I. US Department
I. US Department
of Transportation MAJOR REPAIR AND ALTERATION
Federal Aviation (Airframe, Powerplant, Propeller, or Appliance) Administration , Form Approved
OMB No. 2120-0020
For FAA Use Only
Office Identification/WA—P./06-U trg INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).
1. Aircraft Make
Gulfstream Aerospace Model
G-IIB
Serial No.
151 Nationality and Registration Mark
N909JE
2. Owner Name (As shown on registration certificate)
Hyperion Air, Inc. Address (As shown on registration certificate)
103 Foulk Road, Suite 202
Wilmington, DE 19803-3742
he alteration
aircraft subject
DATE identified herein complied
to conformity inspection
2-1/4-4/ 2-6'D 7with applicable
by a person
FAA Inspector3. For FAA Use Only
air-worthiness requirements and is approved
authorized in FAR 43.7. only for the above described
4. Unit Identification 1 5. Type
Unit Make Model Serial No. Repair Alteration
AIRFRAME (As described in Item 1 above) ------- X
POWERPLANT
PROPELLER
APPLIANCE Type
Manufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency C. Certificate No.
1111111111111 U.S. Certified Mechanic
11JR439Y
LIMITED AIRFRAME Foreign Certified Mechanic
X Certified Repair Station
Manufacturer
D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge.
Date
2.---c//:, 7Signature of Authorized Individual
Glenn Tietjen
7. Approval for Return to Service
Pursuant
Administrator
BY to the authority given persons specified below, the unit
of the Federal Aviation Administration and is identified in item 4 was inspected in the manner prescribed by the
APPROVED • REJECTED
FAA Flt. Standards
Inspector Manufacturer Inspection Authorization Other (Specify)
FAA Designee X Repair Station Person Approved by Transport
Canada Airworthiness Group
Date of App oval or ejection
2.— e_c" a 7 Certificate or
Designation No.
I1JR439Y Signature of Authorized Individual
Glenn Tieten _
FAA Form 337 (12-88)
EFTA00278135
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with
all previous alterations to assure continued conformity with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets, Identify with aircraft nationality and registration mark and date work accomplished.)
Gulfstream Aerospace, G-IIB, SIN 151
I) Removed, refurbished and re-installed interior furnishings as outlined below:
2) Replaced the existing crew seat dress covers with Teddy & Arthur Edelman OLD-B3 Old Shrunken Buffalo Bull Leather, lot KA06FL and
Aeristo Aerolamb Camel sheepskin, lot Y6M343. Attached Skandia, Inc. F.A.A./D.E.R. approved 8110-3, dated 01/24/07, work order
155311-07, document ID 74756, test ID 12NW-77971, DERY-405143-CE. Seatbelts were re-webbed by A.B.I. Attached SC-108B
Certification / Packing list dated 01/19/07, to color coordinate. Each belt is tagged and identified as meeting FAA-TSO-C114, -C22F, or -
C22G requirements.
3) Replaced the existing veneer on the entrance bulkheads with Carl F. Booth & Co. Elm Burl Veneer. Attached Skandia, Inc., F.A.A./D.E.R.
approved 8110-3, dated 02/13/07, work order 156511-07, document ID 75004, test ID 60NW-6004, DERY-405020-CE.
4) Fireblocked and upholstered six (6) single cabin chairs, one (1) double seat, one (1) jumpseat, and potty seat with Teddy & Arthur Edelman
OLD-B3 Old Shrunken Buffalo Bull Leather, lot KA06FL. Aircraft seat cushions have been fireblocked as per the requirements of 14 CFR,
25.853(c) Amendment 25 — 116 Appendix F Part II. Results of sample burn tests are documented on attached Skandia Inc. FAA/D.E.R.
approved 8110-3, dated 02/09/07, work order 156074-07, document ID 74969, test plan 15724, DERY-410100-CE. Seatbelts were re-
webbed by A.B.I. Attached SC-108B Certification / Packing list dated 01/19/07, to color coordinate. Each belt is tagged and identified as
meeting FAA-TSO-C114, -C22F, or -C22G requirements.
5) Fireblocked and upholstered the UH aft divan assembly with Jeffrey Arnoff Dugally Beige Chenille Fabric. Aircraft seat cushions have been
fireblocked as per the requirements of 14 CFR, 25.853(c) Amendment 25 — 116 Appendix F Part II. Results of sample burn tests are
documented on attached Skandia Inc. FAA/D.E.R. approved 8110-3, dated 01/18/07, work order 153082-06, document ID 74710, test plan
15465. DERY-410100-CE. Seatbelts were re-webbed by A.B.I. Attached SC-108B Certification / Packing list dated 01/19/07, to color
coordinate. Each belt is tagged and identified as meeting FAA-TSO-C114, -C22F, or -C22G requirements.
6) Replaced the existing carpet throughout the aircraft with Texstyle 58A, 58B, 58C custom wool carpet. Attached Skandia, Inc. F.A.A./D.E.R.
approved 8110-3 dated 01/09/07, work order 154634-07, document ID 74508, test ID 12-19848, DERY-405143-CE.
7) Removed the existing cabin ALC fluorescent indirect lighting system and replaced with B/E Aerospace LVIII Elite LED Lighting System and
replaced the galley and lavatory incandescent lights with B/E Aerospace 6800 LED Lighting as per International Jet Interiors wiring
diagram, B/E Aerospace Cabin LED Lighting System Installation, JRW0706-WD. Attached Skandia, Inc. F.A.A./D.E.R. approved 8110-3,
dated 02/14/07, DERT-830134-NE.
8) Modified the existing Cabin 14VDC Accessory Power Distribution System as per International Jet Interiors wiring drawing, JRW0707-WD,
Rev I/R Cockpit 14VDC Power Receptacle Installation. Attached F.A.A. form 8110-3 dated 02/16/07 by F.A.A./D.E.R. DERT-636280-NM.
9) Replaced the footrest hydroloks on the six (6) cabin seats with P.L. Porter Controls Hydrolocks. Attached F.A.A. 8130-3, dated 01126/06,
tracking number 536641, Authorization No. ODAR F601987NM.
10) All stitching is performed IAW International Jet Interiors Stitching Guide IJISG-1, rev. I/R.
11) All materials meet 14 CFR, 25.853 (a) Appendix F, Part I (a) (1) (ii).
12) Reference W.O. # 06264 on file at this agency for further information.
13) A logbook entry has been made reflecting this alteration.
14) A supplemental equipment list has been provided.
15) It has been determined that there is no significant weight change.
16) Passenger aisle width maintained per 14 CFR, 25.815.
17) The work described, has been found to be in conformity with the above mentioned approved data and continues to meet the airworthiness
criteria under which it was originally certificated.
18) No further entries.
❑ Additional Sheets Are Attached
EFTA00278136
U.S. DEPARTMENT OF TRANSPORTATION . . . FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
01/24/07
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION MAKE
Gulfstream MODEL NO.
•
GlIB TYPE (Airplane, Radio, Helicopter,
etc.)
Airplane NAME OF APPLICANT
Skandia, Inc.
International Jet Interiors
LIST OF DATA IDENTIFICATION TITLE
Work Order #
155311-07
Document ID 74756
Purchase 0rder _.#
2092 FLAMMABILITY TEST RESULTS
REF:Skandia, Inc. Design Data # S155311
..SPECIMEN .#1,Test specimens are 31N..12" compos4es consisting of Teddy & Arthur Edelman
OLD-B3 Old Shrunken Buffalo Bull Leather Lot OKA06.FL sewn back to .bCk to Aeristo
Aerolamb Camel Sheepskin Lot #Y6M343. Test specimens are representative of Crew Seat
Dress Cover., REF TEST ID # 12NW-77971
"Flammability test witnessing only, does not constitute installation approval of the material."
PURPOSE OF DATA
Demonstration of compliance with material flammability requirements in support of Major Repair & Alteration for S/N 151
APPLICABLE REQUIREMENTS (List specific sections)
14 CFR PART 25.853 (a) Amdt 25-116 Appendix F Part I (a)(1)(ii)
CERTIFICATION -Under authority
of appointment under Part 183 of
have vested by direction of the Administrator and in accordance with conditions the Federal Aviation Regulations, data listed above and on attached sheets been examined in accordance with established procedures and found to comply
Regulations.
approval of these data
these data and limitations
numbered
with applicable requirements of the Federal Aviation
• ecommend 1 (We) Therefore Approve
SIGNATURE(S) OF SI NATED ENGINEERING REPRESENTATIVE DESIGNATION NUMBER(S) CLASSIFICATION(S)
0-j9' - DERY -405143-CE Structural Special
Carin Demus
FAA Form 8110-3 (11-70) SUPERSEDES PREVIOUS EDITION
EFTA00278137
now
•
EFTA00278138
• U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
02/13/07
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION MAKE
Gulfstream MODEL NO.
GII TYPE (Airplane, Radio, Helicopter,
etc.)
Airplane NAME OF APPLICANT •
Skandia, Inc.
International Jet Interiors
LIST OF DATA IDENTIFICATION TITLE
Work Order #
156511-07
Document ID 75004
Purchase Order #
2139 FLAMMABILITY TEST RESULTS
REF:Skandia, Inc. Design Data # S156511
SPECIMEN # I Test specimens are 3" x 12" composites consisting of AAR Composites 1/8" ATR-FP-12IF1 bonded to Carl F Booth & Co Elm Burl Veneer. Veneer is finished as per International Jet Interiors Process Specification #01IJINVIAB. Components are bonded together with Akzo Nobel 3M 8046 Top/Trim Adhesive. Test specimens are representative of Entrance Bulkheads., REF TEST ID # 60NW-6004
"FIammability test witnessing only, does not constitute installation approval of the material."
PURPOSE OF DATA . Demonstration of compliance with material flammability requirements in support of Field Approval for S/N 151
APPLICABLE REQUIREMENTS (List specific sections)
14 CFR Part 25.853 (a) Amdt 25-116 Appendix F Part I (a)(1)(i)
CERTIFICATION -Under authority of appointment under Part 183
have vested by direction of the Administrator and in accordance with conditions of the Federal Aviation Regulations, data listed above and on attached sheets been examined in accordance with established procedures and found to comply Regulations.
approval of these data • these data and limitations
numbered
with applicable requirements of the Federal Aviation
Recommend I (We) Therefore Approve
SIGNATURE(S) OF D SI AT NGINEERING REPRESENTATIVE DESIGNATION NUMBER(S) CLASSIFICATION(S)
.nr----,
DERY-405020-CE Structural Special
Judy ns •
FAA Form 8110-3 (11-70) SUPERSEDES PREVIOUS EDITION
EFTA00278139
S
EFTA00278140
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
02/09/07
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION
MAKE
GULFSTREAM MODEL NO.
G-1159B TYPE (Airplane, Radio, Helicopter,
etc.)
Airplane NAME OF APPLICANT
Skandia, Inc.
International Jet Interiors
LIST OF DATA
IDENTIFICATION TITLE
Work Order #
156074-07
Document ID 74969
Purchase Order #
2126 FIREBLOCKING FLAMMABILITY TEST RESULTS
REF: Skandia, Inc. Test Plan #15724
Rev IR
Dated: 02/06/07
For PN's 15724-1, 15724-2, 15724-3 & 15724-4
Edelman Leather, OLD-B3 Old Shrunken Buffalo Bull, Dye Lot KA06FL
Skandia, Inc. F/R Canvas Natural
Skandia, Inc. DAX Graphite/Poly 26 ILD
Skandia, Inc. Ethafoam 4101
PURPOSE OF DATA
Demonstration of compliance with material flammability requirements in support of Field Approval for S/N 151
APPLICABLE REQUIREMENTS (List specific sections)
14 CFR Part 25.853 (c) Amendment 25-116 Appendix F Part II
14 CFR Part 25.853 (a) Amdt 25-116 Appendix F Part I (a)(1)(ii)
CERTIFICATION -Under authority
of appointment under Part 183
have vested by direction of the Administrator and in accordance with conditions
of the Federal Aviation Regulations, data listed above and on attached sheets
been examined in accordance with established procedures and found to comply
Regulations.
approval of these data
these data and limitations
numbered
with applicable
requirements of the Federal Aviation
•• Recommend I (We) Therefore Approve
SIGNAT E(S) OF SIGNATED E N ERING EPRESENTATIVE DESIGNATION NUMBER(S) CLASSIFICATION(S)
•/ DERY-410100-CE Structural Special
Donna J. arri
FAA Form 0-3 (11-70) SUPERSEDES PREVIOUS EDITION
EFTA00278141
•
S.
EFTA00278142
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
; - STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
01/18/07
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATJON MAKE
•
GULFSTREAM MODEL NO.
G1159B TYPE (Airplane, Radio, Helicopter
etc.)
Airplane _ NAME OF APPLICANT
Skandia, Inc.
International Jet Interiors
LIST OF DATAIDENTIFICATION TITLE
Work Order #
153082-06
Document ID 74710
Purchase Order #
2074 FIREBLOCKING FLAMMABILITY TEST RESULTS
REF: Skandia, Inc. Test Plan #15465
Rev IR
Dated: 01/10/2007
For PNs: 15465-1 & 15465-2
SKANDIA, INC.: DAX GRAPITE/POLY 26 ILD
JEFFREY ARNOFF: FABRIC, DUGALLY, BEIGE, TREATED AT SKANDIA, INC. REF.
TREATMENT #SKFP 152676
"Flammability test witnessing only, does not constitute installation approval of the material."
PURPOSE OF DATA •
Demonstration of compliance with material flammability requirements in support of Field Approval for S/N 151
APPLICABLE REQUIREMENTS (List specific sections)
14 CFR PART 25.853 (c) Amendment 25-116 Appendix F Part II
14 CFR PART 25.853 (a) Amdt 25-116 Appendix F Part I (a)(1)(ii)
CERTIFICATION -Under authority
of appointment under Part 183 of
have vested by direction of the Administrator and in accordance with conditions and limitations the Federal Aviation Regulations, data listed above and on attached sheets numbered been examined in accordance with established procedures and found to comply with applicable Regulations.
approval of these data
these data requirements of the Federal Aviation
0 Recommend I (We) Therefore Approve
SIGN URE(S) OF DE'SIGNATED ENGINEERI EPRESENTATIVE DESIGNATION NUMBER(S) CLASSIFICATION(S)
DERY-410100-CE Structural Special
Donna J. Parrish
FAA Form 8110-3 (11-70) SUPERSEDES PREVIOUS EDITION
EFTA00278143
EFTA00278144
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
01/09/07
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION
MAKE
GULFSTREAM MODEL NO.
GlIB TYPE (Airplane, Radio, Helicopter
etc.)
Airplane NAME OF APPLICANT
Skandia, Inc.
International Jet Interiors
LIST OF DATA IDENTIFICATION TITLE
Work Order #
154634-07
Document ID 74508
Purchase Order #
2070 . FLAMMABILITY TEST RESULTS
REF:Skandia, Inc. Design Data # V154634
SPECIMEN #1 TEXSTYLE: CARPET, 58A, 58B, 58C, CUSTOM WOOL TO BE . , • • . • . • INSTALLED UNBONDED IN. AIRCRAFT MAIN CABIN, GALLEY, COCKPIT AND.LAV _,
FLOORS , REF TEST ID # 12-19848
"Flammability test witnessing only, does not constitute installation approval of the material."
PURPOSE OF DATA
Demonstration of compliance with material flammability requirements in support of Major Repair & Alteration for S/1•1 151
APPLICABLE REQUIREMENTS (List specific sections) .,.,.
14 CFR PART 25.853(a) Amdt 25-116 App F Part I (a)(1)(ii)
CERTIFICATION -Under authority
of appointment under Part 183 of
have vested by direction of the Administrator and in accordance with conditions
the Federal Aviation Regulations, data listed above and on attached sheets been examined in accordance with established procedures and found to comply
Regulations.
approval of these data
these data and limitations
numbered
with applicable requirements of the Federal Aviation
• Recommend I (We) Therefore X: Approve
SIGNATURE(S) OF DESIGIATED ENGINEERING REPRESENTATIVE DESIGNATION NUMBER(S) CLASSIFICATION(S)
de,.A.1/g../ 01-7,P0-----DERY-405143-CE Structural Special
Carin Demus
FAA Form 8110-3 (11-70) SUPERSEDES PREVIOUS EDITION
EFTA00278145
_
•
•,
•
EFTA00278146
L.:130 v • v • . vv A.
U.S, DERAR7SAENT-Or . 1 RA N'S PORTATION • . : TEDERALAOATIONADMINiSTRATIDN .
STATEMENT OF COMPLIANCE WITH.THEPEDERAk.: -AVIATION.REGULATIONS OATE
February 14, 2007
AIRCRAFT.OR AIRCRAFT COMPONENT IDENTIFICATION:
MAKE. .
Gultstream.Aerospace
Corporation. MOOELNO • ' . .
3 HS TYPE 1)Ii!Pienel 41.r.010. "encirki.'ef0
Airplane NAME OF A.OPLICA NT
International Jet Interiors
• .LIST OF DATA
IOWILEISAWN T1711
B/E Aerospace Inc,.
Report dated Feb, 14,
2007
Drawing No.
JRW0706-WD, Rev.I/R
Dated 2/8/07 LVIII "Elite" LED, fluorescent lighting system replaceMent on aircraft # 151 GLIB (see
attached report -10 pages)
•
8/E Aerospace Cabin LED. Lighting System Installation
Reference Documents:
1- inverter AL-5114 Installation InStruction AL-11026M,
2- Master ControllerInstallatibn Manual AL-11630M; Initial Rel;Oated 1/23/2007
3- TR Module Installation Manual AL-11625M, Initial Rel. Dated V26/2.007
4- Drawings; N©.: 6825 Rev. B, dated 1/30/2007. LE lighting unit; No. 81529 Rev. B.,
dated:12/30/20QT COntrollet Module; No'. 81528 Rev. :B, dated 1/29/2007, TR Module
5- Envl0rtriental Test Report No. STR-07006-1
.6, EMI Test Report STR-07906-2
, .
This approval is fOrtrigineering•design data only. It indicates the data listed above
demonstrates compliance only with the regUlations SpeCified.by.paragraph and.
subparagraph listed Pelow:as "Applicable. Requirements". This form does constitute FAA
• approval of all the engineering data necessary for substantiation of compliance to
neceSsarYrequireMents for the entire alteration.
This approval is subject to satisfactory ground functional check and ground EMI/RFI
checks to be conducted by International Jet Interiors.
puroose OF:nATA To support a major alteration on /N 151
APPUCAEILg REQUIREMENTS (List specificsections) • FAR 25,853(a) Arndt 115; 25.869 (a)(4)Aindt.11.3; 25.1301(?),(b),(c),(d);
25.1307(c) Amdt.72; 25.1309(a),(b),(d),(g) Amdt,41;.2 .1351a)(1) Amdt.72; 25.1353(a) ;(d)(1),(2),(3)Arndt.113;
25.1357(a):-25.1431(a)(c) Amdt:113; 25:1529.Amdt:54.
CERTIFICATION:- kinciet eUthority vortad 1).y direction of the. AdniInistielee'and!•in aCCoreatxt ,w1h. CooriditioS
under. Pari 153 of the. Federal Avlatien.RetiulAtlenS. data Ilsted.aboveand on' ttaciled StrielS•nurnberral
accordonee vOn e.oiilished procedures and found to corn* with apoilc.ablefeoulrements of the Federal
0 Recommend approver of the data
I (We) Therefore i.Approve thooe data end firnlatione of aPpOinimertf
1 filru 10 ha r: /Irian eirlairia In
Avration:Regulatfons
SICNATUREfSj OF DESIGNATE° ENGINEERING REFRESENTATNE(S) OES:GNATION NLIMBERS{S} CLASSIHCATION(S)
Vito A. PUlera
ati'-"--.DERT-830134 ,NE Systems and Equipment-
Electrical & Mechanical.
•
FAA Form 81104 (11-?o) SUPERSEDES PREVIOUS COITION ELECTRONIC FORMAT OM)
EFTA00278147
EFTA00278148
FEB-16-2007 15:29 From:BALL f UDC,
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
16 Feb 2007
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION
MAKE
Gulfstream MODEL NO.
Gl1B TYPE (Airplane, Radio. Helicopter. ofc.)
Airplane NAME OF APPLICANT
International Jet Interiors
LIST OF DATA
IDENTIFICATION TITLE
JRW0707-WD
Rev IR
2 Sheets
dated 08 Feb 2007 Cockpit 14VDC Power Receptacle Installation
Notes:
1. This Statement of Compliance addresses only the electrical aspects of the
engineering design data in the referenced drawing.
2. This document documents a finding of compliance only for the regulations listed
below in the APPLICABLE REQUIREMENTS box. Compliance to additional
regulations may be required.
3. This document does not provide full FAA approval of the equipment installation.
Additional engineering data may be required for approval.
4. This approval is valid for Gulfstream Model GIIB aircraft , tail number N909JE (SN
151) only.
PURPOSE OF DATA To demonstrate compliance with applicable FARs in support of an aircraft modification
documented in FAA Form 337.
APPLICABLE REQuIREmENTS (List specific 'tenons)
FAR 25.1301(a), FAR 25.1357(a)
CERTIFICATION - Under authority vested by direction of the Administrator
Part 183 of the Federal Aviation Regulations, data listed above and on anacneo
established procedures end found to comply with applicable requirements of
ERecommend approval of these data
I (We) Tnerefore CZ Approve these data sno In accordance with conditions
sneets numbered -NA- and limitations of appointment under
have been examined in accordance with
the Federal Aviation Regulations.
SIGNATURE(S) OF DESIGNATED ENGINEERING REP SENTATIVE(S) DESIGNATION NUMBERS(S) CLASSIFICATIONLS1
Systems Karl M. Frantz 7(4,4i DE RT-636280-NM and Equipment
orm /3110-3 (I t-70) SUPERSEDES PREVIOUS EDITION ELECTRONIC FORMAT (7.00)
EFTA00278149
I.)
EFTA00278150
1 . Approving National Aviation
Authority/Country:
FAA/UNITED STATES 2.3
• • . Form Tracking Number:
AUTHORIZATION RELEASE CERTIFICATE
FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG 536641
4. Organization Name and Address: DECRANE AIRCRAFT SEATING CO., 701 MAPLE ST., P.O. BOX-129, PESHTIGO, WI 54157, USA
do P.L Porter Controls, Inc., 3000 Winona Ave., P.O.Box 7722, Burbank, CA 91510-7722.USA.
TSO C39b; TSO C127a . 5. Work Order/Contract/Invoice Num:
..
7. 0 2005-527 •
6. Item: 7 - Description: 8. Part Number: 9 . Eligibility:` 10. Qty: ii- Serial/Batch Number112. Status/Work
1
- HYDROLOK • SL02300-28 TSO Article: N/A .,... •:•‘....-
. •,4•::. ,..,:.., T.*. ..5tn•-;
V.:All 1-IZe• .
14.9..4.• !,tt",'-.. 50 5 1 5 0 1 9 • New .
13. Remarks THE PART SHIPPED UNDER THIS APPROVAL IS A SUB COMPONENT OF A FAA-PMA HIGHER A.fi.S.EMBLY.
DIRECT SHIP AUTHORIZATION II:..;. EER
DECRANE AIRCRAFT SEATING CO., 701 MAPLE ST., P.O. BOX 129, PESHTIGO, WI 54157, USA
do P.L Porter Controls, Inc., 3000 Winona Ave., P.O.Box 7722, Burbank, CA 91510-7722 USA •
ISO C39b; TSO C127a ' .,::'.,:•
14. Certifies the items identified above were manufactured In conformity to:
• . . ...
:.14 cFR.43:9 Return toSerVi4.•
• • - . . . .. ,. .. . . . .
:.- Other regulation specified in Block.t3..:7:•:.
.....:
• • , • • ..:,
dertifiesthat iiii.10s Otneiirjte:s00:Ci4d in.iiiii;013;fthe work identifie.ii irBlack.1 and • ..
described inbiock.i was accomplished. in ootofdanee with. Title 14; Code of Feder's! ..,.- - ...,...
f,feguletione,iikti4Otiii.in.fesj5ect to thSt work, the itemsSieapkOVedfoi return: to Service..::
• - ...- -";::-.-
-, ... .
X Approved design data and are in condition for safe operation .e-:.1;:”•:::.
I I Non-approved design data specified In Block 13.
15. Authorized Signature: ,••-•.. „..s.. /
tr:j L. L.X_____,_ k.),, •:----,-- 16. Approval/Authorization No.:
ODAR F601987NM . . •:
irij .Authorized.Signaiiire:r I- •••• `'...1. - .... .. . • ,..
- - - -' . . . .. . _
21„:APproval/Certificate NO.;-- ....
18. Date(m/d/y): JAN/26/2006 0>:.
...1.•!..,/p0:(-f;psi, pr:0nTni • ... 4 Date(mi ' • -•• • •-•
17. Name (Typed or Printed): Eva Alarcon User/Installer Responsibilities
At is important to understand that the existence of this document alone does not automatically constitute authority to Install the part/component/assembly. • t . .
:'Where the user/installer performs work in accordance with the national regulations of an airworthiness authority differem •••.,.rthe airworthiness authority of the country specified in Block 1, it is essential that the user/ins' Vier ensures that
• his/her airworthiness axepts parts/components/assemblies from the airworthiness authority of the country specified i-. ..1. ,,,
. !'.
Statements in B' ! i and 19 do not consitutue Installation certification. In all cases, aircraft mainenance records r : .intain an installation certification issued in accordance with the national regulations by the ut, .'!'er before the
• -
aircraftcaircraftmay be :• i -..,
i .. .
••...:
EFTA00278151
%.-
EFTA00278152
Aircraft pelts Inc.
P.O. Box 845
2000 Anders Lane
Kemah Texas 77565
FAA R.S. #: YB1R632K
Packing Slip: 208
Ship To:
PO: 2073
Ship Date: 1/19/2007 AIRCRAFT BELTS, INC. TM
t"t.nt
Sold To:
International Jet Interiors
•
Ship Via:FedEx PI
SO: 73092
-IRLO.f.1W.1; . antipc1446.- Ai* 6410:01, _ • . ekz4
1 1.00 EA 1.00 0.00 r5ptrps
Description: Reweb Pac Sci 4pt Assy w/Inertia Reel # 210 / #12 FOB: ORIGIN
Sales Person: Terri Phillips Page: 1
t'Ot
fssewsiq,
IR
2 2.00 EA 2.00 0.00 r4ptfps
Description: REWEB PAC SCI 4PT FIXED HARNES # 210/ #12 IR
3 4.00 EA 4.00 0.00 r3ptrabi IR
• Description: Reweb ABI.3.PointAssy. ..w/Jpertiayeel #.12 . . • -
, •
4 7.00 EA 7.00 0.00 rlaabi IR
Description: Reweb ABI Lap Belt # 210
5 1.00 EA 1.00 0.00 rlaabi-p IR
Description: Reweb Plated ABI Lap Belt # 210 1
2
3
5
CERTIFICATION This is to certify that the above components have been manufactured/repaired and inspected in accordance with current Federal
Aviation Regulations: ISO C-22 and/or TSO C-114 and found airworthy for service unless otherwise noted. The conditions
and tests required for TSO approval of this article are minimum performance standards. It is the responsability of those
desiring to install either on or within a specific type of class of aircraft to determine that the aircraft installation conditions are
within the ISO standards. If not within the TSO standards, the article may be installed only if further evaluation by the
applicant documents an acceptable installation and is approved by the administrator. Details of this manufacture/repair are on
file at this facility.
EFTA00278153
tit
EFTA00278154
MAJOR REPAIR AND ALTERATION usloepariment (Airframe, Powerplant, Propeller, or Appliance) of Transportation
Federal Aviation
Administration Form Approved
OMB No. 2120-0020
For FAA Use Only
Office Identificaticg ib4,—/
INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instr tions and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act of 1958).
1. Aircraft Make Model
GULFSTREAM AEROSPACE G1159B
Serial No. Nationality and Registration Mark
151 U.S.A. N909JE
2. Owner Name (As shown on registration certificate) :.
HYPERION AIR INC. I s : 2. # • ,#§ • s :.• . : •• # z • cats)
3. For FAA Use Only
4. Unit Identification - 5. Type
Unit Make Model Serial No. Repair Alteration
AIRFRAME described in 1 X (As Item above)
POWERPLANT
PROPELLER
APPLIANCE Type
' Manufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency C. Certificate No.
JET AVIATION ASSOCIATES LTD.
WEST PALM BEACH. FL. 33406 U.S. Certified Mechanic CRS EYKR782D
AIRFRAME 1,3.
RADIO 1,2,3.
LIMITED AIRFRAME, & P/P
LIMITED INSTRUMENT Foreign Certified Mechanic
X Certificated Repair Station
Manufacturer
D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge.
Date Signature of Authorized Individual . . . . . , _ . . ---------- 8/20/04
John K. Urso, Inspector.
7. Approval for Return to Servi
Pursuant
Administrator
BY to the authority given
of the Federal Aviation persons specified below, the unit
Administration and is identified in item 4 w nspected in the manner prescribed by the
❑ REJECTED r APPROVED
FAA Flt. Standards
Inspector Manufacturer Inspection Authorization Other (Specify)
FAA Designee X Repair Station Person Approved by Transport
Airworthiness Group
Date of Approval or Rejection
8/20/04Certificate or
Designation No.
EYKR782D Signature of Authorized Individual
John K. Urso, Inspector. /- ZIA-6"--
FAA Form 337 (12-88)
EFTA00278155
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with
all previous alterations to assure continued conformity with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets, Identify with aircraft nationality and registration mark and date work accomplished.)
GULFSTREAM - II (G-1159), S/N 151, REG N909JE, W/O 20985
INSTALLED AN ARTEX 406 MEGAHERTZ EMERGENCY LOCATOR TRANSMITTER (ELT) SYSTEM (ISO C126), IAW ARTEX
C406-N MHZ EMERGENCY LOCATOR TRANSMITTER OPERATION, INSTALLATION AND MAINTENANCE MANUAL, DOCUMENT
NO. 570-5060, REV B, AND THE FOLLOWING JET AVIATION DRAWINGS:
WIRING DRAWINGS:
• G2B-20895-370, REV IR, DATED 8/10/04, TITLED - EMERGENCY LOCATOR TRANSMITTER SYSTEM.
REFERENCE F.A.A. FORM 8110-3, DATED 8/16/04 BY SYSTEMS AND EQUIPMENT DER NO. DERT-510087-NM
STRUCTURAL DRAWINGS AND REPORTS:
• G2B-20895-1370, REV IR, DATED 8/9/04, TITLED - ELT EQUIPMENT INSTALLATION.
• G2B-20895-1371, REV IR, DATED 8/9/04, TITLED - ELT ANTENNA INSTALLATION.
• ER01489, REV IR, DATED 8/9/04, TITLED SUBSTANTIATION REPORT, ELT & EGPWS INSTALLATION FOR GULFSTREAM
G1159B, S/N 151
REFERENCE FAA FORM 8110-3 DATED 8/9/04 BY STRUCTURES DER NO. DERT-810028-NE.
THE NEW EQUIPMENT AND ASSOCIATED SYSTEMS WERE FUNCTIONALLY TESTED PER ARTEX 406 MHZ EMERGENCY
LOCATOR TRANSMITTER OPERATION, INSTALLATION AND MAINTENANCE MANUAL, DOCUMENT NO. 570-5060, REV B,
WITH NO DISCREPANCIES.
AN EMI TEST, REPORT NO.: G2B-20895-080 WAS CONDUCTED AND THE INSTALLED EQUIPMENT DOES NOT INTERFERE WITH
ANY OTHER INSTALLED EQUIPMENT.
THE STATIC LOADING OF THE INSTALLED EQUIPMENT MEETS THE REQUIREMENTS OF AC 43.13-2A, CHAPTER 1,
PARAGRAPH 3 AND WAS FOUND TO MEET THE REQUIREMENTS OF PARAGRAPH 2. MATERIALS AND PRACTICES COMPLY
WITH PARAGRAPHS 4 THROUGH 12. THE ELECTRICAL LOAD ANALYSIS UPDATE REPORT NO O2B-20895-040 WAS
COMPLETED IN ACCORDANCE WITH AC43.13-1B, CHAPTER 11, SECTION 3, PARAGRAPH 11-37.
A LOGBOOK ENTRY REFLECTING THIS INSTALLATION WAS COMPLETED PER F.A.R. 43.9 AND ENTERED INTO THE AIRCRAFT
LOGBOOK. THE EQUIPMENT LIST WAS AMENDED AND THE NEW WEIGHT AND BALANCE WAS COMPUTED AND ENTERED IN
THE AIRCRAFT RECORDS IAW AC43.13-1B, CHAPTER 10, SECTION 2 AND AC 43.13-2A, CHAPTER 1 PARAGRAPH 9.
MAINTENANCE FOR CONTINUED AIRWORTHINESS IS CONTAINED IN JET AVIATION DOCUMENT G2B-20895-050, TITLED -
INSTRUCTIONS FOR CONTINUED AIRWORTHINESS FOR ARTEX C406-N MHZ EMERGENCY LOCATOR TRANSMITTER.
THERE ARE NO COCKPIT PROCEDURAL CHANGES OR FLIGHT MANUAL SUPPLEMENT DUE TO THIS MODIFICATION
-------- - END --------------- -------
D Additional Sheets Are Attached
O U.S. G.P.O 1990-761-753
EFTA00278156
4111.1.11 ME eiKnoN
GE4WITH -, ; ;cFED
.'7,::;a:Nsi.k..acsewit}s1114 .11. aK,10'449 16.
Ina leaCh
'ittlra:/:<09 .40.ttrAelektlaCti
EFTA00278157
I
•
EFTA00278158
DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
STATEMENT OF COMPLIANCE WITH THE FEDERAL AVIATION REGULATIONS DATE
August 9, 2004
AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION
' MAKE
Gulfstream MODEL NO.
G1159B TYPE (Airplane, Radio, Helicopter, etc.)
Airplane NAME OF APPLICANT
Jet Aviation Associates
LIST OF DATA
IDENTIFICATION TITLE
G2B-20895-1370
G2B-20895-1371
G2B-20895-1450
ER01489 ELT Equipment Installation, Sht 1-4, Rev IR
ELT Antenna Installation, Sht 1-3, Rev IR
Minor Deviation to STC ST02789AT Mk VIII EGPWS Equipment Installation, Sht 1-7, Rev IR
Substantiation Report Substantiation Report - ELT & EGPWS Installation for
Gulfstream G1159B, s/n: 151
Note:
1. This approval is for structural aspects only.
2. This approval is based on analysis and drawing review.
3. After the repair or alteration, the aircraft must be returned to service by
FAA authorized personnel.
PURPOSE OF DATA
To approve structural aspects of an alteration to Gulfstream G1159B, s/n: 151, TCDS Al2EA
APPLICABLE REQUIREMENTS (List specific sections)
FAR 25.301 25.303 25.305 25.307 25.321 25.561
25.601 25.603 25.605 25.609 25.611 25.613
25.625
CERTIFICATION - Under authority vested
under Part 183 of the Federal Aviation
In accordance with established procedures
I (1)1 Therefore by direction of the Administrator and in accordance with conditions
Regulations, data listed above and on attached sheets numbered
and found to comply with applicable requirements of the Federal
Recommend approval of these data.
Approve these data. and limitations of appointment
0 have been examined
Aviation Regulations.
SIGNATURE(S) OF DESIGNATED ENGINEERING REPRESENTATIVE(S) DESIGNATION NUMBER(S) CLASSIFICATION(S)
Structural David E. Haralson Po.‘Evet. licerze.,__ DERT-810028-NE ,
FAA Form 8110-3 (11-70) SUPERSEDES PREVIOUS EDITION ER01489.doc
EFTA00278159
I
EFTA00278160
REVISION STATUS
REV
LTR REV
BY DESCRIPTION APPROVAL DATE
(No data herein shall be deemed to have been approved by any regulatory agency).
v. . iates, Ltd.
‘I'l _SWF 11117177711A1 am eac n rport
CRS-EYKR782D West Palm Beach, FL 33406
PROPRIETARY NOTICE:
This document contains specifications and/or data, technical material, proprietary information that are the sole property of JET AVIATION
ASSOCIATES, LTD, to be held and treated by its recipient on a confidential basis and is not to be shown or disclosed to any unauthorized
organization or person without the written authorization of JET AVIATION ASSOCIATES, LTD.
Woric Order No.: 20895 MODEL: TITLE:
INSTRUCTIONS FOR CONTINUED AIRWORTHINESS
FOR
ARTEX C406-N EMERGENCY
LOCATOR TRANSMITTER Gulfstream
G-1159B NAME DATE
Prepared By: T. CARR 08/10/04
Checked By: J. URSO 08/16/04 S/N:
151 Q/A: J. URSO 08/16/04
Engineer: N/A N/A DOCUMENT NO.:
G2B-20895-050 REV:
IR SCALE:
NONE SHEET:
1 OF 9 Approved: N/A N/A
EFTA00278161
I
EFTA00278162
, 0
MAJOR REPAIR AND ALTERATION US Department
of Transportation (Airframe, Powerplant, Propeller, or Appliance)
Federal Aviation
Administration Form Approved
OMB No. 2120-0020
For FAA Use Only
Office Identificati
INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instr i s
and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed
$1,000 for each such violation (Section 901 Federal Aviation Act of 1958).
1. Aircraft Make Model
GULFSTREAM AEROSPACE G1159B
Serial No. Nationality and Registration Mark
151 U.S.A. N909JE
2. Owner Name (As shown on registration certificate) Address As shown on r: .istration certificate
HYPERION AIR INC.
3. For FAA Use Only
4. Unit Identification 5. Type
Unit Make Model Serial No. Repair Alteration
AIRFRAME • described X (As in Item 1 above)
POWERPLANT
PROPELLER
APPLIANCE Type
Manufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency C. Certificate No.
JET AVIATION ASSOCIATES LTD. U.S. Certified Mechanic CRS EYKR782D
AIRFRAME 1,3.
RADIO 1,2,3.
LIMITED AIRFRAME, & P/P
LIMITED INSTRUMENT Foreign Certified Mechanic .-.......,
x Certificated Repair Station
Manufacturer
D. I cert
have
furnished unit(s) identified in item 4 above and described on the reverse or attachments hereto
Part 43 of the U.S. Federal Aviation Regulations and that the information been made in accordance with the requirements of
herein is true and correct to the best of my knowledge.
Date Signature of Authorized Indivi ual.....,
-Jo-tm K. Urso, Ins----ector. -- - - — it - --
7. Approval for Return to Sery
Pursuant
Administrator
BY to the authority given persons specified below, the unit
of the Federal Aviation Administration and is identified in item 4 inspected in the manner prescribed by the
❑ REJECTED 4 APPROVED
FAA Flt. Standards
Inspector Manufacturer Inspection Authorization Other (Specify)
FAA Designee X Repair Station Person Approved by Transport
Canada Airworthiness Group
Date of Approval or Rejection
8/20/04 Certificate or
Designation No.
EYKR782D Signature of Authorized Individual
John K. Urso, Inspector._ /(--• 66v--
FAA Form 337 (12-88)
EFTA00278163
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with
all previous alterations to assure continued conformity with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets, Identify with aircraft nationality and registration mark and date work accomplished.)
GULFSTREAM - II (G-1159), S/N 151, REG N909JE, W/O 20985
ACCOMPLISHED AN UPGRADE TO THE EXISTING HONEYWELL MST-67A TRANSPONDERS FOR THE INCORPORATION OF
FLIGHT ID. REMOVED TRANSPONDERS PIN 066-01143-0601 (TSO C112) AND INSTALLED TRANSPONDERS P/N 066-01143-2101
(TSO C112). REMOVED HONEYWELL TRANSPONDER CONTROL UNIT P/N 071-01507-3603 (TSO C112) AND INSTALLED
TRANSPONDER CONTROL UNIT P/N 071-01618-0021 (TSO C112, C I 18, C119b). REFERENCE AC20-41A, SUBSTITUTE TECHNICAL
STANDARD ORDER AIRCRAFT EQUIPMENT.
NO WIRING OR STRUCTURAL ALTERATIONS WERE ACCOMPLISHED.
THE NEW EQUIPMENT AND ASSOCIATED SYSTEMS WERE FUNCTIONALLY TESTED PER HONEYWELL MST67A MODE S
TRANSPONDER SYSTEM MANUAL 006-00681-0006 WITH NO DISCREPANCIES.
AN EMI TEST, REPORT NO.: G2B-20895-080 WAS CONDUCTED AND THE INSTALLED EQUIPMENT DOES NOT INTERFERE WITH
ANY OTHER INSTALLED EQUIPMENT.
THE STATIC LOADING OF THE INSTALLED EQUIPMENT MEETS THE REQUIREMENTS OF AC 43.13-2A, CHAPTER 1,
PARAGRAPH 3 AND WAS FOUND TO MEET THE REQUIREMENTS OF PARAGRAPH 2. MATERIALS AND PRACTICES COMPLY
WITH PARAGRAPHS 4 THROUGH 12. THE ELECTRICAL LOAD ANALYSIS UPDATE REPORT NO G2B-20895-040 WAS
COMPLETED IN ACCORDANCE WITH AC43.13-1B, CHAPTER 11, SECTION 3, PARAGRAPH 11-37.
A LOGBOOK ENTRY REFLECTING THIS INSTALLATION WAS COMPLETED PER F.A.R. 43.9 AND ENTERED INTO THE AIRCRAFT
LOGBOOK. THE EQUIPMENT LIST WAS AMENDED AND THE NEW WEIGHT AND BALANCE WAS COMPUTED AND ENTERED IN
THE AIRCRAFT RECORDS TAW AC43.13-1B, CHAPTER 10, SECTION 2 AND AC 43.13-2A, CHAPTER 1 PARAGRAPH 9.
MAINTENANCE INSTRUCTIONS FOR CONTINUED AIRWORTHINESS REQUIRED PER F.A.R. 25.1529 ARE CONTAINED IN JET
AVIATION DOCUMENT G2B-20895-051.
THERE ARE NO COCKPIT PROCEDURAL CHANGES OR FLIGHT MANUAL SUPPLEMENTS DUE TO THIS ALTERATION.
-END
❑ Additional Sheets Are Attached
O U.S. G. P.O 1990-761-753
EFTA00278164
REVISION STATUS
REV
LTR REV
BY DESCRIPTION APPROVAL DATE
(No data herein shall be deemed to have been approved by any regulatory agency).
ATE!' RIAERFICIII . . ' s, Ltd.
a m Bea n Airport
West Palm Beach, FL 33406 CRS-EYKR782D
This document contains specifications
ASSOCIA TES, LTO. to be held and
organization or PROPRIETARY NOTICE:
the sole property of JET AVIATION
or disclosed to any unauthorized
LTD. and/or data, technical material, proprietary information that are
treated by its recipient on a confidential basis and is not to be shown
person without the written authorization of JET AVIATION ASSOCIATES,
Work Order No.: 20895 MODEL: TITLE:
INSTRUCTIONS FOR CONTINUED AIRWORTHINESS
FOR THE INSTALLATION OF THE HONEYWELL
PS-578A MODE S/TCAS CONTROL PANEL Gulfstream
G-1159B NAME DATE
Prepared By: T. CARR 08/10/04
Checked By: G. L. KARR 08/16/04 S/N:
151 Q/A: J. URSO 08/19/04
Engineer: N/A N/A DOCUMENT NO.:
G2B-20895-051 REV:
IR SCALE:
NONE SHEET:
1 OF 5 Approved: N/A N/A
EFTA00278165
•
EFTA00278166
e
MAJOR REPAIR AND ALTERATION US Department
of Transportation (Airframe, Powerplant, Propeller, or Appliance)
Federal Aviation
Administration Form Approved
OMB No. 2120-0020
For FAA Use Only
Office lc,ra_lioryt
INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for structions
and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed
$1,000 for each such violation (Section 901 Federal Aviation Act of 1958).
1. Aircraft Make Model
GULFSTREAM AEROSPACE G1159B
Serial No. Nationality and Registration Mark
151 U.S.A. N909JE
2. Owner Name (As shown on registration certificate) A. :, ,, i•ir or :A.' . .IPI :IC . e)
HYPERION AIR INC.
3. For FAA Use Only -
4. Unit Identification 5. Type
Unit Make Model Serial No. Repair Alteration
AIRFRAME .. described in X (As Item 1 above) ----- -.
POWERPLANT
PROPELLER
APPLIANCE Type
Manufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency C. Certificate No.
JET AVIATION ASSOCIATES LTD. U.S. Certified Mechanic CRS EYKR782D
AIRFRAME 1,3.
RADIO 1,2,3.
LIMITED AIRFRAME, & PIP
LIMITED INSTRUMENT Foreign Certified Mechanic
X r-
Certificated Repair Station
Manufacturer
D. I certi o the unit(s) identified in item 4 above and described on the reverse or attachments hereto
have ements of Part 43 of the U.S. Federal Aviation Regulations and that the information
furnished herein is true and correct to the best of my knowledge.
Date
8/20/04 Signature of Authorized . Individual — ---. — / 1- - -------- -
e---(A.--y^ John K. Urso, Inspector.
7. Approval for Return to Se e
Pursuant
Administrator
BY to the authority given
of the Federal Aviation persons specified below, the unit
Administration and is identified in item as inspected in the manner prescribed by the
❑ REJECTED APPROV
FAA Flt. Standards
Inspector Manufacturer Inspection Authorization Other (Specify)
FAA Designee X Repair Station Person Approved by Transport
Airworthiness Group
Date of Approval or Rejection
8/20/04 Certificate or
Designation No.
EYKR782D Signature of Authorized Individual
John K. Urso, Inspector. /('CiA
FAA Form 337 (12-88)
EFTA00278167
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with
all previous alterations to assure continued conformity with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets, Identify with aircraft nationality and registration mark and date work accomplished.)
GULFSTREAM - II (G-1159), S/N 151, REG N909,1E, W/O 20985
REMOVED THE EXISTING HONEYWELL MK I GROUND PROXIMITY WARNING SYSTEM AND INSTALLED A HONEYWELL MK
VIII ENHANCED GROUND PROXIMITY WARNING SYSTEM (EGPWS) IN ACCORDANCE WITH JET AVIATION ASSOCIATES, LTD.
STC NO. ST02789AT PER JET AVIATION ASSOCIATES, LTD., MASTER DRAWING LIST, DOCUMENT NO. G1159-19760-010, REV A.
DATED 01/30/04, TITLED - MASTER DRAWING LIST FOR THE INSTALLATION OF THE MK VIII ENHANCED GROUND
PROXIMITY WARNING SYSTEM (EGPWS) IN THE G-1159 SERIES AIRCRAFT. CONCURRENTLY ACCOMPLISHED RADIO
ALTIMETER UPGRADE BY REMOVING THE # 1 AND # 2 COLLINS RADIO ALTIMETER ALT-50 AND INSTALLING COLLINS
RADIO ALTIMETER ALT-55B IAW COLLINS ALT-50/55 RADIO ALTIMETER SYSTEM INSTALLATION MANUAL 523-0775918-
004118 DATED 4/11/97. DEVIATIONS TO THE STC ARE DOCUMENTED ON THE FOLLOWING JET AVIATION DRAWINGS.
WIRING DRAWINGS:
• G2B-20895-450, REV IR DATED 8/13/04, TITLED - MINOR DEVIATIONS TO STC ST02789AT MK VIII EGPWS SYSTEM
WIRING DIAGRAM.
• G2B-20895-506, REV IR, DATED 8/13/04, TITLED - MINOR DEVIATIONS TO STC ST02789AT AUXILIARY ANNUNCIATOR
SYSTEM WIRING DIAGRAM.
REFERENCE FAA FORM 8110-3 DATED 8/16/04 BY SYSTEMS AND EQUIPMENT DER NO. DERT-510087-NM
STRUCTURAL DRAWING AND REPORT:
• G2B-20895-1450, REV IR DATED 8/5/04, TITLED - MINOR DEVIATIONS TO STC ST02789AT MK VIII EGPWS EQUIPMENT
INSTALLATION.
• ER01489, REV IR, DATED 8/9/04, TITLED SUBSTANTIATION REPORT, ELT & EGPWS INSTALLATION FOR GULFSTREAM
G1159B, S/N 151.
REFERENCE FAA FORM 8110-3 DATED 8/9/04 BY STRUCTURES DER NO. DERT-810028-NE.
THE MK VIII EGPWS WAS FUNCTIONALLY TESTED PER JET AVIATION GROUND TEST PROCEDURE DOCUMENT NO.
G1159-19760-060 REV. A DATED 01/30/04, TITLED - CERTIFICATION GROUND TEST PROCEDURE FOR THE MK VIII EGPWS,
WITH NO DISCREPANCIES.
A LOGBOOK ENTRY REFLECTING THIS INSTALLATION WAS COMPLETED PER F.A.R. 43.9 AND ENTERED INTO THE AIRCRAFT
LOGBOOK. THE EQUIPMENT LIST WAS AMENDED AND THE NEW WEIGHT AND BALANCE WAS COMPUTED AND ENTERED IN
THE AIRCRAFT RECORDS IAW AC43.13-1B, CHAPTER 10, SECTION 2 AND AC 43.13-2A, CHAPTER 1 PARAGRAPH 9.
MAINTENANCE INSTRUCTIONS FOR CONTINUED AIRWORTHINESS REQUIRED PER F.A.R. 25.1529 IS CONTAINED IN JET
AVIATION ASSOCIATES, LTD. DOCUMENT NO. G1159-19760-050, REV. IR, DATED 11/19/03.
THE REQUIRED FAA APPROVED AIRPLANE FLIGHT MANUAL SUPPLEMENT DOCUMENT NUMBER G1159-19760-100, REV. IR,
DATED FEB 09 2004 HAS BEEN INSERTED INTO THE AIRCRAFT FLIGHT MANUAL.
END
❑ Additional Sheets Are Attached
O U.S. G.P.O 1990-761-753
EFTA00278168
Anita, Atatts of jknuriat
pepartment of Zranspartztlian gtbtral cikfliritiorc gaiministration
Supplant/Ifni Type Terlifirate
oeio4jecale essaedlotiVel,9216,e ST02789AT
tes, Ltd.
Palm Beach, FL 33406
_ceirleXe4.4ea4.64-aeanfe 1;s 44, *Aise Aujg"),e).• 44i4a,eorivywedaci-coae-44'471444144, -44-aisii-eillitiAWAt
ccs .ysearXedievrws ',see& ezeiveoWdecizeos .v9a-eirmeysis elgirel 25 e/ Federal Aviation
aiov:sa,g;od.e- .9;y7e Fe..4;4.74, Al2EA
,A6,718 Gulfstream Aerospace Corporation
../#20.41.• G-1159, G-1159A & G-1159B Series
g"-1••04:91' e/Tf" "",""'
Installation of a Honeywell Model MK VIII Enhanced Ground Proximity Warning System (EGPWS) in accordance with Jet Aviation Master Drawing List (MDL) G1159-19760-010, Rev. A, Dated January 30, 2004 or later FAA approved revision.
...Wthiezz.tievs4 ezepeinvu/44O,9 ".s...
FAA Approved Flight Manual Supplement (AFMS) for Gulfstream Aerospace Corp. Models G-1159, G1159A & G-1159B Series Aircraft with Honeywell Model MK VIII EGPWS, Jet Aviation Document No. G1159-19760-100, Rev. IR, Dated February 9, 2004, is a required part of this STC. This approval should not be extended to other aircraft of this model on which other previously approved modifications are incorporated, unless it is determined by the installer that the interrelationship between this change and any other previously approved modifications will produce no adverse effect upon the airworthiness of that airplane. If the holder agrees to permit another person to use this certificate to alter the product, the holder shall give the other person written evidence of that permission.
ces.-4/eoale czaatZ4 Jurpo"1.44, eaveic.42 a, ,0,.< Wale .3zuvinoelesm JeAyseved. ~Weider Iewmisalay, dale ss ode.~4se e,s4de.‘„i6. 46 ,AL/Z174/%3€4Z4710V. VW,
le cy,gereo September 19, 2003 ros:isreed.
07.41 oi,s;ssuaekre February 9, 2004 grah, a'nevwfool.
gri,..aetzejgae;TA5s, .Adme:44.V.sale
,990, c/46
6,1414. gffled;" (w-gnature)
jot Melvin D. Taylor
Manager
Atlanta Aircraft Certification Office
(Title)
Any alteratico or this certificate is punishable by • fine of not exceeding $1,000, or imprisonment not exceeding 3 years, or both.
SPA Poem $110-1(10-6I) PA= 1 of 1 PAGIS This certificate ray be transferred in accordance with fAR 21.47.
EFTA00278169
I
.
EFTA00278170
SET Rff711778111
SUPPLEMENTAL TYPE CERTIFICATE N°. ST02789AT
BY USING THIS SUPPLEMENTAL TYPE CERTIFICATE, YOU AGREE TO THE FOLLOWING TERMS. IF YOU
DO NOT AGREE TO THE TERMS OF THIS AGREEMENT, PROMPTLY RETURN THE SUPPLEMENTAL TYPE
CERTIFICATE, MAINTENANCE INSTRUCTIONS, AND FLIGHT MANUAL SUPPLEMENT TO JET
INCORPORATED FOR A FULL REFUND.
Jet Aviation Associates, Ltd (JET) grants you (the "Licensee") the right to use the Supplemental Type Certificate
("STC") referenced above on the Gulfstream G-1159B aircraft Serial N°. 151 , (the "Aircraft"). You may not use the
STC and related materials, including drawings, flight manual inserts, instructions or other materials for any other
aircraft or for any other purpose.
COPYRIGHT. The STC is owned by JET and is protected by United States copyright laws, other United States
laws, and international treaty provisions. Therefore, you must treat the STC like any other copyrighted material.
One (1) copy of the written materials accompanying the STC package may be made for each aircraft Serial Number
listed above.
CONFIDENTIALITY. Licensee will protect the STC Data Package, whether in storage or in use, with the same
degree of care as the Licensee uses to protect its own confidential and proprietary material against public
disclosure and unauthorized use, but in no case with any less degree than reasonable care. Licensee will keep the
STC Data Package confidential and will not disclose it to anyone other than employees of the Licensee reasonably
having a need to have access to it for the purposes specified above, and such disclosure to them shall be made
only under conditions of strict confidentiality.
LIMITED TRANSFER RIGHTS. You may not sell, rent or lease the STC, except that you may transfer your license
to the STC to any purchaser of the Aircraft.
INDEMNIFICATION AND LIMITATION OF LIABILITY. Licensee shall have no recourse against JET for, and
hereby agrees to defend, indemnify and hold harmless JET, its shareholders, directors, officers, employees and
agents, against any and all claims (whether in contract, tort, or otherwise, including negligence of any degree) for or
in respect of any loss (including loss of use and/ or profit), expense, liability, property damage and/or bodily injury
(including death) which may at any time be suffered or incurred (for any reason whatsoever) by Licensee and/or
any third parties (including persons or any property being carried in the Aircraft in any capacity whatsoever), directly
or indirectly ar
📷 Images in this document (276 detected; 6 largest described)
AI-generated factual descriptions of embedded images (llava:13b). These are searchable across the corpus.
[Image 1] The image shows a document with text and a table. The document appears to be a form or a report, possibly related to a medical or health-related context, given the references to "patient," "physician," and "medical records." The visible text includes sections such as "Patient Information," "Physician Information," and "Medical Records Information." There are also fields for patient name, date of b
[Image 2] The image shows a document that appears to be a form or a record of some sort. It contains various fields with handwritten text, including names, dates, and possibly other details. The document is not clearly legible due to the quality and resolution of the image. The visible text includes names and dates, but the specific content of the form is not discernible. The document is a physical piece of
[Image 3] The image shows a document that appears to be a letter or a form, with visible text and a stamp in the upper right corner. The text is too small to read clearly, and the document is slightly blurred, making it difficult to discern specific details. The stamp has a date and a name, but the exact content of the document is not legible due to the quality of the image.
[Image 4] The image shows a document that appears to be a form or a checklist with various fields and checkboxes. The form includes sections with headings such as "Name," "Address," "Phone Number," "Date," and "Signature." There are also checkboxes next to each section, indicating options such as "Yes" or "No." The form is filled out with handwritten text, but the details are not clearly visible due to the
[Image 5] The image shows a document that appears to be a form or a checklist with various fields filled out. The form includes sections with headings such as "Name," "Address," "Phone Number," "Date," and "Signature." There are also numerical fields with checkboxes next to them, indicating a list of items or tasks to be completed. The form is filled out with handwritten text, and there is a signature at th
[Image 6] The image appears to be a document scan, possibly a letter or a form, with visible text and handwritten notes. The text is too small and blurry to read clearly, and the handwriting is not legible. The document has a header and a footer, which are common features in official documents. The background is white, and the text is in black, which is typical for printed documents. The document is slightl