Piper Malibu PA-46-310P Pilot Operating Handbook page 219

US Deportment
Of
Tronsportat,on
(
MAJOR REPAIR AND ALTERATION
(Airframe, Powerplant, Propeller,· or Appliance)
l
J
Form Approved~ •
0MB No. 2120-0020
For FAA Use Only
Office tdentif ication
federal A¥latlon
Admlnlslaollon
~c..l-F5/t?-t?
~
INSTRUCTIONS: Print or type
all
entries. See FAR
43.9,
FAR
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.
1421 ).
Failure to report can result in a civil penalty not to exceed
$1.000
for each such violation (Section 901 Federal Aviation Act of 1958).
1.
Aircraft
2. Owner
Unit
AIRFRAME
POWERPLANT
PROPELLER
APPLIANCE
Make
Piper
S
Model
PA46-310P
Nationality and Registration Mark
Name (As shown on registration certificate} Address (As shown on registration certificate)
701 Wilson Point Road
Baltimore, MD 21220
Make
3. For FAA Use Only
·• 1
ne data kllntlfied herein
complln
with the
applloable
ainvorlt\inna
raqu1NHnefttll and i1 approved for duplication on identlcal aircraft
m~ke. model, and aStered configuration when accompllahtd by the
onglnal modfler ...
tJ
~
-tl
7-
9
I;'
~~
C-( ..
~,.,_,.._,,t,,tfq;-
&; -
nfl=U..
4. Unit Identification
Model
Serial No.
,,,,,,,,, , ,,,,,,, (As described in Item 1 above) ,,,,,,,,,,,,, ,,, ,,
Type
Manufacturer
6. Conformity Statement
5. Type
Repair
A. Agency·s Name and Address
B.
Kind of Agency C. Certificate No.
Skytech, Inc.
P.O. Box 4942
Baltimore, MD 21220
U.S. Certificated Mechanic
Foreign Certificated Mechanic
LF1R294K
X
Certificated Repair Station
Manufacturer
Alteration
X
·.
D. · 1
certify that the repair and/or alteration made to the unit(s) identified in item
4
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 infdrmation
furnished herein is true and correct.to the best of my knowledge. ·
Date
24
July
199S
s ~
of Authorized lndi~homas
p.
Scarbrough
'2f--~/!7- -
7.
Approval
tor Rehlrn To Service
Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the
Administrator of the Federal Aviation Administration and is
:Kl
APPROVED
D
REJECTED
BY
FAA Flt. Standards
Inspector
Manufacturer
r,
Inspection Authorization
FA D · R · s · Person Approved by Tran sport
Other (Specify)
A es1gnee
X
epa,r tation Canada Airworthiness Group
--------------------------~------------..,_---1------~----------------,__--------------------------------~·
DateolApprovalorRejection Certificateor
S ~ l ~ A u t h o r i ~ e d l n d i idual
homas P.
Designation No.
~ ~
24 July 1995
LF1R294K
Scarbrough