AIM/Luftfartsinformationsledelsen, Ellebjergvej 50, DK-2450 København SV, Danmark
TEL: +45 36 18 60 00, FAX: +45 36 18 60 22, E-mail: ais@slv.dk, Internet: www.slv.dk
Statens Luftfartsvæsen
Civil Aviation Administration - Denmark
AIC B
10/07
15 MAR 2007
AIC B 10/07. Salg og brug af ikke luftdygtigt luftfartøjsmateriel. Unapproved Parts Notification (UPN).
(Erstatter AIC B-33/05)
Salg af luftfartøjsmateriel der enten er produceret uden fabrikations-
landets myndigheds godkendelse, eller sælges med manglende
eller ugyldigt luftdygtighedsattest, er desværre et kendt problem.
For at kunne advisere markedet om sådanne forhold, har FAA opret-
tet et kontor, der jævnligt udsender information om kendte forhold til
myndigheder og brugere.
Statens Luftfartsvæsen (SLV) modtager derfor jævnligt information
om sådanne forhold bl.a. fra FAA.
SLV har valgt, at informere luftfartøjsejere, -brugere, -vedligeholdere
og fremstillere af luftfartøjsmateriel i Danmark om sådanne forhold,
ved udsendelse af disse informationer via AIC form.
SLV skal minde om, at det påhviler ejer/bruger samt alle der er
involveret i brug og vedligeholdelse af luftfartøjer/ -materiel, kun
at montere luftdygtige dele på luftfartøjer. Endvidere skal de, som
monterer dele på luftfartøjer/ -materiel sikre sig at tilfredsstillende
dokumentation følger delene.
SLV har vedlagt et "Suspected Unapproved Parts Notification"
skema til rapportering af tilfælde, som kunne tyde på, at delen(e) fal-
der ind under begrebet "Unapproved Parts Notification (UPN)". Vej-
ledning i udfyldelse af "Suspected Unapproved Parts Notificaion"
fremgår af skema side 2.
Som noget nyt har FAA’s kontor for ikke-godkendte dele "Unappro-
ved Parts Notifications (UPN)" oprettet en hjemmeside med informa-
tioner om udsendte Notifications. Hjemmesiden kan findes på
internettet under adressen:
http://www.faa.gov/aircraft/safety/programs/sups/upn/
Foreign CAA Unapproved Parts Notification under adressen:
http://www.faa.gov/aircraft/safety/programs/sups/caaup/
På SLV’s hjemmeside:
http://www.slv.dk/Dokumenter/dscgi/ds.py/View/Collection-33
Findes denne AIC B, hvori der er påført links til FAA’s "Unapproved
Parts Notification" liste.
Ref. BL 1-1, BL 2-1, BL 2-4, EF 1592/2002, EF 2042/2003.
Bilag:
1. Suspected Unapproved Parts Notification. (skema) FAA Form
8120-11 (02/07), Form SLVLD-145, February 2007 Rev 1.
(TL)
Statens
Luftfartsvæsen
Danish Civil Aviation Administration
a member of the
European Aviation Safety Agency (EASA).
SUSPECTED UNAPPROVED PARTS NOTIFICATION
To report multiple part numbers, please use continuation sheet
1. Date the Part Was Discovered:
2. Part Name:
3. Part Number:
4. Part Serial No.:
5. Quantity:
6. Assembly Name:
7. Aircraft Make & Model:
Assembly Number:
8. Name, Address, and Description of Company or Person(s) Who Supplied or Repaired the Part
Name:
Street Address:
City:
State:
Zip:
Country:
Phone Number:
Who has supplied or repaired the part:
Air Carrier Cert. #
Mechanic Cert. #
Repair Station Cert #
Distributor
Owner/Operator
Supplier
Production Approval Holder
Manufacturer
Other
Unknown
9. Description of Event: (Include why you think the part(s) is not approved).
10. Name and Location of Company or Person(s) Where Part Was Discovered:
Name:
Street Address:
City:
State:
Zip:
Country:
Phone Number:
Check One of the Following Applicable to the Person Who Discovered the Part:
Air Carrier Cert. #
FAA Inspector
Mechanic Cert. #
DOT / Office of Inspector General
Repair Station Cert. #
Defense Criminal Investigation Service
Distributor
Other Government Agency
Supplier
Foreign Civil Aviation Authority
Production Approval Holder
Owner / Operator
Unknown
Other
11. Date of This Report:
12.
Check this box if you request anonymity
13. Reporters name:
Name:
Street Address:
City:
State:
Zip:
Country:
Phone Number:
14.
Check here if you want your identity to be kept confidential
15.
Check here if you do not wish to receive an acknowledgement letter
16.
Check here if you have attached additional information’s
FAA Form 8120-11 (02/07)
Form SLVLD-145, February 2007
Page 1 of 3
FAA Form 8120-11 / Form SLVLD-145 Instructions
1. Record the date the suspect part was discovered.
2. Provide part name (i.e. nut, bolt, blade) or description of the suspected unapproved part.
3. Provide part number or identification number on the part.
4. Provide serial number if any.
5. Provide quantity of suspect parts.
6. Provide the assembly name and assembly number (where the part was or could be installed).
Example:
Part Name:
BOLT
Part Number:
P/N 12345 – installed on
Serial Number:
678
Assembly Name:
Main Landing Gear
Assembly Number:
P/N PG12389
Note: To report other part numbers use blank sheet of paper using following column headers:
Part Name – Part Number – Part Serial Number – Quantity – Assembly Name – Assembly Number
7. Identify what type of aircraft the part was (or could be) installed on.
8. Provide complete name and address of the company or person(s) who last supplied or repaired the suspect part.
Please do not provide PO Box address unless this is all you have. Check the appropriate box to designate the type
of company. Please provide certificate number in space provided, if known.
9. Provide brief descriptions of suspect part (discoloration, suspect marking, different material etc.) and provide
narrative why you feel the part is not approved. Provide as much detail as necessary to enable an inspector to
determinate the status of the part.
10. Provide complete name and address of company (or person) where the suspected part was found. Check the
appropriate block to reflect the affiliation of the person/company who discovered the part.
11. Record the date the Form 8120-11 is being completed and submitted.
12. Check this box if you request anonymity.
13. Provide name and address and phone number of the person who is reporting the suspect part. This information is
necessary in case FAA needs to get in touch with the reporter for more information.
14. If you want your name to remain confidential, please check this block.
15. If you
do not wish to receive a letter acknowledging receipt of the Form 8120-11 by the FAA, please check this block.
16. If you have provided additional information, photos, parts listing, etc., please check this block.
The completed FAA Form 8120-11 / Form SLVLD-145, Suspected Unapproved parts Notification, should be
forwarded to:
Luftfartshuset
Attn.: Airworthiness Division
Ellebjergvej 50
DK-2450 Copenhagen SV
Fax:
+45 3618 6000
Phone:
+45 3618 6001
E-mail:
dcaa@slv.dk
To obtain an electronic copy of Form 8120-11, visit SUP Web Site
http://www.faa.gov/aircraft/safety/programs/sups/
In addition, a completed electronic copy of
the 8120-11 may be sent via that internet site.
This information is collected by the FAA’s Suspected Unapproved Parts (SUP) Program and will be used to support SUP
investigations and other summary management reports. Submission of this information is voluntary, with questions
limited to reduce any burden to the reporter. Completion is estimated to take fewer than 15 minutes. Information
collected is not available elsewhere and is vitally important to FAA’s SUP Program and its commitment to remove the
potential threat posed by unapproved parts from the aviation system. By request of confidentiality for the reporter, the
reporter may be protected from disclosure under 5 USC 522(a). Form 8120-11 is also available through
Internet/FEDWORLD or through the FAA at the above website. An agency may not conduct or sponsor, and a person is
not required to response to, a collection of information unless it displays a currently valid OMB control number. Use of
this form is authorized under OMB control number 2120-0552.
FAA Form 8120-11 (02/07)
Form SLVLD-145, February 2007
Page 2 of 3
SUSPECTED UNAPPROVED PARTS NOTIFICATION
Form 8120-11 / SLVLD-145 Continuation Sheet Page ( ) of ( )
Part Name
Part Number
Serial Number Quantity Assembly
Name
Assembly
Number
FAA Form 8120-11 (02/07)
Form SLVLD-145, February 2007
Page 3 of 3
