Field Approval Checklist PDF Details

When you are out in the field, it is important to have the right supplies with you. A field approval checklist can help make sure that you have everything you need. This checklist can vary depending on what type of work you do, but there are some general items that should be included. By having a field approval checklist, you can make sure that your work goes smoothly and safely.

You will see info about the type of form you want to prepare in the table. It can show you how much time it will need to complete field approval checklist, what fields you need to fill in, etc.

QuestionAnswer
Form NameField Approval Checklist
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesfield approval checklist fillable form, resource family approval checklist, ac 43 210a field approval checklist, describe the scope of checklist for field inspection

Form Preview Example

MODEL
SERIAL NUMBER
YES: If YES Do Not Complete This Form
NO: This will be a Request for a Field Approval

DOUBLE CLICK ON YELLOW NOTE PAD FIELD APPROVAL CHECKLIST

THE MATERIAL LISTED ON THIS FIELD APPROVAL CHECKLIST IS NOT REGULATORY,

NOR DOES IT ESTABLISH MINIMUM STANDARDS.

When requesting a Field Approval, you may use this form to provide the requested data, forms, descriptive items and other information. If you do not use this form, an equivalent method for presenting the information and data may be used ( EXAMPLE: Advisory Circular AC 43-210 ). The checklist form (or equivalent), its attachments, Federal Aviation Administration (FAA) Form 337 and the data make up the Standard Data Package.

INSTRUCTIONS: PRINT OR TYPE ALL ENTRIES. THIS INFORMATION SHOULD BE COMPLETE AS POSSIBLE PRIOR TO YOUR INITIAL DISCUSSION WITH THE FAA

1.STC

INFORMATION

IS THERE AN EXISTING SUPPLEMENTAL TYPE CERTIFICATE FOR THIS MODIFICATION: COVERING THE MAKE AND MODEL OF THE PROPOSED ?

2.AIRCRAFT INFORMATION

MAKE

REGISTRATION

 

 

 

 

 

 

 

 

 

 

POINT OF CONTACT

 

 

 

COMPANY NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O.C TELEPHONE

P.O.C FAX

 

STREET ADDRESS

 

 

3. APPLICANT

 

 

 

 

 

 

 

 

INFORMATION

TYPE OF APPLICANT

 

 

 

STREET ADDRESS

 

 

 

CERTIFIED REPAIR STATION

 

A&P / IA MECHANIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CRS #

A&P IA Number

 

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. TYPE OF PRODUCT AND CERTIFICATION BASIS

CHECK ITEM:

 

 

 

 

 

 

 

 

TCDS #

 

AIRFRAME

 

ENGINE

 

APPLIANCE

 

 

 

 

List Type Certificate Data Sheet Number:

CHECK ITEM:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART 23

 

PART 25

 

PART27

 

PART 29

 

PART 31

 

PART 33

 

CAR 3

 

CAR 4(b)

 

CAR 6

 

CAR 7

 

CAR 8

 

CAR 13

OTHER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. SCHEDULE FOR COMPLETION OF PROJECT

DATE WHEN FIELD APPROVAL IS NEEDED:

DATE FOR ASI VISIT (PROPOSED/REQUESTED)

PROJECTED COMPLETION DATE FOR ALTERATION:

5A. BRIEF DESCRIPTION OF PROJECT

FAR

COMPLIANCE

REVIEW

5B. PREVIOUS ALTERATIONS OR REPAIRS THAT MAY BE AFFECTED BY THIS ALTERATION

FIELD APPROVAL CHECKLIST

6. DESIGNEES (DAR'S AND DER'S)

NAMES AND TELEPHONE NUMBERS OF THE DESIGNATED ENGINEERING REPRESENTATIVES (DER'S) AND/OR DESIGNATED AIRWORTHINESS REPRESENTATIVES (DAR) WHO ARE HELPING WITH

THE PROJECT

NONE

 

 

NAME:

 

TELEPHONE

CERTIFICATE NO.

DER

 

 

 

 

 

DAR

NAME:

TELEPHONE

CERTIFICATE NO.

DER

DAR

7. AIRCRAFT OPERATING UNDER ONE OF THE FOLLOWING

AIR CARRIER CERTIFICATE

FAR PART 91

DO NOT KNOW

PRESSURIZED AIRCRAFT

121

125

135

 

 

YES

NO

DO NOT KNOW

 

 

 

 

 

 

 

 

8. AIRCRAFT FLIGHT MANUAL SUPPLEMENT (AFMS)

WILL THIS ALTERATION REQUIRE AN AFMS ?

YES

 

NO

DO NOT KNOW IF AFMS IS REQUIRED

 

 

 

IF YES, ATTACH COPY

 

 

 

 

 

 

 

 

9. INSTRUCTIONS FOR CONTINUED AIRWORTHINESS

 

 

 

 

 

ICA INCLUDED IN BLOCK 8 OF FAA FORM 337

 

 

ICA INCLUDED SEPARATE DOCUMENT

 

 

 

 

 

 

 

 

IF CHECKED, ATTACH COPY

10. DATA ATTACHED

CHECK ALL THAT APPLY:

FAA FORM 337 FOR THE ALTERATION PROPOSED

COPIES OF OTHER PREVIOUSLY APPROVED FAA FORM 337 (SUPPORTING DATA)

COPY OF SUPPLEMENTAL TYPE CERTIFICATE (STC) (SUPPORTING DATA)

DRAWINGS,SCHEMATICS & DIAGRAMS

ELECTRICAL DRAWINGS

STRUCTURAL DRAWINGS

SUPPORTING TEST DATA

EMI/RFI PROCEDURES

GROUND TEST PROCEDURES

LOAD ANALYSIS

ELECTRICAL

STRUCTURAL

FAA FORM 8110-3

ELECTRICAL

STRUCTURAL

PLACARDS (COPY OF EXACT VERBIAGE)

OTHER

11. DAMAGE TOLERANCE EVALUATION

Does Damage Tolerance and Fatigue Evaluation of Structure (FAR Parts 23.573, 25.571, 27.571 OR 29,571) apply to any

portion of the purposed Alteration/Repair ?

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

IF "YES" PROVIDE A COPY OF THE FOLLOWING

 

 

 

 

 

 

 

 

 

 

Damage Tolerance 8110-3

 

Damage Tolerance Report

 

 

 

Damage Tolerance Specific ICA

 

 

 

 

 

 

12. ADDITIONAL INFORMATION

CHECK ALL THAT APPLY:

WILL A FLIGHT TEST BE REQUIRED UNDER FAR PART 91.407 (b) ?

YES

 

NO

 

PMA PRODUCT

 

YES: ON AIRCRAFT ELIGIBILITY LIST

YES: NOT ON AIRCRAFT ELIGIBILITY LIST

NO

 

TSO PRODUCT

 

YES

LIST TSO CERTIFICATION

NO

 

FIELD APPROVAL CHECKLIST

FAA USE ONLY

Date Received:

 

 

 

 

 

 

Assigned Inspector:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is a Field Approval Appropriate?

 

YES

 

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If a Field Approval is not performed, what is the proper method for the alteration?

 

 

Record Entry

 

 

STC

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Requires ACO Concurrence?

 

YES

 

NO

Requires AEG ICA Review?

 

 

YES

 

 

NO

Additional Information Required:

 

NO

 

YES

 

 

 

 

 

 

 

 

How to Edit Field Approval Checklist Online for Free

This PDF editor allows you to fill out the field approval check list form. You should be able to build the file immediately by following these simple actions.

Step 1: The page has an orange button stating "Get Form Now". Please click it.

Step 2: After you've entered the field approval check list editing page you'll be able to see every one of the actions you can undertake concerning your document from the upper menu.

For each part, add the information requested by the application.

entering details in field approval checklist step 1

Complete the AIRFRAME, ENGINE, APPLIANCE, CHECK ITEM, List Type Certificate Data Sheet, PART, PART, PART, PART, PART, PART, CAR, CAR b, CAR, and CAR areas with any information that are asked by the system.

field approval checklist AIRFRAME, ENGINE, APPLIANCE, CHECK ITEM, List Type Certificate Data Sheet, PART, PART, PART, PART, PART, PART, CAR, CAR b, CAR, and CAR fields to fill

The application will require details to effortlessly prepare the section DESIGNEES DARS AND DERS NAMES AND, TELEPHONE, CERTIFICATE NO, NONE, DER, DAR, DER, DAR, NAME, TELEPHONE, CERTIFICATE NO, AIRCRAFT OPERATING UNDER ONE OF, AIR CARRIER CERTIFICATE, FAR PART, and DO NOT KNOW.

Entering details in field approval checklist part 3

Make sure you record the rights and obligations of the parties inside the EMIRFI PROCEDURES, GROUND TEST PROCEDURES, LOAD ANALYSIS, ELECTRICAL, STRUCTURAL, FAA FORM, ELECTRICAL, STRUCTURAL, PLACARDS COPY OF EXACT VERBIAGE, OTHER, DAMAGE TOLERANCE EVALUATION Does, YES, Damage Tolerance, Damage Tolerance Report, and Damage Tolerance Specific ICA paragraph.

step 4 to entering details in field approval checklist

End by taking a look at the next fields and preparing them as required: PMA PRODUCT, YES ON AIRCRAFT ELIGIBILITY LIST, YES NOT ON AIRCRAFT ELIGIBILITY, TSO PRODUCT, YES NO, and LIST TSO CERTIFICATION.

Finishing field approval checklist part 5

Step 3: Hit the Done button to save your document. At this point it is obtainable for transfer to your electronic device.

Step 4: Just be sure to generate as many duplicates of your file as you can to avoid future troubles.

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