Maintenance and Manufacturing Staff Instructions, MSI 53



APPENDIX A-1 NORMAL, UTILITY, AEROBATIC AND COMMUTER CATEGORY AEROPLANES – CAR 523BLOCK 1

Name of the applicant for the design change approval: ___________
Description of the design change: ___________________________
________________________________________________________
Certification Basis of design change and revision date: _______________
G523.1(c): Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed: ______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:
Title of Document ________________ & Part # ______________

BLOCK 2Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
G523.2 (a) (Manual(s)
The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided..
ICA ref: ______________ Supplemental ICA ref: ______________
G523.2(b) (Practical arrangement)
The format of the manual or manuals must provide for a practical arrangement
ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:
 

 
G523.3 (a) Aeroplane Maintenance Manual or Section. ICA ref: Supplemental ICA ref:
G523.3 (a) (1) (Introduction) ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 (a) (2) (Description)
A description of the aeroplane and its systems and installations including its engines, propellers, and appliances.
ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 (a) (3) (Control & Operation)
Basic control and operation information describing how the aeroplane components and systems are controlled and how they operate, including any special procedures and limitations that apply.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (a) (4) (Servicing)
Servicing information that covers details regarding servicing points, capacities of tanks, reservoirs, types of fluids to be used, pressures applicable to the various systems, location of access panels for inspection and servicing, locations of lubrication points, lubricants to be used, equipment required for servicing, tow instructions and limitations, mooring, jacking, and levelling information.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 The Instructions for Continued Air worthiness must contain the following manuals or sections, as appropriate, and information:
 

 
G523.3 (b) Maintenance Instructions. ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (b) (1) (Scheduling) ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (b) (2) (Troubleshooting)
Troubleshooting information describing probable malfunctions, how to recognise those malfunctions, and the remedial action for those malfunctions.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (b) (3) (Removal/replacement)
Information describing the order and method of removing and replacing products and parts with any necessary precautions to be taken.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (b) (4) (General)
Other general procedural instructions including procedures for system testing during ground running, symmetry checks, weighing and determining the centre of gravity, lifting and shoring, and storage limitations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (c) (Access )
Diagrams of structural access plates and information needed to gain access for inspections when access plates are not provided.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (d) (Special inspections)
Details for the application of special inspection techniques including radiographic and ultrasonic testing where such processes are specified.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (e) (Protective treatment)
Information needed to apply protective treatments to the structure after inspection.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (f) (Fasteners, torque values, etc)
All data relative to structural fasteners such as identification, discard recommendations, and torque values.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (g) (Special tools)
A list of special tools needed.
ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 (h) (1) (Electrical Loads)
In addition, for commuter category aeroplanes, the following information must be furnished:
(1) Electrical loads applicable to the various systems;
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
G523.3 (h) (2) (Methods of balancing control surfaces)
Methods of balancing control surfaces;
ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 (h) (3) (ID of Primary/Sec Structures)
Identification of primary and secondary structures; and
ICA ref: ______________ Supplemental ICA ref: ______________
G523.3 (h) (4) (Special Repair Methods)
Special repair methods applicable to the aeroplane.
ICA ref: ______________ Supplemental ICA ref: ______________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

G523.4 (a) (AWL - Separate Section1)
The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth each mandatory replacement time, structural inspection interval, and related structural inspection procedure required for type certification. If the Instructions for Continued Airworthiness consist of multiple documents, the section required by this paragraph must be included in the principal manual. This section must contain a legible statement in a prominent location that reads: "The Airworthiness Limitations section is approved by the Minister and specifies maintenance required under any applicable airworthiness or operating rule, unless an alternative program has been approved by the Minister".
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________

BLOCK 4 – Applicant Statement of Compliance

The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________
 

BLOCK 5 – Minister’s Statement of Acceptability


The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister.

Reviewer’s Name: ______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number: ______________


 

 

APPENDIX A-2 TRANSPORT CATEGORY AIRCRAFT – CAR 525 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
_____________________________________________
Certification Basis of design change and revision date: ______________
H525.1(c): Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:
______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:
Title of Document ______________ & Part # ______________
 

BLOCK 2Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
H525.2 (a) Manual(s)
The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:______________
______________
Supplemental ICA ref: ______________
______________
H525.2 (b) (Practical arrangement)
The format of the manual or manuals must provide for a practical arrangement.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3
The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:

 

 
H525.3 (a) Aeroplane maintenance manual or section. ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (a) (1) (Introduction)
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (a) (2) (Description)
(2)A description of the aeroplane and its systems and installations including its engines, propellers, and appliances.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (a) (3) (Control & Operation)
(3)Basic control and operation information describing how the aeroplane components and systems are controlled and how they operate, including any special procedures and limitations that apply.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (a) (4) (Servicing)
(4)Servicing information that covers details regarding servicing points, capacities of tanks, reservoirs, types of fluids to be used, pressures applicable to the various systems, location of access panels for inspection and servicing, locations of lubrication points, lubricants to be used, equipment required for servicing, tow instructions and limitations, mooring, jacking, and levelling information.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3
The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:

 

 
H525.3 (b) Maintenance Instructions. ICA ref: ______________ Supplemental ICA ref: ______________
 
H525.3 (b) (1) (Scheduling) ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (b) (2) (Troubleshooting)
(2)Troubleshooting information describing probable malfunctions, how to recognise those malfunctions, and the remedial action for those malfunctions.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (b) (3) (Removal/replacement)
(3)Information describing the order and method of removing and replacing products and parts with any necessary precautions to be taken.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (b) (4) (General)
(4)Other general procedural instructions including procedures for system testing during ground running, symmetry checks, weighing and determining the centre of gravity, lifting and shoring, and storage limitations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (c) (Access )
(c)Diagrams of structural access plates and information needed to gain access for inspections when access plates are not provided.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (d) (Special inspections)
(d)Details for the application of special inspection techniques including radiographic and ultrasonic testing where such processes are specified.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (e) (Protective treatment)
(e)Information needed to apply protective treatments to the structure after inspection.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (f) (Fasteners, torque values, etc)
(f)All data relative to structural fasteners such as identification, discard recommendations, and torque values.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
H525.3 (g) (Special tools)
(g)A list of special tools needed.
ICA ref: ______________ Supplemental ICA ref: ______________

BLOCK 3Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

H525.4 (a) (AWL -Separate Section 2)
(a) The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth: (NPA 2002-043)
ICA ref: ______________ ______________ Supplemental ICA ref: ____­­­­­____________________
H525.4 (a) 1 (Structures)
(1) Each mandatory replacement time, structural inspection interval, and related structural inspection procedures approved under 525.571.; and
ICA ref: ____________________________ Supplemental ICA ref: ____­­­­­____________________
H525.4 (a) 2 (Fuel Tank System)
(2) Each mandatory replacement time, inspection interval, related inspection procedure, and all critical design configuration control limitations approved under 525.981 for the fuel tank system.
ICA ref: ____________________________ Supplemental ICA ref: ____­­­­­____________________
H525.4 (b) (Principal Manual)
(b) If the Instructions for Continued Airworthiness consist of multiple documents, the section required by this paragraph must be included in the principal manual. This section must contain a legible statement in a prominent location that reads: "The Airworthiness Limitations section is approved by the Minister and specifies maintenance required by any applicable airworthiness or operating rule, unless an alternative program has been approved by the Minister."
ICA ref: ____________________________ Supplemental ICA ref: ____­­­­­____________________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________

 

BLOCK 5 – Minister’s Statement of Acceptability


 The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name:______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________

 

APPENDIX A-3 NORMAL CATEGORY ROTORCRAFT – CAR 527 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
______________
Certification Basis of design change and revision date: ______________
CAR Standard A527.1(c) Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:
______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:
Title of Document ______________ & Part # ______________
 

BLOCK 2 Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
A527.2 (a) Manual(s)
(a) The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:____________________________ Supplemental ICA ref: ______________
______________
A527.2 (b) Practical arrangement
(b) The format of the manual or manuals must provide for a practical arrangement.
ICA ref: ______________ ______________ Supplemental ICA ref: ______________
______________
A527.3
The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:
   
A527.3 (a) Rotorcraft maintenance manual or section ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A527.3 (a) (1) (Introduction) ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A527.3 (a) (2) (Description)
(2) A description of the rotorcraft and its systems and installations including its engines, rotors, and appliances.
ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A527.3 (a) (3) Control & Operation
(3) Basic control and operation information describing how the rotorcraft components and systems are controlled and how they operate, including any special procedures and limitations that apply.
ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A527.3 (a) (4) Servicing
(4) Servicing information that covers details regarding servicing points, capacities of tanks, reservoirs, types of fluids to be used, pressures applicable to the various systems, location of access panels for inspection and servicing, locations of lubrication points, lubricants to be used, equipment required for servicing, tow instructions and limitations, mooring, jacking, and levelling information.
ICA ref: ______________ Supplemental ICA ref: ____________________________
A527.3
The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:

 

 
A527.3 (b) Maintenance Instructions. ICA ref: ______________ Supplemental ICA ref: ______________
A527.3 (b) (1) Scheduling ICA ref: ______________ Supplemental ICA ref: ______________
______________
A527.3 (b) (2) Troubleshooting
(2) Troubleshooting information describing probable malfunctions, how to recognize those malfunctions, and the remedial action for those malfunctions.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (b) (3) Removal/replacement
(3) Information describing the order and method of removing and replacing products and parts with any necessary precautions to be taken.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (b) (4) General
(4) Other general procedural instructions including procedures for system testing during ground running, symmetry checks, weighing and determining the center of gravity, lifting and shoring, and storage limitations.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (c) Access
(c) Diagrams of structural access plates and information needed to gain access for inspections when access plates are not provided.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (d) Special inspections
(d) Details for the application of special inspection techniques including radiographic and ultrasonic testing where such processes are specified.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (e) Protective treatment
(e) Information needed to apply protective treatments to the structure after inspection.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (f) Fasteners, torque values, etc
(f) All data relative to structural fasteners such as identification, discard recommendations, and torque values.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A527.3 (g) Special tools
(g) A list of special tools needed.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

A527.4 AWL - Separate Section 1
The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth each mandatory replacement time, structural inspection interval, and related structural inspection procedure approved under 527.571. If the Instructions for Continued Airworthiness consist of multiple documents, the section required by this paragraph must be included in the principal manual. This section must contain a legible statement in a prominent location that reads: “The Airworthiness Limitations section is approved by the Minister and specifies maintenance required by any applicable airworthiness or operating rule unless an alternative program has been approved by the Minister.”
ICA ref: ____________________________ Supplemental ICA ref: ____________________________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design. Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________

BLOCK 5 – Minister’s Statement of Acceptability


 The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name:______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________

 

APPENDIX A-4 TRANSPORT CATEGORY ROTORCRAFT – CAR 529 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
Certification Basis of design change and revision date: ______________
CAR Standard A529.1(c) - Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:__________________
CAR Standard 513.05 (1) (g) (iv): - Installation Instructions:
Title of Document ______________ & Part # ______________

BLOCK 2 Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
A529.2 (a) Manual(s)
(a) The Instructions for Continued Airworthiness shall be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:____________________________ Supplemental ICA ref: ______________
______________
A529.2(b) Practical arrangement
(b) The format of the manual or manuals shall provide for a practical arrangement.
ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 The Instructions for Continued Airworthiness shall contain the following manuals or sections, as appropriate, and the following information:
 

 
A529.3 (a) Rotorcraft maintenance manual or section. The rotorcraft maintenance manual or section shall contain the following information: ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 (a) (1) Introduction ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A529.3 (a) (2) Description
(2) a description of the rotorcraft and its systems and installations including its engines, rotors, and appliances;
ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 (a) (3) Control & Operation
(3) basic control and operation information describing how the rotorcraft components and systems are controlled and how they operate, including any special procedures and limitations that apply;
ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 (a) (4) Servicing
(4) servicing information that covers details regarding servicing points, capacities of tanks, reservoirs, types of fluids to be used, pressures applicable to the various systems, location of access panels for inspection and servicing, locations of lubrication points, the lubricants to be used, equipment required for servicing, tow instructions and limitations, mooring, jacking and levelling information.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A529.3 The Instructions for Continued Airworthiness shall contain the following manuals or sections, as appropriate, and the following information:  
 
A529.3(b) Maintenance Instructions. The Maintenance Instructions shall contain the following information: ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 (b) (1) Scheduling ICA ref: ____________________________ Supplemental ICA ref: ______________
______________
A529.3 (b) (2) Troubleshooting
(2) troubleshooting information describing probable malfunctions, how to recognize those malfunctions, and the remedial action for those malfunctions;
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A529.3 (b) (3) Removal/replacement
(3) information describing the order and method of removing and replacing products and parts with any necessary precautions to be taken;
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A529.3 (b) (4) General
(4) other general procedural instructions including procedures for system testing during ground running, symmetry checks, weighing and determining the centre of gravity, lifting and shoring, and storage limitations.
ICA ref: ____________________________ Supplemental ICA ref: ____________________________
A529.3 (c) Access
(c) diagrams of structural access plates and information needed to gain access for inspections when access plates are not provided;
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A529.3 (d) Special inspections
(d) details for the application of special inspection techniques including radiographic and ultrasonic testing where such processes are specified;
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A529.3 (e) Protective treatment
(e) information needed to apply protective treatments to the structure after inspection;
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A529.3 (f) Fasteners, torque values, etc
(f) all data relative to structural fasteners such as identification, discard recommendations, and torque values
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A529.3 (g) Special tools
(g) a list of special tools needed.
ICA ref: ______________ Supplemental ICA ref: ______________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

A529.4 (a) AWL - Separate Section1
The Instructions for Continued Airworthiness shall contain a section titled "Airworthiness Limitations" that is segregated and clearly distinguishable from the rest of the document. This section shall set forth each mandatory replacement time, structural inspection interval, and related structural inspection procedure approved under section 529.571. If the "Instructions for Continued Airworthiness" consist of multiple documents, the section required by this paragraph shall be included in the principal manual. This section shall contain a legible statement in a prominent location that reads:
"The Airworthiness Limitations section is approved by the Minister and specifies maintenance required by any applicable airworthiness or operating rule unless an alternative program has been approved by the Minister."
ICA ref:______________
______________
Supplemental ICA ref:______________
______________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________

BLOCK 5 – Minister’s Statement of Acceptability


The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name: ______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________

 

APPENDIX A-5 MANNED FREE BALLOONS – CAR 531 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
Certification Basis of design change and revision date: ______________
CAR Standard A531.1(c): Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:
Title of Document ______________ & Part # ______________

BLOCK 2 Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
A531.2 (a) Manual(s)
(a) The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:______________
______________
Supplemental ICA ref: ______________
______________
A531.2(b) Practical arrangement
(b) The format of the manual or manuals must provide for a practical arrangement.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 Content
The Instructions for Continued Airworthiness must contain the following information:
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (a) Introduction ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (b) Description
(b) A description of the balloon and its systems and installations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (c) Control & Operation
(c) Basic control and operation information for the balloon and its components and systems.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (d) Servicing
(d) Servicing information that covers details regarding servicing of balloon components, including burner nozzles, fuel tanks, and valves during operations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (e) maintenance ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (f) Troubleshooting
(f) Troubleshooting information describing probable malfunctions, how to recognise those malfunctions, and the remedial action for those malfunctions.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (g) Inspection after Hard Landing
(g) Details of what, and how, to inspect after a Hard Landing.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (h) Storage Instructions
(h) Instructions for storage preparation, including any storage limits.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A531.3 (i) Repair Instructions
(i) Instructions for repair of the balloon envelope and its basket or trapeze.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

A531.4
(AWL - Separate Section1

[The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth each mandatory replacement time, structural inspection interval, and related structural inspection procedure, including envelope structural integrity, required for type certification. If the Instructions for Continued Airworthiness consist of multiple documents, the section required by this paragraph must be included in the principal manual. This section must contain a legible statement in a prominent location that reads:
"The Airworthiness Limitations section is approved by the Minister and specifies maintenance requirements that are mandatory for the continued airworthiness of this aircraft as specified in CAR 605.84".]
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________

BLOCK 5 – Minister’s Statement of Acceptability


The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name: ______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________

 

APPENDIX A-6 AIRCRAFT ENGINES – CAR 533 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
______________
Certification Basis of design change and revision date: ______________
CAR Standard A533.1(c) Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:
______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:
Title of Document ______________ & Part # _____________

BLOCK 2 Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
A533.2 (a) Manual(s)
(a) The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:______________
______________
Supplemental ICA ref: ______________
______________
A533.2 (b) Practical arrangement
(b) The format of the manual or manuals must provide for a practical arrangement.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) Content
The Instructions for Continued Airworthiness must contain the following manuals or sections, as appropriate, and information:
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (1) Introduction
a) Engine Maintenance Section.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (2) Description
(2) A detailed description of the engine and its components, systems and installations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (3) Installation Instructions
(3) Installation instructions, including proper procedures for uncrating, deinhibiting, acceptance checking, lifting and attaching accessories, with any necessary checks.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (4) Control and Operation
(4) Basic control and operating information describing how the engine components, systems, and installations operate, and information describing the methods of starting, running, testing and stopping the engine and its parts including any special procedures and limitations that apply.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (5) Servicing
(5) Servicing information that covers details regarding servicing points, capacities of tanks, reservoirs, types of fluids to be used, pressures applicable to the various systems, locations of lubrication points, lubricants to be used and equipment required for servicing.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (6) Scheduling ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (7) Troubleshooting
(7) Troubleshooting information describing probable malfunctions, how to recognise those malfunctions, and the remedial action for those malfunctions.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (8) Removal & Replacement
(8) Information describing the order and method of removing the engine and its parts and replacing parts, with any necessary precautions to be taken. Instructions for proper ground handling, crating and shipping must also be included.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (a) (9) Tools & Equipment
(9) A list of the tools and equipment necessary for maintenance and directions as to their method of use.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
(b) Engine Overhaul Section. ICA ref: ______________ Supplemental ICA ref: ______________
A533.3 (b) (1) Disassembly
(1) Disassembly information including the order and method of disassembly for overhaul.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (b) (2) Cleaning & Inspection
(2) Cleaning and inspection instructions that cover the materials and apparatus to be used and methods and precautions to be taken during overhaul. Methods of overhaul inspection must also be included.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (b) (3) Fits & Clearances
(3) Details of all fits and clearances relevant to overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A533.3 (b) (4) Repair Methods
(4) Details of repair methods for worn or otherwise substandard parts and components along with the information necessary to determine when replacement is necessary.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (b) (5) Assembly
(5) The order and method of assembly at overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A533.3 (b) (6) Instructions for Testing
(6) Instructions for testing after overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A533.3 (b) (7) Storage Instructions
(7) Instructions for storage preparation including any storage limits.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A533.3 (b) (8) Special Tool List
(8) A list of tools needed for over-haul.
ICA ref: ______________ Supplemental ICA ref: ______________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

A533.4 AWL - Separate Section1
The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth each mandatory replacement time, inspection interval, and related procedure required for type certification. If the Instructions for Continued Airworthiness consist of multiple documents, the section required by this paragraph must be included in the principal manual. This section must contain a legible statement in a prominent location that reads: "The Airworthiness Limitations Section is approved by the Minister and specifies maintenance required by any applicable airworthiness or operational rule, unless an alternative program has been approved by the Minister.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________ Applicants Name: ______________ Phone # ______________ Email: ______________

BLOCK 5 – Minister’s Statement of Acceptability


The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name: ______________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________

APPENDIX A-7 PROPELLERS – CAR 535 BLOCK 1


Name of the applicant for the design change approval: ______________
Description of the design change: ______________
Certification Basis of design change and revision date: ______________
CAR Standard A535.1(c) - Program showing how changes to supplemental ICA made by the applicant or by the manufacturers of products and appliances installed in the aeroplane pursuant to the design change will be distributed:
______________
CAR Standard 513.05 (1) (g) (iv): Installation Instructions:______________
Title of Document ______________ & Part # ______________

BLOCK 2 Note: Enter "N/A" when no supplemental ICA are needed.

Regulatory Standard Reference
Column 1
Design Approval Holder (DAH)
ICA Reference
Column 2
Applicant Means of Compliance
Supplemental ICA Requirements
Column 3
A535.2 (a) Manual(s)
(a) The Instructions for Continued Airworthiness must be in the form of a manual or manuals as appropriate for the quantity of data to be provided.
ICA ref:______________
______________
Supplemental ICA ref: ______________
______________
A535.2 (b) Practical arrangement
(b) The format of the manual or manuals must provide for a practical arrangement.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 Content
The Instructions for Continued Airworthiness must contain the following sections and information:
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (1) Introduction
(a) Propeller Maintenance Section.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (2) Description
(2) A detailed description of the propeller and its systems and installations.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (3) Control & Operation
(3) Basic control and operating information describing how the propeller components and systems are controlled and how they operate, including any special procedures that apply.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (4) Installation Instructions
(4) Instructions for uncrating, acceptance checking, lifting, and installing the propeller.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (5) Operational Checks
(5) Instructions for propeller operational checks.
ICA ref: ______________ Supplemental ICA ref: ______________
A535.3 (a) (6) Scheduling ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (7) Troubleshooting
(7) Troubleshooting information describing probable malfunctions, how to recognize those malfunctions, and the remedial action for those malfunctions.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (8) Removal & Replacement
(8) Information describing the order and method of removing and replacing propeller parts with any necessary precautions to be taken.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (a) (9) Special Tools List
(9) A list of the special tools needed for maintenance other than for overhauls.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
)(b) Propeller Overhaul Section
A535.3 (b) (1) Disassembly
(1) Disassembly information including the order and method of disassembly for overhaul.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (b) (2) Cleaning & Inspection
(2) Cleaning and inspection instructions that cover the materials and apparatus to be used and methods and precautions to be taken during overhaul. Methods of overhaul inspection must also be included.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (b) (3) Fits & Clearances
(3) Details all fits and clearances relevant to overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A535.3 (b) (4) Repair Methods
(4) Details of repair methods for worn or otherwise substandard parts and components along with information necessary to determine when replacement is necessary.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (b) (5) Assembly
(5) The order and method of assembly at overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A535.3 (b) (6) Instructions for Testing
(6) Instructions for testing after overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________
A535.3 (b) (7) Storage Instructions
(7) Instructions for storage preparation including any storage limits.
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________
A535.3 (b) (8) Special Tool List
(8) A list of tools needed for overhaul.
ICA ref: ______________ Supplemental ICA ref: ______________

BLOCK 3 Note: The statement in block 5 does not constitute an approval of the Airworthiness Limitations Section. Airworthiness Limitations differ from other maintenance tasks, in that they are mandatory, as a direct condition of the approval of the type design. They are therefore referenced directly in the approval document itself. However, they must also be included in the Supplemental Instructions for Continued Airworthiness.

A535.4
(AWL - Separate Section1)

The Instructions for Continued Airworthiness must contain a section titled Airworthiness Limitations that is segregated and clearly distinguishable from the rest of the document. This section must set forth each mandatory replacement time, inspection interval, and related procedure required for type certification. This section must contain a legible statement in a prominent location that reads: "The Airworthiness Limitations section is approved by the Minister and specifies maintenance required by any applicable airworthiness or operational rule, unless an alternative program has been approved by the Minister".
ICA ref: ______________
______________
Supplemental ICA ref: ______________
______________

BLOCK 4 – Applicant Statement of Compliance


The Supplemental ICA referenced above comprises the complete listing of supplemental ICA necessary to show compliance with the regulatory standard that supports this change in type design.
Applicants Signature: ______________ Date: ______________
Applicants Name: ______________ Phone # ______________ Email: ______________

BLOCK 5 – Minister’s Statement of Acceptability


The design change is adequately supported by existing ICA and/or supplemental ICA, as identified above and is acceptable to the Minister. Reviewer’s Name:___________ Phone # ______________ Email: ______________ Mail Routing Symbol: ______________ Signature: ______________ Date: ______________ NAPA Number ______________
Date modified: