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Service Difficulty Report Aeronautical Equipment (2120-0039) Form. This is a Official Federal Forms form and can be use in Federal Aviation Administration (FAA).
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FORM APPROVED OMB No. 2120-0039 06/30/2006 DEPARTMENT OF TRANSPORTATION RIS- WS 8070-1 FEDERAL AVIATION ADMINISTRATION Control No. U.S. Department of Transportation Federal Aviation Administration Service Difficulty Report Code ATA AERONAUTICAL EQUIPMENT MAJOR EQUIPMENT IDENTITY Enter pertinent data MANUFACTURER MODEL/SERIES SERIAL NUMBER N AIRCRAFT POWERPLANT PROPELLER PROBLEM DESCRIPTION DATE STATUS AIRCRAFT TYPE ATA CARRIER CONTROL NO. N- TEXT SPECIFIC PART CAUSING PROBLEM PART NAME MANUFACTURER PART TSO PART TT Report whole hours MFG. MODEL/NUMBER COMPONENT/APPLIANCE ABOVE PART INSTALLED ON COMP/APPL NAME PART/DEFECT LOCATION PART CONDITION MFG. PART NUMBER SERIAL NO. SUBMITTED BY A PREC. PROC. NATURE STAGE STAT B C D E F G H I CARRIER SUBMITTER (Check one) REP STA. OPER MECH AIR TAXI MFG FAA OTHER Spec. ROLL Frame SYS. P. S. L. ALERT OPER/D.O. SYS. ADDITIONAL COMMENTS FAA Form 8070-1 (11-84) SUPERSEDES PREVIOUS EDITION Shaded Areas are for FAA USE ONLY American LegalNet, Inc. www.FormsWorkflow.com All Submitters - Instructions for Completing FAA Form 8070-1 Major Equipment Identity TITLE ENTRY Aircraft Powerplant Propeller Identify major equipment related to problem. Enter manufacturer, model, and serial number per FAA/MANUFACTURER type certificate data sheet. If amateur built, use plan or kit name. Use military model designators when appropriate. Avoid colloquial names and market titles. N Aircraft Registration Number. Problem Description Date Give date problem occurred (i.e., 7-1-84). Text Whenever possible, describe conditions subsequent to, or leading up to, the reported problem: (a) Identify the cause for malfunction and emergency measures execute. (b) Include com pliance or noncompliance with Airworthiness Directives, Service Bulletins, STC's, and PMA's. (c) Provide any significant fact you feel may help to reduce or eliminate recurrence (i.e., cycles, landings, and suggested changes). Part Name Skin, rib, shaft, Venturi, transistor, capacitor, etc. Avoid colloquial names. Mfg. Part Number Alphanumeric part identifiers assigned by manufacturer. Part Condition Cracked, bent, burned, corroded, shorted, etc. Part/Defect Location L.H. alternator, audio, R.H. outboard, range switch, etc. Part TT Total service time on part in whole hours (i.e., 00531). Part TSO Service time on part since overhaul in whole hours (i.e., 00200) Comp/Appl Name Fuselage, wing, alternator, carburetor, VOR receiver, etc. Manufacturer Comp/appl manufacturer: Beech, Cessna, Prestolite, Bendix, Collins, etc. Mfg. Model/Number, Serial Number Alphanumeric model and serial numbers or identifiers assigned by comp/appl manufacturer (i.e., ALU8403, NAS3A1, 51 RVII). Do not repeat ''MAJOR EQUIPMENT IDENTITY" in these locations. Submitted By Submitter As noted on form. FAA District Offices - Refer to FAA Order 8010.2 PAPERWORK REDUCTION ACT STATEMENT: The information collected on this form is required. This form reports occurrences or detection of each failure, malfunction, or defect in an aircraft. We estimate that it will take 1 hour to complete the form. No assurance of confidentiality is promised. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0039. Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Ave SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ABA-20 U.S. GOVERNMENT PRINTING OFFICE: 1984-461-823-21521 American LegalNet, Inc. www.FormsWorkflow.com