Piper Malibu PA-46-310P Pilot Operating Handbook page 204

·o
Fann Approved
0MB No. 2120-0020
MAJOR REPAIR AND ALTERATION
us
Oepar1mem
(Airframe, Powerplant, Propeller, or Appliance)
For FAA Use
Only
of Transporta!lon
Office Identification
· FedeAI Aviation
Admmislration
INSTRUCTIONS: Print or type al entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for ·instructions
and disposition of this fonn. This
report
is required
by law
(49 U.S.C. 1421). Failure
to
report can resulfin·civll penally
not to
exceed $1,000
: for each
$Uch
violation (Section 901 Federal Aviation Act of 1958).
Make Model
Piper PA46-310P
1. Aircraft
Serial No. Nationality and Registration
Mark
USA
Name (As shown on mglstratlon certmcate)
Address
(As shown on regJstmtlon certificste)
2.0wner
3. For FAA Use Only
4. Unit Identification S. Type
Unit Make Model
Serial No. Repair Alteration
AIRFRAME
(As described
in
Item 1 above)
X
POWER PLANT
eROPELLER~
---
----
-
--- --
-
-
--
~ ' - - - . -
-
----
-
----~-----------
-
-----~-
-
-
- - - - - --
-
Type
APPLIANCE
Manufacturer
6. Conformity Statement
A. Agency's
Name
and Address
B.
Kind of Agency
C. Certificate No.
Mead Aircraft Services, Inc.
X
U.S. Certificated Mechanic
443641987
648 Arrowhead Rd
Fonmn Certificated Medlanic
Inman, KS 67546
Certificated Renalr Station
Manufadurer
0.
I certify that 1he repair and/or alteration made
to
the unit(s) identified in item 4 above and desaibed on the
mve,se
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.
Qate
Signature of Authorized Individual
8-4-03
/A-.~~
Kevin Mead
7. Approval for Retum To Service
Pursuant
to
the authority given persons specified below, the unit idenfified in item 4 was ins~ed in the manner presaibed by the
Administrator of the Federal Aviation Administration and is [XI APPROVED REJECTED
FM FIL Standards
Manufacturer
X
Inspection Authorization
Other
(Specify)
Inspector
BY
FAA Oesignee Repair Station
Person ~roved by Transport
Cenada irworthiness Group
Date of Approval or Rejection Certificate or Signature of Authorized lndMdual / / '
8-4-03
Designation No.
/ ~ _
~ .-
,.. Kevin Mead
IA 443641987
. . ·-. - 7.
-
FAA Fonn 337
(12-88)