What it approves
Installation of a One Man Loading Patient Litter System
What the certificate says
From the PDF’s text layer, without the form’s printed wording. Layout and order may differ; the PDF is the record.
Number SR02125LA
This certificate, issued to LifePort, LLC 1610 Heritage Street Woodland, WA 98674
Part 29* of the Federal Aviation Regulations. *Certification basis is set forth in Type Certificate Data Sheet H1NE.
Original ProductType Certificate Number: H1NE Make: Sikorsky Model: S-76A, S-76B, S-76C Description of the Type Design Change: Installation of a One Man Loading Patient Litter System in accordance with FAA Approved Master Drawing List for the One Man Loader EMS System as Installed in the Sikorsky S-76 Series Rotorcraft per CF1-078, MDL-837-00, Revision G, dated March 18, 2008, or later FAA approved revision. FAA Approved Rotorcraft Flight Manual Supplement No. EGR-837-11, dated March 26, 2008, or later FAA approved revision is required as part of this installation.
Limitations and Conditions: Approval of this change in type design applies to the above model aircraft only.
This approval should not be extended to other aircraft of these model series on which other previously approved modification are incorporated unless the installer determines that the relationship between this change and any other previously incorporated approved modifications, including changes in type design, will introduce no adverse effect upon the airworthiness of that aircraft. A copy of this certificate must be maintained as part of the permanent records for the modified aircraft.
If the holder agree to permit another person to use this certificate to alter the product, the holder shall give the other person written evidence of that permission.
Date of application: November 9, 2007 Date reissued: May 10, 2019 Date of issuance: March 28, 2008 Date amended:
FAA FORM 8110-2 (5/14) PAGE 1 OF 2 PAGES By direction of the Administrator
(Signature)
Acting Manager, Seattle ACO Branch (Title)
Transfer the ownership of Supplemental Type Certificate Number
to (Name of Transferee)
(Address of Transferee)
(Number and Street)
(City, State, and ZIP Code)
from (Name of Grantor) (Print or Type)
(Address of Grantor)
(Number and Street)
(City, State, and ZIP Code)
Signature of Grantor (In Ink):
U.S. GPO: 1987-763-289
ADs that name this STC · 0
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