Appendix 4 FAA Form 8120-10 (11-05) Supersedes Previ ous Edition (Representation)
1. Request for Conformity Inspection: Enter the FAA office that the applicant asks to perform the conformity inspection.
2. Project No.: Enter the FAA project number for the project.
3. Date: Enter the current date.
4. Part Conformity/Installation/Other: Check the applicable blocks.
5. Applicant Name: Enter the name of the applicant as shown on the original project application.
6. Company Name: Enter the name of the supplier, vendor, or test firm where the desired inspection will occur.
7. Street/City/State/Zip: Enter the address of the company named above. A post office box is not acceptable.
8. Time/Date Available: If you know when the product, part, assembly, appliance, or test article will be ready, enter the expected date.
9. Type Installation: Enter a brief descriptive statement, which includes the product, part, assembly, appliance, or test article to be inspected (for example, landing gear assembly, galley flammability test articles, wing spars, and so forth).
10. Make/Model: Identify the end product being certificated or modified.
11. Quantity: Enter the quantity of parts requiring inspection (for example, 1 shipset, 5 test samples, and so forth).
12. Requesting document such as a purchase order ( P.O.) and date: Reference the applicant’s letter or other correspondence identifying the pending certification test.
13. Design Data: Identify the data to be used for the inspection, that is, drawings (including revision and date).
14. Special Instructions: Enter any special instructions, as necessary.
15. Applicant Contact: Enter the name, title (if known), and telephone number of the person to contact at either the applicant’s or the vendor organization to arrange the inspection.
16. FAA Project Manager: Enter the name and telephone number of the FAA project manager.
17. FAA Project Engineer: Enter the name and telephone number of the FAA project specialist involved in the pending test. In “Remarks,” (if applicable), enter:
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Appendix 4
a. The name of the designated engineering representative authorized to disposition unsatisfactory conditions found during conformity inspection.
b. The name of the designated airworthiness representative requested by the applicant.
18. MIO type certification management specialist (TCMS): Enter the name and office symbol of the manufacturing inspection office (MIO) TCMS, who covers the project manufacturing inspection district office’s principle inspector (PI) conformity activities.
19. MIDO Project Principle Inspector: Enter the name and office symbol of MIDO PI responsible for the conformity request.
20. “Form Blocks”: Place a check mark in each applicable block:
a. TIA Issued: Check this block for requests to supplement a previously issued type inspection authorization (TIA).
b. TIR Required: Check this block to have related conformity inspection records placed in the pending type inspection report (TIR) or supplemental type inspection report (STIR) (when the FAA has issued a TIA).
c. 8130-3 Tags Required: Check this block when you will move or ship the inspection articles from the inspection site to a remote testing site, and want assurance that the article will be inspected. FAA Form 8130-3 is the conformity inspection tag.
d. FAA Form 8100-1 Required: Check this block for every request. FAA Form 8100-1 is the conformity inspection record.
e. FAA Form 8130-9 Required: Check this block for every request. The FAA requires this form under 14 CFR § 21.53.
21. Note: Enter “Please return this request for conformity, with the FAA conformity document, to the project PI. The project PI sends the documents to the MIO TCMS, who sends them to the FAA project engineer.”
22. Reviewed By: Enter the name, title, and office symbol of FAA project engineer reviewing the FAA conformity document.
23. Continuation Sheet: Enter additional information on Design Data, Special Instructions, and Remarks, if necessary. The purpose for the STC checklist is to monitor and communicate early, and throughout the certification process, the requirements to be fulfilled for an STC to be issued.
The checklist has all FAA requirements that an STC applicant should meet. Throughout the certification process, each item in the checklist should be checked, marked and dated when complete. Both the applicant and ACO should use the checklist to monitor the progress of the STC project, and to ensure that all requirements are met. Applicant, project manager/ engineer and the MIDO should likewise use this checklist and share in updating it.
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Appendix 5 APPENDIX 5. STC FILE CHECKLIST Task DateCompleted PROJECT INITIATION:
Application for STC, FAA Form 8110-12
One-only
Multiple
Certification program notification
Project notification letter to applicant
PSCP or Certification Plan
NotACO to ACO Coordination Required ____ required _____ Prototype Aircraft U.S. Yes NoRegistered? ____ _____ NotFCAA coordination Required ____ required _____ DATA TO SUPPORT STC:
Compliance checklist Master drawing list Photographs, sketches, drawings Installation instructions Instructions for Continued Airworthiness Substantiation Reports/ FAA Form 8110-3 Approvals:
Structural Systems and equipment Electrical load analysis Propulsion Flight Test Weight and balance Continued airworthiness Qualification Ground Testing:
Structural Systems and equipment Environmental Flammability Propulsion HIRF (RTCA/DO-160) Software (RTCA/DO-178) Compliance to 14 CFR § 21.93 (b) (Acoustical Change) Compliance to 14 CFR § 21.93 (c) (Emissions Change) A-15
Appendix 4 Task DateCompleted CONFORMITY/FLIGHT TESTING:
Statement of Conformity, FAA Form 8130-9
Request for Conformity, FAA Form 8120-10
Conformity Inspection Record, FAA Form 8100-1
Type Inspection Authorization, FAA Form 8110-1
Type Inspection Report:
Part I (STIR, FAA Form 8110-26)
Part II (Flight Test Report)
Flight Manual Supplement or Supplemental Flight Manual PROJECT CLOSEOUT:
Project substantiation summary
STC Issuance
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Appendix 6 APPENDIX 6. LIST OF FAA FORMS The following forms are available at http:// www.faa.gov/library/forms/
1. FAA Form 337
2. FAA Form 8000-4
3. FAA Form 8000-5
4. FAA Form 8100-1
5. FAA Form 8110-1
6. FAA Form 8110-2
7. FAA Form 8110-2-1
8. FAA Form 8110-3
9. FAA Form 8110-9
10. FAA Form 8110-12
11. FAA Form 8110-14
12. FAA Form 8110-26
13. FAA Form 8120-10
14. FAA Form 8130-3
15. FAA Form 8130-9
16. FAA Form 8430-9 Major Repair and Alteration (Airframe, Powerplant, Propeller, or A p p l i a n c e .
Air Agency Certificate Certificate of Designation Conformity Inspection Report Type Inspection Authorization Supplemental Type Certificate Type Certification Continuation Sheet Statement of Compliance with the Federal Aviation Regulations Type Certificate Application for Supplemental, Production or Type Certificate Statement of Qualifications (DAR – ODAR - DMIR - DER) Supplemental Type Inspection Report Request for Conformity Airworthiness Approval Tag Statement of Conformity Certification of Authority A-17
Appendix 7 APPENDIX 7. LIST OF FAA AIRCRAFT CERTIFICATION/FIELD OFFICES Anchorage Aircraft Certification Office (ACE-115N) Federal Aviation Administration 222 West 7th Ave #14 Anchorage, AK 99513-7587 Telephone: (907) 271-2668 FAX: (907) 279-6365 Atlanta Aircraft Certification Office (ACE-115A) Federal Aviation Administration 1895 Phoenix Blvd., Suite 450 Atlanta , GA 30349 Telephone: (770) 703-6035 FAX: (770) 703-6097 Boston Aircraft Certification Office (ANE-150) Federal Aviation Administration 12 New England Executive Park Burlington, MA 01803 Telephone: (781) 238-7150 FAX: (781) 238-7170 Chicago Aircraft Certification Office (ACE-115C) Federal Aviation Administration 2300 East Devon Avenue Des Plaines, IL 60018 Telephone: (847) 294-7357 FAX: (847) 294-7834 Denver Aircraft Certification Office (ANM-100D) Federal Aviation Administration 26805 E. 68th Ave., Room 214 Denver, CO 80249 Telephone: (303) 342-1080 FAX: (303) 342-1088 Fort Worth Rotorcraft Certification Office (ASW-170) Federal Aviation Administration 2601 Meacham Blvd.
Fort Worth, TX 76137 Telephone: (817) 222-5170 FAX: (817) 222-5959 Fort Worth Special Certification Office (ASW-190) Federal Aviation Administration 2601 Meacham Blvd.
Fort Worth, TX 76137 Telephone: (817) 222-5190 FAX: (817) 222-5959 Los Angeles Aircraft Certification Office (ANM-100L) Federal Aviation Administration 3960 Paramount Blvd.
Lakewood, CA 90712 Telephone (562) 627-5200 FAX: (562) 627-5210 New York Aircraft Certification Office (ANE-170) Federal Aviation Administration 1600 Stewart Avenue, Suite 410 Westbury, NY 11590 Telephone: (516) 228-7300 FAX: (516) 794-5531 Seattle Aircraft Certification Office (ANM-100S) Federal Aviation Administration 1601 Lind Avenue SW
Renton, WA 98057 Telephone: (425) 917-6400 FAX: (425) 917-6590 A-18
Appendix 7 Engine Certification Office (ANE-140) Federal Aviation Administration 12 New England Executive Park Burlington, MA 01803 Telephone: (781) 238-7140 FAX: (781) 238-7199 Fort Worth Airplane Certification Office (ASW-
150) Federal Aviation Administration 2601 Meacham Blvd.
Fort Worth, TX 76137 Telephone: (817) 222-5150 FAX: (817) 222-5959 Wichita Aircraft Certification Office (ACE-115W) Federal Aviation Administration 1801 Airport Road, Room 100 Wichita, KS 67209 Telephone: (316) 946-4100 FAX: (316) 946-4107 Military Certification Office (ACE-100M) 8200 E. 34th. St. N.
Bldg. 1000, Suite 1005 Wichita, KS 67226 Telephone: (316) 350-1580 FAX: (316) 350-1586 A-19
Appendix 8 APPENDIX 8. GLOSSARY OF TERMS AC: Advisory Circular.
ACO: Aircraft Certification Office AEG: Aircraft Evaluation Group AFM/RFM: Aircraft/Airplane/Rotorcraft Flight Manual AFMS/RFMS: Aircraft/Airplane/Rotorcraft Flight Manual Supplement Agent: Individual authorized by the applicant to act on behalf of applicant.
AML: Special case of multiple STC using an approved model list to control installation eligibility, so adding new make and model products does not require amending the STC.
AN: Aeronautical Standard Applicable Regulations: Those portions of 14 CFR or CAR which apply to the STC modification (also called the certification basis).
ATC: Amended Type Certificate Authorized Designee: FAA designee granted FAA approval to perform a specific task for the applicant, such as witnessing a certain test or conducting a certain conformity inspection.
CAA: (Foreign) Civil Aviation Authority CAM: Civil Aeronautics Manual CAR: Civil Air Regulations Certification Basis: (See “Applicable Regulations.”) Certification Plan: Written plan for the coordination of the STC application process, including identification of all applicable regulations and anticipated methods for demonstrating compliance with the regulations, proposed use of designees, and anticipated project schedule.
Certification Testing: (See “Component Testing”, “Ground Testing” and “Flight Testing.”
Also called Compliance Testing) CG: Center of Gravity A-20
Appendix 8 CMACO: The ACO managing the product’s TC. Also manages the continued airworthiness for all products they approve for as long as the products are in service.
Compliance Data: Data necessary to substantiate that the modification or installation complies with the applicable regulations (also called substantiating data).
Compliance Inspection: Specification review and physical inspection of hardware to verify that a particular component or modification complies with the requirements of the applicable regulations.
Compliance Testing: (See “Component Testing”, “Ground Testing” and “Flight Testing.”
Also called Certification Testing) Component Testing: Testing of a detail part, component, or subassembly to demonstrate that it functions as required to meet the applicable regulations.
Conformity Inspection: Physical comparison of the component or modification to the engineering drawings and specifications to verify that component or modification conforms to the data.
DAR: Designated airworthiness representative DAS: Designated Alteration Station DER: Designated Engineering Representative Descriptive Data: Data necessary to completely define the design of the modification or installation.
Designee: Individual authorized by FAA to approve data, conduct inspections, witness tests, etc.
DMIR: Designated Manufacturing Inspection Representative ELOS: Equivalent Level of Safety EMI: Electromagnetic Interference Experimental Airworthiness Certificate: As referenced in this guide, a certificate to operate the aircraft with the modification installed before STC approval is granted in order to perform research and development testing and FAA flight testing.
FAA: Federal Aviation Administration FADEC: Full Authority Digital Electronic/Engine Controls A-21
Appendix 8 Flight Testing: Testing in flight of the final modification or installation on the aircraft. Can also include related ground testing 14 CFR: Title 14 of the Code of Federal Regulations FSDO: Flight Standards District Office Ground Testing: Structural, environmental, fuel flow, or similar tests (other than tests in flight) performed on the final modification or installation to demonstrate that it complies with the applicable regulations.
ICA: Instructions for Continued Airworthiness Major Change: Change to an aircraft, engine, or propeller which appreciably affects weight, balance, strength, reliability, operational characteristics, airworthiness characteristics, power, noise characteristics, or emissions.
MDL: Master Drawing List MIDO: Manufacturing Inspection District Office Minor Change: Change to an aircraft, engine, or propeller which does not appreciably affect weight, balance, strength, reliability, operational characteristics, airworthiness characteristics, power and noise characteristics, or emissions.
MISO: Manufacturing Inspection Satellite Office MMEL: Master Minimum Equipment List MOA: Memorandum of Agreement MRB: Maintenance Review Board MS: Military Standard
“Multiple” STC: An STC applicable to more that one serial number aircraft, engine, propeller, or appliance.
NAS: National Aerospace Standard NTIS: National Technical Information Service ODA: Organization Designation Authorization ODAR: Organizational Designated Airworthiness Representative A-22
Appendix 8 “One-only” STC: An STC applicable to only one serial number aircraft, engine, propeller, or appliance.
PACO: ACO working a certification project. May need to coordinate with the CMACO, if the project is a follow-up certification activity, such as an STC or PMA.
PAH: Production Approval Holder PCSP: Project Specific Certification Plan PHAC: Plan for Hardware Aspects of Certification PMA: Parts Manufacturer Approval POH: Pilot’s Operating Handbook Project Engineer: FAA ACO engineer assigned to the STC project to evaluate the data submittals.
Project Manager: FAA ACO engineer or supervisor assigned to coordinate the approval process of an STC application.
Project Number: Number assigned by the FAA ACO to the STC application to facilitate approval process.
Project Team: FAA personnel assigned to the STC project.
Request for Conformity: Request from the FAA project engineer to the FAA manufacturing aviation safety inspector to perform a conformity inspection on a specific article.
Statement of Conformity: Official signed statement from the applicant signifying that the modification or installation conforms to the design data and to the type design. (FAA Form 8130-9.)
STC: Supplemental type certificate, issued for a major design change to a type-certificated product when the changes are not so extensive as to require a new type certificate.
STC Application: Application for a supplemental type certificate. (FAA Form 8110-12.)
Substantiating Data: (See “Compliance data.”) STIR: Supplemental Type Inspection Report, an official document that allows the manufacturing inspector to record the results of the inspections and tests conducted on modified products presented for STCs (FAA Form 8110-26).
TC: Type Certificate A-23
Appendix 8 TCAS: Traffic Collision (Alert) and Avoidance System TCB: Type Certification Board TCDS: Type Certificate Data Sheet, part of the TC which documents the conditions and limitations necessary to meet the airworthiness requirements of Title 14 of the Code of Federal Regulations, and provides a concise definition of the configuration of a type-certificated product.
Test Article: Components, aircraft, engines, or propellers used specifically for certification testing.
TIA: Type Inspection Authorization, an official document listing the inspection, ground test and flight test requirements for the modification. TIA initiates official FAA flight testing (FAA Form 8110-1).
TIR: Type Inspection Report, an official document used with the TIA that enables the manufacturing inspector to report the results of the ground inspection (part one of the TIA).
TSO: Technical Standard Order, a minimum performance standard issued by the Administrator for specified materials, parts, processes, or appliances used on civil aircraft.
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