Piper Malibu PA-46-310P Pilot Operating Handbook page 230

U.S. DEPARTMENT OF TRANSPORTATION
F onn A'fJ':':.vtd
FEDERAL AVIATION ADMINISTRATION
Budgtl urtau No. 04-R060. I
MAJOR
REPAIR AND ALTERATION
FOR FAA USE ON LY
OFFICE IDENTIFICATION
( Airframe, Powerplant, Propeller, or Appliance)
INSTRUCTIONS: Print o r type a ll entri es. ~e FAR 43.9 , FAR 43 Appendix B, and AC 43 .9-1 (or subsequent revision thereof)
fo r ins tructions and d isposition of this fo rm .
MAKE
Pi per
MODEL
PA-46- 310P
1. A IRCRAFT
SERIAL NO .
, NATIONALITY AN D REGISTRATION MARK
I
NA.ME ( A$ shown on r11gistration certi ficate,)
i
ADDRESS
(A<
,h,_
~
~,,-,,,;~ corl;flcatoJ
2. OWNER
3. FOR FAA USE ONLY
4. UNIT IDENTIFICATION
5.
TYPE
i
UNIT
MAU
MODEL
SERIAL NO.
ALTU·
REPAIR
ATIO N
AIRFRAME ####################"
(A• d11scr ibe d ,n i tc,m
I
abov11)######################
xx
POWERPLANT
PROPELLER
-
I
-
--
.
-
,~
·~
TY,E
APPLIANCE
MAN UfACTUltfll
6. CONFORMITY STATEMENT
A. AGENCY'S NA.ME AND ADDRESS
8. KIND OF AGENCY
C. CERTIFICATE NO.
U.S. CERTIFICATED MECHANIC
Kal - Jl.ero , Inc .
.
FOREIGN CERTIFICATED MECHAN IC
5605 Portage Road
X
CERTIFICATED ll!PAlll STATION
-
CRS# 3240
Kal amazoo , MI . 49002
MANUfACTUllf ll
D. I certify that the repair and/ or a lteration made to the unit(s ) identified in item 4 aboye and described on the reverse or
attachments hereto have been m ade in accordance with the requirements of Part 43 of the U.S.
Federa l Aviation Regulation,
and th at the information furnish ed herein is tru e and correct t o the best of my know ledge.
DATE
SIGNATURE OF AUTHORIZi::D INDIVIDUAL
Oct ober 24, 1984
M ~
7. APPROVAL FOR RETURN TO SERVICE
Punuant to the authority given person, sp ecified below, the unit ide ntified in item 4 w as in ~ e d in the manner prescribed by
the Administrator of th e Feder al Aviation Administration and is
rn
APPROVED
n
REJEC
fM FLT. fTANDARDS
MANUFACTUR!R
INSPECTION AUTHORIZATION
OTHER (S1>«i/y
)
INll'tCTOA
IY
CANADIAN
oe, . .
UTMENT
fAA 1)1510NfE
X
REPAIR STATION
Of TRANSPORT INSPECTOR
Of AIRCRAFT
DATE
0 1'
APPROVAL OR
CERTIFICATE OR
S IGNATURE Of' AUTH O
RIZED INDIVIDUAL
REJECTION
DESIGNATION NO .
~
~
10-24-84
CRS# 3240
'
FAA Fonn 337
(7-67l
(8320)