06 - Aircraft Description Form.docx
DOCX document 26 KB Posted
- Attached to
- 2022 Forestry Gypsy Moth Suppression FPM22-02
- Solicitation number
- 6100054866
- Issued by
- Adams County, Pennsylvania
About this file
This document is an Aircraft Description Form for a state or local government spray project contract. It requires the spray project contractor to provide detailed information about the aircraft they intend to use for the project, including the aircraft owner, type, specifications, condition, instrumentation, and emergency equipment. The form must be completed, signed, and submitted to the Field Project Coordinator as part of the contract requirements. The Field Project Coordinator and Aircraft Operations & Safety Specialist will review the information to determine if the aircraft meets the contract specifications.
The form collects comprehensive data on the aircraft, including make, model, series, number of engines, FAA registration, passenger capacity, cruising speed, fuel capacity, and time since inspections and overhauls. It also gathers details on the airframe, engines, propellers, helicopter components, instruments, and overall condition. Finally, it requires information on the electrical system, lighting, radios, guidance equipment, and spray system. The pilots authorized to fly the aircraft must also be listed with their flight hours, qualifications, and license details.
View the file
Other files
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment 2 . AIRCRAFT DESCRIPTION FORM
1. Spray Project Contractor Information
| a. Name |
| b. Telephone |
| Type or print all information in ink. Return completed and signed form to the Field Project Coordinator. See Contract Specifications for the name and address. |
| c. Address |
| d. City, State, and Zip Code |
e. Contractor's PA Department of Agriculture pesticide application business license number:
2. Aircraft Owner Information
a. Aircraft is (check one):
Owned _____, subcontracted _____, or leased _____ by the spray project contractor
| b. Owner's Name |
| c. Address |
| d. City, State, and Zip Code |
| e. Telephone |
3. Aircraft Description and Information
a. Type of aircraft (check one):
Spray fixed-wing ____ Spray helicopter ____ Observation fixed-wing ____ Observation helicopter ____
b. Qualified under:
FAR Part 135____ FAR Part 137 ____
c. Aircraft:
Make __________________ Model _______________ Series ___________
| d. Number of engines |
| e. FAA Number |
N____________
| f. Year built |
| g. Passenger capacity |
h. Registration certification Yes _____ No _____
i. Airworthiness certification Yes _____ No _____
j. Cruising speed:
MPH _____ Knots _____
| k. Hours of fuel |
| l. Time since 100-hour inspection |
| m. Registration category |
| n. Major modifications |
4. Airframe
| a. Hours since new |
| b. Used for acrobatics: |
Yes _____ No _____
c. Parking brakes:
Yes _____ No _____
d. Paint scheme
5. Engines
| a. Make and model |
| b. Horsepower |
| c. Type fuel |
| d. Supercharger: |
Yes ____ No ____
e. Hours since new:
Engine 1 __________ Engine 2 __________
f. Hours since major overhaul:
Engine 1 __________ Engine 2 __________
g. Hours before next major overhaul:
Engine 1 __________ Engine 2 __________
6. Propellers
a. Hours since overhaul Number 1 __________ Number 2 __________
7. Helicopter Components
a. Hours since new:
Main rotor __________ Tail rotor __________ Transmission __________
b. Hours since overhaul:
Main rotor __________ Tail rotor __________ Transmission __________
c. Hours before next overhaul:
Main rotor __________ Tail rotor __________ Transmission __________
d. Drop stops:
Yes _____ No _____
e. Skids:
Yes _____ No _____
f. Rotor brakes:
g. Other (specify)
8. Instruments
a. Fuel quantity:
Yes _____ No _____
b. Stall warning:
Yes _____ No _____
c. Airspeed:
Yes _____ No _____
d. Clock:
Yes _____ No _____
e. Compass:
Yes _____ No _____
f. Turn and bank:
Yes _____ No _____
g. Directional gyro:
Yes _____ No _____
h. Artificial horizon:
Yes _____ No _____
i. Altimeter:
j. Rate of climb indicator: Yes _____ No _____
9. Condition
a. Glass:
Good _____ Fair _____ Poor _____
b. Fabric:
Good _____ Fair _____ Poor _____
c. Tires:
Good _____ Fair _____ Poor _____
d. Paint:
Good _____ Fair _____ Poor _____
e. Seat belts:
Good _____ Fair _____ Poor _____
f. Shoulder harness:
Good _____ Fair _____ Poor _____
g. Cabin:
Good _____ Fair _____ Poor _____
h. Cockpit:
Good _____ Fair _____ Poor _____
10. Emergency Equipment
a. First aid kit:
Yes _____ No _____
b. Engine fire extinguisher:
Yes _____ No _____
c. Cabin fire extinguisher:
11. Electrical System
| a. Volts |
| b. Auxiliary Power Unit: |
Yes _____ No _____
c. H/D battery Yes _____ No _____
d. Ammeter
12. Lights
a. ant-collision beacon:
Yes _____ No _____
b. Landing:
Yes _____ No _____
c. Cockpit Yes _____ No _____
d. Position:
e. Other (specify)
13. Radios and Guidance Equipment
a. VHF system installed as specified:
Yes _____ No _____
b. FM radio installed as specified:
Yes _____ No _____
c. Selector switch for simo-monitoring of VHF and FM: Yes _____ No _____
d. GPS guidance system installed:
Yes _____ No _____
e. ETGARS installed:
Yes _____ (Make/Model _________________) No _____
f. DGPS installed:
Yes _____ (Make/Model _________________) No _____
14. Spray System
a. STCs or 337s for all components:
Yes _____ No _____
b. Total tank capacity:
__________ gallons
c. Emergency dump system:
Yes _____ No _____
d. Operating load capacity:
__________ gallons
e. Spray system make
f. Nozzles:
Hydraulic ___ (Type __________ Size ________) Rotary atomizer ___ (Make __________ Model _________)
g. Electronic flow-metering system:
Yes ____ (Make/Model _________) No ____
15. Pilots Authorized to Fly Described Aircraft:
| Name |
| Total Flight Hours |
| Special Qualifications |
| Rating |
| FAA Medical Date |
| FAA License Number |
16. Certification I certify that the information contained herein is accurate.
Signature – Contractor Title Date
17. Review – Field Project Coordinator I have reviewed the information provided. Based upon that review, my determination of the aircraft's compliance with the requirements for aircraft as set forth in the _______ forest insect pests suppression program contract specifications is as follows: ______ meets requirements; ______does not meet requirements. If rejected, see explanation below.
Signature – Field Project Coordinator Date
18. Review – Aircraft Operations & Safety Specialist I have reviewed this information and am in agreement with the decision of the field project coordinator.
Signature – Aircraft Operations & Safety Specialist Date
19. Reasons for Rejection
File details come from the government source that posted it. Updated .