Title Page

  • Site conducted

  • Conducted on

  • Prepared by

General Information

General Information

  • Name of Applicant

  • Address of Applicant

  • Date of Inspection

  • Place of Inspection

  • Registration Marks

  • C of A Category

  • Helicopter Manufacturer

  • Date of Manufacture

  • Type of Helicopter

  • Helicopter Serial No.

  • Total Airframe Hours

  • Helicopter Serial No.

  • Total Airframe Hours

  • Total Airframe Cycles

  • Hrs/Cycs. Since Last C of A Renewal

  • Engine Manufacturer

  • Engine Designation

  • Main Rotor Blades Manufacturer

  • Main Rotor Blades Designation

  • Tail Rotor Blades Manufacturer

  • Tail Rotor Blades Designation

Engines, Rotor Details:

  • Engine TBO/TBI

  • Rotor TBO/TBI

  • Rotor Scrap Life/ Time to Life limit

Engine 1

  • Serial Numbers

  • Total Engine Hours

  • Total Engine Cycles

  • Hrs. to Overhaul/Shop visit

  • Cycles to Shop Visit

Engine 2

  • Serial Numbers

  • Total Engine Hours

  • Total Engine Cycles

  • Hrs. to Overhaul/Shop visit

  • Cycles to Shop Visit

Main Rotors

  • Serial Numbers

  • Total Rotor hours

  • Hours since Overhaul

  • Date Fitted

Tail Rotors

  • Serial Numbers

  • Date Fitted

  • Total Rotor hours

  • Total rotor Cycles

  • Hours since Overhaul

  • Hours since Overhaul

Aircraft Documents

  • Last Major Maint. Certificate of Release to Service

  • Current C R S (if different from 1 above)

  • Certificate of Insurance

  • Radio Station Licence

  • Weight and Balance Schedule

  • AD’s and SB’s Compliance Status

  • Compliance Status with Aircraft Maintenance Programme

  • Minimum Equipment List (MEL) Approval page &<br>MMEL Rev. Status

  • Technical Records – Complete and Updated

  • Log-Books Entries Update and Certification

  • Rotorcraft Flight Manual Revision Status

  • Approval of Aircraft Maintenance Programme

  • Manufacturer’s Documents (AMM, SRM, WDM,<br>etc.)Available and current

  • Production or Flight Test Report (For First of its type) on<br>Nigerian Register or as applicable

  • Technical Log-Book up-to-date

  • Allowable Deferred Defects Clearance

  • A/C Ageing Programmmes &Corrosion Control Program<br>Compliance

  • Aircraft Instruments and Avionics Equipment Form

  • Aircraft C of A Issue / Renewal Status Report

  • Standby Compass Swing Status

  • Helicopter life limited component status

  • List of Avionics Equipment(issue only)

  • History of Accidents/Reportable Incidents Statement

  • Dent and Buckle Mapping

  • Last Flight Data Recorder Data Readout

  • Noise Certificate (issue only)

  • Certificate of Airworthiness (or Export C of A)

  • Manufacturer Delivery Documents (If New) (issue only)

  • Electrical Load Analysis (as applicable)

  • Approved LOPA and Safety Equipment Layout(issue only)

  • Modification and Repairs Record

  • Aircraft Type Certificate Data Sheet (TCDS) (issue only)

  • FDR Data Frame Layout Information Available

  • Annual examination of the recorded signal on the CVR

  • Statement of Compliance with Nig. CARs Part 7 (Issue<br>only)

  • Airworthiness Review Report by CAMO (every 6 months)

PHYSICAL INSPECTION

1. FLIGHT DECK

  • Cockpit Placards – (e.g. Flight Manual Helicopter airspeed and power plant limitations, MEL Placards) - Check presence and legibility

  • First Aid Equipment – Check presence of and adequacy of contents. (Note: Do not open if<br>sealed).

  • Sliding Window (Push out Window)

  • Safety belt and shoulder harnesses – check condition, type approval, proper operation,<br>expiry date, etc.

  • Life jackets (if applicable):- condition, expiry date etc.

  • Crew compartment lights.

  • Blackout curtains / sun visors.

  • Fire extinguishers – expiration date.

  • Torch Light

  • Radio Altimeter – date of last functional check (as per requirements)

  • Check completeness and currency of Helicopter documents aboard, viz;

Onboard Library

  • Certificate of Registration.

  • Certificate of Airworthiness

  • Helicopter technical log.

  • MEL and Configuration Deviation List (CDL).

  • Air Operator Certificate (AOC) and Opspecs, if required

  • Noise certificate

  • Rotorcraft Flight Manual (RFM)

  • Category II or III Manual, as applicable

  • NOTAMs briefing documentation

  • Mass and balance documentation

  • Radio station licence

  • Insurance certificate

  • Maintenance Release

  • Forms for reporting of MOR to the Authority.

  • Function Check Mandatory equipment visible:

Function Check Mandatory equipment visible:

  • FDR (must be digital )

  • CVR

  • GPS (Navigation database up to date)

  • Radio Altimeter

  • GPWS (Terrain and Obstacle database up to date)

  • ELT 406Mhz (Check battery validity, that ELT is registered, copy<br>hexadecimal Code)

PASSENGER CABIN

  • Passenger Door and other exits – Check for proper markings and operation.

  • Emergency and other exit lights (including floor lights) – check proper for functioning.<br>

  • Access to emergency exits – Check seat reclines with emergency exit door clearance.

  • Cabin crew and passenger safety seat belts – Check for type approval, condition, proper<br>operation, expiration date, etc.

  • First Aid equipment – Content, expiry date and locations.

  • “No Smoking” and “Fasten Seat Belts” signs available and legible.

  • Fire extinguishers – numbers and expiry dates.

  • Life jackets and Life rafts (if applicable) – Check for proper location, expiry dates etc.<br>

  • Door Safety Straps (if available).

  • Emergency instructions on all seats and “life jacket under your seat” sign displayed (if<br>applicable).

HELICOPTER EXTERIOR

  • Registration Markings:<br>(i) Tail boom: must be on both sides.<br>(ii) Fuselage: (or equivalent structure): must be on either side of the structure.

  • Identification and Data Plate (location and condition/ legibility)

  • Engines :- check security and condition of cowlings, nacelles, air intakes, fire access<br>panels, main gear box etc.<br>- check for leaks (fuel, oil, etc.)<br>- check for presence of fuel and oil specification markings.<br>

  • Swashplate, pitch change rods, Main rotor blades, scissors links etc. check for condition, physical damages

  • Check for evidence of leakage of hydraulic and other fluids

  • Passenger Door Markings.

  • Windshield/ Canopy – Check for proper installation and cracks, evidence of delamination etc.

  • Nose cone/ radome – Check condition, evidence of paint stripping, delamination, pitting etc.

  • Fuel and hydraulic fluid specification markings.

  • Towing angles markings.

  • Floats – “NO STEP” etc. condition and location.

  • Nose/Flood Lights (serviceability)

  • Nitrogen – Cylinder replenishing points and instructions, expiry date and quantity.

  • Markings for static vents.

  • Condition of the landing gear/skid gear

  • Condition of:<br>(i) Main rotor blades.<br>(ii) Tail rotor blades (including check of static discharge wicks)

  • Horizontal stabilizer – Check condition and stabilizer datum and range markings (if any ).

  • Condition of the fuselage and tail planes/tail boom/tail guard.

  • Baggage hold loading instruction labels: Check for presence of and the compartment door for security.

  • Tail rotor drive shaft fairings – for safety and condition. Check tail rotor gear box for leaks

  • External lights – Navigation.<br>Landing - Check for proper functioning of<br>Anti collision

  • Markings and Placards in accordance with AMM/AFM (check for presence and legibility)

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