Staff Instruction (SI)

Appendix 3 - Delegated Projects – technical review Checklist

Delegated Projects – Technical Review Check Sheet

Napa Project Number   Delegate Name/Number  
Approval/Issue Number   Delegate Project Number  
Number of projects since
last review (20% freq)
  Project Title  
Reviewer   ARASS Task Number  
Date Reviewed      

Item Description

Auditor’s Comments/Results

Audited By
N/A = Not Applicable, Fdg = Finding, PF = Parallel Finding, N/C = Not Checked
1 Has compliance been shown? If no, then corrective action should be pursued. YES ? NO?  
2 Is a Finding Report Required? YES ? NO?  
3 Has all the proposed documentation been included? Are all documents complete and current (fees, certificates, applications, signatures etc)? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
4 Was registration verification done? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
5 (Future item) Was an AD check done? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
6 Does the compliance program or checklist identify the correct basis of certification for this modification? Is the use of earlier or later amendment levels/special conditions etc. justified? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
7 Have operational and equipment rules that affect the design standard been incorporated? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
8 Have policy, procedures and advisory materials been considered (SIs, APLs, ANs etc?) N/A ? OK ? Fdg ? PF ? PO ? N/C?  
9 Has the compliance program identified all necessary areas in order to base an approval? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Delegation Limitations    
10 Is the approval within the scope of delegation? No delegate may approve any of the following: equivalent safety, exemptions, basic loads (except from approved data), fatigue or damage tolerance, flutter and aeroelastics analysis, compliance with ditching requirements, software, flight manual supplements, MMELs or supplements life-limits, Ads and FMECA. N/A ? OK ? Fdg ? PF ? PO ? N/C?  
11 Has reference material been accurately cited? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
12 Are diagrams and drawings accurate and complete? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
13 Are components installed as per manufacturer’s specifications or other applicable data (including TSO)? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
14 Are analytical assumptions appropriate? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
15 Has aircraft eligibility been considered? This could include either the types of aircraft, the role or the configuration. N/A ? OK ? Fdg ? PF ? PO ? N/C?  
16 Have noise and emissions standards been considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
17 Was weight and balance, and CG considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
18 Was test plan accepted/approved? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
19 Do the test results support compliance? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
20 Is the installation compatible with the aircraft design and procedures? (SwissAir) N/A ? OK ? Fdg ? PF ? PO ? N/C?  
21 Is the flight manual supplement appropriate? Are the limitations affected? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
22 Is the maintenance manual supplement appropriate? Are the limitations affected? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Avionics/Electrical Systems    
23 Has environmental standard (DO-160C TSO) been applied correctly? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
24 If system performs an essential function, or is interfaced to essential equipment, has an FHA been performed correctly? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
25 Is pilot-to-equipment interface acceptable (cockpit layout, controls accessibility, crew workload)? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
26 Is electrical load analysis acceptable? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
27 Is the EMI/RMI test accepted and completed? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Flight    
28 Was flight-testing coordinated with Headquarters? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Human Factors    
29 Has maintainability been considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
30 Has accessibility been considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
31 Has a cockpit review been conducted? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
32 Has a cabin review been conducted? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
33 Have placards been reviewed? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Interior/Occupant Safety    
34 Have applicable policy documents been considered (AC 25-17 etc.)? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
35 Was an interior review conducted to verify aisle widths, exit access, equipment access, O2 in rotorburst zone, etc? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
36 Were special factors/procedures passed on to Cabin Safety? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
37 Was emergency equipment/ communications required by the Operational rules considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Mechanical Systems    
38 Has a safety assessment been conducted? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Powerplants    
39 Has the engine and/or propeller certification been considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
40 Has rotorburst been considered? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
41 Has a fire safety review been conducted? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
42 Has performance been verified? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
43 Has systems integration been reviewed/verified? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
  Structures    
44 Have all applicable loads been accurately established? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
45 Has adequate static strength been established (assembly, sub-assembly, details)? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
46 Have safe life, fail safe, or damage tolerance structures been adequately addressed? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
47 Has fatigue been adequately addressed? N/A ? OK ? Fdg ? PF ? PO ? N/C?  
Function Summary (Delegated Projects – Technical Review Check Sheet)
Items Completed By: Date:



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