Piper Malibu PA-46-310P Pilot Operating Handbook page 198

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Form Approved
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Electronic Tracking Number
0MB No.
2120-0020
MAJOR REPAIR AND ALTERATION
11/3C\12007
US Department
For FAA Use Only
of Transportadon
(Airframe, Powerplant, Propeller, or Appliance)
Federal Aviation
Administration
INSTRUCTIONS: Print or type all entries. See TiUe 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
1. Aircraft
Make Model
I
Series
PA46-310P
Name (As shown on registration certificate) Address (As shown on registration certificate)
Address
2. Owner
City
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State
Zip
2
Country
3. For FAA Use Only
4.Type
5. Unit Identification
Repair
Alteration Unit
Make Model Serial No.
D
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AIRFRAM E
(As described in Item 1 above)
D
D
POWERPLANl
D D
-
-
-
-
PROPELLER
Type
D D APPLIANCE
Man ufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency
Name
Kevin Mead Mead Aircraft Services, Inc. 648
Ar,
y.
U.S. Certificated Mechanic
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Manufacturer
Addrass
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Acco.
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Foreign Certificated Mechanic C. Certificate No.
City
:r::k'.l
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IC)
State
1 .lS
Certificated Repair Station
Zip
!t2"1$"9"~
Country Certificated Maintenance Organization
A&P 443641987
D.
I certify that the repair and/or alteration made to the unit(s) identified in item 5 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.
-
Extended range fuel
Signature/Date of Authorized Individual
-~P
per 14 CFR Part 43 D
Kevin Mead 10-31 -07
$----
App. B
7. Approval for Return to Service
Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner
prescribed by the
Administrator of the Federal Aviation Administration and is
[i1
Approved
0
Rejected
FAA Flt. Standards
Manufacturer
Maintenance Organization
I
Persons Approved
by
Canadian
Inspector
Department o f Transport
BY
Other (Specify)
FAA Designee Repair Station
)(
Inspection Authorization
Certificate or Signature/Date of Authorized Individual
/
Designation No.
Kevin Mead 10-31-07
7~
A&P 443641987