Title Page
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Site conducted
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Conducted on
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Prepared by
General Information
General Information
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Name of Applicant
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Address of Applicant
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Date of Inspection
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Place of Inspection
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Registration Marks
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C of A Category
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Helicopter Manufacturer
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Date of Manufacture
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Type of Helicopter
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Helicopter Serial No.
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Total Airframe Hours
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Helicopter Serial No.
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Total Airframe Hours
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Total Airframe Cycles
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Hrs/Cycs. Since Last C of A Renewal
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Engine Manufacturer
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Engine Designation
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Main Rotor Blades Manufacturer
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Main Rotor Blades Designation
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Tail Rotor Blades Manufacturer
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Tail Rotor Blades Designation
Engines, Rotor Details:
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Engine TBO/TBI
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Rotor TBO/TBI
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Rotor Scrap Life/ Time to Life limit
Engine 1
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Serial Numbers
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Total Engine Hours
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Total Engine Cycles
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Hrs. to Overhaul/Shop visit
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Cycles to Shop Visit
Engine 2
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Serial Numbers
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Total Engine Hours
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Total Engine Cycles
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Hrs. to Overhaul/Shop visit
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Cycles to Shop Visit
Main Rotors
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Serial Numbers
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Total Rotor hours
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Hours since Overhaul
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Date Fitted
Tail Rotors
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Serial Numbers
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Date Fitted
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Total Rotor hours
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Total rotor Cycles
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Hours since Overhaul
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Hours since Overhaul
Aircraft Documents
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Last Major Maint. Certificate of Release to Service
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Current C R S (if different from 1 above)
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Certificate of Insurance
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Radio Station Licence
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Weight and Balance Schedule
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AD’s and SB’s Compliance Status
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Compliance Status with Aircraft Maintenance Programme
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Minimum Equipment List (MEL) Approval page &<br>MMEL Rev. Status
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Technical Records – Complete and Updated
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Log-Books Entries Update and Certification
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Rotorcraft Flight Manual Revision Status
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Approval of Aircraft Maintenance Programme
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Manufacturer’s Documents (AMM, SRM, WDM,<br>etc.)Available and current
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Production or Flight Test Report (For First of its type) on<br>Nigerian Register or as applicable
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Technical Log-Book up-to-date
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Allowable Deferred Defects Clearance
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A/C Ageing Programmmes &Corrosion Control Program<br>Compliance
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Aircraft Instruments and Avionics Equipment Form
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Aircraft C of A Issue / Renewal Status Report
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Standby Compass Swing Status
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Helicopter life limited component status
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List of Avionics Equipment(issue only)
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History of Accidents/Reportable Incidents Statement
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Dent and Buckle Mapping
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Last Flight Data Recorder Data Readout
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Noise Certificate (issue only)
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Certificate of Airworthiness (or Export C of A)
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Manufacturer Delivery Documents (If New) (issue only)
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Electrical Load Analysis (as applicable)
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Approved LOPA and Safety Equipment Layout(issue only)
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Modification and Repairs Record
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Aircraft Type Certificate Data Sheet (TCDS) (issue only)
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FDR Data Frame Layout Information Available
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Annual examination of the recorded signal on the CVR
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Statement of Compliance with Nig. CARs Part 7 (Issue<br>only)
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Airworthiness Review Report by CAMO (every 6 months)
PHYSICAL INSPECTION
1. FLIGHT DECK
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Cockpit Placards – (e.g. Flight Manual Helicopter airspeed and power plant limitations, MEL Placards) - Check presence and legibility
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First Aid Equipment – Check presence of and adequacy of contents. (Note: Do not open if<br>sealed).
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Sliding Window (Push out Window)
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Safety belt and shoulder harnesses – check condition, type approval, proper operation,<br>expiry date, etc.
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Life jackets (if applicable):- condition, expiry date etc.
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Crew compartment lights.
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Blackout curtains / sun visors.
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Fire extinguishers – expiration date.
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Torch Light
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Radio Altimeter – date of last functional check (as per requirements)
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Check completeness and currency of Helicopter documents aboard, viz;
Onboard Library
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Certificate of Registration.
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Certificate of Airworthiness
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Helicopter technical log.
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MEL and Configuration Deviation List (CDL).
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Air Operator Certificate (AOC) and Opspecs, if required
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Noise certificate
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Rotorcraft Flight Manual (RFM)
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Category II or III Manual, as applicable
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NOTAMs briefing documentation
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Mass and balance documentation
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Radio station licence
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Insurance certificate
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Maintenance Release
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Forms for reporting of MOR to the Authority.
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Function Check Mandatory equipment visible:
Function Check Mandatory equipment visible:
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FDR (must be digital )
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CVR
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GPS (Navigation database up to date)
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Radio Altimeter
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GPWS (Terrain and Obstacle database up to date)
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ELT 406Mhz (Check battery validity, that ELT is registered, copy<br>hexadecimal Code)
PASSENGER CABIN
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Passenger Door and other exits – Check for proper markings and operation.
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Emergency and other exit lights (including floor lights) – check proper for functioning.<br>
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Access to emergency exits – Check seat reclines with emergency exit door clearance.
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Cabin crew and passenger safety seat belts – Check for type approval, condition, proper<br>operation, expiration date, etc.
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First Aid equipment – Content, expiry date and locations.
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“No Smoking” and “Fasten Seat Belts” signs available and legible.
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Fire extinguishers – numbers and expiry dates.
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Life jackets and Life rafts (if applicable) – Check for proper location, expiry dates etc.<br>
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Door Safety Straps (if available).
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Emergency instructions on all seats and “life jacket under your seat” sign displayed (if<br>applicable).
HELICOPTER EXTERIOR
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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.
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Identification and Data Plate (location and condition/ legibility)
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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>
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Swashplate, pitch change rods, Main rotor blades, scissors links etc. check for condition, physical damages
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Check for evidence of leakage of hydraulic and other fluids
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Passenger Door Markings.
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Windshield/ Canopy – Check for proper installation and cracks, evidence of delamination etc.
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Nose cone/ radome – Check condition, evidence of paint stripping, delamination, pitting etc.
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Fuel and hydraulic fluid specification markings.
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Towing angles markings.
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Floats – “NO STEP” etc. condition and location.
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Nose/Flood Lights (serviceability)
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Nitrogen – Cylinder replenishing points and instructions, expiry date and quantity.
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Markings for static vents.
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Condition of the landing gear/skid gear
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Condition of:<br>(i) Main rotor blades.<br>(ii) Tail rotor blades (including check of static discharge wicks)
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Horizontal stabilizer – Check condition and stabilizer datum and range markings (if any ).
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Condition of the fuselage and tail planes/tail boom/tail guard.
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Baggage hold loading instruction labels: Check for presence of and the compartment door for security.
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Tail rotor drive shaft fairings – for safety and condition. Check tail rotor gear box for leaks
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External lights – Navigation.<br>Landing - Check for proper functioning of<br>Anti collision
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Markings and Placards in accordance with AMM/AFM (check for presence and legibility)