MAJOR REPAIR AND ALTERATION eel? (Airframe, Powerplant, Propeller, or Appliance)

`Oral MAJOR REPAIR AND ALTERATION eel? (Airframe, Powerplant, Propeller, or Appliance) US Doormen ol turepottabon Nan/ Avignon Admislettifte No 2120-0020 Exp Sal /2014 EMatenc ',sank Hint*. Fa FM the arty 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. 44701). Failure to report can result in a Civil penalty for each such violation. (49 U.S C. 46301(a)). 1. Aircraft Nationality and Registration Mark USA N722JE Serial No. 760750 Model S-76C Series Make SIKORSKY 2. Owner Name (As shown on registration certificate) Hyperion Air LLC Address (As shown on registration certificated AC4ens 610O Red Hook (Nana. 10 City SL Thomas State 20 00F02 Country USA 3. For FAA Use Only • 4. Type 5. Unit Identification Repair Alteration Unit Make Model Serial No. • ISI AIRFRAME _....._.. .... ___ ____.-- (As described in item 1 above) • O POWERPLANT • O PROPELLER O O APPLIANCE itivackew & Conformity Statement A Agency's Name and Address _ B. Kind of Agency r Manufacturer International Jet Interiors U.S. Certificated Mechanic I C Certificate No 2221 Smithtown Ave Foreisn Certificated Mechanic Ronkonkoma, New York x Certificated Repair Station CRS I1JR439Y 11779 USA Certificated Maintenance Organization I D. I certify that the repair and/or alteration made to the units) identified in Hen 5 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 15 true and correct to the best of my knovAed Extended range fuel per 14 CFR Part 43 O App B Signature/Date of Au widual Jay Masser 8/272019 INSP 001 7. Approval for Return to Service _ Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the Adnwiistrator of the Federal Aviation Administration and is n APPROVED O REJECTED FM FN. Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport BY FM Designee X Repair Station Inspection Authorization Other (Specify) Certificate or Designation No. CRS I1JR439Y Signature/Date of Authorized ual INSP 002 Thomas Norden 8/27/2019 ^ FM Form 337 reek SDNY_GM_027 57629 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024455 1 EFTA01329414 NOTICE Weight and balance or operating Imitation 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. IL Description of Work Accomplished (If more space is reQuirad. attach additional sheets. Wordy with 011073n nabonakty and registration mark and date work accomplished.) USA N722JE Dote Nationality and Registration Mark 8/27/2019 I) Reupholstered the existing Divans (Outer Cover Only) with Cowtan & Tout Fabric: 1.8905-07, EMI Silver. All PAX seat belts have been rewebbed by Aircraft Belts Inc. (FAA/CRS # YBIR632K) reference Certificate of Conformance dated 8/9/2019. 2) All PAX Scat Cushions have been fireblocked in accordance with FAA Title 14 CFR 29.853 (a) Amdt 29-23 and Part 25 Appendix F Part I (a)(1Xii) and Title 14 CFR 29.853 (b) and Pan 25 appendix F part II requirements. Reference Skandia Inc. FAA/DER form 8110-3 (attached) dated 08/21/2019 (Skandia TP 28191 Rev A dated 8/21/2019) by FANDER Mackenzie Kacvinsky, (DERV-834396-CE). 3) Relocated the existing phone & reel any (P/N TN1003.101) from the window line panel to the Fwd facing Divan RH cabinet in accordance with International Jet Interiors structural drawing No. 131-S76C-750-01, Rev IR dated 8/13/201% Titled "Instl-Phone Relocation". The listed structural drawing was approved via (attached) FAA/DER Form 8110-3 dated 8/22/2019, by Karol Mordasiewicz (DERT-834582-CE). 4) Reupholstered the existing Crew Seats with Aeristo leather: Aeronappa Incas P/N AN-G-018M, D/L 1118-P-1214 and Aeristo Leather. Alcantara Anthracite PN ALCA-AV-1883 (center insert). Reference Skandia Inc. FAA/DER form 8110-3 (attached) dated 08/21/2019 (Skandia burn report TP1/ 360764-19, Rev A dated 8/21/2019) by FAA/DER Jane Biberstein. (DERV-832780-CE). Crew seat belts have been rewebbed by C&M Marine Aviation Services Inc. (FAA/CRS # VO5R749Y) reference 8130-3 dated 8/1/2019. 5) Stripped and recovered the existing Headliner Panels, Window Line and Side Wall Panels throughout the cabin and cockpit with Aeristo leather: Aeronappa Incas P/N AN-G-0113M. D/L V18-P-1214. Reference Skandia Inc. FAA/DER Conn 8110-3 (attached) dated 08/21/2019 (Skandia burn report TP# 360764.19, Rev A dated 8/21/2019) by PANDER Jane Biberstein, (DERV-832780-CE). 6) Stripped and recovered the existing Headliner Insert with Perrone Fabric: Alcantara Avant 4883 Anthracite ALCA-AV- 4883. Reference Skandia Inc. PANDER form 8110-3 (attached) dated 08/21/2019 (Skandia burn report TP/1 360764-19, Rev A dated 8/21/2019) by FAA/DER Jane Biberstein, (DERY-832780-CE). 7) Stripped and recovered the existing upper and lower side wall panels, cabin door overlay, cabin side ledge throughout the cabin and cockpit with Aeristo leather. Aeronappa Incas P/N AN-G-018M, D/L VIII-P-I214. Reference Skandia Inc. FAA/DER form 8110-3 (attached) dated 08/21/2019 (Skandia bum report TP# 360764-19, Rev A dated 8/21/2019) by FAAMER lane Biberstein, (DERY-832780-CE). 8) Stripped and recovered the existing Cabin Fwd Bulkhead Panels with Aeristo leather: Aeronappa Incas P/N AN-G-018M, D/L YI8-P-1214 and Dedar Fabric: 3040/14 Contemporary/Perla. Reference Skandia Inc. FAA/DER form 8110-3 (attached) W4418/21/2019 and 8/23/2019 (Skandia burn reports TP# 360764-19, Rev A dated 8/21/2019 and TP 360828-195S% dated 8/23/2019) by FANDER Jane Biberstein, (DERY-832780-CE). 1'00 9) Stripped and recovered the existing Cabin Alt Bulkhead Panels with Aeristo leather. Aeronappa Incas P/N AN-G-018M, D/L Y18-P-1214 and E&T Mirror 2064 Grey M IMP K. Reference Skandia Inc. FAA/DER form 8110-3 (attached) dated 08/21/2019 and 8/23/2019 (Skandia burn reports TP# 360764-19, Rev A dated 8/21/2019 and TP 360828-19, Rev A dated 8/23/2019) by FAA/DER Jane Biberstein,(DERY-8327130-CE). 10) Installed new replacement Carpet throughout Cabin and Cockpit with Red Rock carpet: Hampton I-I GR968, Color Black. Reference Skandia Inc. FAA/DER form 8110-3 dated 08/21/2019 (Skandia bum report TPN 360764-19, Rev A dated (attached) 8/21/2019 by FAA/DER Jane Biberstein, (DERY-832780-CE). El Additional Sheets Are Attached FAA Form 337 (10-06) SDNYGM02757630 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244552 EFTA01329415 NOTICE Weight and balance a 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 S. Description of Work Accomplished (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work accomplished) USA N722JE Date Nationality and Registration Mark 8/27/2019 I I) All affected areas of the aircraft interior have been placarded in accordance with Keystone Helicopter Engineering Document No. IC01217 Rev G. 12) This aircraft's W&B has been revised (calculated) this date showing new CG. 13) A logbook entry has been made reflecting this alteration. 14) This Refurbishment/Repair/Alteration to the existing Cabin Interior furnishings requires No Scheduled Maintenance Tasks or Airworthiness Limitations, refer to the OEM Maintenance Manual, and all other existing ICA's. The Aircraft's Scheduled Maintenance Program is not altered by this Modification/refurbishment. IS) 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. Work Order No. 19150, on file at this agency, covers the above described work. No further entries. 0 Additional Sheets Are Attached FM Form 337 (10-06) SDNYGA402757631 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244553 EFTA01329416 SDNY_GM_02757632 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFIA_00244554 EFTA01329417 Control Number. 2019-117 Sheet 1 of 1 119. DEPARTMENT OF TRMISPORTAT/ON FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS I. DATE Elnrzois AIRCRAFT OR AIRCRAFT empower IDENTIFICATION 2. MAKE Sikorsky Aircraft Corporation & MOOG. NO. S-78C 4. TYPE Obtat &Una Pnettn. Vol Aircraft S NAME OF AFRICAN International Jet Interiors. UST OF DATA 6. CDITIFCAIION T. MIRE .121: a: UkS76C-750-01 Rev IR Dated 08113)2019 Decurnents Instl-Phone Relocation. Structural Analysis Phone Relocation Installation Sikorsky S76 END IJI-S76C-750-0ISA Rev IR Dated: 08/16(2019 END Notes I This approval is for engineering design data only. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as Applicable Requirements. 2. This form constitutes FAA approval of all the engineering data necessary (or substantiation of compliance to necessary requirements for the entire atterationirepair. Electrical and Flammability approval may be required. 3. The modified cabinet is not part of the seat TSO. 4 Applicable Requirements are per the TWA HINE Rev 47, dated Apr1130, 2019 a. PURPOSE Of DATA Engineering drawing and report release in support of Field Approval of major alteration for Sikorsky helicopter Serial Number 780750. N722JE as outlined In drawing'. IJI-S78C-750-01 Rev IR, Dated 08113/2019 9 FFPuCial McMullin No WOW maws) 14 CFR Part 29 Arndt 29-11, Sections: 29.301 Amdt 29-0, 29.303 Amdt 29-0, 29.305 Arndt 29-0, 29.307(a) Arndt 29-4, 29.309(a) Arndt 29-0, 29.337(a) Arndt 29-0, 29.561 (a)(b)(e) Amdt 29-0, 29601 Amdt 29-0, 29.603 Am* 29-0, 29.805 Arndt 29-0, 29.607(a) Arndt 29-5, 29.609(a) Amdt 29-0, 29.813 (a,b) Arndt 29-0, 29.825 Amdt 29-0 and 25.787 Arndt 29-0 10. aRTIFICATON . Undo autarky inset by Orecbon d OW AONIUMOY and n entadinca ent cantons and Inane:dm or aapposentani &d 14 CFR Pm In. data Bled is. AM 00 toted ghee furlIblred hat ONO atanted in liett0nfalce ern est atlases porettwes and town to amply at toncatle ettnernenb of the AnonymMesa Slant MINA 0 Recommend approval of Mese Oats I ONal TORO= =e Approve Owns darn 11. SIONAIURE4 • TED ENGIICERING REPRESENTATIVES) n. CESIGTATIONTAMMERS(S) 11 CUISSIFWATKVES) Karol a vewiat DERT-834582-CE Structures FAR Fens 91104 (0OJI0) SuPERSEOES PREVIOUS EOTiON SDNY_GM_02757833 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244555 EFTA01329418 SDNY_GM_02757634 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244556 EFTA01329419 U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE 08/21(2019 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MANE Sikorsky 3. MODEL NO. S-76C 4. Typo (Mw. Eva At spas c. as f Helicopter 5. NAME OF APPLICANT International Jet Interiors LIST OF DATA 6. IDENTIFICATION 7. TITLE TP 28191 Rev A Dated 8/21/2019 Skandia. Inc. Flammability Test Report Oil Burner Testing and Vertical Burner Testing Notes: 1) Work accomplished under Skandia Inc. WO e 360502-19. Ref Document ID 102212 2) Flammability test witnessing only, does not constitute Installation approval of the matenals. 8. PURPOSE OF DATA Demonstration of compliance with material flammability requirements in support of Major Repair 8 Alteration for WI 760750 9. APPLICABLE REQUIREMENTS (List speak sections) 14 CFR Part 29.853 (a) Anull 29-23 and Ran 25 Appendix F Pail I (aXIX ii) 14 CFR 29.853(b) and Pan 25 Appendix F Part II 10. CtaTtFKATION - Under authority vested by direction of the Administrator and in appointment under 14 CFR Part 183. data listed above and on attached sheets numbered in accordance with established procedures and found to comply with applicable requirements 0 Recommend approval of these data I iYerd Therefore tjlk Approve these data th conditions and limitations of have been examined of the Ainseethiness Standards listed. 11. SIGNATURE(S) OF OESIGNATED ENGINEERING REPRESENTATIVE 12. DESIGNATION NUM ['ERIS) 13. cl.ASSiFiCATioN(S) A frOcirtjA au fild - aCkenzie Kacvinsky DERY-834396-CE Structural Special FAA Form 8110-3 (WO) SUPERSEDES PREVIOUS ION SDNY_GM_02 757635 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244557 EFTA01329420 SDNY_GM_02757636 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244558 EFTA01329421 U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE OW21/2019 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Sikorsky Aircraft Co I. MODEL NO. S-76C 4. Type wen, &oak Props. WO Helicopter S. NAME OF APPLICANT International Jet Interiors UST OF DATA S. MENT1P1CATION 7. TITLE TP 360764-19 Rev A Dated 8/2112019 Skandia. Inc. Flammability Test Report Bunsen Burner Testing Test Specimen Part Numbers: PN: 1 (Represents: Headliner panels) PN: 2 (Represents: Cockpit door panel & side wall panels) PN: 2A (Represents: Cockpit door panel & side wall panels) PH: 5 (Represents: Cockpit crew seats) PN: 6 (Represents: Cabin floor covering carpet) PN: 12 (Represents: Headliner panel insert) PN: 13 (Represents: Cabin door panel overlay) Notes: 1) Work accomplished under Skandia Inc. WO # 360764-19, Ref Document ID 102231. 2) Flammability test witnessing only, does not constitute installation approval of the materials. 8. PURPOSE OF DATA Demonstration Cr compliance with material flammability requirements in support of Major Repair 8 Alteration for S/N 780750 9. APPLICABLE REQUIREMENTS (List specific sections) 14 CFR Part 29.853 (a) Arndt 29-23 and Part 25 Appendix F Part I (a)(1)(0 14 CFR Part 29.853 (a) Arndt 29-23 arid Part 25 Appendix F Part I (a)(1 )00 10. CERTIFiCATiON - Under authority vested by direction of the Administrator appointment Mkt 14 CFR Part 183. data fisted above and on attached In accordance with established procedures and found to comply with applicable O Recommend approval of these data I (Prt.)Thefefore X Approve these data and in accordance with conditions sheets numbered and limitation of have been examined Standards listed. requirements of the Airworthiness it. 814 TURNS) OF DESIGNATIDEN8INEERING REPREStNTATTVE 12. DESIGNATION NUMBER(5) 13. CLASSIFICATION(S) \ i ... bmJani\Biberstein DERV-832780-CE Structural Special FAA Fom181O.3 103110) SUPERSEDES PREVIOUS EDITION SDNY_GM_02 757837 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244559 EFTA01329422 1 SDNY_GM_02757638 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244560 EFTA01329423 U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATKIN ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE 0803/2019 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Sikorsky Aircraft Co 3. MODEL NO. S-76C 4. Typo (Nrplem, Engtv, Prewar. itc.) Helicopter S. NAME Of APPLICANT International Jet Interiors UST Of DATA • IMMOLATION 7. TTTLE TP 360828-19 Rev A Dated 8/23/2019 Skandia, Inc. Flammability Test Repel Bunsen Burner Testing Test Specimen Part Numbers: PN: 9 (Represents: FWD cabin bulkhead) PN: 14 (Represents: Aft cabin bulkhead) Notes: 1) Work accomplished under Skandia Inc. WO # 360828-19. Ref Document ID 102236. 2) Flammability test witnessing only, does not constitute installation approval of the materials. S. PURPOSE OF DATA Demonstration of compliance with material flammability requirements in support of Major Repair 4 Aiteratlon for SIN 760750 9. APPLICABLE REQUIREMENTS (LW specific sections) 14 CFR Part 29.853 (a) Arndt 29-23 and Pan 25 Appendix F Part I (at] xi) 70. CERTIFICATION - Under authonty vested by *renew of the Administrator appointment under 14 CFR Part 183, data listed above and on attached in accordance with established procedures and found to comply with applicable O Recommend approval of these data I ( ) Therefore yc Approve these data and in accordance with conditions sheets numbered and limitations of have been examined Standards listed. requirements of the AinvortNness 11. TURERDOF D64961M-11TED ENGINEERING REPRESENTATIVE 12. DESIGNATION NUMBER(S) 13. CLASSIFICATION'S) r \ -,. l-)A1)j (Z:v_r t 1 XO \IRc DER Jarte B ibersiein DERY-832780-CE Structural Special FAA Fon\ 110-3 ( 10) SUPERSEDES PREVIOUS EDITION \ SDNY_GM_02757693 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024456 I EFTA01329424 SDNY_GM_02757640 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244562 EFTA01329425 0 MAJOR REPAIR AND ALTERATION Le DaierUmm Treigatieo• (Airframe, Powerplant, Propeller, or Appliance) Feral miaow Mlainliengen roan Aperoad OM No 21200320 2/2610‘ II WI/0/K Tn.:bay Wrest am IML We ay <I INSTRUCTIONS Prnt or type al Nines See Tree 14 CFR §139. Part 13 Appends( R and AC 139.1 Mr subsequent mime thereof) for instructions and depasMon of this form The report a required by law (19 USG 644701) FaUe to report can resat to a awl penally for each such yolaton (49 U S C 546301(a)) I. Aircraft Nationetly and Regetration Mark N722JE Seral No 760750 us, Keystone Helicopter Motel S76 Series C++ 3. Owner Name (As shown on regestranon certificere) ASI Wings LLO MOMS (As Moan on registration comfiest.) bad 151 Farrningten Ava ch Hartford sum ST be 06156 Car,/ USA 3 For FAA Use Only 4. Type 5. Unit klentifkation ROOM Alteration Unit Make Model Ser ai No O El AIRFRAME (As deserted n Am 1 above) El . POWERPtANT O O PROPELLER O O APPLIANCE Type umanurer 6 Conformity Statement A Agencys Name and Address 8 Kind or Agency NPs( Aeennated Aircraft Smile Mr U$ Certfceted Mecham I Mandocauret men. 32 Griffith Way Fear CWced Mechem C Certificate No car 10/aXED4N 1 F•11‘ airs NY i Ctourcated Repair Slaw* 7.4. 12590 owetv USA centsras MaulalelanCe Ononemon AYPR340S CI I certty that the repar anctror alteration mac* to the und( ) Identified n date 5 above ant deserted on the reverse or attachments hereto have been made in accordance weft the requirements of Pad 43 or the U 5 Federt Aviation Regulations and that the inkonabon !unshed hewn a true and correct to the best oh my knowledge Extended range fuel pet 14 CFR Pan 43 O Alt 8 S Dale of Autnonzed Individual ' Tom Henry 28 Apr 16 / 7. Approval for Return to Service Recut t to the authority 9 von pe Jr %decried tekm, the unit denied Administrator of the Federal Amber, Adminstraton and is le in Item 5 was napectecl in the manner prescribed by the APProved O Rejected BY FAA Pt Standards Inspector Manufacturer Maintenance Orgamzsion Persons Approved by Cowden Chicanmers or Tenger, FAA Designee it Repair Sieben Inspector' AuthOrtZatiOn Other (SPX* Cenificate or Designation No AYPR34OS SgnatureOate of Authonred I intuit a/ C-2(-4?2-4-4-I CP Scheftic 28 Apr 16 FAA Form 337 norm SDNY_GM_02757841 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244563 EFTA01329426 NOTICE Weight and balance or operating hmitahon changes shell be entered in the composts 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 to more space gs requv-ed attach Sitcshei sheets Identify with suctalt nationekly end regsstaton ins* and dote work 00ettplitifx1) N722JE Nationally and Repastration Mark Alteration to Sikorsky S-76C++, N722JE, 760750 @Aircraft TSN 1.747 0, Lndgs 3.698 Removed engine oil access door PIN 76302-07014-061 and installed new engine oil access door P/N 76302-07014-049, modified with the "Thumb Latches" IAW Sikorsky Drawing No 33776.84145 Ref also Sikorsky Drawings 33776-84145-AL-001 Application List and 33776.84145 -PL-001 Parts List The Door with Thumb Latches is an on-condition component with no airworthiness life limited parts This alteration does not require a Rotorcraft Flight Manual revision Weight and Balance is not affected by this alteration Airworthiness Inspections will be accomplished IAW the existing Sikorsky Airworthiness Limitations and Inspection Requirements Manual, ALIRM, SA 4047-76C-2-1, Ch 5-20.00 Pertinent details are on file under Work Order 5262-04.2016 28 Apr 16 O ildarbonal SheetS Are *decree Date A AS INSP. FAA Form 337 ecot. SONY_GM_02757642 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244564 EFTA01329427 • f. SDNY_GM_02757643 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244565 EFTA01329428 SDNY_GM_02757644 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244566 EFTA01329429 I lef 1 --- --- t 4,-- - . -- - -- S. § -- --- -- ---- ....._ 1....11 -.4--, 18 ; IVII ii 114:1 I'll;p gilei Mil le O21 Iliiii Mai 1 le st 1) it !' f i• I; Ii14 il11 2 211x tri it 'Z',-l; 3 1 p 11 i- • 1! it!a i E I i 1 h Ili '1 .- ... , a C 0 a .a. o. I II gi L. . rs I 21 ptvi g .. 01 .2 9. I i. 8 I .IIII 14 5 Lo i., iI ; el. , i I II. ::: Fill !!! i 8 il • !.? ill0 !IS0 I i!e... - 1., I. M i! i e 1 1 z 1 .. z g ',1 . . if NOTED I 0 . .. ' I !!: III/ i 1 : I/ ' 1o R3a. i I Iii! i I 1 . t s -'. k : 2 : 1 i : ea II : rkgtices. APPLIE1 AUUMfNUM ALLOY r,'".1 II Ili i .. ; I • I • ftq ... ' r.!ISil!! • .• e. * i !if il", • i i iI It .46 ta51'i.f4 4-2; ar.-..,%-...t.:g.:1-..:.5...._......._______—_ 17Li Va i-2E4 i 7'. 1 15 3 z.1............. . 1. -- --- --- -- --- --- --A -!thIli f • " - • m li !I SI, ;1 -iii :: 7 77 It .. 4,- SDNY_GM_02757645 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244567 EFTA01329430 SDNY_GM_02757646 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024456% EFTA01329431 C CO rn H -O 0 H rn H n xP 0 3D -O 3> 3> 70 -O (/) • 3/44 00 SC) V•el CA P 13 • 0 0.3 ;14 CL I-a0 Sikorsky DESIGNED BY APPLICATION LIST ACCESS DOOR MOD REL. AUTE 39066A AL 33776-84145 8E 001 • u•••• •••••••pwOm eso CAGR 78286 SIZE A CRTC . RUM. ORIG. PREP. UNDER CONTRACT CESOCIIR NAPIER NATHRIAL NAPIER REVISED BY N ERICKSON REV. DATA 13JUL98 R E CODS 1 LA • WITS/ DUOS KW IleTSWIAL PART CODS 3 •PART ml D • DRTAIL I - IllTALLATION N - NOT TO II 011D T • TOOL A • All1WOLT 1 - On IT I • SIT V - tones cram, v. voccanan le • an V • TOI0ING I. • MOLT 0OWT OTT R • /Alt KleTS12/1• V • V131211031 C • COMM II • @PIC TOITTIlin N • ALTERED ITS/ CODS 3 - 100. WITIRCRWKWAIIZLITY tawny. 2 .v or nertano 3 • en icons APPLES/ TO PART NO. IN LETT RAND CO VIP 111_.156330N TO PART NO. nun prate° R 2 V PART NUMBER C D 1 C D 3 NEXT ASSEMBLY QTY NA PART NUMBER BEING REPLACED • • CTISTOMER• EP PECTIVI TY MODEL IN OUT • INTERNAL* • IN OUT E • • • • EXTERNAL APPLICATION 33776-84145-011 . REVISION 13 DESCRIP 33776-84145-011 • ION • NEXT 33776-20407.011 33776-20453-011 33776-20472-011 33776-20485-011 33776-20489-012 33776-60290-041 ASSY 33776-20489-112 • • • APPLICATION 0001 0001 0001 0001 0001 0001 LIST MODEL S76PEC - SKEET 001 LAST S76PEC 0001 SUBQ S76PEC 0001 SUBQ 976P EC 0001 SUBQ S76PEC 0001 SUBQ S76PEC 0001 SUBQ S76PEC 0001 SUBQ 0001 SUBQ ADDED SHEET • • • 0001 SUBQ 0001 SUBQ 0001 SUBQ 0001 SUBQ 0001 SUBQ 0001 SUBQ This thiCUINCIII. Of an embrliterne of tr in any media. th.elow, anfahnenen ranch 1. repenter. ts ehe paperer al Solonly .Ittraft Ceoperanan, lieu nnpeNnhed wort reverted ethic er.haable eatinght laa t. end A Ile/awed on the awn. antlaten thee n h nee la he awl. inekned, or repeadurni. N whole or in pate winding reproduction to a dernathr work. re innd for own...fanny for rapine other than SiAan.4 ite raft Coeparetn wither kViOCIIC0ITWIll. end throe right i• tenni., I I to Inekne er so site any utionnanan tomatoes I Glenne.. All nchA relayed ,in at: in nelanen of appliceble Sew ary nth In rail end ethwinel powthie‘ IpJ Ln EFTA01329432 SDNY_GM_02757648 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244570 EFTA01329433 0, us himmuzi MAJOR REPAIR AND ALTERATION of Tfric011210II (Airframe. Powerplant, Propeller, or Appliance) hash Aviation arminisentioa Awn Wawa O4 He 21200320 TIMM IChrome Third Harem cot MA use One INSTRUCTIONS: Print or type al entries. See Title 14 CFR 343.9. Part 43 Append* B. and AC 43.91 (or subsequent revision thereof) for instnictions and disposition of this form This report is required by law (49 U.S.C. $44701). False to repeat Can Masse in a tail penalty for each such violation. (49 V.S.C. §46301(a)) 1. Aircraft Nationality and Registration Mark N722JE Saul No. 760750 make Keystone Helicopter Model S-76C Series 2. Owner Name (As shown on registration cert#icare) ASI Wings. LLC Address (As show) on registration certificate) Men, 151 Farmington Avenue car Hartf0rd Sim CT as 06156-0001 camy USA 3. For FAA Use Only 4. Typo 5. Unit Identification Repair notation UM Make Model Serial No. • 2 AIRFRAME (As desenbe0 In Neil I above) O . POWERPLANT O O PROPELLER O O APPLIANCE Type Manufamwar 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency rom Pm Star Aviation 11 C u. S Carthame Mecham I Manstlactiger Add,SI 5 Industrial Drive, Manchester Airport FIXIMII Ceeirlicaed MecMnic C. Certificate No hi I ondondenv sue NH i Char-Med Repar StabOn P6UR006Y is 03053 cach, USA Chair-Mee Maintionanos 0rganzath D. I certify that the repair andiw alteration made to the urea( ) identified in item 5 above and described on the reverse or attachments hereto have been made Ni accordance with the requrements of Parl 03 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Extended range fuel per 14 CFR Part 43 ADP. 6 Signature/Date of Authorized individual Spencer Roy ,------, --?(s----- 04-tea-16 T. Approval for Return to Service Pursuant IO the authority specified below. the identified in tern 5 was -nSpected in the manner by the given persons int Admirntrater of the Federal Aviation Adieu titration and * 2 Acoroved • proscribed Rejected _ BY FAA Ft Standards inspeacir Manufacturer Maintenance Organization Persons Appoanse by Camden Deperimeni of tismoon FAA Designee V Repair Staten Inspection Authonzation Other (Speciiy) Certificate or Designation No. P6URONY Signature/Date of Authorized Individual Spencer Roy ..______?..<_-- 04- ._-"471 6 FAA Form 337tmob SDNY_GM_02757649 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024457 I EFTA01329434 NOTICE Weight and balance or operating limitation changes shalt be entered in the appropnate 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 add.tonat sheets. ldenbty web aircraft nationaMy and regisbacon mark and date work completed.) N722JE Nationally and Registration Mark 04-9-A-62016 ------ DUAL TDR-94D TRANSPONDER WITH ABS-B OUT UPGRADE (STC SR09641RC) Date • Upgraded the Transponder System by removing the existing TOR-94 (2 each) and installing the New TDR-940 (2 each), Annunciator (2 each), associated electrical wiring and component provisions, per the Installation Instructions (-02 Installation), PHI document PHI-S7641.0003, revision 2. • Installed the TDR-94D (part number 622-9210-551. 2 each). per the PHI mechanical drawing PHI-S76-60936. revision IR. Installed the ADS-B 1/FAIL Annunciator (part number 95-40-17-H1-E1BKK), per the PHI mechanical drawing PHI-576-60937, revision A. Installed the ADS-B 2/FAIL Annunciator (part number 95-40-17-H1-E18KL), per the PHI mechanical drawing PHI-S76-60938, revision A. • Modified the wiring for the #1 Transponder System, per the PHI electrical drawing PHI-S76-13204, revision E. Modified the wiring for the #2 Transponder System, per the PHI electrical drawing PHI-576-13205. revision E. • Completed the configuration of the Dual Transponder Upgrade, as recorded on the Configuration Instructions, PHI document PHI-S76-CFG-0002, revision 2. • Completed the checkout for the Dual Transponder Upgrade, as recorded on the Installation Check Out Procedure, PHI document PHI-S76-ICP-0002. revision 3. • Rotorcraft Flight Manual Supplement, Pro Star Aviation document 21394-FMS-01, revision A. DER Approved on FAA Form 8110-3. dated 0411a-16, has been supplied to the operator, to insert into the existing Rotorcraft Flight Manual. • For continued airworthiness of the Dual TDR-94D Transponder with ADS-B Out Upgrade, refer to the Instructions for Continued Airworthiness, PHI document PHI.576-ICA-0005, revision B. supplied to the operator. Where the CTL-92E Controller is referenced in the ICA, refer to the existing aircraft maintenance documentation for the Collins RTU-4200 Radio Tuning Unit. • No change to the electrical load for this rotorcraft. • Refer to the updated Aircraft Computed Weight and Balance, and Aircraft Equipment List Supplement, dated 04- gin-16. for further information reflecting this modification. • The upgrade for the Dual TOR-94D Transponder with ADS-B Out System has been accomplished per the Master Drawing and Documents List. PHI document PHI.576-DL-0015, revision B. in accordance with STC SR09641RC. Pertinent details of the above modifications are retained on work order 21394, on file at Pro Star Aviation. END O Additional Sheets Are Anathen FAA Form 337 oocei SDNY_GM_02757650 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244572 EFTA01329435 thriontateroperenea (Department of Transportation Teeferaffiviation Administration Suppkmentaf Type Certcate Wum6ersRo9e4iRc This certfficate issueito: Rockwell Collins. Inc. 400 Collins Road NE, MS 164-100 Cedar Rapids, IA 52498 certifies that the change in the type disOnfor the following product with the limitations andconditions there ore as specified hereon meets the airuorthiness requirements ofeart nof the Federal Aviation RyguLttions Original Product - Type Cenificate Number: HINE Make: Sikorsky Airmail Corporation Model: S-76C Description of Type Design Change: Installation of DO-260B compliant Mode S Transponder System with ADS-B Out capability in accordance with Master Document List. PHI-S76-Dl...0015, Revision B. doled February 26, 2014. or later FAA approved revision. Rower:raft Flight Manual Supplement. PHI.959-S76-TDR-001, Revision 0, dated March 13, 2014, or later FAA approved revision is required for this installation. Instructions for Continued Airwonhiness, FHI-576-11CA-0005, Revision A. dated February 21. 2014. or later revision is required. Limitations and Conditions: I The installer must determine whether this design change is compatible with previously approved modifications. 2 A ropy of this certificate must be maintained as pan or the permanent records for the modified aircraft. 3 If the holder agrees to pennit another person to use this certificate to alter a product. the holder must give the other person written evidence of that permission. This certiwate oaths supporting data which is the hasit for approval shalt remain in effect untilsurrend red susperuk4 and revoked or a termination date is otherwise estahlished 6y the Administrator of the federal Aviation Administration. Date of application: January 17, 2014 Date reissued: July 15.2014 Date of issuance: March 21.2014 Date wended: By direction of theAdministrator Tale Manager, Rotoreraft Certification Office. Southwest Region Any aserationof this certificate is purinhable by a me anal media, SI.000.m imprisonment not eneding 3 yews. or both. Tbes certificatenay be transcend or ma& avertable to tknd µsae by hemming ethreernents w accordacce with 14 CFR 21.47. Possession of this Supplemental Type Cenillase ISTCleoctorent by persons mho than the STC holder does sot destitute nem to the dela darn not to eke an stiasA. oi renal Ogee. oe propeller. The STC's sweeten documemation (drawings. instructions. spreificaimen. flight manual sapplemenes. eiel is the peoµny of the STC bather An SIC holler nem alkms a µnee '0 use the SIC to alter an meant. aircraft rn5uw or propeller arm semi* that µism with %WM* periftiniCsa metpuble untie FAA. (Ref le CFR 33130) FAA Form el t0-2 (3/13) Page I SDNY_GM_02757651 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244573 EFTA01329436 SDNY_GM 02757652 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244574 EFTA01329437 PHI, INC. ENGINEERING DEPARTMENT MASTER DRAWING AND DOCUMENTS LIST NO. PHI-S76-DL-0015 FOR INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER Revision (B) 02/26/2014 Prepared By. PHI Engineering, Electrical Approval: PHI Engineering, Structural Approval: Project Management Approval: 0070900AA“ Page I of 6 SDNY_GM_02757653 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244575 EFTA01329438 SDNY GM 02757654 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244576 EFTA01329439 PHI-S76-DL-0015 Rev (8)02/26/14 REVISIONS REV DATE DESCRIPTION PAGES ADDED PAGES DELETED PAGESAPP REVISED IR 02/06/14 Initial release N/A N/A N/A RG A 02/10/14 Added signature block; added Revisions page: changed the date on documents PHI.576-60936, PHI.576.60942, PHI.576.60943. PHI-S76-60944. PHI.576.60945. and PHI.050-60948: changed the date and revision of document PHI-S76-SA-0019; changed the date and revision of document AC345289011; added document A1345289011; changed revision on document 523- 0821779; changed revision and title of document 523- 0821492 2 N/A 1-6 EH B 02/26/14 Updated revision status for documents PHI.576.13204, PHI.576.13205. PHI.576-60937. PHI.576.60938. PHI- 576-CFG-0002. PHI-S76-II-0003. PHI-S76-FHA-0006. PHI-S76-SA-0019, PHI-S76-TP-0028. PHI-S76-FTP-0005. PHI-S76-ICP-0002, AC345289011, A1345289011; added documents PHI-576-13081, PHI-S76-13082, PHI-576- BTR-0001, PHI-S76-TR-0028, PHI-S76-FTR-0005; removed Universal Avionics Systems Corporation Service Bulletin No. 3XXX.XX.( )-34-3565 N/A N/A All EH - PROPRIETARY NOTICE THIS DOCUMENT AND THE INFORMATION HEREIN ARE PROPRIETARY DATA TO PHI. INC., ARO ALL DESIGN MANUFACTURING. REPRODUCTION, USE, PATENT RIGHTS. AND SALES RIGHTS REGARDING THE SAME ARE EXPRESSLY RESERVED. THIS DATA IS SUBMITTED UNDER A CONFIDENTIAL RELATIONSHIP FOR A SPECIFIC PURPOSE AND NEITHER THIS DOCUMENT NOR THE INFORMATION CONTAINED HEREIN SHALL BE REPRODUCED. USED. OR DISCLOSED TO OTHERS 0070900A cloc Page 2 of 6 SDNY_GM_02757655 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244577 EFTA01329440 SDNY GM 02757656 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244578 EFTA01329441 DOCUMENT PHI-S76-OL-0015 Rev: ELECTRICAL INSTALLATION DESCRIPTIVE DATA (8) 02126/14 DATE TITLE / SUMMARY REVISION PHI-S76-13204 NO. 1 TRANSPONDER SYSTEM, ROCKWELL COLLINS TDR-94D/CTL-92E WITH EXTENDED SQUITTER (ADS-8) E 02/20/14 PHI-S76-13205 NO. 2 TRANSPONDER SYSTEM. ROCKWELL COLLINS TDR-94D/CTL-92E WITH EXTENDED St:WITTER (ADS-8) E 02/20/14 PHI-576-13081 ELECTRICAL ROUTING - NO. 1 TRANSPONDER SYSTEM. ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-B) IR 02/11/14 I PHI-S76.13082 ELECTRICAL ROUTING - NO. 2 TRANSPONDER SYSTEM. ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-B) IR 02/11114 I STRUCTURAL AND MECHANICAL INSTALLATION DESCRIPTIVE DATA PHI.576-60935 TOP DRAWING - SINGLE OR DUAL ROCKWELL IR 01/20/14 COLLINS TDR-94D ATC/MODE-S (ADS-B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER PHI.576.60936 INSTALLATION - SINGLE OR DUAL ROCKWELL COLLINS TOR-94D TRANSPONDER($) IR I 02/10/14 PHI.576.60937 INSTALLATION - ANNUNCIATOR, NO. 1 TRANSPONDER A 02/20/14 I PHI-576-60938 INSTALLATION - ANNUNCIATOR, NO. 2 TRANSPONDER A 02/20/14 I PHI-576-60939 INSTALLATION - RELAY MOUNT. NO. 1 TRANSPONDER IR 01/20/14 PHI-S76-60940 INSTALLATION - RELAY MOUNT. NO. 2 TRANSPONDER IR 01/20/14 PHI.576.60941 INSTALLATION - TRANSPONDER CONTROL (CTL-92E) JIR 01/20/14 PHI-S76-60942 INSTALLATION - NO. 1 TRANSPONDER ANTENNA (TOP) STA. 143.67, LBL 27.00, WL. 119.82 IR 02/10/14 PHI-576-60943 INSTALLATION - NO. 2 TRANSPONDER ANTENNA (TOP) STA. 143.67. RBL 27.00, WL. 119.82 IR 02/10/14 0070900A0oc Page 3 of 6 SDNY_GM_02757657 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244579 EFTA01329442 SDNY_GM02757658 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 002445R0 EFTA01329443 PHIS76-DL-0015 Rev: (8)02/26/14 PHI-S76-60944 INSTALLATION - NO. 1 TRANSPONDER ANTENNA IR 02/10/14 (BOTTOM) STA. 140.00. LBL. 14.50. WL. 49.00 PHI-S76-60945 INSTALLATION - NO. 2 TRANSPONDER ANTENNA IR 02/10/14 (BOTTOM) STA. 126.00. LBL. 14.50. WL. 49.00 PHI-050-60913 TANDEM ADAPTER ASSY - 4.500' MOUNTING HOLE IR 01/20/14 SPACING. 3.990" INSIDE HEIGHT DIMENSION PHI-050.60947 MANUFACTURE - ANTENNA COVER PLATE. SIX HOLE IR 01/20/14 BASE CONFIGURATION, DMNI50 SERIES ANTENNA PHI-050.60948 ASSEMBLY - ANTENNA RETAINER, SIX HOLE BASE IR 02/10/14 CONFIGURATION, DMNI50 SERIES ANTENNA INSTALLATION & CONFIGURATION INSTRUCTIONS PHI.576-CFG-0002 CONFIGURATION INSTRUCTIONS FOR SINGLE OR 2 02/19/14 DUAL ROCKWELL COLLINS TDR-940 ATC/MODE-S (ADS-8) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S76C HELICOPTER PHI-S76-II-0003 INSTALLATION INSTRUCTIONS FOR SINGLE OR 2 02/19/14 DUAL ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-8) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER SUBSTANTIATION DATA PHI-S76-FHA-0006 INSTALLATION SYSTEM SAFETY ASSESSMENT 1 02/19/14 FOR INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TOR-94D ATC/MODE-S (ADS- 8) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER PHI-S76-SA-0019 STRUCTURAL ANALYSIS REPORT FOR B 02/21/14 INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-8) TRANSPONDERS) IN A SIKORSKY AIRCRAFT CORPORATION MODEL S-76C HELICOPTER PHIS76-BT-0008 FLAMMABILITY TEST PLAN FOR INSTALLATION OF IR 01/16/14 ADDED MATERIALS (ELECTRICAL WIRE AND COAXIAL CABLE) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER 0070003A.doc Page 4 of 6 SONY_GM_O2 757659 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244581 EFTA01329444 SDNYGM02757660 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244582 EFTA01329445 PHI-S7643L-0015 Rev: (6)02/26/14 PHI-576-BTR-0001 FLAMMABILITY TEST RESULTS FOR TESTING IR 02/19/14 PERFORMED IN ACCORDANCE WITH PHI FLAMMABILITY TEST PLAN DOCUMENT PHI-576- BT-0008 (ELECTRICAL WIRE AND COAXIAL CABLE) PHI-59243T-0004 FLAMMABILITY TEST PLAN FOR INSTALLATION OF A 07/07/13 ADDED MATERIALS (ELECTRICAL WIRE AND. ASSOCIATED ELECTRICAL COMPONENTS) IN A SIKORSKY AIRCRAFT CORPORATION S-92A HELICOPTER PHI-S92-BTR-0003 FLAMMABILITY TEST RESULTS FOR TESTING IR 07/23/13 PERFORMED IN ACCORDANCE WITH FLAMMABILITY TEST PLAN PHI-S92-BT-0004 (ELECTRICAL WIRE AND ASSOCIATED ELECTRICAL COMPONENTS) PHI.576C-SLA-760730 SUPPLEMENTAL ELECTRICAL LOAD ANALYSIS IR 01/14/14 FOR SIKORSKY MODEL S76C++ N772P S/N 760730 PHI.576-TP-0028 EMURFI GROUND TEST PLAN FOR INSTALLATION 2 02/15/14 OF SINGLE OR DUAL ROCKWELL COLLINS TDR- 94D ATC/MODE-S (ADS-B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER PHIS76-TR-0028 EMURFI GROUND TEST REPORT FOR 1 02/20/14 INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TDR-94D ATC/MODES (ADS-B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION 5-76C HELICOPTER PHI-S76-FTP-0005 IN-FLIGHT EMI/RFI AND ADS-B FLIGHT TEST PLAN 1 02/16/14 FOR INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS- B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER PHIS76-FTR-0005 IN-FLIGHT EMURFI AND ADS-B FLIGHT TEST IR 02/26/14 REPORT FOR INSTALLATION OF SINGLE OR DUAL ROCKWELL COLLINS TDR-940 ATC/MODE-S (ADS- B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER OPERATIONAL & CONTINUED AIRWORTHINESS DATA PHI-576-ICP-0002 INSTALLATION CHECK OUT PROCEDURE FOR 3 02/19/14 SINGLE OR DUAL ROCKWELL COLLINS TDR-94D ATC/MODE-S (ADS-B) TRANSPONDER(S) IN A SIKORSKY AIRCRAFT CORPORATION S-76C HELICOPTER 00709COA Doc Page 606 SDNY_GM_02757661 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244583 EFTA01329446 SDNYGNI02757662 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244584 EFTA01329447 PHI.576.01.-0015 Rev: (8)02/26/14 COMPLIANCE DATA AC345289011 CERTIFICATION PROGRAM PLAN, AUTOMATIC B 02/25/14 DEPENDENT SURVEILLANCE -BROADCAST (ADS-B) I SYSTEM A1345289011 WIRING COMPLIANCE INSPECTION REPORT, MODE S TRANSPONDER SYSTEM A 02/16/14 I REFERENCE DATA SIKORSKY AIRCRAFT CORPORATION SER-761924 ELECTRICAL LOAD ANALYSIS FOR BASELINE S76 C++ AIRCRAFT, SERIAL NUMBERS 641 AND SUBS 05/15/07 ROCKWELL COLLINS 523-0821779 AUTOMATIC DEPENDENT SURVEILLANCE BROADCAST (ADS-B) OUT INSTALLATION GUIDE 0 05/07/13 523-0821492 TDR-94/94D ATC/MODE-S TRANSPONDER SYSTEM (-5)(X) INSTALLATION MANUAL 0 05/01/13 946-4833-115 SUPPLEMENTAL MOPS 8 ROBUSTNESS TEST - 01/17/14 PROCEDURES AND RESULTS FOR TDR-94 ADS-B OUT UNIVERSAL AVIONICS SYSTEMS CORPORATION SERVICE LETTER NO. 2847 WAAS/SBAS FLIGHT MANAGEMENT SYSTEMS COMPLIANCE WITH AC 20.165A C 10/10/13 0070900Adoc Page 6 of 6 SDNY_GM_02757663 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244585 EFTA01329448 SDNY GM 02757664 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 002445R6 EFTA01329449 5 INDUSTRIAL DRIVE LONDONDERRY, NH 03053 FAA CRS# P6UR006Y FAA APPROVED ROTORCRAFT FLIGHT MANUAL SUPPLEMENT SIKORSKY MODEL S-76C EQUIPPED WITH IIDS AND 2S2 ENGINES FOR Installation of dual TDR-94D ATC/MODE-S/ADS-B Transponders Reg. No. N722JE Serial No. 760750 This supplement must be attached to the FM Approved Sikorsky S-76C Flight Manual when dual Rockwell Collins TOR-94D ATC/MODE-S/ADS-B Transponders are installed in accordance with FAA Form 337 dated 04-27-16 , The information contained herein supplements the basic Rotorcraft Flight Manual only in those areas listed herein. For Limitations, Procedures, and Performance information not contained in this Supplement; consult the basic Rotorcraft Flight Manual. This document and all information and expression contained herein are the property of Pro Star Aviation, and is provided to the recipient in confidence on a "need to know" basis. Your use of this document is strictly limited to a legitimate business purpose requiring the information contained herein. Your use of this document constitutes acceptance of these terms. FAA APPROVED: Refer To Page iii FM APPROVED DATE: APR12712016 Document Number 21394-FMS-01 Revision A Page i SDNY_GM_02757665 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244587 EFTA01329450 SDNY_GM_02757666 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244588 EFTA01329451 Pro Star Aviation. LLC. Londonderry. NH 03053 Part 1 FM Approved Rotorcraft Flight Manual Supplement Installation of dual TDR•94D ATC/MODE-StADS-B Transponders Sikorsky S-76C Sheet Intentionally Left Blank FM APPROVED DATE: APR/27/2016 Document Number 21394-FMS-01 Revision A Page ii SDNY_GM_02757667 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244589 EFTA01329452 SDNY_GM_02757668 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244590 EFTA01329453 Pro Star Aviation. LLC. Londonderry, NH 03053 Pad 1 FM Approved Rotorcraft Flight Manual Supplement Instalation of dual TDR-94D ATC/MODE-S/ADS-8 Transponders Sikorsky S-76C U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE APR/27/2018 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Sikorsky 3. MODEL NO. 8-76C 4. TYPE (Aaent& Engine. Prepear. ac.) Rotorcraft 5 NAME OF APPLICANT Pro Star Aviation UST OF DATA S IDENTIFICATION 7 TITLE Pro Star Aviation Document 21394-FMS-01 Revision A FM Approved Rotorcraft Flight Manual Supplement For Sikorsky Aircraft Corporation Aircraft Model S-78C Aircraft Equipped with IIDS and 2S2 Engines For Installation of dual TDR-940 ATC/MODE-S/ADS-B Transponders The approval of this Airplane Flight Manual Supplement is valid for Sikorsky Aircraft Corporation S-76C, serial number 760750 only 8. PURPOSE OF DATA In support of a Major Alteration on S76C serial number 760750 9 APPLICABLE REQUIREMENTS (LisI SWAN tierdent0 14CFR Pan 29: §29.1501(a)(bXc) [Arndt 29-0); §29.1581(a)(b) [Arndt 29-0) ; §29.1583(e) [Amdt 29-3): 29.1585(a) [Arndt 29-2] io. CERTIFICATION • Under autNonty vested by deaden Of The Administrator and n accordarce Mel conatone and Iimitairsna of atmantment under 14 CFR Part 183. data laded atom and on attached sneers nornband nave been enameled on accordance wt. establiOled iNOCedtreS ard bond lo I (We) Therefore campy wan acomatte readmit...not die Anathema Standards lead. . Recommend approval Of theta data Egl Approve these data II. SIGNATURES) OF CESIGNATEDENCANEERING 12. DESIGNATION modIERSSII 13. CIASSIFICATIONM r9W,„„,,e Mark D. Haycock DERT-500112-CE Flight Analyst FAA Form 8110-3 103710) SUPERSEDES PREVIOUS EDITION ELECTRONIC FORMAT (4.11 FM APPROVED DATE: APR/27/2016 Document Number 21394-FMS-01 Revision A Page iii SDNY_GM_02757669 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244591 EFTA01329454 SDNY_GM_02757670 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244592 EFTA01329455 Pro Star Aviation, LLC. Londonderry, NH 03053 Part 1 FAA Approved Rotorcraft Flight Manual Supplement Installation of dual TDR-940 ATC/MODE-S/ADS-B Transponders Sikorsky S-76C PART 1 LOG OF REVISIONS Revision Date Original (IR) 01/06/2016 A 04/27/2016 LOG OF PAGES Page i ii iii iv v vi 1-1 1-2 2-1 2-2 Revision Page A 3-1 A 3-2 A 3-3 A 3-4 A 4-1 A 4-2 A A A A Revision A A A A A A APPROVED: Refer to Page iii NOTE: Revised text indicated by a black vertical line. Insert latest revision pages; dispose of superseded pages. FAA APPROVED DATE: APR/2712016 Document Number 21394-FMS-01 Revision A Page iv SDNY_GM_02757671 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244593 EFTA01329456 SDNY_GM_02757672 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244594 EFTA01329457 Pro Star Aviation. LIC. Londonderry. NH 03053 Part 1 FAA Approved Rotorcraft Flight Manual Supplement Installation of dual TDR-94D ATC/MODE-S/ADS-B Transponders Sikorsky S-76C TABLE OF CONTENTS FAA FORM 8110-3 iii LOG OF REVISIONS iv TABLE OF CONTENTS INTRODUCTION vi SECTION I OPERATING LIMITATIONS 1-1 SECTION II NORMAL PROCEDURES S-76C++ 2-1 SECTION III EMERGENCY PROCEDURES 3-1 SECTION IV PERFORMANCE DATA 4-1 FAA APPROVED DATE: APR/27/2016 Document Number 21394-FMS-01 Revision A Page v SDNY_GM_02757673 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244595 EFTA01329458 SONY_GM_02757674 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFFA_00244596 EFTA01329459 Pro Star Aviation, LLC. Londonderry, NH 03053 Part 1 FAA Approved Rotorcraft Flight Manual Supplement Installation of dual TOR-94D ATC/MODE-S/ADS•B Transponders Sikorsky S-76C INTRODUCTION GENERAL This Rotorcraft Flight Manual Supplement describes dual TDR-94D ATC/Mode- S/ADS-B transponder(s) with dual RTU-4200. The RTU-4200 is capable of providing Flight ID information to the Mode S transponder system(s) for ADS-B operations. The Rockwell Collins TDR-94D ATCIMode-S Transponder System with ADS-B Out meets the equipment requirements of 14 CFR 91.227. FAA APPROVED DATE: APR/27/2016 Document Number 21394-FMS-01 Revision A Page vi SDNY_GM_02757675 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244597 EFTA01329460 SONY_GM_02757676 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244598 EFTA01329461 Pro Star Aviation. LW. Londonderry, NH 03053 Part 1, Section I FAA Approved Rotorcraft Flight Manual Supplement Installation of dual TDR-94D ATC/MODE-S/ADS-B Transponders Sikorsky S-76C SECTION I OPERATING LIMITATIONS This RFMS is only applicable to S-76C++ s/n 76O750 equipped with IIDS. TYPES OF OPERATIONS ADS-B OPERATIONS The following equipment must be operational for ADS-B coverage: 1. One Universal Avionics Systems Corporation UNS-1Fw Flight Management System. 2. One Air Data Computer (ADC). 3. One Rockwell Collins TDR-94D ATC/Mode-S/ADS-B transponder. 4. One Radio Tuning Units (RTU-4200). 5. One Attitude Heading and Reference System (AHRS). If the No. 1 ADC fails, activate the No. 2 transponder. If the No. 2 ADC fails, activate the No. 1 transponder. FAA APPROVED DATE: APR/27/2016 Document Number 21394-WSW Revision A Page 1.1 SDNY_GM_02757677 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS