~~- ),~ w ·

6 TERMS AND CONDITIONS. \~ '•\ .• / . ~ r l/ >> 1/i . . '~ -" Unless sooner surrendered, su~pen\Jed; revoked, ar-C! terr11in9ti6n date is ofhe~w.ise established by the A~.min.istroh.:,thh airworthiness certificate is'"'effeCtive as long as the"mOintenonce, preYertoti~e 'maintenance, and alterations ore performed in accordance with P~!:t; 2\:;_~J. and 91 of the, Federal AviO'tion.,tR'«fgvlotions, as oppropifote, and the aircraft is registered in the Uni~~ .. "-s!ot-;~- ·,., \ _ 4 '\ $' · . ·

DATE OF ISSUANCE FAA REPRE~E.t,J_jATIVE .- .·' r;.>_ :,r;; 10 "~ DESIGNAT.ION NUMBER

'\ ~ ~ ~ . ':;\ >J"'' 'J ~ "

Nov. 21; 1980 D. MS~P~o~tt'eo:us...-d OOA,'PJ~Afo8~. Any alteration, reproduction, or misuse of this certificate may be punishable by a fine not exceeding" $1,000, or im· prison men I nat exceeding 3 years, or both. THIS CERTIFICATE .MUST BE DISPLAYED. IN THE AIRCRAFT .IN. ACCORD· ANCE WITH APPLICABLE FEDERAL .AVIATION REGULATIONS.

FAA Form 8100-217-671 FORMERLY FAA FoRM 1362 tf U.S Gow.nmen1 Prulllng Oll~ee ..:. 1i16-67S-5.26

UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION --FEDERAL AVIATION ADMINISTRATION

STANDARD AIRWORTHINESS CERTIFICATE I. NATIONALITY AND

REGISTRATION MARKS

Nl46TA

· -prisonment not exceeding- 3 -years; or bo1h. THIS CERTIFICATE -MUST ANCE WITH APPLICABLE FEDERAL AVIATION REGULATIONS.

4. CATEGORY

US Department of Transportation Federal Aviation Administration % Princ!fal Maintenance Inspector 6020 28 AveS Room201

~ Minneapolis, MN 55450-2704

To Whom It May Concern:

I am requesting a replacement Standard Airworthiness Certificate for N146TA, Beechcraft A36TA SIN EA-176. This request is because of the registration number change from N38097 to N146TA. · ..

- "-~--- ·~If-you"have-questions-call-me-at-(320)235-8148 -

Sincerely,

~~~-----------Todd Asche P.O. Box501 Willmar, MN 56201

to/~

0 Form Approved

MAJOR REPAIR AND ALTERATION OMB No. 212Q-0020

US Deporrmenr (Airframe; Powerplant, Propeller, or Appliance) For FAA Use Only

of Transpor!Oroon Office Identification

Federal lallation .. N··\b::.~ ~-Administration

INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 1421 ). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

Make Model

1. Aircraft Beech craft A36TC

Serial No.EA-176 Nationality and Registration MarkN38047

Name (As shown on registration certificate) Address (As shown on registration certificate)

2. Owner Repro-Air, LLC. 113 Barksdale Professional Center

Newark, DE 19711

3. For FAA Use Only

·-- - -- - _ ____,- - - ~------- ------ ·- - ---- - ------- --



AIRFRAME .. . . ••• (As described in Item 1 above) , • •• • . .. , X

POWER PLANT

PROPELLER

Type




Beegles Aircraft Service, Inc. U.S. Certificated Mechanic

____ 7LLCrosier Av.enue ____ Foreign Certificated Mechanic _ ____.. .. _ x . -- - -- -- - --Greeley, CO 80631

Certificated Repair Station BX4R092M Manufacturer


Date Signature of Authorized Individual

10-02-03 Scott V Mauch ~~-- ~ 1. Approval for Return To Service

Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is W APPROVED 0 REJECTED

FAA Fit. Standards Manufacturer Inspection Authorization Other (Specify)

Inspector BY

FAA Designee X

Repair Station Person Approved by Transport Canada Airworthiness Group

Date of Approval or Rejection Certificate or Signature of Authorized Individual

10-02-03 D\3~~8~\1: Scott V Mauch .A:- _,_ ~~

FAA Form 337 !12-88)

NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must b.e compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.

8. Description of Work Accomplished . . (If more space is required, attach additional sheets. Identify with aircraft nationality and registration "!ark a·nd date work completed.)

1. Installed L.P. Aero Plastics, Inc. STC # SA992NE. Installation of .500·thick windshield pn LP-269500SG in accordance with L.P. Aero Plastics, Inc. single piece extra thick windshield installation drawing list: Report No. 269/con, Revision 4 dated April28, 2001.

2. Weight and Balance revised 10-02-03.

END __________________________ _

' '· \

0 Additional Sheets Are Attached

-QU.S. GOVERNMENT PRINTING OFFICE: 1992-769-012/60157

~.

.. --- ! /

~

~

11

I j ~

If~ ·1

Tt t~ ~1 ~~

1t i~ -~ ~

: ~~

~ ~nitel:l ,;States of ~m£ric:~

~epudment of 'illrunspodution -- Jlf eoerul J\biution J\oministrution

LP Aero Plastics, Inc. 1086 Boquet Road Jeannette, PA 15644

Co"f£'~,; d~.r /k ck~/1?"' lA /k &"/'"' rU.J':frn ft"' /k ftt'&-t~m? p,;-.ctb~ct' tNd' /k &:r.~u~a/kvM f'L/U/ uvu/u~"cn-.;

d'e/'eft/' a.J o/'tMe;/fer/k,,.e'nmN·~ /k at/w.•c,;-Mr/,,.,j,j '"'?tu:remNu~.; e'/'?IU"t' 3/23 e'/d'.. Civil Air/Federal Aviation

,'jig~kc/M.

(fj.tpinr~~;?/).ctt'Uct'-- ·~/'"' ~,k_;4oak A~uf~,"' .· 3Al5

._4{;a£,. . · Beech

./lbNktf.. 35-33, 35-A33, 35-833, 35-C33, 35-C33A, E33, E33A, E33C, F33, F33A, F33C, G33, H35, 135, K35, M35, N35, P35, S35, V35, V35A, V358, 36, A36, A36TC, and 836TC

~.Jc.--~/ecn (;'/~./'"' ~,;1m 'lf;f,.L/lcf'e: Installation of .250 .312, .375, or .500 thick windshield in accordance with L.P. Aero Plastics, Inc., Single Piece Extra Thick Windshield Installation Drawing List: Report No. 269/CON, revision 4 dated April 28, 200 I.

I. Compatibility of this design change with previously approved modifications must be determined by the installer. 2. If the holder agrees to permit another person to use this certificate to alter the product, the holder shall give the other person

written evidence of that permission.

.JiJf.,;.; u,;-kpcru!t• tZ/1r/ d'.. ,;,~~'""'/'/'.? rk/-/r/- r«'hc./ t;; ~ /£,.;?.; _;0,.. r~~,,,.,,.,,tf d/-,f';f',..,.ntru/,, r/6 ~c/ U/t/~i!'

,JtU'/'1"!/ltb,;-u/. ,JtL-Y'e/ubr/. ,;-n•tv<f'n/ C/' a /e,;-m-t/u~/ecn tk~/,. iJ e'd-nN;;e e.;/rufft~r/ 17 d- . ./~rb-nt/u;;/.n~/c/" (;'/de ,'}l;,t~>,~/ . ./.g,,~izhcn ,_.;.g,t?,,.,:,,_,:..;/n~/rc.n-.

·~--=~~·- .· --·-· -~ --· --~-lc ~~r· ! J&9

1i ~LI.- (;'/'¥1/'&oa//(;'.n- : April 21, 1992 st'al.- ,;-n;;.;an/ : March 11, 2003

!Z;u~· runenrkr/: January 13, 1997, June 17,2003 ~~a. e'/k;.;,~a/tCe : August 3, 1992

1~ ~l

31 ~ ~

....

L-7'~ . . . . hito A.)~ul~:a . (Signature)

· · · · ' Manager· · ·. · ' · New York .Aircraft Certification Office·'

(Title)

Ally alteration of chis ce.rcificat:e is punishable by a fine of not exceedi."'lCJ $1,000, or imprisonment not exceeding J years, or both.

FAA Farm 8110-2 (10-681 Page 1 of 1 This ce.rtif.icate may be transferred in accordance with FAR 21. 47.

\

0 US Department ofTransportation Fed end Aviation Admlnlslra!lon

MAJOR REPAIR AND ALTERATION (Airframe, Powerp.lant, Propeller, or Appliance).

Fonn Approved OMB No. 2120-0020

For FAA Use Only

INSTRUCTIONS: Print or type aU entries. See FAR 43.9, FAR 43 AppencfiX B, and AC 43.9-1 (or subsequent revision thereof) for inslnlctions and disposition of this fonn. This report Is required by law (49 U.S.C. 1421). Failure to report can result in civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

1. Aircraft

2. Owner

Mal<e Beech craft

Serial No.

EA-176 Nama (As shOwn on registration certificate)

John Hoek

Model A36TC

Nationality and Registration Mark

N 38047 Address (As shown on registration certificate)

437 South Creek Ospr~y, FL 34229

3. For FAA Use Only



AIRFRAME

POWERPLANT

PROPELLER

Type


A. Agency's Name and Address

Douglas Helterbran · 359 Parkview Dr. Venice, FL 34293

(As described in Item 1 above) --------

6. Conformity statement

B. Kind of Agency

_X U.S. Certificated Mechanic

Forei~n Certificated Mechanic

Certificated ReDalr Station

Manufac:turer

C. Certificate No.

AP287661086

D. I certify that the repair and/or aHeration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the re(luirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. I

Date .:.: ~d~~ --._

D8f27199 J.. ~ - ,F

7.Approval£6rRetum To Service

Pursuant to the authonly given peJSons specified below, the unit ide~ed in item 4 was ins_Q_ected in the manner prescribed by the Administrator of the Federel Aviation Administration and is / xJ APPROVED 0 REJECTED

Fn~~f!andards Manufacturer X Inspection AUthorization Other (Specify)

BY~-+------------~--~----------~--~------------------~ FAA Designee

Date of Approval or Rejection

FAA Form 337 !12-88)

Repair Station

Certificate or Designation No.

lAt9ttBo'?!$w~

P~~~~ed by Transport Cay- .~.orthiness Group

v -

X

NOTICE . -.

Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible wi{h all previous alterations to assure continued conformity with the applicable airworthiness requirements.


- - . INSTALLED BASIC AIRCRAFT PRODUCTS, INC. 28 VOLT MODEL 2025 AIR DRIVEN ALTERNATOR, S.T.C. SA 01807 AT.

INSTALLATION DONE IN ACCORDANCE WITH BASIC AIRCRAFT PRODUCTS, INC. BONANZA INSTALLATION KIT, DWG. N0.45-2325-0PL, REV. A, DATED FEBRUARY 18,1998 AND INSTALLATION MANUAL NO. 80-2325-101A, DATED FEBRUARY 20, 1998.

INSTALLATION PRACTICES FOLLOWED AS CALLED OUT IN THE A. C. 43.13-1 Bf2A, CHAPTERS 4,7, 10 AND 11.

INSTRUCTIONS FOR CONTINUED AIRWORTHINESS, INSTALLATION INSTRUCTIONS, SUPPLEMENTAL TYPE CERTIFICATE AND AUTHORIZATION TO USE S.T.C. ON THIS AIRCRAFT INSERTED INTO AIRCRAFT RECORDS.

FAA APPROVED AIRPLANE FLIGHT MANUAL SUPPLEMENT, DATED JAN 14, 1999, INSERTED INTO AIRCRAFT'S OPERATING HANDBOOK.

EQUIPMENT LIST AND WEIGHT & BALANCE UPDATED.

NOTE: INSTRUCTIONS FOR CONTINUED AIRWORTHINESS ATTACHED.

lldditional Sheets Are Attached

• U.S.G.P.O. 1990-761-753

. , .,

.. ~rb .$taus of~

Jflepartment af 'atranspartatiott -lJfwerai ~iathttt ~ini&trathttt

$uppUmentnl mvp.e Qt.ertifirat.e

§~ SA01807AT

~DII&l ~ .. c ~h Basi Al-AD-...1 •• _.. Jnc C.nuwa.tL~l~lll, •

4474 Hickory Drive Evans, GA 30809

~ "~ d!Md'. ~- .«'. .. ~fo d,~~(/Jy,~/'0' "'-f .d ~ ~ ·c.;,e-_ .... tUUI" _,,&,·~-w d/e ,~ tUojs~WA!.,.,e,,,.unJJ.a,..,;WI"Qd!,;......u.¥'4W.'IM't/.J ~~ 3 ~a, CivilAir~~~~<t ,.,

(J;~~--~~tf9d!d./V~.· A771&3A15

~-· Beech

~- Bonanza Models 33.35,36

Description of Type Daip Clrage: · ! Installation of a Basic Type BAE 14/28 Model202S Air Driven Alternator in accordance with Basic Aircraft Products, Inc. Bonanza JnstaiJation Kit, Dwg. No. 45-2325-0PL, Rev. A, dated February 18, 1998 and InstaUation Manual No. 80-2325-IOJA, dated February 20, 1998, or later FAA approved revisions.

LIM/tlltions a4 Comlltimu: "This approval should not be extended to other aircraft of this model on which other previously approved modifications are incorporated. unless it is determine by the installer that the interrelationship between this change and any other previously approved modifications will produce no adverse etfect upon the airworthiness of that airplane. F M Approved Airplane Flight Manual Supplement, dated January 14, 1999, is a required part of this STC. If the holder agrees to pennit another petSOn to use this certificate to alter the product, the holder shall give the other person written evidence of that permission. 11

.91/'N. ~~ .... ,...d. "4J"'" ~ ... ~ N. ~ tf:uN.fo ~ JJ¥,...,w.-~ ~ ol~ ..( "M+"""~ --.1'-'-• Al•w.We<i'DI• ~ N. ~ ""(ler ~a-r&"JJ~f?a, ~.r:•N"-~~· c,/'d., ~J~·i.l'i:t• ~-.... -~-<ii:t ...

§..6 ~,., '· ••tw .•1anuary 14, 1999

§A. ..... , •..

(Signature)

ilAif C. J. Wodhoy, AdiJ!&Manager d- . Atlanta Aircrtft Certification Office

(Title)

Any alt•rat.ton of thJ..t ct~rtJtJcate i.s punt.shele by a tJ.ne ot not exCHdJ.ng $l,OOO, or .1~tpr1.sonaent not excHdlng 3 'Yflal:;;-,;;.~

. ' US Department o!Transportation

Federal Aviallon Admlnlstrallon

MAJOR REPAIR AND ALTERATION (Airframe, Powerplant, Propeller, or Appliance}

Fonn Approved OMB No. 2120-0020

For FAA Use Only Office Identification

TAMPAFSDO INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this fonn. This report is required by law (49 U.S. C. 1421). Failure to report can result in civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

1. Aircraft

2. Owner

Make BEACH CRAFT

Serial No. EA-176

Name (As shown on registration certificate)

John Hoek

Model A36TC

Nationality and Registration Mark N38047

Address (As shown on registration certificate}

437 Sooth Creek Osprey, FL 34229

3. For FAA Use Only

4. Unit Identification 5.Type


AIRFRAME

POWERPLANT

PROPELLER

Type



DOUGLAS HELTERBRAN 359 PARKVIEW DR VENICE, FL 34293

(As descn'bed in Item 1 above) --------

6. Conformity Statement 8. Kind of Agency

1-X u.s. Certificated Mechanic

Foreian Certificated Mechanic

Certificated Repair Station

Manufacturer

C. Certificate No.

AP 287661086

D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or allachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the infonnation furnished herein is true and correct to the best of my knowledge. A

Date c- SianatureKiJ At.dhi)rizid Individual IV' I lA '" 27 AUG 1999

7. Approval Jbr Return To Service

Pursuant to the authority given persons specified below, the unit iden)1ied_ in item 4 was inspected in the manner prescribed by the AdminiStrator of the Federal Aviation Administration and is _flO APPROVED D REJECTED

FAA Fit. Standards Man· ... --h··~r X I ti Auth-"'~...,.· Other (Specify) Inspector UI""-"Un.- nspec on yuL.cuiOn BYr--+-------------r--r-----------~~-r------------------_,

FAA Designee


27 AUG 1999

FAA Form 337 112-BBJ

Repair Station

Certificate or Designation No. lA 186568862

P~~~roved by Transport Car ~rworthiness Group

u

X

NOTICE

Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable aifWorthiness requirements.

8. Description of Work Accomplished (If mere space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)

INSTALLED JPI EDM-700 IN AN EXISTING UNUSED. HOLE IN THE INSTRUMENT PANEL, S.T.C. SA 2586 NM.

INSTALLATION DONE IN ACCORDANCE JP INSTRUMENTS STC SA2586NM, FOLLOWING THE SUPPLIED JP INSTRUMENTS FAA APPROVED INSTALLATION MANUAL FOR THE EGT-701 REPORT NO. 103 REV. BAND THE GUIDE LINES AS SET FORTH IN THEA.C. 43-13-1B CHANGE 0, CHAPTER 10, SECTION 2, CHAPTER 11, SECTIONS 3,5,6,7,8, 1 0,13,15 AND 17, AC42.13-2A CHAPTERS 2 AND 11.

INSTRUCTIONS FOR CONTINUED AIRWORTHINESS HAVE BEEN INCLUDED IN THE AIRCRAFT RECORDS AND A COPY ATTACHED TO THIS DOCUMENT.

OPERATION MANUAL INSERTED INTO FLIGHT MANUAL

EQUIPMENT LIST UPDATED.

WEIGHT AND BALANCE UPDATED.

1·~ditional Sheets Are Attached

• U.S.G.P.O. 1990-761-753

,._Jioloo.,__ ~qarlzMttt•ftl~·~thual~~=

~upphmtenhtl ~UPe <tiertifiade

.!Vam&,. SA2586NM .11'.l ~..._,.. J. P.INSltWMBNIS

PO l!os 7033 HIXlliDJtoll Beldl, C\ 926116

~i/<HAfNd.,.(.,"'",;,.tf,'ir"'~~l/&.~,_..,-_.. ~,: X Gi .,.,.J

,..,.M;.,.,~ .. +-¢-'"--..olf. - ~--r~.,I'"A.r 3 -Y""~ .AJ,..:.,r.;w.:tt, <~- .....,.-"r.......,_ .. .g f o ... ~.:.""-.e...-~, *' ~.!Jfw.

.H~.- • ~ Efi&ibility List No. SA2586NM for list

.1'-Y- • or II'PfiMd aitaz!l models llllllpplicable T(l)S !f.......,..- .,1.~ ~....;- Y..l-,. lmtalllaonofJ.P.~~~~-.e&~•~willtfMApplo\'edl.P • ._Ora.,. List Report No. IOO,RcvisiOIID,da!td Decaolbrr 19,1996.Gt'*rfMij:lllrD¥CI! ICYIUOIIS. FMA~Airp~F\ipU4.-l$11fPla!IMNo.lfcrEGT·l011ttiljltt-C lft<bcllor. RcYUICII A. dated [)eccftlber ll.l~ar'*r fAA .....,.awd reris;onL

:1....,_......, --~· The appnmloftllecbqe in lypedcsjzn ll!'l'lics IOibebasie airpl..e or !be specifiC modds thai are Cllllclwisc .nodilicd. This lpprU\'Il siQdd aol be csteiiCkd 10 ather specific aitpbnes oftbesc models an which oeherpreviaasly lppiOYed IIIOCiiticati0111 are incof'poRlcd. unless it is dctetmrned that !be intcmla!ianslri between lhis jmttllacina mel any p~e..-iously appcow:d coafi!U"tion wiD aa1 illtroduce any acfweBD eiTeel apan !hem wordtinas of that ailpiAnc. If the holder ass-to permit anolhcrpcrson to use this catiflale to ;her the prodiJcl, the holder shall give the Olbcr rcrson wrium evidence afth;t permissioa. (See eonlimlalion sbcd) .l?14 -.1'-_... "W"""..,. ..w. ..&;.( ~ "'-'.4.Nfo_,.._t'J.K-.:..:.#N ~ ~- '""' ,....,..,...e.!,.,..U,,.l\.i~JM· ... ~~~~~...;«' ~ ~( ~ ,Yd..~A' ............. ..t~,; IW:•IA..,

~.Ywl'-- Dcambet31,19!4

!/--/- Au¢14,1935 §W.-..J.tiuly 13,1987, Nomaber 13, 1992. Dmmber 19, 1996, May IS. 1998 -:4-~.,-~...-M - u-...

i,4-., .~;:;~.

. ' -

US.Dtpailia• cilasptcdeli

ftcllrallllfalcln .............

NOV 10 mz

'WIISI'OIT Amt.QE DliECJ'IIUTE AIIWFT CElTIFICATIOR SElYICE

LOS ASELES AIICIAFT CERTIFICATIOI omtE 32U EAST SPRIIIIi stmT

LOll& lfACII, CA !0806-2425

J P InstT!IIellts 3402-1 West MacArthur Santa Ana, CalifOl'llia 92704

Gent leJII!ll:

J P Instrwents, Teiiperature Indicator; Technical Standard Order C43b

Your application dated August 24, 1!19Z, requesting the issuance of a Technical Standard Order (TSO} authorization in accordance with the procedural requiresents of Federal Aviation Regulation (fAR) Part 21, Subpart 0, has been reviewed. Based upon your data and state.ent of confonunce certifying your articles have .et the requiJ'ellel\ts of fAR Part 21, Subpart 0, ami the ~ni&~~~ perforunce standards of TSO C43b (Ref. FAR 21.305(b)). authorization is hereby granted for the following:

PIO!!El/PART !P. DESCRIPTIO!!

EGT-701( ) Exhaust Gas Te.perature Indicator

The teclinical data sutmtted with your letter, have been accepted as fulfilling the require.ents for your TSO authorization and will be retained in our files.

The quality control procedures contained in your quality control mnual, currently on file at the los Angeles Manufacturing Inspection District Office, and your stateent that those procedures will be applied to the mnufacture of the subject article at the above address, are considered adequate in accordance with FAR 21.143.

Effective this date, you are authorized to use TSO procedures for the subject te.perature indicator. You my identify this article with the applicable TSO mrlcings as required by TSO C43b.

As recipient of this TSO authorization, e~tcept as provided in FAR 21.3{d). you are required to report any failure, ulfunction, or defect In any product or part lllanufactured by you or your contracted suppliers, and which you have deterlrined has resulted or could result in any of the occurrences listed in FAR Z1.3(c}. The report should be co-.micated initially by telephone to the Manager, Technical and Ad!linistrative Support Staff,

u ~li."i !=>""""' '

4 ~~1:4 a Ylld .Form Approved

MAJOR REPAIR AND ALTERATION OMB No. 2120-0020

us Deportmenr (Airframe, Powerplant, Propeller, or Applianc~CT .,7 t 1"""' For FAA Use Only

• ofTransporrohOn :bltice Identification ',J)_ . ' Federal Alllatlon S£v ... f=5.PtJ.-l 3 .. Administration

INSTRUCTIONS: Print or type all entries. See FAA 43.9, FAA 43 Appendix B, and AC43.S-1 (or subsequent revision thereof) forinstUions and disposition ofthis form. This report is required by law (49 U.S.C. 1421 ). Failure to report can result in a civil penalty notto exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

Make Model

1. Aircraft Beech craft A36TC Serial No. Nationality and Registration Mark

EA-176 N38047 Name (As shown on registration certificate) Address (As shown on registration certificate)

2. Owner John B. Hoek 217 Woodland Dr. Osprey,Fl. 34229

3. For FAA Use Only



AIRFRAME """" ••••• •••• .., •• (As described in Item 1 above) •• .., ..... ··-~··· X -

POWERPLANT,

-PROPELLER

Type


6. Conformity Statement A. Agency's Name and Address B. Kind of Agency C. Certificate No.

Abilene aero Inc. U.l). Certificated Mechanic

2850 Airport Blvd. Foreign Certificated Mechanic

Abilene,Tx. 79602 X Certificated Repair Station GSTR469E Manufacturer

D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information , furnished herein is true and correct to the best of my knowledge .

Date . ,·a:::o:#."P~ 10-3-96 1. A~ for Return To Service

Pursuant to the authority given persons specified ~ the unit identified in item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ~APPROVED 0 REJECTED


Inspector BY

FAA Designee Repair Station Person Approved by Transport X Canada Airworthiness Group

Date of Approval or Rejection Certificate or

Slg~_;":''':d'~~ Designation No.

10-3-96 GSTR469E

FAA Form 337 112·881 "

NOTICE " Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. '


Installed J.L.Osborne Wing Tip Fuel Tanks IAW STC SA4-1629 drawings and instructions. Installed Aero Safe Guardian I Standby Vacuum/Pressure System IAW STC SA483SSW drawings and instructions. Installed Shadin Company Fuel Flow Indicating System IAW Shadin Report No 4017 and STC SA449GL. Weight and balance change revised and equipment list updated.

----------------------------------------END----------------------------------------------

~ Additional Sheets Are Attached

* U.S.GP0:1990·0·566·012/40004

• Form Approved

~ MAJOR REPAIR AND ALTERATION OMB No.@~-@2<4 US Deportment I ) for FAA Use Only orrronsporral•on (Airframe, Powerplant, Propeller, or App ia·nce 'jjoflficjj?Eill~eairo.k\ ff .11 ,i!J. Q / ~I Aviation i ~\';TITII'h""" Administration Clil Y!IY f!J U._. :;;tt.hVCIJ)

INSTRUCTIONS: Pnnt or type all entries. See FAR 43.9, FAR 43 Appendix B. and AC 43.9-1 (orsubse~~~t rev1sion thereof) for instructions and disposition of this form. This report·is required by law (49 U.S.C. 1421\ Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

Make ~-----------------~----~rM~o~de~l~------------------------------------i

1. Aircraft

2. Owner

Umt

A36TC BEECH ~------------------------------------~~~~--~~~~~~ Nationality and Registration Mark Serial No.

EA-176 Name (As shown on registration certificate)

JOHN B. HOEK

Make l

USA N38047 Address (As shown on registration certificate)

217 WOGDLAND DRIVE OSPREY, FL. 34229

3. For FAA Use Only


Model Serial No Repa1r Alteration

XXX

~A-IR--FR_A_M __ E---1---------~-~-N-~~-~-~-~-~N-~~~-~-~-N_N~~·--(Ar-s-d_e_sc~r-ib~e~d~in--ft_e_m_1 __ a_b_o_ve_J __ ~_~_~_~,~-N_N_N_~~========~--------+-------~~-------1 515718

POWERPLANT I CONTINENTAL

l PROPELLER 1

Type



EDWARD BROWN 4511 EDDIE RICKENBACKER DALLAS, TX. 75248

TSI0-520-UB -.

I 6. Conformity Statement

B. Kind of Agency C. Certificate No.

X U.S. CertifiCated Mechanoc

Foreign Certificated Mechanic IA 465214848 Certificated Repair Station

Manufacturer

D I certif~· that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made on accordance w1th the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledg~

Date I Sign~ of~~ Individual

OCT. 3, 1997 I~ ~",-,..

7. ApproVai for Return To Service

Purs~~nt to the authority given persons specified below. the unit identified in item 4 was inspected in the manner prescribed by the Admon1strator of the Federal Aviation Administration and is ~ APPROVED 0 REJECTED

BY

FAA Fit Standards Inspector

FAA Designee


OCT. 3, 1997

FAA Form 337 112 881

Manufacturer

Repa1r Stat1on

Certificate or Designation No. IA465214848

X Inspection Authorization

Person Approved by Transport Canada Airwo~"" -&{>up

"'----

Other {Specify)

r----------------------------------------------------------------------------------~.----~.~ NOTICE

Weight and balance or operating limitatiOn changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure contmued conformity w1th the applicable auworthiness reqwrements.

8. Description of Work Accomplished (If more space is required. attach addttional sheets. ldentilywtth aircraft nattOnaltty and regtstrattOn mark and date work completed.}

Rerroved six (b) T01 fuel rozzles P/N 632748 - r7J3 and installed General Aviation !•bdifications I Inc. turboGAHijectors Kit No. 6/V 16 S/N 2'503 src No. SE09289SC PMA NO. PQ82lSW per turb:::>GAMijector Installation Procedure N3: IP-97-002 (rev 002) dated February 6, 1997. lb change in weight and balance. ///////////////////////////

/////////////////////////////////////////END/////////////////////////////////////////


* U S GPO 1989·0·663·171

'' •'

••

': ~ • I ~ . : ···~~r··

•)'.

lH · ''""' ~, :

' i. . ~~I./Men,.~.· [see attached FAA Approved, Model List (AML) for list of

- • '; , \ i.._.t~·1! '{• A

approved models' and ~ppiiciible airworthiness regulations) ·.to,( ' • , \·:/:/~;: 'l

~(in-.-WAf<i.n,?~· Installation of modified fuel injector nozzles in accordance with General vm•,.~,,, ... ,,,,>JJU<ll ..,.A~ , Revision 002, dated February 13, 1997, and Installation Procedure No. IP

~1j~i~qi:,J1l'st!1JIIati9~ Procedure", Revision 002. dated February 6, 1997, or later FAA approved

~J~~,'!i~~'-''~~tn~j~~J\~ppr,oV.•ea~QJ~I~ll~is~_ci« Cpn1Vmtibillity of this design change with previously approved modifications must be s:n::::1:onlv applies to Teledyne Continental Motors (fCM) engine models listed on

a~~:aclled continuation sheet.

~ <

)

1 i {

(Title)

.~;.!-~fjf-:~::~\~:~\i~fi~~~;Tear;;fi;;n'i[iii;Jt~tijiTc;;Ce:j~;~ fi;;;;i!tJ.~;t;j";_;t.~ by " tine of not exct-edJ.ng $1,000, or lDprl30ilZJ€."nt n,.,c l!xcee .. :1J.nq J ye.Jc.s, or both.

Ttd.; <.·ert1l1cate Day be tc.ln.sfecce..1 Jn .JI.. .. ..:..:>cd4nce W'Jth F'AR 21.4?.

-; l •

TSI0-520-A, ·

-D;:..DB, -E, ~~~~jF't~::S~~ ..... ~ii.l J, -ID, -K, -~ .... LI;'~".J.J•· N, -NB, -M, -UB, -AE, &-CE

Original Type

Certificate Number E8CE

E5CE

E3SO

E5CE

FAA Approved:;;~

C(Jl~l Date: April 8, 1997

Regulation /Part

CAR 13

CAR 13

FAR33

CAR 13

States Code§ 44704 (b) (3) (effective October 19, 1996) the menl and permission of General Aviation Modilications,

of N , to alter that certain Teledyne

,:;""-+'~-..... P"-'L---.:i-~-<--> S N 5 I :5 71 8': and jLJ / fl and

·I

:I :i ;! ·I !;

ers), by application of STC No. SE09289SC, to that specific nS.talling the fuel injector nozzles which are the subject of that STC

•I : j•

General Aviation Modifications, Inc

IA<-4cw-J ~Koehl, President Or George W. Braly, CEO Or Mack A. Smith, V P.-General Manager

...

' :: l.-

! '~·

l ~.

I

l ~ .,. i ,tt :. ~ It._,~

1, I

'~ . . . . • !

_,. f, ' \ ·~

·'·.

KIT NO. GT17B ... ·'

·o Form Approved


us Deparrmenr (Airframe, Powerplant, Propeller, or Appliance) For FAA Use Only

or Transporrar•on Office Identification Federal Aviation Administration

INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by Jaw (49 U.S.C. 1421 ). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

Make Model BEECH A36TC

1. Aircraft Serial No. Nationality and Registration Mark

EA-176 USA N38047 Name (As shown on registration certificate) Address (As shown on registration certificate)

217 WOODLAND DRIVE 2. Owner JOHN B. HOEK OSPREY, FL. 34229

3. For FAA Use Clnly



AIRFRAME ,,,,, , • ,., ,. (As described in Item 1 above) , , ,. ,. ,.,. • XXX

POWER PLANT

PROPELLER

Type




EDWARD BROWN y U.S. Certificated Mechanic

4511 EDDIE RICKENBACKER Foreign Certificated Mechanic IA 465214848 DALLAS, TX. 75248 Certificated Repair Station

Manufacturer

D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. ~

Date

Sl?t;Aum~:~-' OCT. 3, 1997

7. Approvarior Return To SerVice

Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ~ APPROVED 0 REJECTED


Inspector X BY

FAA Designee Repair Station Person Approved by Transport Canada Ai 7 · "ss Group

Date of Approval or Rejection Certificate or .~Mdual OCT. 3, 1197 £rlfgcg~~1 ~08 4 8

.A:

FAA Form 337 !12·88)


8. Description of Work Accomplished' (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)

THE FOLLOWING WORK WAS ACCOMPLISHED ON AIRCRAFT N38047, S/N: EA-176:

INSTALLED ROSEN COCKPIT SUN VISOR KIT STC SA3598NM AS PER STC AND'l.'SUPPLIErD illNSTRUCTIONS AND DRAWINGS, P /N: RBB300-19, S/N: 0797536. Ne WEIGHT & BALANCE CHANGE. ////I////.//III/II////I/END///II/II////II/II//////////

D Additio~ai-Sheets Are Attached

*U.S.GP0:1994-568-012/00019

'l.lnltcd ~totc.s or 9mcrfro

:IE>cportmcnt or 'm:ron.sportotion -jfcdcrol 21\Jiotion 2ldmini.Strotion

~upplcmcntal 1!C~pc Q:cttificatc SA3598NM

Rosen Product Development Inc.

..tf:de- Civil Air

.9t.?.a~~1'lA'.

ti.~~~-~1-Q~~~~-kA~m/..c~: 3Al5

~k: Beech

JUt: Bonanza

Cockpit Sun Visor installation in accordance with FAA-approved Rosen Drawing List Number RBB-OODL, dated August 25, 1986, or later FAA-approved revisions.

The approval of this change in type design applies basically to the above aircraft models only. This approval should not be extended to other aircraft of this model on which previously approved modifications are incorporated, unless it is determined that the interrelationship between this change and any other previously approved modifications will introduce no adverse effect upon the airworthiness of that aircraft. A copy of this Certificate and FAA-approved.frrawing List Nu~ber RBB-OODL shall be

Ofi. m.n.;i!nbined ~ns n¥"t of +-he nermanent recopds of th~ modified air~ft • •. //ud,.=nru-..ali/.n4u.C.I/u·,.4,r-y'c:r'/,.:n,?/.dai'n,A¥u.vv .... ..v_ul-U..oaJ~yc~'--#t-:rcv.u{"~A'Mnauv-Mv-r/U..eu~..d~

August 25, 1986

September 22, 1906

l1anager, Seattle Aircraft -----rtrrtt1'1ca;tJilm) Office, ANM=1-oos-

A I!J' alteration of this "certificate is punishable ~y a .fine of not exceeding I I ,000, or imprisonment not exceeding 3 ;~ears, or bnth.

fM Tou< G 110-2 (10-68) This cut!ficat~ may b~ lransfnml in accorclanu with FAR 21.17.

I ~~ Form Approved


US Oeoorrmenr - (Airframe, Powerplant, Propeller, or Appliance) For FAA Use Only

01 Tronsponoroon Office ldentifi~l F.o.rol A via lion .~ 88 F~nn Admlnlslrollon

INSTRUCTIONS: Print ortype all entries. See FAA 43.9, FAR 43 Appendix-B. and AC 43.9-1 (orsubseq!Jent revision thereJO for instructions and disposition of this form. This report is required by law (49 U.S.C. 1421 ). Failure to report can result rna civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

MaJ<e Model Beech Aircraft Corporation A36TC

1. Aircraft Serial No. Nationality and Registration Mark

EA-176 N38047 ·-Name (As shown on registration certificate) Address (As shown on registration certificate)

2. Owner John B. Hoek 217 Wood lana Dro Osprey FL 34229

. 3 •. For .f.P.,A t,l_se .O.~)y Jl.:..w ... "'"" •. ~ .......... """ Jj o; ;;:- ; ......... u* '""·• . . •

"""""""'"""'""""·f".''·~:::'.'·~~ '"'~ ~:::r::zA·· -~~:.:!2_ ·


Unit I Make Model I Serial No. Repair I Alteration

AIRFRAME

I (As described in Item 7 above) X

POWERPLANT

I

I

I

PROPELLER

I Type




Ab il.ene Aero, Inco I U.S. Certificated Mechanic

2850 Airport Blvdo I Foreign Certrficated Mechanic

Abilene TX 79602 X I Certificated Repair Station GSTR469E I Manufacturer

0. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the mformation furnished herein is true and correct to the best of my knowledge.

Date Slgnatu'e #;:d~ndi•ldual~ 10-08-96

7. Approval lor Return To Service

Pursuant to the authority given persons specified'below, th~it identified in item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is APPROVED 0 REJECTED

FAA Fit. Standards Manufacturer I Inspection Authorization Other (Specify)

Inspector BY

I FAA Designee Repair Station Person Approved by Transport X Canada Airworthiness Group

Date of Approva~ or Rejection rert;fioalem Signature of P,.uthorized Individual

10-08-96 Designation No.

~~~~ GSTR469E

FAA Form 337 112·88) /

NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to·assure continued conformity with the applicable airworthiness requirements. -

8. Description of Work Accomplished (If more space is required. attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)

1) Flight tested Bendix/King KLN-90B GPS installed by Form 337 dated 10-07-96 in accordance with AC20-138, App. 1 (2) (d) to verify proper operation and accuracy for a follow-on IFR approval. Original IFR approval was accomplished by STC SA002qlWI-D, Master Drawing List 159-08133-001, Rev. 4, dated 01-24-95. Ant. and unit weremanufactured to TSO-Cl29 performance. specifications.

2) Installed a FAA Approved Flight Manual Supplement in the aircraft flight manual, and a Pilot's Guide P/N 006-08773-0000, dated 02/95 ?nd an abbreviated pilot's guide P/N 006-08774-0000, dated 02/95 in the aircraft. The Operational Revision Status must match the ORS level annunciated on the self test page.

3) Removed the "GPS LIMITED TO VFR USE ONLY 11 placard installed by Form 337 dated 10-07-96.

4) FAA Apbroved Flight Manual Su~1ement dated 4/7/97 must~be readily -----~~~~~-!~~E-~~~!!!~h~-£~e~---~~~g~tfftr-!~-~-~~~~----------------------


..,. U.S.GP0:1 989·0.683•1 71

·~· - ~ -r-~----------------------------------------------------------~~~~~~~------~~~~~~--------------, •"" .... """ () Form Approved ,_

,_.., MAJOR REPAIR AND ALTERATION ~9 :-~~l-o_M_B_N_o_.2_12_o_-o_o2_o_-....---t tQ For FAA \J.S_e On.Jf US Oeponmenr

01 Tronsportollon

~Aviation Administration

(Airframe, Powerplant, Propeller, or Appliance) q, _ ~~ ~ off~l.eaae;~~roati~ ~

INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).

1. Aircraft

2. Owner

Make

Beech Aircraft Corp. Serial No. ·

EA-176 Name (As shown on registration certificate)

John Bo Hoek

Model

A36TC Nationality and Registration Mark

- N38047 Address (As.shown on registration certificate)

217 Woodlana Dro Osprey FL 34229

4. Unit ideniification 5. Type


AIRFRAME ,_,...,..~..,...-~ • ..,....,....-(As described in Item 1 above)--· ............................................. ,,....,.........

POWERPLANT

PROPELLER

Type

APPLIANCE Manufacturer :

A. Agency's Name and Address.

Abilene Aero, Inco 2850 Airp~rt B1~do Abilene TX q9602


B. Kind of Agency

U.S. Certificated Mechanic ·•

Foreign Certificated Mechanic

X Certificated Repair Station

Manufacturer

X

C. Certificate No.

GSTR469E

D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in acc.ordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the rnformation furnished herein is true and correct to the best of my knowledge.

Date Signature of Authorized Individual

1V~~~~ 10-0 7-96

-7. Approval for Return To slrvice

Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the Administrator of-the Federal Aviation Administration and is :D{APPROVED 0 REJECTED _

FAA Fit. Standards Other (Specify) Inspector Manufacturer lnsp~ction Authorization

BY FAA Designee

-· .. Date of Approval or Re1ectron

10-0 7-9 6

FAA Form 337 112·88)

X Repair Stat!on

Certificate or Designation No.

GSTR469E

Person Approved by Transport Canada Airworthiness Group

Signatu~;;ri~~vidu~~

_,.. . .

NOTICE Weight ~nd b~lance or OJ?erating lim_itation changes shall be entered in the appropriate aircraft record. An alteration must be compattble wtth all prevtous alteratiOns to assure continued conformity with the applicable airworthiness requirements.


1) Installed Bendix/King GPS in accordance with Installation Manual 006-10521-0002, rev. 2, f./95 and· AC20-138, App. 1 (1) (a) - (d), AC43.13-1A and AC43.13-2A 9 in existing radio rack. KLN-90B. ·

2) Installed Mid-Continent MD-41-328 in cutout above flight instru·ments in existing pilot's instrument panel,· in ac.cordance with Installation Manual 7016074, rev. 3, 1/24/96, and above-cited AC's.

3) Relocated Bendix/King KT-76A transponder and Bendix/King KR-87 ADF to auxiliary radio rack previously installed in map box opening by Form· 3·37 dated 07-25:-89 •.

4) All units sufficiently restrained in the event of emergency landing loads.

5) The MD-41 cited above includes a navigation source annunciator to indicate #1 CDI is displaying NAV or GPS information as selected. NAV 1 or GPS, depending on MD-41 selection, is coupled to autopilot nav input when autopilot nav source switch is in the up position labled NAV ·1. NAV 2 is coupled to autopilot nav

GPs·

input when switch is in the down position labled NAV 2.

6) Installed placard on instrument panel reading: "GPS LIMITED TO VFR USE ONLY"

7) Installed Bendix/King KA-92 GPS antenna using supplied doubler plate in accordance with above-cited manual and AC's at approximate fuselage station 83.0 inches on top of fu~elage. Ant. is TSOd

8) Interconnected the Bendix/King KLN-90B GPS with the Shadin Company $uel Flow Indicating System instal)ed by Form 337 dated 10-03-96 in accordance with Shadin Report po. 4017, STC SA449GL, and authorities cited above for the GPS system.

9) Checked electrical loading -- maximum probable electrical load does not exceed 60% of alternator capacity per AC43.13-1A.

10) Ground and flight tests were conducted and determined that the GPS does not interfere with the normal operation of other·equipment installed in the aircraft, and the GPS equipment is not a source of objectionable electromagnetic interference. Proper operation and accuracy were verified, and the unit functions properly and safely in accordance with manufacturers specification

11) Ground-checked magnetic compass ~- deviation unaffected.

12) Prepared new s~pplemental wt. & balance & corrected equip. list.

-------------------------------------END-----------------------------------------1


+II S C::Pn· 1 QAP·O·AA~. 171

~------~~-------~---------------------r-------------, '> DI!PAIJM!NT

01 1'1.\NSPmA!10N ~=:J;,1f/':,;:: No. 04-R060.! RD!IIAI. AVIATION ADMINilTIAOON

FOR FAA USE ONLY · · ... MA,I()R REPAIR AND ALTERATION · OFFICE IDENTifiCATION

-·; JA~m~pt~nt, Propeiler, c, Appliance) N/11- ~t..C ~~s 1>o INSTRUcrtbNSs Ptmt or qpe all entrlet. .· See PAl\ 43.9, PAR 43 Appeadla B, and AC 43.9-1 (CK oabtequent rnlalon tbHeO() fOr lnatnlctioftl and ·dltJ!OSli~n ol ddt Corm. · ·

''· 11\Al(E. . - MODEL

2.- OwtiEl I. . .

BEECH ~ A36TC SERIAL NO •. . EA~f7&-.. .

NAME C~ ...c,..., on Fegi.!roflon c.rtl!larte) LABRUM, LLOVD·L.

HATIONAlnY AND REGISTRATION MARK

·N38047 ADDRESS (~ ....,_ on ntQirtrotion .te1illcole}

.1000 r,f,. MAIN ST. • . ,..,.,., ·~-i .D. UT A471711

3. FOK fAA USE OBLY

.,'-.. ... 4. lUIIT IDEITIFICAIIOII 5. TYPE UNIT

AIRFRAMe

POWERI'lANT

PROPEllER

APPLIANCE

itliAlt<O.

·············~IIHiilll (AI cle1erlbed ~ item J aboYe)I'HII#IIIIIIIIIIIItlll

Tl'PI

MAHUPACTUI!I i!

-- .i .. _,.

· 6. <OHFOIMIIY 51ATEM£HT

IIPAII AI.T!l· ATIOH

A. AGENCY'S NAME AND ADDRUS ·. 8. KIND OF AGENCY C. CERTIFICAlE HO. : · · il.l. CIIITIIICAUD' lo'ICHAHIC ·,

KfNBS 'AVIOliltCS;c:::;:fNc POIIIOH CliiTIPicAfiD MICHAHIC

3E.9 N. . 2370 w. X CIIITIPICATI!D llPAiliTAYIOH

-SALT LAKE CITY, 'LIT. -s411E ~HUPACTUIU i<nl'-~1=.1'.1~ 0. lcenifr tllat 'be repair and/or·alcer~don made i~-the anit(t) Identified in item -4 •boye and ducribed o~ the re~eroe or

atttdu'!entt hucto have beea made In acCordance wilh the reqairemenu of Pan H of the U.S. Federal Aviadon Reauiadonp aod thet the lnfor~at1011 f?~.thed. herein It true and corrrct to the best of my knowledge. '

DATE SIGNATURE Of AUTHORIZED INDIVIDUAL

X

07/25/89 //?~,~L-L STEPHEN D, HAYDEN t------ ~· ·- _ ,_...,__yPJID AL FOR.,..ETURN TO -IDYitE

Panaant to th. aatborlry ai_-nn peuo~• tpecified below, the unit ~enli6ed in hem~ wu lntpected In the manner presctlbed br tbt A.tmlolttntor of tbe l'ederal ATiatlon Admlnlurulon and io Ill/ APPROVED' u REJECTED

fM F\T.IT-AJDI IMNUPACIUI!I INSP!CTIOH AUtlia.tiATION OTH!l!Spodly) IN I~

IY

DATE OP APPROVAL OR REJECTION

07/25/89 FAA Fonn 337 11-•11

X lll!rAII STATION

16ERTIFICATE OR DESIGNATION NO.

KD6R661N

CANADIAN DIPAITM!NT OP DANSI'OKT IN$I'KTOI

I or AIRCIAPT SIGNATURE Of AUTHORIZED INDIVIDUAL .d/c2.DY7~-I', Harold s. Hayden

(8ll0)

-.

FAA AIBCR.AP7 II.

CAMERA llO. 2 STB.Y · •

g- 22-90

. ' . . . -. ----'-~---·-- ...... : ...... : .. _·_' _ _::_, __ , ___ . -- -'-~ -·~:--·-------'--...:.-._

. ~ ·.

~- ~- -· :·. .. .-- ,_ :.c'NOTICE : ~~>- -_,-

. W!i!i-ght,~mf,balance-or opetat~ii~ ·ti~ifaflo_n c:h~!f9e5 shaU ~e· entere~hJi tiNt ·af?J:iropriate air~aft r~cord. An alteration mu5t be compaflbfe w1th ~lr preVI~S alteraftons ro assure continued conformity w1th the applicable aif'ilorlhine5S requiremenb: . - ' ·- . . . . . -

a; -DESCRIPTION: OF WORK .ACCOAWLISI!ED (II more- sjxace is rfdiliired# tittaclt adc:fitional ~eets. Identify with· or-croft ngtioil_oUfy and registration marie· ond·date eQrl, C()mpJered.J _ . _ _

. -· ... _ .....

-···:·.\'

INSTALLED A~NRV ·fiYS'T~M~, -~ril~:., R.:..20.-LORAN- C?f'IAVIBATOR.

-•. - : fNsTALLAnOI\l' Is tt\1 AccoRDANCE :wzl'H .MANUFACTURERs INsTALLATioN MANUALS; AC43;.13-:1A: :Ci-1RPTER£i';?t-B!'ID· 11, AND AC43 •. 13-2A CHAP-; TE~S 2 AND -3; AND' AC20;.;.121 FOR VFR ·LORAN SYSTEMS.

THE CIRCUIT IS PROTECTED BY AN APPROPRIATELY RATED PUS.H-PULL-- TYPE CIRCUIT BREAKER• POWER IS SUPPLIED BY THE AVIONICS

BUSS. TOT~L- CURRENT DOES NOT EXCEED RECOMMENDED LOAD. :;

, THE LORAN RECEIVER WAS-MOUNTED IN A SPACE VACATED BY THE GLOVE BOX ATAN RPPRDXIMATE ARM OF 52.0 JNCHES, WITH HARDWARE

;..--PROVIDED IN THE INSTALLATION kiT. THE LORAN ANTENNA/PREAMP . WAS MOUNTED_ON TOP OF THE AIRCRAFT AT AN APPROXIMATE ARM OF 88.0 INCHES, W~TI-i HARDWARE PROVIDED IN THE INSTALLATION KIT.

THE: WET COMPASS.WAS CHECKED, AND FOUt-!D TO BE UNAFFECTED. THE LDRAN,WAS PUkARDED "LORAN SYSTEM FOR VFR USE ONLY." THE AIRCRAFT WEIGHT AND BALANCE/EQUI~MENT LISTS WERE REVISED. THE AIRCRAF.T LOGS WERE UPDATED. GROUND TESTS WERE PERFORMED,~ Af\.ID THESYSTEM WA~ FOUND TO BE OPERATIONAL.

----------~------:---------THE -END--------------------~-----..:. __

....

. 'v

'~·

:· .. ·:. :;:.- ..

dt:v ~::;;.~~~=No. 04-R060. 1

FOR FAA USE ONU'

-. -ov.w&bf-RANSPOITATION FED~ AVIATION ADMINISTRATION

MAJOR REPAIR AND ALTERATION (Airframe, Powerplant, Propeller, o~ Appliance)

OFFICE IDE~TION . - , 2-0-01

INSTRUCTIONS: Print.or type oil entries: See FAR 43.9, FAR H Appendix ·a, ond AC H.9-l (or subsequent revision thereof) for instructions and disposition of this Form.

~------~-M-AK~E----------------------------------rM~OD~R~------------------------------~.--

8e.e.c.hc.4aU A-36TC 1. AIRCRAFT SERIAl NO. NATIONALITY ANI:', REGISTRATIOt-!- MARK.~ , '- ·::---r------1--~E~A~-~1~7~6--~.--~~~---------+~~N~3~8~0~4~7------~~~~--~--;

NAME (A! shown on ~tstratiori c8r:rficate) ADDRESS fAs .hewn on rotgisfration certificate)

2. OWNER P.O. Sax 4483, S~a~lon A Thoma4 H. Ha4r.{na~on ·A~quel[.4ue NM 87107

3. FOR FAA USE ONLY -w

,

4. liMIT lDENTIFI<ATIOI S. TYPE U!'(IJ /OAODEL .SERIAL NO. ALTU

IEP'AII

-----------~------~~--------------~----------------------~----------------+-----+-A~T~IO~H~

AIRFRAME +1....,__,1'4-IHII .. I#<IHI'4-IHII._II-I (AJ cl&scribed in item } aboYe)#<IIHI_I ..... +I-1+1_1.,11_1.,1~-_.-t----

~ \ X

POWERPLANT

PROPELLER

TY,E

APPLIANCE MANUfACTURE I

6. CONFOR:diTY STATEMENT I c; A .. AGENCY'S NAME AND ADDRESS B. KINO OF AGENCY '-C"1:EliTIFICA TE NO

CuUe.Jt Fiy4..ng Se.l[.vlC.e P.O. Box ;9042·. Aib~quel[.que, N~ 87119

U.S. CEITifiCATED MECttANIC

fOIEIGH CERTtftCAlED MECHANC

X CEITtfiCATED IE,AII STATION

MANUfACTUIEI

201-17

D. 1 ce-rtify rhal lhc rep&i~ an~/or alec ration made co rhe unit(s) identified in item 4 above and described on· 'the rn-enc· or attachmci)U hcrcto havr been m.ade in accon:lance wirh the requiremc:nu of~·"· 43- of lhe U.S. F-ederal Aviation Rc-gubtiunt ond 1ho1 the info.<mation furni•h.,d herein is true ond corre<:l. lo. the be.t· of my lr.no.~:ledgc. \

SIGNATURE dAUTHoRIZED INLIYIDI'.AI. \

~--~Ma~~~c~h~Z~6~~1~9~8~1------~~==~~~~~~~~~.~~~~·~~~·~~~~-------~-~--~J: DATE

._.. 7. APPROVAl FOR IIETURN T.CVSERVICE ~unu~m co lhc aulhurit}" gi ... cn pcnont Jpcci6c:d below, the unit idc-nrifit"d in hem 4i vnu ~ct.f.d in chc manne-r p.rc-KT"ibcd by l_ the Adminimator of ~~I, Aviation AdminiSinrion and i• ~APPROVED O REJE . ED

fM flT STANDARD~ OTHfll (Speo;oly)

INSPECTOR BY ---~---------+-~------------~-1~~~N~~~~~N;AIT~MENT~.-----1

fM DfSIGN£E X - .... ~TAllON ~~Ill INSI'fC!OR

DATE OF API'ROVAL OR REJECTION

f,/.al[.ch 26 FAA Form 337 11-on

19 t 7

CERTifiCATE OR DESIGNATION NO.

201-17

SIGNATURE OF AUTHORIZED INDIVIDUAl

/l

·--~-·-- -----------

I.

(8320)

. i

/

i

! i L

)

- -~ .::

:,

l

NOTICE Weight and balance or operating li~itation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previ-!)US a/rerations to auure continued conformity with the applicable ai~orthineu requirements.

R. DESCRiffiON OF WORK ACCOMPLISHED (If more space is required, attach additional sheets. Identify with aircraft nationality and registration marie and date worlc completed.)

A~opiio~ Edo-Ai~e M~eheii Cen~u~y III, SN 3-4323, K~ AK753

Thi4 equipment w~4 in4t~iied' in aeeo~d~nee wi~h in4~4ue~on4

4e~ 6o~th in Edo-Ai~e Miteheii g~o~nd ~nd 6iigh~ m~nu~i4~ and

~ppiieabie 4eeUon.4 o6 FAR 43-13 p~4U 1 & 2, ~nd appiiea.bie STC

#SA3330SW-V. New weight ~nd b~i~nee. compded. Equipmen~ ii4~

upd~ted.

------------------------~-------ENV----~----------------------------

ONAI. SHEeTS ARE ATTACHED 0 (...-...... i ._,,;,:.;-, ____________ ..;. ... ______ __,

.: . . i_

. ,.;_r..:··-·.

,-----------....,~--"'T""-_ ___;,./ ___ . .__ _ __, DEPAIITt.',_/Of TIW<S~ATION l," ,,J ~o;:;~,;1'ff::::: No, 114_R060.l

FEDERAl AVIATION AOM1NISTII,t.TION <·

MAJOR REPAIR AND ALTERATION (Airframe, Powerplant, Propeller, or Appliance)

FOR FAA USE ONLY

OFFICE IDENTIFICATION

s_ l.'· JL.....A6 ~/ INSTRUCTIONS: Print.oi type all entries. See FAR H.9, FAR 4~ Appendix B, and AC H.·9-1 (or subsequent revision thereof) for instruC[ions and disposition of this form. ~,

1. AIRCRAFT

2. DWN~R

MAKE

Be.e.C.hc..ta6t SERIAl NO.

EA-776 NAME (As shown on registration certificate)

Thoma~ H. Ha~~ington

MODEL A36TC

NATIONALITY AND REGISTRATION MARK

N38047 ADDRESS (As shown on re9!strotion certificate)

P.O. Box 448j, Station A Albuque.~que, NM 87107

3. FDR FAA USE DNL Y 1 ne oata{alteratJOn Identified herein camp lied with a;plic:~l: t11 w~rtltiness requirements and is ;pprovad onl1 far the ahm a~, cnbed airc,alt subjeci to confDrlllit) inspection by a perm

zbonzed 111 FAR 43.7. . ~ "AAJ ' . ~~}? r<fr -;M~~:~

4. UNIT IDENTIFICATION ..... 5. TYPE

MODEL SERIAl NO. ALTER

ATION

AIRFRAME 1 ••• 111 t 11111i11 (A.s described in. item ~ obove)11 1 111 1111 1 1111 X

------~--------------------~---------------------4------------~--~- -+----1 PROPELLER

--------~,E~-------------------1----------------------~~--·------~----·---+-----+--~~

APPliAIK~

--·-:---c-=-:::-~cc::-·-,---::-~-:-::-=:'::-:---"'6.,_-T(OMrolMITY STATEMENT ~. A. AGENC~NAME AN~D~AD=.D~~~S~S~----t-~----~B_.~K~IND_cc_~OF~~A~GE~N~CY~------t-~C~._C~E~R~T~IF~IC~A~ff~N~O~--~

U 1. C£1TifiCA.TED MECHANIC

Cu..t.te.~ Flying Se.~vic.e. roaeJGN cm•F•c .. .,.o MECH..,.1C.

P. 0. BoX 9 0 4 2 X cei!ToFICAT'ED ae'"'" ST .. TioN

Albuque~que., NM 87119.. MANuF .. cruou 2 01- 1 7

D I ccnify thou the repair and/or alteration made to the unit(s) identified in iccm 4 .lktve. and described on the reveuc or auachmenu hereto have ~en made in accordance with the requirements of Pan 43 of the C.S. federal Aviauon Reguliuion~ and that the informatiOn furnished herein i.s trur and correct to rbt best of my knowledge. . , .·

DATE SIGNATURE OP AUTHOIJIZED INDIVIDUAL ,

61~-ol&1 ~~ -..:J a A'z <1 .-.6 7. APPROVAL FDR JET URN a'O SERVICE

:~~·~ANDAOOS MANUFACTUltER INSPECTION,AUTHOIIIZATION OTtfEII(!ipo<olyi

BY ~---·------·-4---1------------4--1~~~N~A~D~IA~N~~~PA~I~TM~~~T-----1 fAA OfSIGHfE

DATE Of APPROVAL OR REJECTION

.. t. I 7•' I & 1 FAA Fonn 337 17-671

X ltfP .. IR ST .. TION

CERTIFICAiE OR DESIGNATION NO.

z 01 17

g: ::;.s:;:•r iNSPECTOR r-...._

tr 1,1.5. ao.emmern Printing Otfoce 11177-n2-6ol6t1•1 -

,, ·•

'1.

·j

·NOTICE Weight and balance or'operating limitation changes shall be entered in the appropriate ciircraft rec.ord. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.

8. DESCRIPTION OF WORK ACCOMPLIS!IED (If more space is required, attach additional sheets. Identify with aircraft ncf'ionality and registration mark and date work completed.)

A4ea Navig~tion Syatem conaiating o,.King KNS80 and King KI206 indicato4. Thi6 equ.ipmen.t· Wa-6 -i.:n.6ta!!ed -Ln acco4danc.e. with inat4u.ct-Lon.6 .6et 6o4th-Ln King Equ.-Lpme.nt and -i.:n.6ta!!at-Lon manaal-6 and app!-Lcable .6ection.6 o6 AC 90-45A.

All u.n-i.:t-6 a4i on King Compatab-L!-Lty !-i.:.6tA and have. be.e.n ve~i6ie.d· by K-Lng to meet the. Accu4acy Re.qu.-i.:~e.me.nt-6 -Ln AC 90-45A • ..,

Th.I.-6 .6y.6te.m haa been· bench and 6!-i.:ght c.he.c.k.e.d." And -i.:-6 app4ove.d 6o4 e.n4ou.te, te.Jtmina!·a.n.d app~oac.h IFR ope.Jtat-Lon.

:~e.w weight and balance. computed. Eq,u:-Lpme.nt !-L.6t u.pdate.d.

------------~-------------------ENV--------------------------------

'~-

··~.

L-----"-·---------_:::0::;_A-4l~ •10NAL SHEETS ARE ATIACHED

·;,··

·'

DEPARTMENT OF TRANSPORTATI~N

FEDERAL AVIATION ADMINISTRATION

. APPLICATION FOR AIRWORTHINESS CERTIFICATE

Form Approved _Budget Bureau No. 04-R0058

~ 1. ;~I~T;~l~N·MA"' 2. ~~~~;suA~;~~ME~ma~~RP. 3. i<IRCRAFTM~36~SbGNATK)Nr yi9'BQ fMJ7":t;-t 6 ¢3 $~~5~AI~RCR~An--SE~RI~Al~N~0~.----~6~.-EN-G-IN_E_O_UI-lD~ER_S_N-~--E,-.n-Mk~r)~~~7-.-EN-~---M-O-~-l-DE-S-IG-N-A<-IO-N-L------~-L~.~.,L

7~~A~·)J_//~.~~~4

~~ EA-176 Continental TSI0-520-UB 'f''-{--lf' -~~~.--~-U~--ER_rn __ EN-G~IN_E_S----~9-.-~-0-PE~ll-ER_8_U_ILD-E-RS_N_A_ME __ (m-J7k<-)--~1-0.-P-RO-P-EL-LE_R_M~0-D_El_D_ES-JG-N-ATI-ON------~-----,~~~.A~I~AC~U-n~tS-,~--~

z 0 ;::

" ~ 5 u

z 0 ;:

"" u ;;:

5 u

"'

Hartzell PHC-C3YF-1RF ~ ~IMPORT

APPLICATION 15 HEREBY MADf FOR:· , !•i o-~ppilc.JbiE rttwJ)

A 1 X STANDARD AIRWORTHINESS CERT (inJh·.;te (~!egory) J NORMAL pc ju-yll!TY I l_ACRO!.ATIC j fTRANSPOR~ JGtiDER J j&AUOON

SPECIAL AIRWORTHINESS CERTifiCATE r (beck •Pfropriate items)

2 .LIMITED

3

PROVISICHAl ( ln.it •• at ·' luJJ J

RESTRICTEU ( ln.ill.llt af<T.J./W>I( Jj lo

bt 1onJudi:J)

E:Xf'ERIMENTM '1-'1•11•-llr UfHUium(Jj /fJb(CIIn<it•,lr<fl

I SPECIAl fliGHT Pf:~Mil; l11.1n.1ir

lllf'-rr.l//~1/ lu bt •f.I<~Ju.!oJ ti~1; •ll'flpittr

I

Srdum ~ I .. ~r I fJ .u -'Pi'lt...JJit 1111.

rtirTJr i/J<

2

0

4

0

4

CLASS I

ClASS •I·

AGRICULTURE .& PEST CONTROL 21 ]AERIAl &Uii!:VEYINGI 3 I ~J:;:TISING fOREST (Trrld lrft amJen.Jiron) s I ""'TROLLING 161 fwEATHER CONTRO

OTHER rSpmf,)

RESEARCH AND OfVELOPMEHT ·2j _!AMATEUR 6UILT llJ ~XHI!ITICJt.l RACING Sj _IeREw TRAINING • 1 6 J ~KT. SURVEY

TO SHOW COMPLI..i.NCE WITH fAR

FU~RY f'.IGHT FOR REPio.IRS, ALlERATIQt.IS, MA_IN_TE __ "_AN_C_, _O_R __ ST_O_RA_G_E ----------1 EVACUATE Fl':OM AREA Of I~NDING DANGER

Of'ERATIOH IN EXCESS Of MA.1. CERTifiCATED T A~t Off ...,.E1Gt1T

Dtli'IERING OR EXPORT S j ,pw~-uc-r-,o-,..-fL-IG_tiT_TE_ST-JN-G----------1

C 6 MUlliPLE All(wORTHINf:~,!) CE:RllfiCATE ((beck uj;prupn.Jit: ReJfruted Opa·,,:,un .mJ St.mJ,_.,-.f ur i .rti!fc.i .JI .;ppiicublf .tbou)

-". REGISTERED OWNER ( .-I.J J•':>uwr1 :Jfl l'r:rrJjii.Jif u/ .·1irm.J/t R~:giJtr,.!fiun) If DEALER, CHECK HERE ~ J X·

ADOllEss 9709 E. Central BEECH AIRC~4FT CORP. WichitaJ Kansas 67201

AIRWORTHINESS DlaEGIVES (Cbn.-k t{ o~li 4fiti.Jhi, .-!D's •OI'IIfltcJ u·ttb .m./ f,tl'f X /u:r;t .ID So.)

AIRCRAFT SPECifiCII.TION Otl. TYP£ CfRTifiC;;.TIQN- DII.TA SHEET (Gu-t :':.a.

x .ni.IRtiiJIMJ.''-hJ . 3Al5, Rev. 64 t_?·:r~; Issue 80-23 SUPPUMENTAL TYPE CERTfKATE ( Lw rwt,brr of to~,b STC JniCJrporo-~trJ)

N/A N/A

C.. CHECK If RfCOR05 ~ z COMPLI~NCE W'JH

AIR(RAFl OPtRATIOI" AN() MAINT~NANCE RECORDS

TOTAl AIRFRAME i'tOURS .....,.., ;in DJ& JJ»ifJ}i 6111}

~ X f~~91 173 ·· 2:25 0

· A THE AIRCRAFT DESCRIBED A80~E HAS BEEN INSPECTED AND fOU"lD AIRWORTHY ey, (Compim rim ,{aion on/) if FAR 21.183 rtJ{ app/m) ~ --, -- fAR P11.R.T 121 ~ ! 27. CERTifiCATE HOLlJER rGttt CERTIFtCATED MECHANIC (Gilc J ICfRTIFICATED REPAIR STATION (Gll"r Crrufu .. ar ;::: 2 (r-rllfl•·JI( .~·-·., 3 UrlifuJtt No) 6 1'\'CJ) ·

~" v ~ - . - "'IRCRAFT ·"""-"""Ut-ACTUe£0 r""G-, ,-c,,c-.-m-, •""{-;;F,-,.,-)----"~'---'----'---------------'--L--"---------------------1

~~ 5 <l>rD-A~TE-~'-----------~TIT~l~E--------------------------------,,,S~IGN--A~TU~RE~------~-----------------1

~ z (Check ALL oppiicabie block.s} i fina that the alrc:raft described in Section I or VII meet~ the requiromOnh f.;...: [~}The certlfi:atlol'l

CQ regue~ted, or L4]_----= A, •ndmont or m·'Jdlficatlon of its current airworthiness certificate. lns.pection foe a _special flight permit under -<Z:C Sec.rion VII wg.s conducted by: 0 FAA Inspe-ctor; certificate- holder under 0 FAR 65, 0 FAR 121 '"'127, oc 0"l=AR 145.

c(= ~ -DATI DISTRICT OffiC£'~ ISIGNEE'S SIGN lURE AND HO. fAA INSPECTOR'S SIGNA-:-:JRE

--~~ 41 ~=~ ACE EMOO LJJ. ~~ ...,

11-21-BO 3-0-43 -D. k''Porteous, OOA, PCitB

FAA Form 8130-~ 17-701

/

·'

·;_

A. MANUFACTURER

~DDRESS

e z~ ~------------~~--~~----------------~------------------------------------------~ §e ~B~._PrR~O~DrU~CT~IO~N~BA~S~IS~(C=h~ec~k~ap~~~/r~·Gt~b~u~i~t<m~)~~--~----~~~----------------------------~--------~ :;, ,_ j PRODUCTION CERTIFICATE (G'i.•t productin·n certificate numbir)

8; I TYPE CERTIFICATE ONLY

~~ ~~-~L·A_P_~_o_v_E_D_P_RO_D_U~CT~I_O_N_I_NS_P_ECT __ IO_N __ SY_S~TE~M------~~------------------------------------------~ > C. GIVE QUANTITY OF CERTIFICATES REQUIRED FOR OPERATING NEEDS,

.... .. .....

!i: e ~

?ATE Of APPLICATION .,NAME AND TITlf (P,mt" l)f><)

A. DESCRIPTION Of AiRCRAfT

REGIST EREO OWNER

BUILDER ( ,\-Llkt)

~- . SERI~l NUMBER

~. DESCRIPTION Of FLIGHT

I SIGNATURE

ADDRESS

-" TO

r \ DEPARTURE DATE

z 0 5 ~C~C~RE~W~RE~Q~U~IR~~~TO~O~PE~RA~T~E,THrE~A~I~RC::.R~AfT~A~N~D~ITTS~E~Q~U~IP~M~EN~T~----------------------------·~\~---------·--

1 t>ILOT J i CO-PILOT I .I NAV1G~TCJf \ \OTHER f )pmj)) , \ :;) 0 0

"' ... i ((

~ f:l :z: 0 .. 2 ~ I ...

D THE AIRCRAfT DOES NOT MffT THE APPLICABlE AIRWOR.::.TH:_::I:_:NE:.:S:=S~R:=.EQ=cU::.IR~EM::c.=-EN~Tc:S.c.AS..:.· .c.FO.:..:::LL..:.O.:..:W..:.S':..._ ______________ ''-;----------.C.~:_:_

... -- . ! E THE fOLLOWING RESTRICTIONS ARE CONSIDERED NECESSARY FOR SAFE OPE.RATION (UJ<' att.Jcbmmt if ntt:tiJdT'))

~

;:

'· CERTIFICATION-I hereby certify that; am the registered owner (or his agent) of the aircraft described above; that the aircraft i> reg.,tercd wn h the Federal Aviation .-\tlministration in accordance with Section ~0~ of the Federal Aviatio_n Acr. of 19~8. and .applicable Federal Avsation Regulations; and thar the aircraft has been inspe~d and is airworthy f<>_r ~e fl~t described:

~Z A Oper'ating limitatiahs and Markings in Compliance with FAR. G. Statement of Conformity, FAA Form 317 ( ~"llla_cb wbrn Ttcf'U;r:J)

ZQ- X 91.31 a~o Applicable H. Foreign ~i~orthin-eu Certificat!on for Import Aircraft ( ... -it/.tch U'IKTI . x~i~-~-------~--------------------~------~ O=z:~+=B~C="~".:..:en~t..:.O~~=·a~t~in~g~Li~m~·•a::.••~an~·~A~Mc~c~h·~d~~~--~~---+-+----"~q-HJ-·u_d_J ______________________________ ~

, ~~; f::X:-+~C~D~o_;_;to;.:.'c..D,_:•a_w_'".:.9';.:.·_Ph~o~tog~ro.:...ph.;,;'.:...· ·~·-.:.:.·_;_;(~,1-'-tt;.:."c~b.;_;u;,;'b.,;;en~rtq"'-u-'-in.,;;d,.,::) __ ~ I. Previous Airworthinen Certificate lnued in Af:cordart'e with

, i~:~~D~·(~,,~~~~en~t~W~t~:g~ht~a~n~d~Ba~la~n~ce~ln~fa~rm~a~tio~n~A~v~ai~la~b~le~in~A~i~rc~ra~k~~~~FA~R~======~-~C~A~R~=========J(~O~ri~gt~n-~d~./~lt~.to~-h~~~J~ : o ~ 1-+-E_M_a..,:,lo_r_R...,:ep_,,_.,_o_n d_A_I_••_•o_tiO_".:._· _F A_A_3_3_7_;,(_. i...:tJ_a,_·b_,_d_"n--rtq.:...r-tirt_' d-")-1 J. Current Ai rworthi11eu Certificate lnued in Accordance with

;: X f Thi• ln>pection Recorded in Aimak Records X J FAR. 21.183(8.) per 21.273 (Copy .<tluchtdj .~-\

(- }76-0.P.0.-1703-M/B73-i!S41178

'--

·'.

<< -·------- ----- •<·------···-· --·-·-----

.i

--..;

UNITt:.D STATES OF AMERIC.A DEPARTME"'T OF TRANSPORTATION-FEDERAL AVIATION ADMINISTRATION

• ·· STANDARD ·AIRWORI-HIJt':'-S CERTIFICATE -:.--:=.- c;::.--:--:.·,

FAA Form 8100-2 ,,_t>l FOHMi:RLY FAA for-. .....

/

.i

..

) /

\. \

---~-~-· ~·-~·

DEfiARTMENT of T. -~-·· PoRrATJON FEDERAL AVIATION ADMIN IS TRA TION

MAJOR REPAIR AND ALTERATION (Airframe, Powerplant, Propeller, or Appliance)

f'! ~pprom/ BuUkel !Jun·au NtJ, O~-R060.1

1'011. /·;1;1 W'li UNL\'

OFFICElDENTIFICATION

\sW-G.MY•-1 INSTRUCTIONS: Print,or type all cntric>. See fAR 43.9, fAR 43 Appendix ll, and AC 43.9-1 (or subsequent revision thereof) for instru<.·tion~ anJ Jisposidon of [hi~ foniJ. ·

1. AIRCRAFT

2. OWNER

'MAKE

Be.e.c.hc.Jta.U SERIAL NO.

EA-176 NAME (As shown on re-gJdrafion certificate}

Thuma.~ H. Ha!t!tlngton

!MODEL I A36TC NATIONALITY· AND REGISTRATION MARK~

N38047 ADDRESS (As shown on registrolton certificate)

P.O. Box 4483, Station A Aihuque.Jtque., NM 87106

3. FOR FAA USE ONLY

I ~ ~

) 4. UNIT IDENTIFICATION 5. TYPE

~----~~~------------~------·~---------M-O_D_EL---~--~----J-_____ s_EA-IA_L_N_o_. ____ ~-·-E-PA~IR~-:~~~:~~:~ AIRfRAME X

~~-W--tR_P_LA_N __ T~~-------------._--_--_._·~---~-· ------~------~~,~~--~~ - ~1- /\~ .. ~

--PR __ O __ PE~:__ l:c:.,::-E --~~--·-------+---------·+ \tf~~~-·--lfl~~~~?)-.~ ··---]-APPLIANCE 't. ·9.. ~ . ru . I MANUFAClURER 'DI' ~ '-;:-

, /~ . 6. CONFORMITY STATEMENT "...,: /~ \2: ____ ~ ~~---

A. AGENCY'S NAME AND ADDRESS B. KIND OF AGE~~~ C. CERTIFICATE NO -----------~-~--------'----------t-- ------------------------ -------

C~tte.Jt ~lying Se~vlce P. 0. Box 9042 Albuque.~que, NM 87119

U . .S. CERTIFICATED ME(HA_:,N_IC _______ _,

FOREIGN CERTifiCA.TfD. ME.CHANK:

X ):ERTIFICATED REPAIA-,·-T ... -T-10-.. --------1

MANUFACTUilEI

2 0 1- 1 7

0. I c.cnif) dl.l.l the ~t.-p.t'ir . .t.nd_/ur .tltcr.l(iun n~e unit(~) identified in itt.•rn -1 <thovc and dcHrib .. ·d _on_ the rcn:r)c or .tU.tt.lnnc.:no la·rcto h.n~: been 111.1Jc in accordance \\'ith dll· n:quircmcno. of P;.~rt •f.\ of rht.• U.S. Federal A\·l,ltlon Re,g:ul.l£iou!l .wJ 1h.u du- udoru1.1tiuu fun11)hcJ la:rciu is true anti rorn;n to the ~est of my kilowlt .. ·J~c. '

_ ________ 7. APPROVAL FOR RU'~_N_T0=-.5fR-~-''"'~\Vcc.I=CE~~------~-------· ________ __ Pur)u .. nl I~' tlu: .aud~llfll) _~ivcu pn"'''~ ~pt.·t·ificd hdow, the uuil idt.·lltif~t:d in itt."lll -i. wa~ in~pcl t":d in the.· lll.IIIIH·r JHL"Snill1:J hy

tht·,~dn••nt~~~~-~~- ~~~~~~~~~ldlion Administrttdon .ami i~ K) APPROVED _-0 ~~~-~:~~~~-----~-~---------~--: ~ 1 1 51 0 RO; OTHER (SpKoly) , f I_ r_"." l "-N A MANUFACTURER INSPECTION AUTHOIUlATfON

iiY ~- r· ·:.:_ArEoC __ E:~IMGN--Ef ____ -~-X~ ---·-------CANADIAN. ;EPARTMENT

•~ , REPAIR STATION OF TRANSPORT INSPECTm

:-.... If .')r APPROVAl OR CERTifiCATE OR ~~~~;~;E OF AUTHORIZED INDIVIDUAL HtJf:CTIO,'l DESIGNATION NO. f"' ~

2 I 1 7 I 8 1 -_[:: ·2 0 1 1 7 .d..., ..tt::?~ ' } A'..LLL£. ) FAA form.337 17-671 ·er\.i S. Government Printing: Office 1977-77~/~4..:;1 (8320)

""p."-

NOTICE Weight and balance or operating i1mitation changes shall be entered in the appropriate aircraft record. An alteration m11st be compatible with all previous alterations to assure continued conformity with the· applicable airworthiness requirements. · ·

B. DESCRIPTION OF WORK ACCOMPLISHED (If more space if.required, aHach additional sheets. Identify with a(r-craft nationality and registration mark and date work completed.)

A~ea Navigation Sy~tem conAi~ting o6 King KNS80 and Ki~g K1206

.irtdiC.atM. Thi~ equipment ~a~ in.t>taited in a.ccolldanc.e with in~tllu.c.

.U.on41> .t>e.t 6oJr.:th in King Equipment arr.d IMta..U.a.tion· Ma.rr.u.a.l~ and

applic.a.ble 6ection6 o6 AC 90-45A. r',}

All unit6 a.Jr.e on King Compa.ta.bili.ty li&t~ a.rr.d have been. veti6i_ed

by King to meet the Ac.culla.c.y Requ.iJr.emen.t6 in AC 90-45A.

Thi6 61J6lem ha~ been bene.~ and 6ligh[ chec~ed, and iA a.~plloved

6oJr. enJr.oate, ~e!r.mlna.l and a.pplloac.h VFR opellatlon only;

New weight and ba.lanc.e c.ampute.d. Equlpmen~ ll6t updated.

----~---------------~-----------ENV-------------------------------

..

0 ADDITION,t.l SHEETS ARE ATIACHED

- ~1'!·...,._. .............. ______ _

,. .. ~-

.. #

0 jl major repair and alteration - aso · install bob fields aerocesories inflatable door seal in...

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