EFTA01261493

rn.Pipponi COO No. 2110001,04/1 141/2611 Application for Export Export Certificate No. ill Certificate of Airworthiness ............... Est 3 7_5(ge redonl Adak. Ailsoints. INSTRUCTIONS - This application is to be submitted to an authorized FM representative (one copy) when the aircraft to be exported is (are) presented for inspection. This application may be used, but is not required. for aircraft engines, propellers, and articles. Use Part I for products and Part II for articles. For complete aircraft, execute items 1 through 11, as applicable. For engines and propellers, omit item 5A. Part III is for FM use only. Part I - Application for Export Certificate of NrworthIness (Complete Mims 1.11) 1. Application is made n export certificate hiness to cover the product(s) described below which (are): NEW USED 2. Name and address of exporter 3 Name and address of foreign purchaser 4. Country of destination Summit Aviation, Inc. Greenwich Aerogroup Brazil Leasing Inc Brazil 4200 Summit Bridge RD 4200 Summit Bridge RD Middletown, DE 19709-9340 Middletown, DE 19709-9340 5. Description of products) Type Make and Model Identification Serial Nos. FAA T.C. Operating time (Hours) (a) (b) No. (c) or Spec. No. (e) Transport (d) Since Tout Helicopter Overhaul 49c4. A. AIRCRAFT Sikorsky S-76C N162AD 760472 Hi NE 1.3 03 Turbomeca Arriel P/N #1 eng: 20040 E00054EN #1:09g7 51.94.: B. ENGINES 2S1 02920053 #2 eng: 20533TEC #2:2368.3 zma. 10 3 N/A N/A N/A N/A N/A N/A C. PROPELLERS 8. Does the product comply with all applicable Federal Aviation Regulations. Airworthiness Directives, and other FAA requirements? I YES NO (Explain In "Remarks" 7. Nave ay.e.abliti special rWents of the importing country been complied with? LJYES 11. 1.-INO (ExplainIn "Remarks") 8. Date title passed or is expected to pass to foreign purchaser: 10-Apr-2013 9. For overseas shipment, preservation and packaging methods used to protect product(s) against corrosion and damage (List Spec. No. or Tiffin: Effective duration of above methods: N/A 10. Remarks Reference attached ANAC Letter - Document No. Of.50/2013/GGAC/SAR-ANAC, dated 05 April 2013. Reference attached Summit Aviation, Inc. Exceptions Document SIKORSKY S-76C, SIN 760472, dated 8-April-2013. 11. EXPORTER'S CERTIFICATION — The undersigned certifies that the above statements are true and that the product(s) described herein is (are) airworthy and in a condition for operation except as may be noted under item 10 'Remarks' above. Signature of applicant or authorized represe TT Title Date Edward J. ScullyS o n, VP Summit Aviation, Inc. 08-APR-2013 M1yr Ml SDNY_GM_02754682 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241604 EFTA01261493 SDNY_GM02754683 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241605 EFTA01261494 Pan li - Application for Approval of *Marrs (Complete Items 12-20) 12. Name and address of exporter 13 Name and address of foreign purchaser 14. Country of destination Make and model of product FAA Spec. No or T.C. 15. Articles are eligible for installation on 16 The articles are (Check One) Ear USED 17. ribq articles are described (Check One) Invacingroaclung sheet No l_lBelow by name, part number and quantity On the attached invoce or packing sheet by name. pan number and quantity Name Part number Quantity (a) (b) (C) 18. Have applicable special requirements of the importing country been complied with? YES ❑NO (Explain In item 10 "Remarks" 19 Preservation and packaging methods used to protect articles against corrosion and damage (List Spec. No. or TWO: Effective duration of above methods: 20. Exporters Certification - I certify that the foregoing statements are true and that the articles described herein are airworthy, conform to FAA approved design data. are in a condition for sale operation except as may be noted in item 10 'Remarks'. Signature of applicant or authorized representative Tide Date Part al - Approval (FOR FAA USE ONLY) 21. It is considered that the products) and articles described in Part I or Part II is (are) airworthy and conform a) to pertinent requirements except as noted in Item 10 Check One) Signature Number Oate • 7 Part i ri Part u Sazgreei 'Da Tee -sof ni...Zei A (Check one) * ODA WAR 1 I DAR FAA In actor 22. Give quantity of approval tags, FAA From 8130-3, issued for the articles described in Part Quantity II.--* N/A 23. EXPORT FILE SPOT-CHECKED BY: FAJc -Get4r;is l;_ i3kc6lr o D.O. No. Oate„ -Arafk-P'SDO- 31 LAY) \O WILICC41 4 _. _.._........_. /AA PwelYl Porton SDNY_Gtvl_02754684 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241606 EFTA01261495 SDNY_GM_027541385 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241607 EFTA01261496 The United States of America No. £437518 Department of Transportation Federal Aviation Administration Washington, D.C. Export Certificate of Airworthiness This certifies that the product identified below and particularly described in Specification(s)1 of the Federal Aviation Administration, Numbered HINE; E00054EN has been examined as of the date of this certificate is considered airworthy in accordance with a comprehensive and detailed airworthiness code of the United States Government, and is in compliance with those special requirements of the importing country filed with the United States Government, except as noted below. The certificate in no way attests to compliance with any agreements or contracts between the vendor and purchaser, nor does it constitute authority to operate an aircraft. Product: Aircraft Total Time: 6906.8 Engine Manufacturer: Sikorsky Turbomeca S.A. Model: Arriel 2S1 Model: S-76C PI Serial No. 20040 Total Time: 5695.7 Hrs, TSO 5695.7 02 Serial No. 20533TEC Total Time: 2368.3 Hrs, TSO 2368.3 Serial No: 760472 New: Used: x Country to which exported: Brazil Exceptions: Reference Attachment dated 8 April 2013 listing exceptions and ANAC Exception acceptance letter 01.50/2013/CGAUSAR-ANAC dated 5 April 2013 Additional Information: The rotorcraft covered by this certificate has been examined and found to be in conformity with the Brazilian approved type design as defined by the Brazilian Type Cenificate No. 7906 and is in condition of safe operation. Sec Reverse side for listing of Supplemental Type Certificates (Sits) installed. Coyne Signature of Authorized Representative 8 April 2013 DART-801097-EA Date District Office or Designee Number 1 Forcomplete aircraft. AM applicable specification or type certificate data sheet for the aircraft. engine. and propeber. Applicable specification or type certificate data sheet, Knot attached to this export cettificare, ad have been fonyarded to the appropriate governmentalPike of the imparting country. FAA Fore 61304 (04-2011) Supersedes Previous Edition SDNY_GM_02754686 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241608 EFTA01261497 Export Certificate of Airworthiness E437518 Continued from front: Supplemental Type Certificates (Sits) Installed SR09355RC - Aero Seats and Systems, Inc. - 12 Place Passenger Seats - CHST No. 2008506-01 SR09211RC - Aero Seats and Systems, Inc. • External Mount Life Raft Deployment System - CHST No. 2004512-07 SR02822NY • Heli-One • Automatic Deployable ELT System - CHST No. 2009508-15 5R02603NY-D - Sikorsky Global Helicopters, Inc. - CVFDR-145 Cockpit Voice/Flight Recorder - CHST No. 2013501-06 SR01405NY • D & D Design, Inc. - Installation of Honeywell MK-XXll EGPWS - CHST No. 2011509-03 SR01616SE - FDC/Aerofiker WA LP - Engine Filter system with Wiring Modification per FAA DER approved Data SH5778SW -Meggitt (Addison), Inc. - Electrically Driven Vapor Cycle Air Conditioning system-CHST No. 2009507-09 SR00811NY - Technisonic Industries Limited - Installation of TFM-138B - CHST No. 2009511-07 5R01593NY-D - Sikorsky Global Helicopters, Inc. - Installation of Keystone Helicopter Utility Interior Panels - CHST No. 2003511-05 SR01113NY-D — Keystone Helicopter — S-76 Door Pin Kit — CHST No. 2009S09-06 SR01472NY — Eaton Aerospace — Zapper Pulsed Engine Chip Detector System 1K7707- CHST No. 2010505-06 5H241450 — Sikorsky - Installation of the Honeywell SRZ-850 Integrated Radio System. SH2413S0 — Sikorsky - Installation of the Honeywell AV-850 Digital Audio System. SH2361S0 — Sikorsky - Installation of a fixed landing light. SH2360S0 — Sikorsky - Installation of a search light switch on collective stick. 5H235850 — Sikorsky - Installation of gearbox inspection lights. SH235750 - Sikorsky - Installation of a power monitor panel (INSCO). 541236250 —Sikorsky - Installation of a dual static inverter AC power system. 541243050 — Sikorsky - Installation of a Precise Flight Pulselite System. 541243150 — Sikorsky - Installation of Recognition Lights. 541257050 — Sikorsky - Installation of an external power overvoltage monitor. 541290050 - Sikorsky - Installation of a Honeywell P-700 radar system. 5H294250 — Sikorsky • Installation of a Honeywell SPZ-760 digital automatic flight control system. SR00666AT —Sikorsky - Installation of a LITF dual LCR-925 attitude heading reference system (AHRS). SR00432AT — Sikorsky - Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFTS). SR00490AT — Sikorsky - Installation and operation of a Bendix CAS-66A traffic collision avoidance system TCAS). SR00531AT — Sikorsky - Installation of a lower anti-collision light. SR00508AT — Sikorsky - Installation of a Shadin 8800 ADC accessory unit. SR00902AT — Sikorsky - Installation of a Standby JET ADI.335D attitude indicator. SR00877AT-D— Sikorsky - Installation and operation of a Honeywell AA-300 radio altimeter system. 5R010118AT-D — Sikorsky - installation of a Universal Avionics UNS-1D flight management system. SR01407AT —Sikorsky - Installation and operation of a Baker M7950 Page/Chime Amplifier System. END SDNY_GM_02754687 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241609 EFTA01261498 ATTACHMENT TO EXPORT CERTIFICATE OF AIRWORTHINESS E437518 DATE: 8 APRIL 2013 LISTING OF EXCEPTIONS: UNS-1D System (Sikorsky STC SR01088AT-D) with software level SCN 601.X was modified to software level SCN 604. (FAA Form 337, dated 29-Mar-2001 and FAA Field Approval. The RFMS was approved by the New York Aircraft Certification Office). AeroFDC WA LP - STC SR01616SE — Installation of an engine air filter system. (ANAC validated by project number H.02-2619-0 and CHST 2007503-08 was issued). STC SR01616SE is approved & validated for S-76C helicopters with IIDS. This rotorcraft does not have LIDS, but has a Master Caution Annunciator System installed. The STC Holder, AeroFDC WA LP, has provided electrical drawing FDC/aerofilter "KIT, Wiring Modification — IBF System For 5-76C+ W/O IIDS", No. 1076K15 , wiring for the Master Caution, and Rotorcraft Flight Manual Supplement (RFMS) "Sikorsky 5-76C+ Helicopters (S-76C Helicopter Powered by Turbomeca Arriel 251Engines) NOT Equipped With !IDS". Doc. No. 1076-1200-102, which was not approved under the STC. Both the electrical drawing and the RFMS are FAA DER Approved on FAA Form 8110-3 and on the FAA Form 337 when the installation has been completed. The following major alterations were installed per an STC and do not have ANAC validation; however, the basis for the FM SIC is Transport Canada's STC: 1. Heli-One SIC SR02822NY — Installation of the CPI.503 Automatic Deployable ELT. (Basis for STC is Transport Canada STC SHOE- S8 is ANAC validated by project number H.02-3080-0 and ANAC CHST 2009508-15 was issued). 2. Technisonic Industries Limited SIC SR00811NY - TIL Engineering - VHF Marine Radio. (Basis for STC is Transport Canada SIC SH94-10 is ANAC validated by project number H.02.3220.0 and ANAC CHST 2009511.07 was issued). The following major alterations were installed via an SIC and do not have ANAC validation per the special requirements. The STCs are manufacturer options, installed by Sikorsky during production and prior to the original Standard Airworthiness Certificate issuance. These systems have been incorporated into the Maintenance Manual and the IPC. Rotorcraft Flight Manual Supplements (RFMS) are incorporated in the Flight Manual as applicable. Additionally, all of the below listed Sikorsky STCs have been Installed for 6,906.8 hours, exceeding the referenced 6,000 hours, identified in Paragraph 5.6.1 of FM AC 21-21, Appendix 2, Federative Republic of Brazil — Special Requirements, dated August 2011. 1. Sikorsky STC 5H241450 — Installation of the Honeywell SRZ-850 Integrated Radio System. 2. Sikorsky STC 5112413SO — Installation of the Honeywell AV-850 Digital Audio System. 3. Sikorsky STC 511236150 — Installation of a fixed landing light. 4. Sikorsky STC SH236050 — Installation of a search light switch on collective stick. S. Sikorsky STC 511235850 — Installation of gearbox inspection lights. 6. Sikorsky STC SH235750 — Installation of a power monitor panel (INSCO). 7. Sikorsky STC 5H236250 — Installation of a dual static inverter AC power system. 8. Sikorsky STC 5H243050 — Installation of a Precise Flight Pulselite System. 9. Sikorsky STC SH2431S0 — Installation of Recognition Lights. 10. Sikorsky SIC 5H257050 — Installation of an external power overvoltage monitor. 11. Sikorsky STC SH2900S0 — Installation of a Honeywell P-700 radar system. 3 12. Sikorsky STC SH2942S0 — Installation of a Honeywell SPZ-760 digital automatic Right control system. 13. Sikorsky SIC SR00666AT — Installation of a UTF dual LCR-925 attitude heading reference system (AHRS). 14. Sikorsky STC SR00432AT — Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFIS). 15. Sikorsky STC SR00490AT — Installation and operation of a Bendix CAS-66A traffic collision avoidance system (TCAS). 16. Sikorsky STC SR00531AT — Installation of a lower anti-collision light. 17. Sikorsky STC SR00508AT — Installation of a Shadin 8800 ADC accessory unit. 18. Sikorsky SIC SR00902AT — Installation of a Standby JET ADI-335D attitude indicator. 19. Sikorsky STC SR00877AT-D — Installation and operation of a Honeywell AA-300 radio altimeter system. 20. Sikorsky STC SR1088AT — Installation of a Universal Avionics UNS-1D flight management system. 21. Sikorsky STC SR01407AT — Installation and operation of a Baker M7950 Page/Chime Amplifier System. END SDNY_GM_02754688 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 16 10 EFTA01261499 SDNY_GM_02754689 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 16 I I EFTA01261500 reANAC AGeNCIA NACIONAL OE AVIACAO CIVIL Of 50/2013/GGAC/SAR-ANAC Rio de Janeiro. 05 April 2013. Daryl K. Former Principal Maintenance Inspector FAA FSDO-17 2 International Plaza Suite 110 Philadelphia, PA 19113, USA Subject: Exceptions for Sikorsky S-76C S/N 760472. Ref.: 1- FAA letter dated 04 April 2013. Dear Mr. Former, We hereby inform that ANAC will accept the Export Certificate of Airworthiness for the Sikorsky S-76C, serial number 760472 rotorcraft with the following exceptions: a. UNS-ID System (Sikorsky STC SR01088AT-D) with software level SCN 601.X was modified to software level SCN 604.3 (predicated on FAA approved STC SA00876LA, dated 23-Nov-1999, for Raytheon Aircraft Company B-300 KingAir aircraft). (FAA Form 337, dated 29-Mar-2011 and FAA Field Approval. The RFMS was approved by the New York Aircraft Certification Office); b. LSZ-850 Lightning Sensor (Sikorsky STC SI-12416SO) Honeywell model sensor LP- 850. returned to manufacturer for modification & re-installed as Honeywell model sensor LP-860. (FAA Form 337, dated 23 Mar 1999, FAA Field Approval. The RFMS was approved by Boston Aircraft Certification Office); c. Keystone Helicopters-STC SR00919NY- Installed S76, Split Tail Rotor Gear Box Cover. Two piece Tail Rotor Cowling (FAA Form 337, dated 27-Dec-2001); d. STC SR01616SE is approved & validated for S-76C helicopters with 11DS. This rotorcraft does not have 'IDS, but has a Master Caution Annunciator System installed. The STC Holder, AeroFDC WA LP, has provided electrical drawing FDC/aerofilter "KIT, Wiring Modification — IBF System For S-76C+ W/O IIDS", No. 1076KI5, wiring for the Master Caution, and Rotorcraft Flight Manual Supplement (RFMS)"Sikorsky S-76C+ Helicopters (S-76C Helicopter Powered by Turbomeca Arriel 251 Engines) NOT Equipped With IUDS". Doc. No. 1076-1200- 102, which was not approved under the STC. Both the electrical drawing and the SDNY_GM_02754690 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241612 EFTA01261501 SDNY_GM_02754691 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241613 EFTA01261502 ANAC AGENCIA NACIONAL DE AYIACAO CIVIL RFMS will be FAA DER Approved on FAA Form 8110-3 and on the FAA Form 337 when the installation has been completed; e. Heli-One STC SR02822NV — Installation of the CPI-503 Automatic Deployable ELT (Basis for STC is Transport Canada STC SH08-58 is ANAC validated by project number H.02.3080.0 and ANAC CHST 2009508-15 was issued); f. Technisonic Industries Limited STC SR00811NY — T1L Engineering —VHF Marine Radio. (Basis for SIC is Transport Canada STC SH94-I 0 is ANAC validated by project number H.02-3220.0 and ANAC CHST 2009S1 1-07 was issued) ; Sikorsky STC SH24145O - Installation of the Honeywell SRZ-850 Integrated Radio System; h. Sikorsky STC 5112413SO - Installation of the Honeywell AV-850 Digital Audio System; i. Sikorsky STC SH2416SO — Installation of the Honeywell LSZ-850 Lightning Sensor System; j. Sikorsky STC SH23615O - Installation of a fixed landing light; k. Sikorsky STC 5112360SO — Installation of a search light switch on collective stick; I. Sikorsky STC SH2358SO — Installation of gearbox inspection lights; m. Sikorsky STC 5H23575O — Installation of a power monitor panel (INSCO); n. Sikorsky STC SI-12362SO — Installation of a dual static inverter AC power system; o. Sikorsky STC SH2430SO — Installation of a Precise Flight Pulselite System; p. Sikorsky STC SH243I SO - Installation of Recognition Lights; q. Sikorsky STC SH2570SO — Installation of an external power overvoltage monitor; r. Sikorsky STC SH2900SO — Installation of Honeywell P-700 radar system; s. Sikorsky STC 5H29425O - Installation of Honeywell SPZ-760 digital automatic flight control system; t. Sikorsky STC SR00666AT - Installation of a LITF dual LCR-92S attitude heading reference system (AHRS); u. Sikorsky STC SR00432AT — Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFIS); v. Sikorsky STC SR00490AT — Installation and operation of a Bendix CAS-66A traffic collision avoidance system (TCAS); •• Lunoniendtrciademn,avtgebIMAck Sins. As SDNY_GM_02754692 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241614 EFTA01261503 SDNY_GM_02754693 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241615 EFTA01261504 ANAC AGENCIA NACIONAL DE AVLACAO CIVIL w. Sikorsky STC SR00531AT — Installation of a lower anti-collision light; x. Sikorsky STC SR00508AT — Installation of a Shadin 8800 ADC accessory unit; y. Sikorsky STC SR00902AT - Installation of a Standby JET ADI-335D attitude indicator; 2. Sikorsky STC SR00877AT-D - Installation and operation of a Honeywell AA-300 radio altimeter system; aa. Sikorsky STC SR1088AT - Installation of a Universal Avionics UNS-ID flight management system; bb. Sikorsky STC SR01407AT - Installation and operation of a Baker M7950 Page/Chime Amplifier System. 2. The non conformities listed above are major alterations and will be eligible for acceptance by ANAC during the aircraft initial inspection, if they meet the criteria of IS 21.010A (httyliwww2.anac.Rov.br/bibliotecanS/IS%202 I -010A.odt), item 5.6. and MPR-900.04 (http://www2.anac.e.ov.bricertificacao/MPR/Textos/N4PR-900.04-004-P.pdf). 3. Please make reference to this letter on the Export Certificate of Airworthiness. Yours sincerely, • Eduaril Americo Campos Filho Manager, Continued Surveillance Coordination PROTOCOLO ANAC 00065.045227/2013.52 %line re Alm,. a• SDNY_GM_02754694 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241616 EFTA01261505 SDNY_GM_027.695 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241617 EFTA01261506 Greenwich AEROGROUP January 28, 2013 To Whom it May Concern This letter is to confirm that Edward J. Scully is a duty elected Vice president of Summit Aviation, Inc. and is authorized to execute and deliver in the name and on behalf of Greenwich AeroGroup Brazil Leasing, Inc. (the "Corporation") all documents and forms required by the Federal Aviation Administration in connection with the registration and deregistration of aircraft owned by the Corporation. erely, F. Kohler President & Secretary State of Connecticut County of Fairfield On this the 28th day of January, 2013, before me, Linda Appelbaum, the undersigned officer, personally appeared John F. Kohler, known to me to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. In witness whereof I hereunto set my hand. LINDA APPRIAUM Signature of 146tary Public ManPa Sam alOnioltut 31.2018 Date Commission Expires: ktiCamodstionEggsOman Greenwich AeroGroup, Inc. 975 Steamboat Rood www.areenwichaeroarouo.com Greenwich, Cr 06830 SDNY_GM_02754696 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_002416 IS EFTA01261507 SDNY GM 02754697 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241619 EFTA01261508 V•11OVUMS00 11.001 DEPNITLEN1OF TRANSPORTATION-RODIN. AMIN AMItizSTRAION STANDARD AIRWORTHINESS CERTIFICATE ul reaehAV SAVACTO.000.1006. I KNOAII Walt I CATI ICA• NI62AD I Satorsky S-76C 760472 763660.24 • ovIriartrotMid 444..“ ._salve. erns • rerun ea 5: •POPIIttiNg rOISPitintillf••••••••1•00tte. ••••••••••.0.01•••• • •••••0••••• Cosise•I••••••”•• swan rasa me wee bases O i /01•1,A6COIWOrett • enn• eft • to non ain't= • now• holt 41 al 4i. tr. Ras seauroppe0n • •••••• _pot oii ee.....4 /Mon PI NA IALSCIATOO Walt 10/21/1997 .FS120-25 fin ......a........ Area.. nay ;)•••••••••••••••4anna viti:retili WS, IRMA= • nt • ccop.:t ...waintetiowroomurera *1.4 Pon n»!3. • MONS rm.. WAN SDNYSA4_02754698 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00241620 EFTA01261509 •(.26 iSScf6,1 ocV/G/20t I SUFI GM 02754699 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00241621 EFTA01261510 on( Downer Of AViATC*4 ACIMISTWON STANDARD AIRWORTHINESS CERTIFICATE • ••••••ankin II162AL I Pular. AWO•yeFOR 01.0.110.41/4004 .0.•••••••••••••••••• ON MGM/ fa ste.amil Saadi .**. &can ••• ••••••••••• Oa r•Wee••••••••••••••+re. 0•110, SWAG, CSSOIMOniallt• R-10-21-1997 EA 3 -It .nrwrowearseinst - • es n's "swot+ %tn. t* (4.01A • I 61, ACCONOMitt mt. *Main 1.Oy. Ava, c0,CGAAtONS FAA Fenn 610:1•2 04n SDNY_GM":0757707" F TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15 EFTA_00241622 EFTA01261511 SDNY_GAl_02754701 1TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15 EFTA 00241623 EFTA01261512 UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION-FEDERAL AVIATION ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE I NATIONALITY AN D 2 MAHAFACTURERANO MODEL 3 AIRCRAFT SERIAL A CATEGORY REGISTRATION RAMS NUMBER N162AD Sikorsky S-76C 760472 Transport S AUTHORITY ARO BASS FOR ISSUANCE Pis smenNesu anima 'mei mesa • ti U SC VOW AU artin AA bdll dav cliparce.dy siva? /3 Ala mot Ns tan HAHool ib %c€ embn he two an hi tab. TT bi Meant' la us al Ton tow Arm inetaeloinutTli Oro pia* anpren:tirodesail "Ss tybalbN Cosorlocntreanstul0614166 acect as — rem 1.410000 NONE 6 TERMS AND COMYT.OHS Lau wow steam( fesitffit *en s Tantace600 remise WSW* TIN FAA. NT ~fees. Milks asnl knj is re antoura 6.36. AM argots n h KAMM .66 Pao 2I. al.al II d hirFAHTO atiSad Sus OATS OF ISSUANCE MOUTON MOUSER R-10/2111997 AEA-FSDO-25 MraWska. v.:awe.*nut.. al morn- OAS* Ty • sHadal Wew Rstiesi Te NOSS Stwna 346 mts CEA/SCAN MT BE DISGUYED tit ME WACCORSDICE M APFUCAHA FEDERAL AWASCII REGULATORS FM fin SIMI (04.11) Scant:eat Prevoa Edllon SDNY_GM_02754702 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241624 EFTA01261513 SDNY_GM02754703 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241625 EFTA01261514 DEPARTMENT OF TRANSPORTATION DATE: FEDERAL AVIATION ADMINISTRATION September 16, 2011 ROUTE SLIP TO: NAME ROUTING SYMBOL Aircraft Registry AFS-750 • ❑ Per your request ❑ For your information ❑ Per our conversation ❑ Note and return ❑ Discuss with me ❑ For your approval ❑ For your signature 0 Take appropriate action ❑ Comment ❑ Please answer ❑ Prepare reply for signature of REMARKS: Issued replacement airworthiness certificate for Sikorsky Model S-76C, S/N 760472, N I 62AD. Certificate issued due to Registration Number change from N162AE to N162AD accomplished 09/14/2011 per AC Form 8050-64 issued 08/17/2011. Attached are copy of replacement FAA Form 8100-2 dated R-10/21/1997 and original superseded Form FAA 8100-2 dated R-I0/21/1997. ROUTING SYMBOL AEA-FSDO-25 SDNY_GM_02754704 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241626 EFTA01261515 SDNY_GM_02754705 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024I627 EFTA01261516 IMITCOSTAWSOF Millerya TRATION N—FEDERAL AVIATION ADMINIS DEPARTMENT OF TRANSPORTATIO IFICATE STANDARD AIRWORTHINESS CERT • CATEGORY 000.31 SWUM MaTIOPIALITY ARO eitnr). FIGORTRAIXT4 BMWS A Vita 2 SIKOR `RANSP0RT N162AE AUTHOROYM40 6094 ton immat Oa IM /MO of Mora TM THeywoOnrimoil ihreka 6 be on twos*, lot WM malt I* rene• Woad and MOW amertHema COMM 00OraliOn.•04/Watean as IHOMad by Amer IV Emablant .t% NQ 6 lailMSAROCCROilsONS latis646 eV 136 AdnumityIor UnOSS SeOrei M and Orylari an polo/nod in ersOnNwnii tenoca 6,6r1: 46H6 Ltlwaya rafe.pnI.ednw Ualed riaMeamm OCCOrtteralisitsPans2I y Yaw DESIONATICW IMMOLP DAM OF PPINIPE P 'EA—TOO-61 R-10-21-1997 not Weed.' SI101c. unpmemnim Hareamelon03 tr.o• Hisysaogirmaen• ANLMFT IM 6O3O41O.Oia WITH APPLICABLE MEAN RHO alNralgn. rawodua BE CoSPCATIO IN Man 0.0011 litE CER114CAlt WET AVIATION REMOTIONS Y.S. arosool • 0044611 FM Form 8100-2 MCI VNITCO TTTTTT OF AMINRCA RAL AVIATION ADMINISTRATION DEPARTMENT OF TRANSPORTATION —FEDE STANDARD AIRWORTHINESS CERTIFICATE 3 RMISMI SCatat 4 CATT6OMV I. WATENUAITT I. MMof ACtUSCIt MID MOOCI. twitMR 6•4 NARKS •N152AE Sikorsky S76C 760472 ransport S. AUTHOMIT AM, /HMS ISM siSSIIANCE Me. Os N My l e Ndocel AyPsion AO el 1930 end wig.. einoolthinint wHifitere it isyMd pommel ie wer.icom loomed end bond se colony to the typo applicable dole of iis9oN. th• e;iroall le wIth lisped boo beesbet boo down la pro lti •••yopm sb N Me Mottles. to b. o comb Imn Ica woe otTembon, and by Abp. E to the Corpus M , Int.4441.9 41 Gni con.preboni... and aimmlod eimortkinass tecie at OPTION AsHatiya. wimp• os noted Immis loceries. None E. PI In WO CORP 1065 is ethemtior •nobliMed by IN Ad... ; T; TTT0, ..... I WHIR, seem. endoNd. staspipelod. rpobed. or o iltrairation dole my I the meintmenty. istvonlelim meinlononct end elIerobom 1 INs eirwoothloos, triiEspo ; i olloctly• en kw. as of IN Iodate, Ayierbio 17.1oboss. oi oporoymioio, end the patlenowill in octodemy HMI Pens V. 43, end 91 I PrinalI is noWsiwyd is IM POO Pesos. SiCal•II011MusleCII DATE Pt IMAM( 10-21-97 DAR NE200001AC • y bo 'thyblo by • by Nye ozysod49. II.000. 0. iw. Any yahHelien. memcbott6n. r inisys• el this 4 St BE DIOTATIO IN TNT AIIKRATT IN ACED'S. Prisoneoai nN 494voilkii 3 yaws. y• bet% I KAT . MKT WITH APPLICMItt IEDIRM AWATI (01./IATI FAA Fern 1100-2 ,7-47. FORM FAA FORM .36.3 9, 10, m2754706 SUBJECT TO PRO TEC TIVE ORD ER PARAGR APH S 7, 8, soNy_15,_0 and 17 EFTA_00241628 EFTA01261517 SDNY_GM_02754707 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241629 EFTA01261518 Form raftrAd OMB Ns 21204020 0 MAJOR REPAIR AND ALTERATION US Dmrsonol ot For FAA Ow Oak, Trampolaorn fades Minim (Airframe, Powerplant, Propeller, or Appliance) rico klenikobov AIIIMISSO INSTRUCTIONS: Print a 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 mated by Wm (49 U.S.C. 142t) Fakes to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act 1958) Mn moss Sikorsky S.76C 1. Aircraft 34viai NO. PalioNaly MP ROcreralto WO 760472 U.S.A. N152AE NOVO all Vail on orgrantron conks* Aetna Life insurance 151 Farmington Ave. 2. Owner Hartford, Connecticut 06156-0001 3 For FAA L , , n), a IAN ideraleekin 5 Typo lint Mae YDS WY MO REL.., 'dowry, AIRFRAME -Ms dnafbed in lam 1 ebdw) X POWERPLANT PROPELLER Tr:* APPLIANCE lArvoracTior a Conforney summon A. Agency's Mine rd Addend a Ant of /rotor C. Osnecal• NO Keystone Helicopter Services U.S. Candid miasmic Airframe Class 3 1420 PhoenIxWIle Pike West Chester, PA 19380 H reeenc.nired mochank Candied Repair Paton stawlscharm Radio Class I e 2 CRS EGRRS26D Limited Accessory 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 requkoments of Pad 43 of the U.S. Federal Aviation Regulations and that the information liimi,thed herein is true and correct to the best of my knOvidedbe. Date $9540000t rorostan Intimdual December 29. 2006 Jerry Smedley rYl....2.(1.121.4/ T. Approval for Return DO Seneca Pursuant to the authority given persons specified below, the unit Identified in item 4 was inspected in the manner prescribed by re Administrator of the Federal Aviation Administration and is 0 APPROVED O REJECTED FAA Fx Standards Der Mow • O Ilanufaceser O Inspection Authorization BY AIWA lOr o FAA Designee Er/ Repair Sutton O Person Approved by Transport Canada kmorthiness Grow OM al ApprovalCr Roma+ *mikes, a waive or ilitiontod Is3vddai Cimeneton No. DMCOMber 29,2006 CRS EGRR526D Edward H. Waterland 4- 24-9-7 ( -.. . J FAA Fine YR (1246) SDNY_GM_02754708 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241630 EFTA01261519 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. 6. Description of Work Accomplishad Of more space Is rewired. attach &Owned sheets. Identify with aircraft nationality andregistration mark and date work completed.) Model : S-76C Date : December 22, 2006 Serial No. : 760472 Keystone Helicopter Services performed Modification of Tail Pylon Aft Spar in accordance with Sikorsky Customer Service Notice 76-220A, Part 3, cold work fastener kit part number 76070-20564-011. Replaced the tail boom vertical fin aft spar web upper section with new part number 76070-20562-122. Replaced vertical fin aft spar left hand side strap angle part number 76080-20046-101 with new part number 76201-25002-111. Replaced vertical fin aft spar right hand side strap angle part number 76080-20046-102 with new part number 76201- 25002-110. Keystone Helicopter Services repaired the Ft/H pylon forward fairing in accordance with Alert Service Bulletin 76-55- 16A. The aircraft weight and balance has been updated. Refer to Keystone Helicopter Services work orders H01194-2 for details of work performed. 0 Additional Sheets are attached SDNY_GM_02754709 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241631 EFTA01261520 U.S. Department ii) Tronzoonazon MAJOR REPAIR AND ALTERATION For FAA Use Only Firearm Aviation (Airframe, Powerplant, Propeller, or Appliance) Office Wentif.cation Acninisustion INSTRUCTIONS: Print or type al 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 is regured by law (49 U.S.C. 14211. Failure to report can result in a civil penalty not to exceed $1.000 for each such violation (Section 901 Federal Aviation Act of 19581. Make Model SIKORSKY S-76C 1. Aircraft Serial No. Nationality and Registration Mark 760472 NIS2AE Name lAs shown on registration certificate) Address (As shown on registration certificate/ 2. Owner Aetna Life Insurance Co. 151 Farmington Ave. Hartford, CT 06156-0001 3. For FAA Use Only ma ../ REOur ----- A rirkiEwrsAND 1B62iffFII3 ED HEREINscED ABLE A1RWO NESS DESCRIBED AIRCRAFT SUBJECT TO A °C ON!:F UO9S R THE WIMI ABO TIVIT CONFO INSPECTION BY A PERSON AUTHORIZED IN FAR SECTION 43-7 N /-O 4. Un ant 6. Type Unit Make Model I ‘. Serial No. Repair Atieration AIRFRAME (As dactilaidIn hem I above 3OOC POWERPLANT PROPELLER Type APPLIANCE Manufacturer 8. Can Ginty Statement A. Agency's Name and Address B. Kind of Agency C. Certificate No. U.S. Certified Mechanic 7715R223N VIP AERO INSTRUMENTS AND AVIONICS Foreign Certified Mechanic 68 LINDBERGH DRIVE x Certified Repair Station HA ciTFORD, CT 06114 Manufacturer D. I certify that the repair and/or alteration made to the uni (a) 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 Signature of Authorized individual 0/y0% al°wS-4 1 11 7. Approval for Return To Service Pursuant to the authority given persons specified below, the ure'identified in item 4 wa* Inwood in the manner prescribed by the Administrator of the Federal Aviation Administration and is A, PPROVED REJECTED 0 FAA Flt.Standerds Other ISPecify) Manufacturer Inspection Authorization Inspector BY Person Approved by Transport FAA Designee X Repair Station Canada Airworthiness Group Date of App al or ' ction Certificate or ignature of Allhorized Individual Designation No. TH5R223N 14.--A-----/ /O / Pi FAA Fo 337 SDNY_GM_02754710 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241632 EFTA01261521 NOTICE e Weight and balance or operating limitation changes shall be entered In the appropriate adorer record. An alteration must be compatible with allprevious alterations to assure continued conformity with the applicable airworthiness requirements. •• 8. Oestaiption of Work Accomplished (f/more space is required, attach additional sheets. Identify with Aircraft nationality and registration math and dare work completed., 1- Removed the following equipment: Global Wolfsberg Flight Phone VI system consiting of RT-18D receiver transmitter, FF VI antenna, C-118 cockpit dialer and WH-I0 cabin handset. Removed Sikorsky Rotor Craft Flight Manual Supplement NO. 102 for operations of FLIGHTFONE VI System. 2- The equipment identified in the following steps was installed and tested in accordance with AC43.13-1B, chapter 4, para. 50 thru 62, chapter 10, para. 14, 16, 19, 20 & 21, chapters 11 para. 7, 8, 30, 31, 32, 37, 38, 47 thru 263, Chapter 12 para 1 thru 38 and AC43.13.2A, chapters 2 pan 21 thru 28, chapter 3 para. 37 thru 44, chapter 11 para. 211 thru 214, and chapter 13 para. 261 thru 263 when applicable. 3- Installed an Iridum Satellite Communication System consisting of the following: - International Communications Group ICS 100 p/n: 500616-2 Iridium Transceiver providing cabin and cockpit station intercom and phone operation. The ICS 100 transceiver is located on the aft avioincs bay equipment shelf at station: 265.0 - ICG Iridium Antenna p/n: 500644-1 installed on tail boom at station: 519.0 in accordance with Sikorsky antenna installation drawing number 33776-64681 sheets 1,6 and 14. - ICG Sigma 7 handset p/n: 500905-20-02-1 installed in cabin at same location as removed WHIO handset in aft center cabnet at station 204. The Sigma 7 handset is wired as SAT Phone station 13. - Northern Airborne Technologies FTAI2-100 cabin dialer with Bose Series X noise cancelling headset The PTA12-100 cabin dialer with Bose Series X noise cancelling handset is wired as SAT Phone station 12. The PTA12-100 Cabin Dialer is located in the cabin RH forward facing arm rest at station 198. - Northern Airborne Technologies PTA12 cockpit dialer for crew operation. The PTA12 cockpit dialer is wired as SAT Phone station II. The PTA12 Cockpit Dialer is located in the center pedestal at station 103. All wiring was accomplished in accordance with VIP Avionics, Inc. wire drawing ft: 2006W0001 Rev - dated 10/17/06 Sheets I thru 3. The drawing was DER approved on FAA form 8110-3 dated 10/20/06. Installed placard on both sides of aft cabin cabnet near Sigma 7 handset " TO CONTACT PILOT REMOVE HANDSET FROM CRADLE PRESS ON THEN DIAL 1!" VIP Avionics, Inc. Iridium Sat Phone Rotorcraft rators Guide dated 10/30/06, ICS 100 Users Guide p/n: 501330-UG, igma 7 Handset Users guide p/n: 500114 Rev F, PTA12 Operators Manual Rev. 1.10, PTA12-100 Operators Manual Rev. 1.0 and Seat Back Card p/n: 500024 rev. A were placed in the rotorcraft. INSTRUCTIONS FOR CONTINUED AIRWORTHINESS: Annually or every 100 hours end of page 1/3 - continued on next page... do Additional Sheets are Attached SDNY_GM_02754711 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241633 EFTA01261522 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. a. Descdption of Work Accomplished (IImore space is required, attach additional sheets. Identify with Aircraft nationality and registration mark and date work completed.) inspect for insecure mounting. The ICS 100 system maintenance is on the condition of failure. There is no required maintenance. Suggested maintenance and troubleshooting proceedures are covered in the Installation manual number 501330 rev I or later in the manual section, Testing. 4- Installed a I I5V AC 60 HZ cabin power system consisting of the following equipment: - KGS Electronics HS-50 SOOVA 115V 60 HZ static inverter provideing 115V AC 60 HZ power to the system. The HS-50 static inverter is located on the aft avioincs bay equipment shelf at station: 263.0 - Levitron 8590-W Ground fault Isolater to provide ground fault isolation to the two cabin 110V AC recepticles. The 8590-W GFI is located on a fabricated mounting bracket next to the HS-50 static inverter on the aft avioincs bay equipment shelf at station: 256.0 - Two Hubbell HBL5258 AC Outlets to provide up to 4 amps of AC power for portable accesory utilization. The HBL5258 AC Outlets are located on the right and left side forward facing cabnets at station: 184.0. The outlets are placarded "110VAC 60 HZ 4 A MAX". - A MS24658-23D Lever Lock SPDT Switch connected to a M83536/6-025 remote relay to interupt power input to the HS-50 Static Inverter. The MS24658-23D switch is located at station 101 on the RH side of the pedestal and labeled "CABIN 110VAC 60HZ / OFF". The M8356/6.025 relay is located on a fabricated bracket just forward of the Aft AC junction box at station 272. All wiring was accomplished in accordance with VIP Avionics, Inc. wire drawing ft: 2006W0002 rev - dated 10/17/06 Sheets 1 thru 2. The drawing was DER approved on FAA form 8110-3 dated 10/20/06. INSTRUCTIONS FOR CONTINUED AIRWORTHINESS: Annually or every 100 hours inspect for insecure mounting. Annually or every 100 hours the Ground Fault Isolater (GPI) should be tested. With the aircraft running on the ground test the GFI by pressing the button labled TEST. The RESET button should pop out indicating a succesful test. Pressing the RESET button re-arms GFI for use. If the GFI reset button fails to pop out when the TEST button is pressed the GFI should be replaced. The SS-50 system maintenance is on the condition of failure. There is no required maintenance. See KGS Electronics Removal/Installation manual DWG No. 112106 rev. F dated AUG 03 2003 paragraph 2 E for ICA and removal and installation instructions. 5- Systems are protected by circuit breakers whose value are listed in the approved wiring drawings and labeled accordingly. All wiring was done IAW AC 43:13-la, ch. 11, sec. 3 thru 7. An Electrical Load Analysis was accomplished and recorded on VIP Avionics, Inc. Document Number 2006R0001 Rev - dated 10/18/06. The Electrical Load Ahalysis Addendum meets the requirement of I4CFR part 29.1351(a)(1). 6- All systems were tested per manufacturer's detailed check out procedures and all systems checked out satisfactorily. EMI/RFI tests were succesfully end of page 2/3 - continued on next page... ty Additionil sheets are Attached SDNY_GM_02754712 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241634 EFTA01261523 SDNY_GM_02754713 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241635 EFTA01261524 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 0/ more space is required, attach additional sheets. Identify with Aircraft nationality end registration mark and date work completed.1 completed per VIP Avionics, Inc. EMI/RFI Test Proceedure document number 2006R0002 dated 10/26/06. 7- Equipment list and weight and balance revisions have been entered into the aircraft POH. Aircraft log entries have been made. ❑ Additional Sheets are Attached SDNY_GM_02754714 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241636 EFTA01261525 SDNY_GM_02754715 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241637 EFTA01261526 r A Form Arosnoved 0148 No 1I10CC20 0 MAJOR REPAIR AND ALTERATION .., S Conan,. ti For FAA tht• Ont., •,...,........ (Airframe, Powerplant, Propeller, or Appliance) ran ... Adaird'enik. AltliilIDO-17 81R INSTRUCTIONS: Print or type al entries. See FAR 43.9. FM 43 Appendix B. and AC 43.91 (or subsequent revision thereof) for instructions and disposition or this form. TNs report is required by law (4gu S.C. 1421) Failure to report can result in a civil penalty rot to exceed $1.030 for each such violation (Section 901 Federal Aviation Act 1958) UAW MoStl Sikorsky S-76C I. Alityaft UN. No. N•taNatY AM APPAPAPP0 Mani 760472 U.S.A. N152AE ewe (As Plow, an wand= cerate.PV Metes Pao WYPPI an reparscon celAcAM Aetna Life Insurance Co. 151 Farmington Ave. 2. Owner Hartford, CT 06156-0001 3., For FAA Us. No, 4. Unit kIentescatIon S. Typo Unit UNA Model Wu, No. Artue.co AIRFRAME (As described In Item f above) X POWERPLANT PROPELLER 'hos APPLIANCE MarvIscanr I. Conionnity Sisheraet A. AO.PCys Name 460 Address a tow a Agency c. cent NO Keystone Helicopter Services — at coarse mousinit Airframe Class 3 1420 Phoenixville Pike Foreign Craned Mechanic Radio Class 182 West Chester, PA 19380 (! ewe's, Repair Melon CRS EGRRS281) ..„ 1444444Clurer limited Accessory 0. !certify that the repair and/or alteration made to the units) 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 k creamily. Darn Slin•lie• a matrixes 054.4444 2 June 2004 Christopher A. Macario e 0,42T sthe- 4.-, .20Ar.ar, _.) 7. APProval kw Rheum 10 Service Pursuant to the authority given persons speofie4 below. The unit identified in Bern 4 was Inspected in the mamer prescnbed by the Administrator of (2)e Federal Aviation Administration and is C8) APPROVED 0 REJECTED MI FM RI Standards O Manulactwer O Irmectica Aul/exitatan EXhat (Sper.41 ev inspector O FM Designee 0 Repay Susan O Person Append by Transport Canada Airworthiness Group Dino pl span' itit R*aen Genital* or Spume al Atasewed intilwerat Clesierutdon No. 2 June 2004 CRS EGRR526D David Druce -ala 4.4, ) Ci ti.t.,“,......._ FAA Form 337 (12418) SDNY_GM_02754716 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0O241638 EFTA01261527 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compaitftriatE tcrvious alterations to assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished (If mom space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.) Model : 5-76C Date : 6-2-2004 Serial No. : 760472 Acft Total Time :4226.3 hrs. Keystone Helicopter Services installed inspection panels on the left and right hand side of tailboom vertical fin in accordance with Sikorsky Customer Service Notice 76-207C. An aircraft actual weighing has been performed and equipment list updated. Refer to Keystone Helicopter Services work order G03972 for details of work performed. — END 0 Additional Sheets we attached SDNY_Ghl_02754717 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241639 EFTA01261528 3«S - iii, us OCOVIIIN 01 MAJOR REPAIR AND ALTERATION .._ ., (Airframe, Powerplant, Propeller, or Appliance) MAY triseano020, - ilfkni For FAR US4 0414 lansixibUn hderMAAmbn Maditsimbn • L--- , n 1 n . , _ , ry 3 INSTRUCTIONS: PAM nth,* all "Pries. See FAR 43.9. FAR 43 Appendix B. and AC 4341 eSimiecrice15 -41ei ixacijlounstructiOdr— and disposition of tis Joon Pis rant it regained by Inv (40 U.S.C. 14213 Failure b MOW Can main a eke Franey not to mooed $ 1.000 • ter oath such violation (Seceon 901 Federe0M44401AD 1958) • Wks Model • SIKORSKY S76C 1. aJrctah Serial No. Nationality and Ftegetration beam 760472 N152AE Name (As Moaner, reeislialicocertnicale) Address Old thOW/1on regismion ceetittcale) 2. Owner AETNA LIFE INSURANCE COMPANY 151 FARMINGTON AVE HARTFORD, CT 06156.0001 3. for FAA Use Only 4. Untl Idantiecation 6. Type unit Make Modet Serial No. Repair Aderalion AIRFRAME (As described in item 1 above)------ X POWERPtANT PROPELLER T)po APPLIANCE Manufacturer 6 Conformity Statarent A Agencys Name end Address B. Kind of Arpricy C Cartificate No JOHN KEATING GI U.S. Corned methsne AP46641737IA 168 EAST HILL ROAD O Foreign Garbled Mechanic CANTON. CT 06019 O tamed Repair Stabon O Manufacbser D. I cents that to repair sober alteration made to the en(s) dentine:lin nom 4 above and described on the reverse or ettactreete$ here* hoe bean made in accordance with the requirements of Part 43 of the US. 4000* AviattOn Rogreations end that the information Nmished In, Is eta and Maga 10 Ma best of my knowledge. Data Signature of Authorded Incavidgai 05125/2003 ) 7. for Return to Service Punuant to the authority given persons wedded below. the unit kknelle2 In item 4 was inspected In the manner presorted by the ACInsmilralge a to Federal Asiabon Admnistraton and is El APPROVED 0 REJECTED FAA Fit Standards PAsnulacturer 141401:60n AUth047.4:01 Coat (Spec Inspector X BY FAA Designee Repair Station Person Approved by Tramped Canada Ainver1tmen Group Data tat Approval or Rejecton Cakficate of Signature:[4Zatred Individual 05/25/2003 Oismanalitm No AP46641737IA 944441 FAA Form 337 (1244) SDNY_GiA_02/5.4718 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241640 EFTA01261529 NOTICE weight and balance a operating limitation changes shall be entered in the appropnate aircraft record. An alteration must be. compatible with aft previous alterations to assure continued conformity with the applicable airworthiness requirements. 8. I/ascription of Work Accomplished (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date MOM completed) 0326/2803 SIKORSKY NI52AE SIN 760472 TOTAL TIME 3722.9 HOURS Installed Eaton Aerospace Zapper Pulsed Engine Chip Detection System I K7707 in accordance waft STC ISR01472NY dated 03/08/2002. Modified existing engine chip detection system to allow non-cntical slivers of wear fuzz to be pulsed away. Instated two channel power module. Chip Pulse switch, and Chip Detector test switch. Wired system and performed functional test. All work done IAW instuctions of STC. See attached for Instructions for Continued Airworthiness. FM Approved Rotoraaft Flight Manual Supplement a FM00508 inserted in Flight Manual Airaaft Weight and Balance change is negligible. il ialltadilShileb.An Altietild U.S.C.F43:1989-0-663-P7I SDNY_GM_02754719 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241641 EFTA01261530 INSTRUCTIONS FOR CONTINUED AIRWORTHINESS FOR THE EATON AEROSPACE, ENGINEERED SENSORS/TEDECO PRODUCT S ZAPPER® PULSED ELECTRIC CHIP DETECTOR SYSTEM 1K7707 ON SIKORSKY HELICOPTER MODEL S-76 EATON/TEDECO ZAPPER'' SYSTEM 1K7707 DOCUMENT 1K7707 I.C.A. SONY GM 02754720 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241642 EFTA01261531 SDNY_GM_02754721 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241643 EFTA01261532 1K7707 I.C.A. Rev: -- Maintenance Requirements — Instructions for Continued Airworthiness Manual 1K7707 I.C.A. Introduction 00-00.00 Modification of an aircraft by this Supplemental Type Certificate obligates the aircraft operator to include the maintenance information provided by this document in the operators Aircraft Maintenance Manual and the operators Aircraft Scheduled Maintenance Program. Maintenance manual information — system and component descriptions, testing, troubleshooting, inspection procedures — is contained in this EatonfTedeco document, and should be placed into the operators appropriate airplane Maintenance Manual. This document includes part numbers and supplier information for line replaceable units (LRI and for the fasteners used in the installation of the Zapper System. This II • • info tion should be placed in the aircraft operator's appropriate Illustrated Parts catalog. • I•1 , urnent also includes wiring information for the Zapper System. This information "du be bladed in the aircraft operators appropriate Wiring Diagram Manual. , • • • s ons and recommended periodic checks are also included. These inspection ,23requir ems should be added to the airplane operator's Scheduled Maintenance lPog' is 1 I . ,I .! : • • • LI •I • Ilk i I; Jamul 21.2002 Eaton Aerospace Engineered Sensors/rodeo° Products 24 Easl Glenolden Avenue 198 W: SDNY_GM_02754722 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0241644 EFTA01261533 SONYGM02754723 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241645 EFTA01261534 1K7707 I.C.A. Rev: --- Airworthiness Limitations Section 04-00-00 No Change Inspections Section 05-10-00 Test the zapper chip detector system every 500 hours of service or every 6 months, whichever comes first. See Testing and Troubleshooting section of 46-50-00. Scheduled maintenance on engine components of the system remain unchanged. Servicing 12-00-00 The manufacturer recommends following the Testing and Troubleshooting section of 46-50-00. For additional assistance or information, please contact Eaton Aerospace. Information Systems Chapter 46-50-00 Description and Operation A pulsed chip detector system is provided for each engine. (See figure 1.) The system includes one or two chip detectors (cd) on each engine, relays on No. 1 and No. 2 relay panels, a two-channel Zappers power module (zpm), a CHIP PULSE switch, a CHIP DET TEST switch, and two caution indicators on the IIDS or the caution/advisory panel. The, system enables the pilot to pulse away nuisance debris on the cd in either engine. The two-channel zpm is mounted overhead in the cockpit, the CHIP PULSE and CHIP i DET. TEST switches are on the console or instrument panel, within the pilot's reach, and : bothiare connected to the engine relays, to each engine cd, and to the IIDS or • .i. 't luti 'r ' advisory panel. 4 I .. See' gurei 2.) When debris closes the chip gap of a cd, it completes a ground circuit to I l' :• he coriesponding channel in the zpm and thru the relay panel output of the zpm to i erateirelay ill K4 • , or K8 in the respective engine relay panel. Twenty-eight-volt do is ii: connected ,to the other side of the winding through normally closed contacts of the CHIP l' PULSE switch. The relay closes a circuit to light the associated caution indicator. The relay also self-latches. WhenI-,the cHip, PULSE switch is set to momentary position ENG 1 or ENG 2, a set of contacts connects a ground to the pulse switch input of the zpm and a 28-volt pulse is applied to the chip gap. The pulse is the charge from a large capacitor in the zpm. If the chici is Pulsed away, the caution indicator will go off after the applicable ENG CHIP DET ci ,cuit breaker is cycled to open the relay latch. If the chip is not pulsed away, the cautioniindicator will remain on after the ENG CHIP DET circuit breaker is cycled. • I,i January 21, 2002 Eaton Aetoepace Engineered Sensca/Tedeco Products 2 24 East Glonolden Avenue GlencIden PA 1 210a fu SDNY_GM_02754724 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241646 EFTA01261535 SDNY GM 02754725 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 I EFTA 00241647 EFTA01261536 1K7707 I.C.A. Rev: --- A momentary CHIP DET TEST switch connects a ground to the chip detector circuit to simulate a chip. If the chip detector circuit is operating properly, when the test switch is set to the momentary position and released, both engine caution indicators come on and remain on until both ENG CHIP DET circuit breakers are cycled to release the relay latches. After the ENG CHIP DET circuit breakers are cycled, both caution indicators will go off. The system discriminates between debris particles which are large enough to be associated with engine failure and non-critical slivers of wear fuzz. Stored energy from a zpm will pulse away debris of 0.001-inch diameter and smaller. Debris larger than 0.003-inch diameter will not be pulsed away and the caution indicator remains on. Power to operate the Zapper. function of the system is obtained from the CHIP PULSE circuit breaker. Power to operate the relays is obtained from the ENG CHIP DET circuit breakers. Power consumption is 3 watts maximum. On each engine, magnetic plugs without electrical indication are fitted to module 1 or to module 5. They are installed outboard for easy access depending on engine location. Refer to the applicable Arriel Turboshaft Engine Maintenance Manual, Magnetic Plugs, 72-80-04 for description and maintenance procedure. January 21.2002 &Ow Aerospace Engineered Sensortiladsco Products 3 24 East Menage) Avenue Glenola 2196 tot: floc ' SDNY GM_02754726 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241648 EFTA01261537 SONYGMJ)2754727 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 1 EFTA 00241649 EFTA01261538 1K7707 I.C.A. Rev: --- I Com nent Descriptions A. Zapper® Power Module (ZPM) The Zapper® power module (zpm) is a two-channel control device which senses nuisance debris on a chip detector (cd) and provides a calibrated electrical discharge to pulse away the debris. The zpm is mounted overhead in the cockpit, typically just aft of No. 2 relay panel, and is secured by four screws through mounting flanges. Miniaturized solid-state circuitry is enclosed in a cast aluminum box. The zpm has two connectors, one for each engine chip channel. B. CHIP PULSE Switch The CHIP PULSE switch is a lever-lock double-pole, double-throw center-off momentary switch in the pilot's compartment. The switch connects a ground to activate the pulse switch circuit on the zpm. C. ' CHIP DET TEST Switch The CHIP DET TEST switch is a momentary double-pole, single-throw switch in the pilot's compartment. The switch is activated to connect a ground to both chip detector circuits to simulate a chip for system testing. D. Chip Detector Each magnetic chip detector (cd) consists of a magnet with a chip gap. One end of the magnet is covered with a conductive sleeve, connected by wire to a terminal on the connector. The other terminal is connected to ground. Debris retained by the cd closes the circuit, and activates the ENG CHIP caution indicator for the engine. E. Relays No. 1 engine chip detector relay K4/1R is on No. 1 relay panel and No. 2 engine chip detector relay K612R is on No. 2 relay panel, overhead in the cockpit. Electrical power is applied to the relay winding when power is applied to the helicopter and the circuit breaker is closed. However, the electrical ground necessary to energize the winding of the relay is provided only when debris on the cd activates the circuit on the corresponding zpm channel. The relay, when actuated, lights the respective ENG CHIP caution indicator and latches on until the debris is pulsed away by the pilot and the applicable ENG CHIP DET circuit breaker is cycled. For relay removal installation, refer to No. 1 and No. 2 Relay Panel Typical Relay — Maintenance Practices, 39-40-04 and 39-40-05 in Maintenance Manual SA4047-76C-2 or the applicable Arriel Maintenance Manual 77-44-00. January 21.2002 Eaton As* Encirmand Sensonflonaco Procluols 4 24 East Canoldan Avenue Glanoklen, PA 19098.219E IN: tax: EDNY_GM_02754728 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241650 EFTA01261539 I SONY_GM02754729 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024165 I EFTA01261540 r 11(7707 I.C.A. Rev: --- "-I Me AI/I/1N DIM /PAN tio 216LWI — MOW —a /AMA f h/IH i J i OOPPUJO I 14 CNA OETECTOA TYPICAL CAUTION NOICATORS IMOKTIC OAP PLAG TYPICAL No. 1 AND HA 2 ENGINE NOTE: IN SOME ENGINES, A SECOND CHIP DETECTOR IS INSTALLED IN PLACE OF A MAGNETIC CHIP PLUG. Figure 1. Zapper Pulsed Engine Chip Detector System — Location Diagram January 21. 2002 EaIon Aerospace Enpineesed Sentersgedeco Products S 24 East Glenolden Avenue Giencedan, PA 1903134196 %IC SDNY_GM_02754730 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241652 EFTA01261541 SONY GM 02754731 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024I653 EFTA01261542 1K7707 I.C.A. Rev: --- A..O1 IHAAA 11O747 OW RAH HRH KINAIMII CAA001. Imof LOLA al COVEN MADI, .191.3. ISA I CHO. S PAHL 0.e 4 0•010. ANNL/A. HIC OH ?- 41 0101 2' 9—P 2'94 9- 41f 061 li•-•1• Al'', A Figure 2. Zapper Pulsed Chip Detector System — Simplified Schematic li January 21.2002 Eat*, Atortapaco Enphearad Sansas/Taclaco Prcducts 24 Eam GlanoMen Avows A 1 2198 10A SDNY_GM_02754732 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241654 EFTA01261543 SDNYGM02754733 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 I 655 EFTA01261544 IS lb IS U iipg 00913i"? 0 la DCPPIMOnl ed F. TrirapMaim AstIlen MAJOR REPAIR AND AL- (Airframe, Powerplant, Propellei TION Pan nc-ei 2ii iii • fi l.ii4 FAA Use ONy Naga A0440MIlibet gr eD3 INSTRUCTIONS: Print a type all entries. See FAR 43.9, FAR 43 Appendix Et. and AC 499-1((a on subsecoent reviSiOn See trucdons and cSNOsitico of tres lorm. This report 8 reared bylaw (49 U.S.C. 1421). Failure 10 penally noL e 51,000 toe each such violation tSecdon 901 Federal Aviation Ad 1950) WINDSOR L6CKS FS Make Model Sikorsky S76- C+ I. Aircraft Serial No Nallonafily and Registration Mark 760472 N152AE Name (As Marmon reperrafion coridcale) Address (As shown on misfradon opet/cale) 7. Owner Aetna Life Insurance 151 Farmington Ave. HanlOrd, CT. 06156 'ATTN. Plinht rgarationel 3. For FAA Use Only 4. Unit Identification 5. Type Unit Make Model SartalNo. Repair Alterawn AIRFRAME -------..-----(As described In Item f above}....---- X POWERPLANT PROPELLER Type APPLIANCE Manufacturer 6 Conformity Statement A. A9011415 Name and Address 8. 11 nd of Agency C. Certificate No. Shawn Landry CS uS. Certified Meduric A&P 46701613 19 Monroe Rd. 0 Foreign canoed Mechanic Enfield, CT. 06082 O Certified Rear Station O Manutactwer D. I cenily mat the repair andier aeration made to the urd(s) identried In item 4 above and described on the reverse or attachments hereto have Nen made in accordance with Ow requirements 01Pan 4301 the U.S. Federal Aviation Rogulatens and MO the intormatien furnished herein is true and correct to the best of my knowledge. Dale Signature ol 'zee troivkki i t 12/27/01 , 2...6 T. Approval for Return to Service AO/ Pursuant In the autharity given persons specified below. M isel Warmed in tem 4 WA, Inspected In ihe manner Neeraibed by the Administrator of IN Federal Aviation ocminiskaeon and is 0 APPRONO 0 REJECTED FAA RI Standards Llanulaclurer impeoion Autncention Omer (SPedfY) Inspector X BV FAA Designee Repay Slake Person Ad9rOved by Trat" G" Caw% Abwerthiness Group Des Cd lasersal a Astectioe Cosficale or %paha ol Aullatted In6W4wal 12/27/01 Oesionalion No. IA 91543730 Ca.: FAAFarmS.17 (1aise) SDNY_Gtv1_02754734 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024I656 EFTA01261545 — . t: (1 ( 7 1 r -I • NOTICE record. M aiteratiOn must be Weight and balance or agenda; Emitatton dap, shall be ;tiered In the appropriate aircraft requirements. compatible with en previats alterations to assuretedgfinuect conformity with the applicable airworthiness a. Description of Wort4te9q02ells.W1.1 I c•evarir %nit. mark and date work completed.) (If more space is ramified:0aqkericItietial sheeis,.tdonti& Mth aircraft nationality and registration The laming work was accomplished on 12/28/01: KeyTech installation drawing list no. IDI..00202 dated Installed Keystone Helicopter S78 split tail rotor gearbox cover in accordance with November 9. 1998, and Keystone STC no. SA00919NY dated December 18, 1998. repot 1000202 Dated February 19, 2001. (Attached) Inflictions for continued aimorthyness wal be carried out In accordance with KeyTech Weight and balance change is negligible. END .404013.19,Ws Me A.IJOIOCI US.C9O:1989-0461471 SDNY_GM_02754735 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024I657 EFTA01261546 poi tea Atoka of Juntrita eparintent of Ignmsportation get:tail jthinfiett ganninisfrniion $upplentental Zgpz antificatt dreelniee n SR00919NY l9 a`t nnGjtrh<Yv w>"4 Keystone Helicopter 1420 Phoenixville Pike Westchester, PA 19380 06441s4tat440,rarz,440rI a410.1/ 4,444eLa w netrielWat'LAdel a441Ceavased,y4lea4 revitrainereonna•aft14 al.voone4sauerekentave tar' 294,44 Federal Aviation ..430aaas 6"*Nreaverake—.54.. reneAradra-,thses... HINE SIKORSKY S76A, S76B, and S76C grasoyelaiv,t4;40§7arejay ridrajow The modification of the tail rotor gear box cover in accordance with KcyTech Installation Drawing List No. IDL00202 dated November 9, 1998. Seirraneonral aside*/ AI: 1. 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 the certificate to alter the product, the holder shall give the other person written evidence of that permission. ealkearito enea .vyro Zi bf AdeArallitte ae l anal:v.~4ndatarnided noweatio.• a tewhimgGo.sa. aaN Sanoleasiai. A V iAGra./goallevs. &EMI* 05eyaddricies : October 07, 1998 2irl•atemeate: §Fr...yokucar.w. : December 18, 1998 &frau/noeka42e: didnemyennas. (SIgnehire) Vito A. Pulera Manager New York Aircraft Certification Office (711k) My .l tors on of te core IO•t• Ispun she • by a (inn ornoolIng SI, 009. Or loptlassat an exceeding 3 roars, or ben. eta age I et I This corellicom any b transferrer In moon:4m* via tm 11.47. SDNY_GM_02754736 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 1658 EFTA01261547 SDNY GM 02754737 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241659 EFTA01261548 ‘11/st yi -echo. ENGINEERING DEPARTMENT Report No. IC00202 Title: Instructions for Continued Airworthiness for Sikorsky S76A, B, C Two Piece Tail Rotor Cowling i REV. B Prepared by: Kevin G. Kurtz Approved by: Date: February 19, 2001 1420 Phoenixville Pike West Chester, PA 19380 SDNY_GM_02754738 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024I660 EFTA01261549 SDNY GM 02754739 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241661 EFTA01261550 KEYTECH Report No. IC00202 Engineering Department Page 2 Subject_ Date February 19, 2001 Rev. B Prepared by: K. G. Kurtz REVISION CONTROL PAGE Rev. Pages Description Approval Date Level Affected -- ALL ORIGINAL RELEASE J. Munda 05-06-98 A 4 Added note for pilots inspection under J. Munda 02-28- Preflight Check. Removed 25 & 50 2000 hour inspection interval. Increased requirements for 300 hour inspection. FAA Minor Change B 4 Revision level and date on pages 2 thru 4, 0 ,,,,, 02-19- 4 did not match cover sheet. 2001 FAA Minor change SDNY_GM_02754740 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241662 EFTA01261551 SONY_GM_02754741 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241663 EFTA01261552 KEYTECH Report No. IC00202 Engineering Department Page 3 Subject_ Date February 19, 2001 Rev. B Prepared by: K. G. Kurtz REFERENCES 1. FAR part 29. 2. KHC Installation drawing list IDL00202, current revision. SDNY_GM_02754742 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 166=1 EFTA01261553 SDNY_GM_02754743 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241665 EFTA01261554 :'2 00 KEYTECH Report No. IC00202 Engineering Department Page 4 Subject_ Date February 19, 2001 Rev. Prepared by: K. G. Kurtz 1.0 SUMMARY: This report addresses the inspection requirements when Keystone Helicopter Corp's. Two piece Tail Rotor Cowling is installed in accordance with ref. #2, KHC's installation drawings. These instructions show compliance with FAR part 21.50(b). 2.0 INSPECTION SCHEDULE 2.1 PREFLIGHT CHECK Visually check the cowling for condition and security. The pilot will determine that the exterior preflight check has been done before the first flight of the day or before the next after extended maintenance. 2.2 300 HOUR INSPECTION Perform all checks described in section 2.1. Inspect attachment points for corrosion, hole elongation, cracks and security of ejector springs. SDNY_GM_02754744 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024)666 EFTA01261555 SDNY_GM_02754745 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241667 EFTA01261556 sr a 9-00616 099. 9 eve w U.S. Otpseenentel MAJOR REPAIR AND ALTERATION PamPamPred OMB No. 2120-0020 For FAA Use Only LtiCh Tneuronason (Airframe, Powerplant, Propeller, or Appliance) fleas seam j k .. . 411; /*Mikan .... --) AsYssisshlreloiss 0 s— ED t INSTRUCTIONS: Print or Noe el entries. See FAR 43.9, FAR 43 Appendix B. end AC 43.9-1 (or subsequent revision thereof) for Instructiccs and disposition of its form. Tres repeats required by law(*) U.S.C. 1421). Falu, to report can result in a civil penalty not to exceed S1.000 for each such videlicet (Section 901 Federal Aviation Ad 1858) Make Model Sikorsky S-760+ 1. Aircraft Segel No. Nationality and Registration mars 760472 N152AE Name (As sham on repssaration certificate) Address (As them on resisfrosion otolika(e) 2. owner Aetna Life Insurance 151 Farmington Ave. Hartford, CT 06156 (ATTN: Flioht Operations 3. For FAA Use Only 4. Unit Identification & Type Unit Make Meal Sethi No. Repair Alterallin AIRFRAME (As describedIn Item 1above)---- X POWERFIANT A ------- i --- \ VT LC‘w—..------.--- i\ PROPELLER i R 2)01 W" t "1 Typo 1 : L............................... ........--4"- "i APPLIANCE tanulacturer .. " - CS F SDC 090?' ..._.e t - 1 .--sa- ----.- 8 Conformity Statement I.--- ---- A APsn's Name and Address 8. K rid of Agency C. Cents* No. Jeraml Credit 0 U.S. Certbed M.echanic A&P 41646769 25 Cottage St. O Foreign ermined ?mount Moosup, CT O Cented Reoak Statist 06354 O Manufacturer D. I eerily that the repair enclitic alteration made to the uNqs) identted In Item 4 above and described on the revere. Or attachmenls hereto have boon made In accordance Met Me requirements of Pert 43 of the V.S. Federal Aviation Regulations and that the information furnished herein is Ks andcorrect to the best of my knowledge. Dale Signature of Aua Zidu 11.13-01 7. or Return to Servle• Pursuant to Cie aulhatity even persona specised beim, the wit Identified InItem 4 was Inspected in the manner presorted by the Administrator of the Federal Aviatico AdneniSbaliell and is lEl APPROVED O REJECTED FAA Mt Standards Manufaceser IniceictIon Authorization Omer (SPOON IrdPvtior X BY FAA Designee Repair Station Person Approved by Transpen Canada Airwathinets Group Date of Approval a Re4OCODI Certificate or Signature of Au:hosted Individual 11-13-01 Designation No. IA 91543730 ...da FAA Form 337 (124)8) SDNY_GIssl_02754746 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241668 EFTA01261557 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with allprevious alterations to assure continued conformity with Me appeicable aiiworMinass requirements. 8. Description of Work Accomplished (IImore space is required, attach additional sheets. Identity with aircraft nationality and registration mark and date work completed.) The following work was accomplished on 11-13-01: Installed Keystone Helicopter S-76 Door Pin KR in accordance with Supplemental Type Certificate Y SR0113NY-D dated 1-22.01. Crew door locking mechanism was checked in accordance with the Sikorsky Maintenance Manuals. Aircraft Weight and Balance change Is negligible. FAA Approved Rotorcraft Right Manual Supplement II FM00278.2 inserted in Flight Manual. See attached for Instructions for Continued Airworthiness. END I(E) 0461<nal Shoat: Am Arshed U.S.GPO:1989.0463.171 SDNY_GM_02754747 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241669 EFTA01261558 KEYTECH Report No. I000278 Engineering Department Page 3 - Subject_ Date: March 22,2000 Rev. . ". Prepared by: KGK 1.0 INSTRUCTIONS FOR CONTINUED AIRWORTHINESS —The-following-inspections-should-be-maintained once-the-door-pin-kitr p/n-0076-10Gr are-- installed on the aircraft. 1.1 PRE-FLIGHT A daily check is performed every time the doors are opened. Check pin for proper operation and that there is no binding. No further check or inspection will be required. 1.2 300 HOURS INSPECTION Check door pins for cracks and excessive wear. Undercuts in the bearing surface of the pin, that could prevent the pin from retracting, must not exceed 0.031". Pins with wear or sharp undercuts in excess of 0.031 must be replaced. - Remove bushing and plate assembly and inspect for excessive wear. Bushings with an ID concentricity in excess of .063 must be replaced. SDNYGlvl02754748 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241670 EFTA01261559 SDNYGM02754749 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241671 EFTA01261560 O - uneaten...is MAJOR REPAIR AND ALTERATION Form Approved •, , .OM8 No. 212000020 • , . •• . s o inmosticeon - (Air)rattle, Powerplant, Propeller, or Appliance) . For FAA Use Only htlonslavleass ' Office Identification somennorisa INSTRUCTIONS: Prin t or type ail entries. See FAR 43.9. FAR 43 Appendix 8, and AC 4394 (or subsequent and disposition of this form. This t °poet is required revision thereof) for instructions by law (49U.S.C. 1421). Failure to tenon can result for each such violation (Section 931 in a civil penalty not to Mew: 51.000 Federal Aviation Net of 1958). - Make Motet t. Aircrall Sikorsky S-76C Serial No. Nationality and Registration Mark • 760472 . N-15 2AE • Name (As shown on agistrafiOn cantfiCa(e) 1 Address (As shOwna registration certificate) 2 Owner .. .t_ AETNA Life Insur•ance • - r Comp 151 Farreiegtoa.AVenue . .• . ....,::.. any Hartford , :CT.. 106158-0.0.01 ,.. :,..• • . . ... ... .. .• 3. For FAA Use Ord/ • ,. • The data identified herein complied With applicable airworthiness requirements and is approv ed only for the above described aircraft, subtonfgityrtion by a person authorized in FAR 43.7. ' Approving Inspector it.) Date: el - ;' - q-- Of 4. Unit Identification •, 5. Type Unit , Make -Model Serial No. Repair Alteration • AIRFRAME (As described in Item I abOve) I XX XX X POWEPSLANT I I PROPELLER I 1 I. I 1 APPLIANCE Tyne I Manufacturer I I . I I a. Conformity Statement; A. Agent/a Name anc Accrete I B. Kano of Annoy I C. Certificate No. Empire Avionics Corp. 1 I U.S. Canine-Wed mecnanic 38 Loop Road, Box 201 I Foreign Censticaita Afinninie I GC1R161K Westchester County Airport White Plains. New York 10604 rcl Certificated ReOale Station manufacturer o. lewdly that the repair ancitor alteration made to theunit(s) identifie have been made in accordance with the d in item 4 above and cascnbed on the ' I RI I Ltd Airframe i Ltd Instruments " requirements of Part 43 of the U.S. Federal reverse or ratacsments hereto furnished herein is true anc correct to the Avtadon Regulations and ;MC the informa best of my knowledge. tion Date - ¢tfzttfra of Authorizad inoivicual • A111iza 29, Lervl c 1 ,- 7. AOSrOVIII for Return To Service Pursuant :0 the autnonty given persons specified below, the unit identified in item Administrator of the Federal Aviation Administration 4 was inspected in the manner and is X APPROVED prescribed by the C REJECTED FAA FS Standards I ! InSpetiOr Manufacturer t Other (Specify) I : IInward*, Authorization , BY 1 • • FAA Designee xxl Repair Station i I Person Az:tivedinby essTrg,:napport Canada Date of Approval or ReieCtion :Certificate or cure of Authorizeo Indivictual • Designation No. . 4/4/.4/1- Z-9/ eau I GCI R161K FAA Form 337 n2.4111 SDNY_CM_02754750 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241672 EFTA01261561 NOTICE • Weigh: and balance as operating limNation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity win the applicable airworthiness requirements. 8. Description of Work Arroorriphshed (II more space is repot/ed. attach additional sneers. Identify with antrati ',monetary. and intimation mark and dare work completed.) The existing UNS-1D system installed in the aircraft with software level SCN 601.x has been modified to software level SCN 604.3. The system was tested after modification and was found to operate satisfactorily. This change is predicated on an FAA approved STC SA00876LA, dated November 23, 1999, for a Raytheon Aircraft Company 8-300 KingAir aircraft Flight Manual supplement for Sikoliky S-76C, N-152AE, serial number 760472 with Universal Avionics UNS-1D FMS dated or latest edition must be available to the flight crew at all times. END 1 O Additional £heels Age • SDNY_GM_02754751 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241673 EFTA01261562 • .Pom1 Approved 0.16 El No. 21204018 , • APPLICATION FOR 0 , INSTRUCTIONS — Pnril or type. DO nO1 wedeln SNOW we*: these aro for FAA US Oeporrrerr AIRWORTHINESS use Only. Sabena original only to an aulhorited FAA Rerannentalne. ll additions/ ollonvatcn AMEN* wry., CERTIFICATE Ignice n required. uSe an attachment. FOr Special MORI perms* complete SeCtiOn3 II and VI or VII as apPaible. Adannwanon I.REGIETRAGOn ARE TARIM'S! WILDER S NAME MIATAI & AIRCRAFT MODEL DESIGNATION 4. VP 'Ma L .3oog FAA N7600A & AIRCRAFT SERIAL NO Sikorsky Aircraft a ENGINE DUILOIR 5 NASA *lava S-76C 7. ENGINE MODEL DESIGNATION 1997 j . ‘. l§ 760472 . S. NUMITER OF ENGINES Turbomeca T. PROPELLER BURGER S HALE MAe. Arriel 2S1 6.C30--?6 W. PROPELLER MODE DESIGNATION I ...CRAFT IS.CINVA .faces., Two N/A N/A lasiKma APPLICATION IS REMIT MADE FOIRICAM mime* memo A 1 STANDARD AdtwORTHINESS CERTIFICATE **Lean ceepern ll !NORMAL I I UTILITY I 'ACROBATIC' I TRANSPORT I I GLIDER I 'BALLOON • SPECIAL AIRWORTHINESS CERTIFICATE CAM ApprOAMP man 2 LIMITED CIANFICATION ACCIVASTEG 1 CLASS I 5 PROVISIONAL Ono** War 2 CLASS II I AGRICULTURE NO PEST CONTROL 2 AURAL WRVETINE) 3 AERIAL ADVIRTIEINO 3 RESTRICTED ilaseare OFPNAPNF I l0 , FOREST 'Wpm* onernmen• $ PATROUJNO E MATINS CONTRITE. IN AMMAN 7 CULAiAGE OP CARGO 0 onvatinwor, 1 RESEARCH AND DEVELOPMENT 2 AMATEUR MALT I EXHIBITION 4 EXPERIMENTAL llatnalte ORIII4I.OnG. 4 RACING S CREW TRAINING lo ot COSNICI101 MKT SUFNEV 0 TO SNOW COMPLIANCE WITH FAR 1 FERRY FIGHT FOR /*PANS ALT ERATO.* RLAINTV4ANCE CR STORAGE X SPECIAL FLIGHT PERIMT PARMA 2 EVACUATE MON AREA OF IMPENOINO WNW F 0011/140. lo oO coaciacree. MI 3 OPERATION IN EXCESS OP maasuu CERTIFICATED TAKEOFF WEIGHT conION•Searon Nolen as aROACAOMNAmesmiNt 4 CrELivERiNG °RUPP* I 5I lasooucnon FLIGHT TESTING X CUSTOMER OVAONSTRATION RANTS 6 C I a I MULTiPLE NIRVORTNINESS CERTIFICATE CAM ABOVE fiesvem Om POI and *senc/Aro or Sawa a Approcpor • A. REGISTERED OWNER*. Nem, w coldals or Nem. repareation• if MALE& CHECK MAE --f.- I NAME Acoams 6900 Man Street Sikorsky Aircraft Corporation Stratford, CT 06601-1381 ..AIACAAFT CERTIFICATION EASES XING, OANCIEff mods 0. <n * grab .s .4RSIRSIS MKAE EONCANON OR TYPE CERTIFICATE DATA SKEET Ian* NO AIRWORTHINESS MECUM IOWA IS NIIPPACOIA4 AO • 0041 i And Moron MAO AO No . 640 4. 11 4.0 PM 4 X H1NE, Revision 13 X 97-20 19 AIRCRAFT LiSTiNG rave one numaerisit SUPPLEMENTAL TYPE CERTIFICATE aumerseer Gwen SIC maRONINIs 6 N/A N/A : C.MAC/AFT OPERATION AND LINNTENANCE RECORDS ATTACK IF RECORDS IN TOTAL AIRFRAME HOURS EXPERIMENTAL ONLY grow bolas Rpm sonedi Ns1 WANTS 1 X g11717O"91.417 9.9 3 Ga.> CIIMI4440/ D. CERTIFICATION — I nweef serif,. Ina I m inn IIISISNgel Sena* lic. M 44410 me anal, OncntER ACIanniunioon in aCCIDISPXO !Mn Secoon 50 ol vie Feesni Ana1.00 Act of Me. Ara of MN. Int Me ..0 IA or wrested wan IM Eton Allallett *plow Federal Mown.. Renutmoont. RV/ ULM Mu Austell nar cern arnvonny and move la v. aarmStIllu4S3cenGesia Noun** onvonlano rs DATE OF APPLICATION NMI AND TITLE 'Ps., oe IV pu i SIGNATURE A. THE AIRCRAFT (*SCRIBED AllOvE HAS BEEN INSPECTED MD 'Our° AdiwORINT BY /Cousane e.., • • . .w Mv.I PAR 21 SR UPPER Iv. INSPECTION FAR PART 12108 1E7 CERTIFICATE HOLDER NOW CERTIFICATIO MECITANIC Ian. CERTIFICATES) REPAIR STATION (Om Cornecal• 2 CAIMAR NOS 3 GENRE...ONO f AGENCY I Nal AIRCRAFT MANUFACTURER Ia.. Ram* of Amu vtruncAnom S DATE NILE I SKINATURE ' ICAM ALL µ**NIA NOM n ~IS .4 STIS 8) THE CERTIFICATE RIONISTED A. I INA MN me Antall oNONTO w S4O041 I at VII salt essvneenenli for X • 4 AMENOMENT OR MOCIONCATIOH Of CURRENT AIRWORTHINESS CERTIFICATE Yo — o O. IMMO*. km 4 %PIGS nom wen unser Snhon 1511 C. wA•C0NIVO40 SIC . FAA INSPECTOR N FAADESIGNEE 1 ii CERTIA1CATE HOWER UNGER. FA ESL IF !FAR 121.12/ or 134 - [FM 145 s wn DATE DISTRICT OFFICE t S SIGNATURE NO FAA INSPECTORS SIGNATURE le IN N 80ct1997 NE-MID0-41 osep P 1 a DAR PNE8800014C FAA Form 8130-6 (11-061 SUPERSEDES PREVIOUS ELKO, / SDNY_GM_02754752 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241674 EFTA01261563 EFTA01261564 SL9M00V1.43 LT Pue 'ST 'OT '6 '8 SHdV2iDVdVd 213C12J0 JALID31O2id Ol1JBISfS Egar9LZ0819- ANGS ettnI0 - 999 - P66i:04091'll• . , . . • A.MANUFACTURER ar NAME ADORE= i i f: IL PRODUCTION BASIS (Can ao•henio sang — PRODUCTION CERTIFICATEPUP proateca WIA/caN numbeD . . '80 TIPECIVITIFICATE ONLY. - ' .• " - I''' . : ' , • • •• • 2 I APPROVED PRODUCTION INSPECTION SYSTEM • ' , . . ... . . C. ONE OUANTSPY OF CEFTFIGATES REQUIRED FOR OPERATING NEEDS" DATE CIF APPLICATION NAME AND ME (Polorar(MO ' . . • I'. DESCRIPTION OF AIRCRAFT • RECUSTEREO OWNER AWIESS Post Office Box 109610 Sikorsky Aircraft Corporation West Palm Beach, FL 33410-9610 BUILDER (maw mOCCL Sikorsky S-76C SCRUB NUMBER REGISTRATION 'PARK 760472 N7600A a. OCSOVOTON Of 11.00 CUSTOMER DEMONSTRATION FLIGHTS 0 Knack 4 aefAcabin )FROM TO ' Jupiter, Florida Local Area VIA DEPARTURE DATE piwAg0.4 C. CREW MOIRE, TO OPERATE TPEI MACRAFT MO in I OUIPmENT . )4 PILOT 1 XI CO-PROT I [NAVIGATOR I I OTHER (Sonny! D. THE AIRCRAFT DOES NOT MET THE AMICABLE PaRwORRANESS RLOUIREMENTS AS FOLLOWS Demonstrate aircraft in flight to customer. • . . THAN MODUCTI0N FLIGHT TIST — . .. . . • ::: "..••::...-- • !.‘. -:7. C I. — - 1 • . •t . • ... t .... ; . .... -• • -_ •3 ... s .. ; • . ... I? tt : ....: :: .....:. t . - . . . .... .. • . . r,. .• • ...... - .. .. . . . •. • C. THE fOLLOWRIG RESTRICTIONS ARE CONSIDERED manure DON SAFE OPERATION ILAN MIORNIPI el nONSISW . • Operate the aircraft in accordance with the current approved Rotorcraft Flight Manual, SA4047-76C-10, Part 1, Revision 4 dated 17 June 1997 and ' Part 2, Revision 2 dated 17 June-1997. : . WI. SPCCIAL IllGHT PERMIT PURPOSCS Mill F.CEATIFICATA)m— tinny randy int 'amine tempered manta ningenal of MO anratteesonn no.e traiinestnalmregnienrowanthefecitroinnawnAarn.nnuahonm occonarce men Sedan 501 of IM Feintal Aomori Ad of as.. and appecabie Feats Ammon tin . aria mat we wan itst been monied and is annum tor toe mom cieureoe DA E NASA AND TITLE (Mena IWO SIGX/tURE a 80ctober1997 Kenneth Gorman, Quality_ Manage- otinoTA (9d)mad.. G. Summon, of Conlormity. I' AA Poem 0130-9 Morn ....or owned) A. Opeomng Limiimions and Mannfyi in Cannon mth FAA x . - ..2 EIJI as Applicable - N. Fortin An Cone Kay. be Moon !Wall (Attar. when irownol r X B. Current Opening Lemembon% Aliened 0 g i E X C. Dam Dra.pnEs. 000togna Vit. .. (MICA when repuve4) . L Mama Anealhoint Cana., Iwo* It ACOOManc• AM °. a l X D. Curt Woe a Ione. IMOIIIMISI arld60.10 in Awcon FAR CAR iOnametAnanse) I2 i. ' *"' ""'"'.• E. MN0; Rep., . amp Amomb:a. FAR PAM W (Anne vont., nyoliwell J. Cuetem Atoonipness Gallica* Issued on Accercloa ish 0• X OAK Inspenon [Wong in Annell Anon, X cth 21,197(a)(5) leen orien.t01 . . roacncrarorramerccur="67cour ....now AMAX AMWORTIONE66 CERTIFICATE rovanan,c0.4 A carECOnwOrRacanON 631901A6 RIGHT MOOT — hcorca ORTON= DIRKOSTPArlOal FL.10.18 roam& AlkOrakr Aircraft Corcoration 'BPA. '"gialra aOcccr.59.0. Doi 109610. Raft Pala, Roach, FL 33410 FR (SUbiect to 02 an Ravers., tidal C fuOni 00 NA 0 c-.76008 maw NO 760472 ft... Baorski Aircraft wan. 6..76C Manor mom. Oct.°, 1997 err. Oct. 31. 1997 0 , 1:11...0.71,4110. 1E0 (I Oct 1997 Mt 0 007 . 7 ..nos , 0=0A71 00AR 4,1000001AC .... ---4.67,v mr,:mi.= - - rzrz.^ «..- wa,. ,-..-.12 ,— aa..7.7,"...-zur, r. Sr( SONY_GM_02754 CT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, E EFTA 00241676 EFTA01261565 ThIntratsIMMA !Ann:Hon shod (role? illo ualtOnly 01 tenant AMYX. AtIpl ION . A awl re AS'S A.U.00. P.O./1bn I'M) • I' nmars.e....a ccrults5nealgram.hernananoar nisi an there...to %.$ ,C0.0.91 POdui-on nt?h int <nit p -Ockvinn Mt, ws orntopl ie.:gamma il ha Ow*. NO B per•An may Coni fAl troattClon 'QM *Vs rnd.. ti. cadikre* 0) CAnrAg Innekt et ',woody fc• CallpWslifolte Pon. Anab tzi Ca-.I nnevnna not meets tore moons 0 . %lit , Ms new:edits, coriliolostemien II. light ;WSW an ne snot Sete Iblitgen .."' .t... M Oka A. US inwlithlimsa Centlealecennei Inas asor mod/YeOf ildaattle trAaAran w•A , &%N heltsiseepeatdancllowdionyiernerarenntresoliNhipcheltilaFAR Tnesotalcion Molex th•inhentint tiorit•ppbutMeconcterseaw okra 4.404 ....wodin.sa NM se 0 peaked ty Awn* so the Cowion On inutwcnsroti A”Atn. AD pr•c., e, op I*Me th•airctatl decimal m l Me reneseue. (I) acapol a tn. 'wont. rda ane in...4~0.mM orb one — liagaicest.lebnry to inapt., frf Iry nexu-nvirect se. 1. 6 O.. race. -I) cm., ay Ain. counter tamps as taws ornwe+ os no Canty. 1.1,4•4 was *ayenders; wapaidel Or ...abed. lin airoolewma cerelcsla sellecb••101 E to claon anti voile unroun comeitas a FACIPAri 11.S.4.1 .1 Mt> 21217. al WITS Want OM. IS. WAY SONY GM 02754755 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA 00241677 EFTA01261566 tr.:C;7.1 -TX.% • • •••i.: • • '7.• : •••• •-tr. • >AV:. - ; •• etargralt..". •.., Page•1 of 2 • • • • • , SPECIAL. FLIGHT PERMIT LIMITATIONS CUSTOMER DEMONSTRATIONk MAKE: S/KORSKY REGISTRATION NUMBER: N7600A MODEL: S-76C SERIAL NUMBER: 760472 a 1. No person may operate this aircraft unless the Special Airworthiness3Certificate, FAA Form 8130-7, for this aircraft is displayed at the cabin or cockpit entrance so that it is legible to passengers or crew. 2. No person may operate this aircraft for other than the purpose of customer demonstration to accomplish the tests outlined in SIKORSKY AIRCRAFT CORPORATION program letter dated Oct. 8, 1997• describing compliance with 14 CFR part 21.197(d). Additionally, this aircraft shall be operated in accordance with applicable air- traffic and general operating rules of 14 CFR part 91, and all additional limitations herein prescribed under the provision of part 91 1 91.320(e). These operating limitations are a part of the FAA Form 8130-7 and are to be carried in the aircraft at all times for availability to the pilot. 3. This aircraft shall be operated for at least (8) hours with at least (3) takeoffs and landings (to a full stop). All flights will be conducted within the Continental United States. 4. Application must be made to the geographically responsible MIDO for any revision to these operating limitations. 5. No person may be carried during flight unless thac person is essential to the purpose of the flight. z I F 6. No person may operate this aircraft for carrying persons or property for compensation or hire. 7. This aircraft will not be operated unless the replacement times for life-limited parts specified in the applicable technical . • publications pertaining to the aircraft and its components are includin g its related componen ts complied with. This aircraft, ' e approved and systems, must be inspected in accordanc with an of 14 CFR part inspection program selected under the provisions recorded is the 91, 4 91.409(e). This inspection program shall'be aircraft maintenance records. MOIGMjVM4756 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241678 EFTA01261567 ,_ • SDNY_GM_02754757 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241679 EFTA01261568 •: • • .••.,,• . . • ;. :,... 1 • r4..pf14 I.: "i-e _ .. , :!. Page 2. 42, ¢c I..: r priate ratings.as.,- i .::•8. Only FAA-certificated mechanics with appro inspections '= perforM -7 authorized by 14 CFR part 43 % 43.3 may requ ired by thes e limi tati ons. and their response "t". 9. The cognizant FAA FSDO must be notified, airc raft after received in writing, prior to flying this 14 CFR part 21 r chan ge as defi ned by • incorporation of a majo 21.93. rd, markings,.etc., 10. This aircraft shall contain the placa required by 14 CFR part 91 1 91.9. must ensure that a copy 11. The owner/operator of this aircraftmodif ications, are carried of the current program letter, and any aboard this aircraft at all times. instrument flight in 12. Unless equipped for night and/or this aircraft must be accordance with 14 CFR part 91 1 91.205, operated VFR, Day only. requirements of the 13. This aircraft does not meet the airworthiness code as applicable, comprehensive, and deta iled Convention of Civil provided by Annex 8 of the International aircraft must obtain of this Aviation (ICAO). The owner/operator s Civil Airworthiness written permission from another country' aircraft in or over that Authority (CAA) prior to operating this carried aboard this be country. That written permission must ess certificate and, airwo rthin aircraft -together with the U.S. FAA inspector or the CAA in• upon request, be made available to an the country of operation. t installed and used under 14. Aircraft instruments and eauipmen ected and maintained in 14 CFR part 91 1 91.205 must be insp thos e instruments found in 14 accordance with the requirements of I CFR parts 43 and 91. ose AR NE800001AC Sikorsky Aircraft, West Palm Beach, FL. October S; 1997 • f"e):41' •.• "7 41: 11: .4.ar r• ' r" --n..71.• •••• - 02754758 10, GNL and 17 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, SDNY_15, EFTA_0024 I ogo EFTA01261569 SDNY_GM_02754759 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241681 EFTA01261570 UNITED . Post Office Box 109610 TECHNOLOGIES West Palm Beach. Florida 33410-9610 407/775-5200 SIKORSKY AIRCRAFT Completion Center 26 October 1997 PIF-F-091-97 Federal Aviation Administration Department of Transportation Mike Monroney Aeronautical Bldg. Airmen & Aircraft Registration Branch Post Office Box 25082 Oklahoma City, OK 73125 Subject Export Certificate S-76C Aircraft Serial Number 760472 Gentlemen: Enclosed please fmd the Special Flight Permit for Aircraft 760472 for Customer Demonstration Flights along with supporting documentation as well as the cancelled Special Flight Permit Please contact me if you have any questions concerning the above at (561)775- 5552. Thank you for your support in this matter. Very truly yours, SIKORSKY AIRCRAFT CORPORATION Kenneth Gorman Quality Assurance Manager West Palm Beach, FL KG:nrw SDNY_Gliol_02754 760 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241682 EFTA01261571 . •. .. . . • • :-.'" ‘. . • =.• .• . • SDNYGik02754761 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024I683 EFTA01261572 . Ontoturrise osime• ppWillitra Or 111.4POR/Artind • IfttRAt AVYT04almaanT MriCet SPECIAL AIRIVOnllIMESS atifiliRCATE a. bit •. ni. A CAlIWORY OFSCaTION SPECIAL naafi PERMIT PisPOSE cus STRATION MICR% a MAW SIX° 1 [[L EM ".. PAMPER PO R•ach, a 93410 C PLIGHT ect to Di on Reyna* 6100) ar 41 1. SCRIAL NO. o N- 7600 760472 L §-7§S. 8U""or • "nr CATE MtU•SCEi C •E SS • -TiTh Mr Oct. 31,1911 E °MUTING uranAT • Wa , ARE A PAW Of Titi COMICATE Of c.rroAtice. 0R 01,(:4 NO P it COAR 012000001AC NY no Yr ~ a ...a? *airs !re ZZ241V`at t I= ns ligra lca P vaThs Arry&Ott 400W AVIAnONMOOLAAT004 SONY _Cal_02754762 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA 00241684 EFTA01261573 A TM ion•OIPArels OM vase 04 MOPIt/ of ihoPalm. Anstea Pp al 1M /00 re. Raw4 00/0300•00.00.0 0400 • 7./ • •morinnr.• cad 4 c.a*/../trcee•• trerea.40:00*/ nandc0the ono Wele pI 1000.000 nom 1.- -// 0, 0 000 .00 .ace.PagNIs 0 aftnal 0/01010/00 /0 Ms= II merlon may co/ uci pte.C.00 00/I $0sis /0/08/ ihry 00.00.•• j I ) C40000 pence* /0 MP/ft 10 ancenssiono hit rota MGM.. patenlietia.witie ton papaie of ire 00/ Tbe/ aincert•-erortitcas ten /PO lel spete•S On pasans ads Ira. yaps `-' ahomi 0 OWL A. The ain/Ortiris Oseultalcans Bra sal Male c• iiisance.IP/00•010 foe 0000/ /sad km tom.01//cled acelI ouult0r0WIns 000/sests Cl Nµgaa*NMR Tile annli 0On 01001/0•41/0 n00014.10://..00/0.0 p sandal be Area 0 le Ow Cfloran OnIntinownst Oa 00•0a. Se pawnairy Optaa• 00 omen cloateil01010 TOM 1030 (II ere/ inisocedargnithint COlicableF041•00 kenos/a /Oh0.044x0 VW PinaSers Suchsea* 00•00000 W1/01010/0blublOre/ pm a Mnnics:* 'now n I on/qn 000/1/0 060404 PO YAM pere0b0C0 0/ 0.4. carry Untionwis wennclere. 'upends* wilfteked /ha amerrseasoseakalii Coon • Miran lc. E to demen 5.3 tear SO 01(411016 pencetes in fart $0/12%. al III co inn na gear men env IS.. 6.•.• SONY GM 02754763 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA 00241685 EFTA01261574 . . ....... Page 1 of 2 SPECIAL FLIGHT PERMIT LIMITA No t iC) CUSTOMER DEMONS \••• ' 0 90 MAKE: SIKORSKY REGIS y ER4400A tFt. MODEL: S-76C SERIAL. NUMBER:. 7§,00%!rte 10 /! -° 1. No person may operate this aircraft less the Special Airworthiness Certificate, FAA Form 8130-7, for this aircraft is legible displayed at the cabin or cockpit entrance so that it is to passengers or crew. 2. No person may operate this aircraft for other than the purpose of customer demonstration to accomplish the tests outlined in SIKORSKY AIRCRAFT CORPORATION program letter dated Oct. 8, 1997' describing compliance with 14 CFR part 21.197(d). Additionally, this aircraft shall be operated in accordance with applicable air- traffic and general operating rules of 14 CFR part 91, and all additional limitations herein prescribed under the provision of part 91 1 91.320(e). These operating limitations are a part of the FAA Form 8130-7 and are to be carried in the aircraft at all times for availability to the pilot. 3. This aircraft shall be operated for at least (8) hours with at least (3) takeoffs and landings (to a full stop). All flights will be conducted within the Continental United States. 4. Application must be made to the geographically responsible MIDO for any revision to these operating limitations. 5. No person may be carried during flight unless than person is essential to the purpose of the flight. 6. No person may operate this aircraft for carrying persons or property for compensation or hire. 7. This aircraft will not be operated unless the replacement times for life-limited parts specified in the applicable technical publications pertaining to the aircraft and its components are complied with. This aircraft, including its related components and systems, must be inspected in accordance with an approved inspection program selected under the provisions of 14 CFR part 91, 1 91.409(e). This inspection program shall be recorded in the aircraft maintenance records. ! SDNYGNL027,A764 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241686 EFTA01261575 SDNY_GM_027.765 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_002 4 16117 EFTA01261576 Page 2 of 2 appropriate ratings as 8. Only FAA-certificated mechanics with may perform inspections authorized by 14 CFR part 43 1 43.3 required by these limitations. notified, and their response 9. The cognizant FAA FSDO must be ng this aircraft after received in writing, prior to flyi chan ge as defi ned by 14 CFR part 21 incorporation of a major 1 21.93. the placard, markings,.etc., 10. This aircraft shall contain 91.9. required by 14 CFR part 91 1 aircraft must ensure that a copy 11. The owner/operator of this any modifications, are carried of the current program letter, and aboard this aircraft at all times. or instrument flight in 12. Unless equipped for night and/ this aircraft must be accordance with 14 CFR part 91 1 91.205, operated 1/FR, Day only. requirements of the 13. This aircraft does not meet the deta iled airworthiness code as applicable, comprehensive, and of the Inte rnat iona l Convention of Civil provided by Annex 8 of this aircraft must obtain Aviation (ICAO). The owner/operator coun try' s Civi l Airworthiness written permission from another this aircraft in or over that Authority (CAA) prior to operating be carried aboard this country. That written permission must airwo rthin ess certificate and, aircraft together with the U.S. ector or the CAA in avai labl e to an FAA insp • upon request, be made the country of operation. alled and used under 14. Aircraft instruments and equipment inst d in d and maim 14 CFR part 91 1 91.205 must be inspecte n urfd. in 14 of thos e inst accordance with the requirements • CFR parts 43 and 91. ose AR PetWcxi - 800001AC yr_ .e ocit c)0 ♦a Sikorsky Aircraft, West Palm Beach, FL *October 8; "1997 SDNY_Glvl_0 10, 15, 275476 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, and6 17 EFTA_00241688 EFTA01261577 • .. .• • • • -.• • •• . • . ,•••:•,.• • SDNY_GM_02754767 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241689 EFTA01261578 . . .. Form Approved - - . — OMB No. 2120-0O20 C MAJOR REPAIR AND ALTERATION USDeocareert " ' Fof FAA flee Oed ofIrcenoonoten (Airframe, Powerplant, Propeller, or Appliance) Office Identificat rs% • resew motion Aeminianation C---::--__ INSTRUCTIONS:Print or typo all entries. See FAR 439.FAR 43 Appendix B.andAC43.9.1(orsubsequent revision thereof) for Instructions . and disposition of this form. This report is required by law (49 U.S.C..1421). Fa lure to mportcanresult ina civil penalty not to(meted $1.000 for each such violation (Section 901 Federal Aviation Act of 1958). Make Model Y Sikorsky S76-C+ 1. Aircraft Serial t.a. Nationality and Registration Mark 760472 N152AE - Name (As shown on registration certificate) Address (As shown on registration certificate) 2. Owner Aetna Life Insurance Company 151 Farmington Ave. Hartford, CT. 06156 3. FAA Use Only THE IDENTIFIED HEREIN CaMPLJES WITH THC: APPLICABLE AIRWORTHINESS REQUIREMENTS D I APP D ONLY FOR THE. ACOVE DESCRIBED AIRCRAFT SUBJECT TO A 1Y I ECT1ON BY A PERSON AUTHORIZED IN FAR SECTION 43-7 INF-FRIall3APPFICNNESIPECTO t DATE NM 3 Q_IIII 4. Unit Identification S. Type Unit Make Model Serial No. Repair Alteration AIRFRAME (As described in Item I above) X POWERPLANT PROPELLER Type APPLIANCE Manufacturer . 6 Conformity Statement A. Agency's Name and Address B. Kind of Agency C. Certificate No. Shawn J. Landry X US Certificated Mechanic Foreign Certificated Mechanic 3 Grant Road A&P 46701613 Canklicated Repair Station BroadBrook, CT. 06016 Manufacturer D. I certify that the repair and/or alteration made to the un t(s) identifled in item 4 above and&scribed on the reverse or attachments hereto have been made In accordance with the requirements of Pad 43 of the U.S. Federal Aviation Regulations and that the Information furnished herein is true and correct to the best of my knowledge. Dale Signature of Authorized Individual • March 23, 1999 ---le--- . 9.1 "--- ,.. • 7. Approval for Return To Se 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 14 APPROVED 0 REJECTED FAA Ft Standards ' Other (Specify) Inspector Manufacturer x Inspection Authorization BY FAA Designee Repair Station Person Approved by Transport Canada Airworthiness Group Dated Approval orRcjection Certificate or Signature of Authorized Individual Designation No. 03/23/99 j itten..,70-to Y66y/737 FAA Form 337 ist-aist SDNYGIvl_02754768 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241690 EFTA01261579 NOTICE record. An alteration must be Weight andbalance or operating limitation changes shallbe enteredIn theappropriate aircraft applicable airworthiness requirements. compatible with all previous alterations to assure continued conformity with the B. Descriptton of Work Accomplished (IImore space is required, attach additional sheets. Identity with aircraft nationality and registration mark and dale work comp:wed) 03/23/99 Sikorsky S76C+ 760472 TT Hours: 114,1:52 Removed existing lightning sensor Honeywell Model LP-850 P/N 7011822-903 and returned unit to manufacturer for modification. Re-installed lightning sensor as Honeywell modeLLP7869,0 7011822-904. 711-1 The airframe wiring between/the -1,i.gbthipa. aensprttanii; antenna has been modified as follows (Reference Honeywell TechnicarbNewSUS6001A2341998-01 (attached) and LSZ - 860 Installation . • - manual). r‘2;•.; i• 1. The overall cable shield ground was removed fret pin 8 of the sensor. The shield termination is now connected to the airframe at the antenna end. 2. A ground strap was added between the antenna backshell and the airframe. 3. The individual shield grounds have been removed from pins 12, 16, 17, 20, and 21 of the sensor. These shields are now chained together and grounded at the sensor. A new Flight Mannual Supplement has been installed in the aircraft. The supplement requires that the Honeywell LSZ-860 lightning Sensor Pilots Handbock be available to the crew at all times. O Additional Sheets Are Attached SDNY_GM_02754769 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241691 EFTA01261580 FA Form Approved Ofr .0 OMB No 2120-0020 MAJOR REPAIR AND ALTERATION For FAA Use Only US Department (Airframe, Powerplant, Propeller, or Appliance) Office Identification of Transportation Federal Aviation AEA-FSDO-17 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 c5 position of this form. This report is required by law (49 U.S.0 1421). Failure to report can result In a civil penalty not to exceed 61,000 for each such violation (Section 901 Federal Aviation Act 1958). Make Model 1. Aircraft Sikorsky S-76C Serial No. Nationality and Registration Mark 760472 N152AE Name (As shown on registration certificate) Address (As shown on registration certificate) 2. Owner Aetna Life Insurance Company 151 Farmington Ave. Hartford, CT 06166-0001 3. For FAA Use Only 4. Unit Identification 5. Type Unit lathe I Model I Serial No. Repair Alteration AIRFRAME (As described in item 1 X above) POWERPLANT ' • PROPELLER ' Type • APPLIANCE Manufacture 6. Conformity Statement A. Agency's Name and Address B. land of Agency C. Certificate No. Keystone Helicopter Services U.S. Certificated Mechanic 1420 Phoenixville Pike Foreign Certificated Mechanic West Chester, PA 19380 X Certificated Repair Station CRS EGRR526D Manufacture D. I certify that the repair andfor alteration made to the unit( ) id ntified in item 4 above and the 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. qn Date Signature of Authorized Individual August 5, 1998 Ronald C. Garrison etiti m 7. Approval for Return To Service Pursuant to the authority given person specified below, the unit identified In item 4 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ri APPROVED O REJECTED Other (Spec/h) FAA Fit. Standards Manufacturer Inspection Authorization BY Inspector Person Approved by Transport FAA Designee X Repair Station Canada Airworthiness Group Date of Approval or rejection Certificate or Signature of Authoriz dividI I Designation No. August 5, 1998 CRS EGRRS2M) David Druce FAA Form 337 (12.88) SDNY_GIvl_02754770 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241692 EFTA01261581 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with allprevious 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.) MODEL: S-76C DATE: 8/5/98 SIN: 760472 Acft Total Timo: 751.8 Keystone Helicopter Services performed the following repairs on aircraft nose section at station 35 : Three cracks on the canopy kevlar ring, a disbond between the kevlar rib and the inner skin. Replaced the R/H support angle P/N 76200-01019-104 and repaired the L/H support angle P/N 76200-01019-103. The work performed was done in accordance with FAA approved Sikorsky Aircraft Structural Repair Manual SA4047-76-12 chapter 61-60-01. Reference attached memo from Sikorsky Aircraft dated July 24,1998 and Keystone Helicopter Services Work Order H00191. END El Additional Sheets Are Attached •0.S GPO: 1990-0-588-012/40004 SDNY_GM_02754771 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241693 EFTA01261582 Sikorsky Aircraft Corporation OXON*. Una. r 0 itasO21 CA34.17 Qin July 24, 1998 AEtnaiLife & Casualty Flight Operations Hangar 85-176 Bradley International Airport Windsor Locks, CT 06096 Attn: C. Breeze Re: Repair of Nose - S-76C+, S/N 7600472 In accordance with our telephone conversations and your attached diagram of damage the following repair is provided: 1. Repair three cracks (labeled 1, 2, 3 in attached diagram) on canopy keviar ring in accordance with standard keviar repair procedures. 2. Separation (disbond) (labeled 4 in attached diagram) between keviar rib and inner skin may be repaired by bonding affected area with hysol. 3. For hysol and repair materials reference the S-76 Composite Manual or the Structural Repair manual. 4. Replace angle 76200.01019-104 in accordance with standard sheetmetal practices. Respectfully ikorsk Aircraft Corporation ose M. Diaz Customer Service Manager CC: A. Baldwin, HelpDesk, R. Wellman, J. McLane, J. Lopez, P. Anderson. za.ta•a actscupcora-a nl A7).0c0:6- V11? 1INI -Lunn cnn Na ST:At RAAT 177 mr SDNY_GNI_02754772 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241694 EFTA01261583 ----„,.. SDNY_GM_02754773 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241695 EFTA01261584 •••- •• -.• sat -•-•••• • • Y - 1" S -• .• •• .t. . r • . - .—.-Z- . .. ...... . L ••••- ..---.......-r ,.. • .. . . - ^ ••• , • ♦ • ......... • ... . ......- . .- •:....... ................ • -........ . .... .....- . .. .... . . „.• .... ... • -- • ........ i' ...- - -7 .- . • . an, ...1•••••••• . . • • • • 7 • • • •• • : • -•• ' • • •• • • . I ' • • . • • • • , • • • • • . • • • • .' ---..--- t na a" 4. 1 i: • i - t lin h■■a Iii i■ll n i al Ttilial kr! IP 111110110111111 5 0 11110111111011111111 11111110111111110111110 UMNIMES111111111 inIIIMINIMMIIMIMMIMMILMONIMMIMMIUM MIUMMMIIIMIIIMEINEUEEIMM • MEMNIMMIPIIIIM SDNY_GM_02754774 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241696 EFTA01261585 • SDNY_GM_02754775 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241697 EFTA01261586 O.M.B. NO. 212040IS 0 US Ctcasrmn APPLICATION FOR AIRWORTHINESS INSTRUCTIONS — NMI DELWIN Do not WOO in shaded areas; thee are for ERA Use Only. Submit ockyral only lo an authorized FAA Roper-AMAIN.. II additional a larammosm SpaCO IS required, use an Mt= menL For special Right permits complete SEC-Eons hard ArkNon CERTIFICATE Rand VI or VII as applicaMe. AdmInbtratim • ISEGISTPATIO4 MARX LAIRCRAFT BUILDERS NAME MOW 3. AIRCRAFT MODEL DESIGNATION 4. YR. ERFR. FAA COOpo st 5g N152AE Sikorsky S76C 1997 . r/r3ber 3 §t s. AIRCRAFT SERIAL NO. S. ENGINE BUILDERS NAME CIAMO I. ER64%1100E-1 DESIGNATION 3; 760472 Turbomeca Arriel 2S1 60030 - IL NUMBER Of LNOWES IL PROPELLER BUILDERS /oda (Mao It PROPELLER MODEL DESIGNATION IL AIRCRAFT IS (CANN 0 amilitable 2 N/A N/A IMPORT APPLICATION IS HEREBY MADE FOR (ChminsmitsbN man A I. 'XX STANDARD AIRWORTHINESS CERTIFICATE (mascan camper's I INORMAL1 I/STACY I IACACIAT/CI XI TRANSPORT I 1" /" A I I BALLOON B ..n,- SPECIAL AMWORTHWESS CERTIFICATE (CANA aweopa&e Maw) •1 METED 1 CLASS I .7 PROVISIONAL ( an F deaf) "2 CAFEII g 1 AGRICULTURE MID PEST CONTROL 3 AERIAL SURVEYING 3. MAUL ADVERTISING 3 RESTRICTED(Mean opwaNNYF) so , FOREST rWAVAN corosenolka) I, PATROLLING I. WEATHER CONTROL 2 b• conchs...) i 4 EXP IAMENTAL(Imumbroism~J 7 I 4 CARRIAGE OF CARGO RESEARCH AND DEVELOPMENT RACING . B, 'S. II. OTHER (Spoes2) AMATEUR BUILT CREW TRAINING '3 E0111KTION NAT.SURVEY I Mb* cown.<4.4) U I TO SHOW COMPLIANCE vain FAR d 1 FERRY FLIGHT FOR REPAIRS. ALTERATIONS. MAINTENANCE OR STORAGE SPECIAL FLIGHT PERMIT (Ancrscatil 2 &AMOR FROM AREA OF IMPENDING DANGER I Opffalliari lobo cantata./ um 3 OPEIMTION IN EXCESS OF MAGNUM CERTIFICATED TAKEOFF WEIGHT comptee• Section VI of Van • apptabi• on rronosido) 4 DELIVERINGOA EXPORT III 'PRODUCTION RIGHT TESTING • CUSTOMER OEMONSTRATION FUCKER C I ii MULTIPLE ANIWORTIENESS CERTIFICATE (OMM ABOVE TboacterlOpwOon"or4 Vardivcror VMS: as •ppWr•WIL) A. RICIISTERW) OWNER IN amen an MGRS OS ease eigistriew• O DEALER CHECK HERE —N—Im I NAME State Street Bank & Trust Co. ADDRESS CorporateTrugt Department, Trustee of the AML Leasing Trust 2 International Place, 4th Fl0or amicamTaimmrsvrmmumuoinkstartig003,,doww..........,seme noston, mass. Uellill S AIRCRAFT SPECIFICATION OR TYPE CERTIFICATE OATA SHEET/643NR logI S* 141 AIRWORTHINESS DIRECTIVES(CM/Ni RS a ent* AD) WRIO•1•0 as•PW 106,1A0 FIN P x Hl-NE Rev. 13 i AIRCRAFT LISTING fOk•MaRembetn N/A C.AIRCRAFT OPERATION AND MAINTENANCE RECORDS AD 97-21 SUPPLEMENTAL1TPE CERTIFICATE (LAS rune Ouch ETC IncoeporaNdl N/A CS1ECK IF RcECORDS IN TOTAL AIRFRAME HOURS ICONENMENTAL ONLY MIME hews /Rasa Nem Jai padiNcate c X M.MY4( 1,T.417) 21.7 2 'shad °""nel N/A D. CERTIFICATION — I hamby candy Mal I ass ma mound (moat (es Ns troll of ma siticaft dscn*ed abort IMI the aircraft is rticidatind with OW Font AvalgOn AcirmirOstrflon in *ay.:taxa tvIITSOCtiOn 50 Or Me Racial AVaISCei MI ol NSA arid applicable 'mini AMMen IN2NImiss - um mama &rum Am amt IF aavontry and (SEM* los the airwoman% central. tepee. DATE OF APPLICATION NAME AND TITLE (PON et 014) Manager IMGNA 10-21-97 James Perro Quality Assurance,,,-- -. A. THE AIRCRAFT DESCRIBED ABOVE HAS BUN INSPECTED MD FOUND AIRWORTHY Mt (Comair It secnon on,/ Of 10( )10010.1) DT FAR PART 111 OR 127 CERTIFICATEHOWER (GM. 7 CERTIFICATED MECHANIC (Gm CERTIFICATEDREPAIRSTATION(OW CarisMale g c 2 Cwnscass N0) i: GAMES NA) • 4 Nos g. 3 - N cc ! AIRCRAFT MANUFACTURER /GA* pas cans) .s., • DATE TITLE SIGNATURE I iCAra ALL . ppncse(. moo. m OMILII A ane 0) X THE CERTIFICATE REOUESTED A. I End Mal Me aircraft easctirato in Section I t VII masts sesissumms Im • AMENDMENT OR MODIFICATION OF CURRENT AIRWORTHINESS CERTIFICATE V. FAA S. Inipoclion Iota Ip•Mil MOE Foam wafts &aim VII FAA INSPECTOR I FAA DESIGNEE REPRESENTATIVE DATE WU cackcied by: DISTRICT OFFICE DESIGNEES SIGNATURE MONO CERTIFICATE WADER UNDER J FARO I IFNI121.177 • IA IPM Ks FAA INSPECTORSSU:MATURE CERTIFICATION 10-21-97 NE MIND 41'•. Kurt Su er DAR 00 i I FAA Form 8130-6 16-061SUPLEISLOGS PERIWOLIS SOROS SDNY_GM_02754776 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241698 EFTA01261587 ttecIlt it.I ii•—•1111 • 04110 Sunup. imisawatota 771 0 huctnandow t.13-1 17 WV! X 10•03410/toovwpoustit.tontodunnird X mu< dontuaarry awn, tinelitatuituAmmtlY Ittut0T 0.u.0.t. ores tottuy)tet 001 WI ‘ 100"0<t<ers0 .1110:0. 3 = 0.0Palf ftu.0A7) HY* WA wort u. <pity< .x.miuolui amiO3 OtIN5•Mtuutu, -0 X EC) t YR.. O.Dueormy a Corns' oirNpu0 siounimomn snowia I assonttu un. Warn -atru.dv6040.1'Cow Loa "WO, it C.Natursuoincon &amid° wouno v Inimenroni. 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(Maw SPSwisa sniapcu3 ...0)31•13titln30 nou.onacnia FLIGHT TESTING (Hen 44#1100 Veva/0SW rottonacnea -a moray ' J 3a11 Walruovsneove V SONY_GM_02754777 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241699 EFTA01261588 '• Von name inwanmEss HS 7 ISIS CIPTIMMOSPORT•1 a,1010-ROCRAL AVIATIION ADMINISTRATIC011 E • •••••••••••• rim sneriCW al.•••Orrt riesal Syn. • u•®.. OileolrAlispi maga t4152AE Sikorsky S76C 760872 r0nsport ---de tztt tole. si••••• este •••••16...mit szrzr. z :xiFs ••••••fs. •••••• any./ bine.. [ ..nom tt• Foal ati In Om Weimi r.'"" 10-21-97 !Kurt SOtt CHS90000'tc •••••••••. ••••=1••••• • • emSna 0.1. Zink:VA= SIgrat avr . FY Fos t100.2,... rtai•o4n,.. SONY GM rAA ?tau In• TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA 00241700 EFTA01261589 SONY_GM_02754779 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA 00241701 EFTA01261590