Appendix D D-1 APPENDIX D. ACAS RESOLUTION ADVISORY (RA) REPORT Your participation in the reporting of ACAS events is essential to the success of ongoing evaluation of ACAS performance. Use the following information to guide your reporting of the ACAS event through the pilot report options outlined in this AC.
Reporting Pilot: ________________ Date: _____/_____/_____ Time: __________ UTC Origin: _________ Destination: _________ Call Sign: __________ A/C Type: _________ Registration Number: __________ Transponder Code: ____________ ATC Control Name: ____________ ATC Control Frequency: _______________ Actual Altitude: ___________ Cleared Altitude: ___________ Own Position: _______________________________ (Lat./Long. or Nav Aid/Radial/Distance) Phase of Flight: Departure (Takeoff to 10,000 feet) Climb (10,000 feet to Cruise) Cruise Descent (Cruise to 10,000 feet) Holding Pattern Approach (Below 10,000 feet) THREAT AIRCRAFT (if known) Call Sign: _____________ A/C Type: Commercial General Aviation Military Other Make/Model: _____________ Actual Altitude: ___________ Cleared Altitude: ___________ Did you have the aircraft in visual contact? Yes No If yes: Before TA / After TA. Before RA / After RA.
Was a TA generated? Yes No Were multiple TAs generated against the same intruder? Yes No Initial RA Generated: Descend, Descend Climb, Climb Monitor Vertical Speed Climb, Crossing Climb Descend, Crossing Descend Maintain Vertical Speed, Maintain Maintain Vertical Speed, Crossing Maintain Adjust Vertical Speed, Adjust ________ feet/minute Level Off, Level Off Did the initial RA change to any of the following?
Adjust Vertical Speed, Adjust Level Off, Level Off Increase Climb Increase Descent Climb, Climb NOW Descend, Descend NOW Descend, Descend Climb, Climb Range to threat aircraft at RA? __________ Bearing to threat aircraft at RA? ___________ Relative altitude of threat aircraft at RA? ____________feet Estimated Closest Proximity: Range ____________NM Altitude ____________NM Your response to the RA was: Climb Descend Change in Vertical rate Level Off Turn No Response No Response Necessary Was the event reported to ATC? Yes No Did ATC provide traffic information on the threat aircraft? Before RA After RA No Did the RA conflict with ATC instructions? Yes No If you did not comply with the RA, please explain why:
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REMARKS (please provide comments/concerns on this encounter):
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Advisory Circular Feedback Form If you find an error in this AC, have recommendations for improving it, or have suggestions for new items/subjects to be added, you may let us know by contacting the Flight Technologies and Procedures Division at 9-AWA-AFS400-Coord@faa.gov or the Flight Standards Directives Management Officer at 9-AWA-AFB-120-Directives@faa.gov.
Subject: AC 90-120, Operational Use of Airborne Collision Avoidance Systems Date: _____________________ Please check all appropriate line items:
An erro r (proc edur al or typographical) has been noted in paragraph ____________ on page _______.
Recommend paragraph _____________ on page __________ be changed as follows:
______________________________________________________________________ ______________________________________________________________________ In a future change to this AC, please cover the following subject:
(Briefly describe what you want added.)
______________________________________________________________________ ______________________________________________________________________ Other comments:
______________________________________________________________________ ______________________________________________________________________ I would like to discuss the above. Please contact me.
Submitted by: Date: ______________________