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Notice Of Proposed Outdoor Laser Operation(s) (And Configuration Worksheet) Form. This is a Official Federal Forms form and can be use in Federal Aviation Administration (FAA).
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Tags: Notice Of Proposed Outdoor Laser Operation(s) (And Configuration Worksheet), FAA 7140-1, Official Federal Forms Federal Aviation Administration (FAA),
Please Type or Print on This Form
Form Approved OMB No. 2120-0662
FOR FAA USE ONLY
Failure To Provide All Requested Information May Delay Processing of Your Notice
U.S. Department of Transportation
Federal Aviation Administration
NOTICE OF PROPOSED OUTDOOR LASER OPERATION(S)
1. GENERAL INFORMATION
(a) To: (FAA Regional Office)
(b) From: (Proponent)
(c) Event or Facility
(e) Customer
(f) Site address
(d) Report Date:
2. DATE(S) AND TIME(S) OF LASER OPERATION
(a) Testing and alignment
(b) Operation
3. BRIEF DESCRIPTION OF OPERATION
4. ON-SITE OPERATION INFORMATION
(a) Operator(s)
(b) On-site phone #1
(c) On-site phone #2
5. FDS CDRH LASER LIGHT SHOW VARIANCE (if applicable)
(a) Variance #
(b) Accession #
(c) Expiration date
6. BRIEF DESCRIPTION OF CONTROL MEASURES
7. ATTACHMENTS
(a) Number of laser configurations [fill out one copy of page 2 of this notice (“Laser Configurations
Worksheet”) for each configuration]
(b) List Additional attachments (including maps, diagrams, and details of control measures)
8. DESIGNATED CONTACT PERSON (if further information is needed)
(a) Name
(c) Phone
(b) Position
(d) Fax
(e) E-mail
9. STATEMENT OF ACCURACY
To the best of my knowledge, the information provided in this Notice and attached worksheet(s) is accurate and correct.
(a) Name (if different from contact person)
(c) Signature
FAA Form 7140-1 (4-01)
(b) Position
(d) Date
Local Reproduction Authorized
032500.111
American LegalNet, Inc.
www.FormsWorkflow.com
Please Type or Print on This Form
Form Approved OMB No. 2120-0662
FOR FAA USE ONLY
Failure To Provide All Requested Information May Delay Processing of Your Notice
LASER CONFIGURATION WORKSHEET
U.S. Department of Transportation
Federal Aviation Administration
1. CONFIGURATION INFORMATION
(a) Configuration number
(b) Name of event/facility
(c) Report date:
of
(d) Brief Description of Configuration
2. GEOGRAPHIC LOCATION
(d) Latitude
º (deg.)
‘ (min.)
“ (sec.)
(a) Site Elevation (ft. above Mean Sea Level)
(e) Longitude
º (deg.)
‘ (min.)
“ (sec.)
(b) Laser Height Above Site Elevation (ft.)
(f) Determined by:
(c) Overall Laser Elevation (a + b)
GPS
(g) Horizontal Datum:
(h) Vertical Datum:
Map (Quad)
NAD 27
NGVD 29
Other
NAD 88
NAVD 88
3. BEAM CHARACTERISTICS AND CALCULATIONS (check one Mode of Operation only, and fill in only that column)
Mode of Operation
Laser Type
(lasing medium)
Power
Watts (W)
Pulse Energy
Joules (J)
Pulse Width
Seconds (s)
Pulse Repetition Frequency
Hertz (Hz)
Beam Diameter @ 1/e points
Centimeters (cm)
Beam Divergency 1/e @ full
Angle Milliradians (mrad)
Wavelength(s)
Nanometers (nm)
SINGLE PULSE
CONTINUOUS WAVE
REPETIVELY PULSED
(not applicable)
maximum power
average power
(not applicable)
(not applicable)
(not applicable)
(not applicable)
(a) MAXIMUM PERMISSIBLE EXPOSURE (MPE) CALCULATIONS (will be used to calculate NOHD)
MPE W/cm²
(not applicable)
MPE per pulse J/cm²
(not applicable)
(b) VISUAL EFFECT CALCULATIONS (will be used only for visible lasers [400-700 nm] to calculate SZED, CZED, and LFED)
Pre-Corrected Power (PCP)
Watts (W)
Visual Correction Factor (VCF)
(Enter “1.0” or use Table 5)
Visually corrected Power
PCP x VCF
Pulse Energy (J) x 4
Maximum Power (from above)
Pulse Energy (J) x PRF (Hz) OR Average Power
4. BEAM DIRECTION(S)
Magnetic variation (degrees)
Maximum elevation angle (degrees)
Azimuth
Minimum elevation angle (degrees, where horizontal = 0º)
(degrees)
5. CALCULATED DISTANCES
(fill in all three columns)
NOHD (based on MPE)
SLANT RANGE (ft.)
True
HORIZONTAL DISTANCE (ft.)
Magnetic
VERTICAL DISTANCE (ft.)
*SZED (for 100 µ W/cm² level)
*CZED (for 5 µ W/cm² level)
*LFED (for 50 n W/cm² level)
*If the laser has no wavelengths in the visible range (400-700 nm), enter “N/A (non-visible laser)” in all blocks.
For visible lasers, if the calculated SZED, CZED, and/or LFED is less than the NOHD, enter “less than NOHD.” than “NOHD.”
6. CALCULATION METHOD
Commercial software (print product name)
Other [describe method (spreadsheet, calculator, etc.)]
FAA Form 7140-1 (4-01)
Local Reproduction Authorized
032500.111
American LegalNet, Inc.
www.FormsWorkflow.com
