Piper Malibu PA-46-310P Pilot Operating Handbook page 193

•
us Department
of Tmnspo,tatio
Faderal Aviation
Admlnlstndlon
INSTRUCTIONS: Print or type aD entries. See TI ii e 14 CFR §43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for
instructions and disposition of this form. This report is required by law (49 U.S.C. §44701 ). Failure to report can result in a civil penalty for each
such violation. (49 U.S.C. §46301(a))
Nationality and Registration Mark
USA
1. Aircraft
Make
Piper
Name
(As shown
2.0wner
4. T y pe
Alteration
Repair
D Ill
D D
D D
-
- .-.
- - -
-oc.
D
D
A. Agency's Name and Address
Mead Aircraft Sevices, Inc
j jag ti! Aic122r::t Bg
Name
Addrass
Hutchinson
City
67501
Coumry
Zip
I certify that the repair and/or alteration made to the unlt(s) Identifi e d in item 5 above and described on the reverse or attachments hereto
D.
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.
Extended range fuel
per 14 CFR Part 43
App.B
Pursuant to the authority given persons specified below, the unit identified in I t em 5 was inspected in the manner prescribed by the
Administrator of the Federal Aviation Administration and Is
FAA Rt Standards
Inspector
BY
FAA Designee
Certificate or
Designation No.
IA 443641987
MAJOR REPAIR AND ALTERATION
(Airframe, Powerplant, Propeller, or Appliance)
on
registration certificate)
Unit
AIRFRAME
POWERPLANl
--
PROPELLER
-
--
-·-
..
_.,..,
-·.
Type
APPLIANCE
Manufacturer
Slate KS
USA
-'8/DaleofAut,orized JodMdual
D
Kevin Mead 1-11-10
7. Annroval for Retum to Service
Manufacturer
Repair Station
Signature/Date of Authorized Individual
Kevin Mead 1-11-10
Serial No.
Model
PA46-310P
Address
AddreB8
City
3. For FAA Use Onlv
5.UnHldentlflcation
Make
(As described In Item 1 above)
......
�-
6. Confonnny Statement
B. Kind of Agency
1./
U.S. Certificated Mechanic
Certific
Foreign Mechanic
Certific
Repair Station
Certificat Maintenance Organization
;7�---
�
G2I
Approved
Maintenance Organization
X
Inspection Authorization
;x..
�
EIBcbanlc
Fonn ApplDll8d
I
0MB No. 2120-0020
11/30t2007
For FAA Use Only
Series
I
shown on
(As regis1rat/on certificate)
Model
--- --
---
-
-.
I
Manufacturer
C. Certificate No.
A&P 443641987
D
Rejected
I
Approved
PerBOns by Canadian
Department of Transport
Other
(Specify)
Number
Serial No.
--
� --- � �=--- -- -