I. Approving National Aviation: 2. 3. Fonn Tracking Numher:

Authority/Country:

FAA/United States

AUTHORIZED RELEASE CERTIFICATE FAA Fonn 8130-3, AIRWORTHINESS APPROVAL TAG WO: 12476

} 3 .. ·· 1 ., :-'j ':' .~ . . I

I I ·2-:_/ j 4. Organization Name and Address: Avtech Corporation Repair Station IG6R621 N

5. WorkOrder/Contract/lnvoice Number:

6. Item:

13. Remarks:

7. Description:

ICU MOD A (DE-H PN N819-8013/BOM PN N819

3400 Wallingford Ave. North Seattle, WA 98103-9095

Part Number:

5088-1-2 N8 19-0166

9 . Eligibility: •

NIA

RIO: VNl341358 ; ·, r

10. Quantity: 11. Serial/Batch Numhcr: I 2. Status/Work :

I 707 REPAJRED

Avtcd1 Corporation certifies that the work specified in l.llock 12 and described in Block 13 was accomplished with EASA part- I 45, and in respect to that work the items arc considered for rekase to

service under EASA Acceptance Certilicate No. EASA.145.4224.

REPAIRED IN ACCORDANCE WITH OEM SPECIFICATION DOCUMENT NO. 50K8-J -2, REV - (1/12/05). CLEANED. REPLACED PA SELECTOR SWITCH AND 10 SWITCH LAMPS.

FINAL TESTED PER ATP 5088-4, REV D (9/20/07).

14 CFR 43.9 Return to Service G::J Other regu lation spccilicd in Block 13

Ccrtilics that unkss otherwise specified in IJlock 13, the work identified in IJlock 12 ,u1d described in

Block 13 wa.s accomplished in accordance with Title 14, Code of Fedcral Regulations, part 43 and in

respect to that work, the items an: approved for return to service.

21. Approval/Certilicatc No.:

IG6R621N 22. Name (Typed or Printed): 23. Date (m/<l/y):

Sergio Rollolazo APR 20 2011

U ser/lnstallcr Responsibilities

It is important to undershu1d that the existence of this document alone docs not automatically constitute authority to insall the part/componcnt/a.~sembly.

Where the user/installer perfonns work in accordance with the national regulation of :u1 airworthiness authoritf dilforent than the airworthiness authority of the country specilied in Block I, it is essential that the

user/installer ensures that his/her air.vorthincss authority accept~ part.~/component~fassemhlies from the air.\'Crthincss authority of the ~ountry spccilied in Block I.

Statement~ in Block 14 ,u1d 19 do not constitute installation certification. In all case:;, airuall maintenance rec.mis 11111st contain an installat ion cerlication issued in ,u.a.:ordanc.: with the national regulations by the

user/installer before the aircrall may be flown.

FAA Form 8130-3 (6-0 1) *Installer must cross-check eligibility with applicable technical data NSN: 0052-00-012-9005

PART: 5088-1-2 Ticket#: 6655 Desc: ICU MOD A (DE-H PN N819-8013/BOM PN N819 WO NO: 12476

S/N: 707 Mfg Date: Mod Level In: Out: 4/1/1995

Customer: UNI AIRWAYS, ENG & MAINT DEPT Warranty Status: Out of Warranty

Cust#: 1642703 Cust P/O: VN1341358 R.R.

Date Received: 3/24/2011

( ,/

1 ....•......•.....•. , ............................ . _\ff/\f/f?f/f \\ ·.· Customer Complaint: Customer Instructions:

Failure Analysis:

Return Code:

Repair Action:

\lotes:

Part Number

245-01071 245-01072 510-01073

Returned For: REPAIR

E2J ~ Repair LJ [J

Estimate Overhaul Exchange

LJ Credit LJ Mod CJ [J Test Expedite

"PA" SWITCH BROKEN.

CONFIRMED COMPLAINT, PA SELECT SWITCH BROKEN (REPLACE) . UNIT DIRTY AND HAS 6 OLD SWITCH LAMPS (REPLACE) . 4 SWITCH LAMPS BURNT OUT (REPLACE). OPEN AND INSPECTED. CUSTOMER DAMAGE REPAIRED IN ACCORDANCE WITH OEM SPECIFICATION DOCUMENT NO. 5088-1-2, REV - (1/12/05). CLEANED. REPLACED PA SELECTOR SWITCH AND 10 SWITCH LAMPS. FINAL TESTED PER ATP 5088-4, REV D (9/20/07).

Description Quantity Ref Failure

Designator Code LAMP,INCAND,28V,T1 , FLANGE, 6.00 M LAMP,INCAND, 5V,T1 , FLANGE, 4.00 F SWITCH,PUSHBUTTON,ILLUM,DPDT,( 1.00 S1 D

Component Failure Codes: F = Failed, D = Damaged, M = Mod/Other

Avtech Corporation 3400 Wallingford Avenue N. Seattle, WA 98103

avl=ech ~ Ideas That Fly~

Ph:1.206.695.8000 Fax:1.206.695.8011 www .avtcorp.com

s UNI AIRWAYS, ENG & MAINT DEPT h C/O ROUND THE WORLD LOGISTICS (USA) i WEST COAST/LOS ANGELES BRANCH p 1440 FRANCISCO ST

TORRANCE CA 90501 T UNITED STATES 0

FEDERAL EXPRESS 2ND DAY 448623043359

Shipping instructions ACCT# 2213-1062-4

Items not assigned to containers

Order information:

Page 1

Pack List Number: 13070 ·

Ship Date . .. : 4/21/1 :1 Shipment number : 13979

co 712813 4/20/11 1642703 UNI AIRWAYS, ENG & MAINT DEPT P . O. information :

VN1341358 Transport terms Shipping instructions

COLLECT ACCT# 2213-1062-4

S~andard ATA300 Packaging Required Cert's Req'd

S / N 707, TICKET 6655: UNIT REPAI RED OUT OF WARRANTY, CHARGE

MARK FOR ONWARD TRANSMITTAL TO: UNI AIR, NO. 340 TUNHWA NO. ROAD SUNGSHAN AIRPORT, TAIPEI, ROC

These commodities, technology or software were authorized by the S . Department of Commerce for export to UNI AIRWAYS

ORP. for use by TAIPEI , ROC. Diversion contrary to U. S . law is prohibited. ECCN: 7A994 NLR

PACKAGED BY:

'!'ff--

AIRWORTHINESS CERTIFICATION/CERTIFICATION OF CONFORMANCE · It is hereby certified that (a) the parts and/or materials reflected herein were produce~ Federal Aviation . on, ation approved manufacturing and quality assuarance system/method, as set for in Federal Aviation Regulation Part 21 , Sub-Part K, Paragraph 21 .303, or Sub (;)'nd all part or m ri s re c ified ew¥conform to the design data, and are in airworthy condition.

Authorized Signature ------------ -----

Avtech Corporation 3400 Wallingford Avenue N. Seattle, WA 98103

avl=ech ~ Ideas That Fly~

Page 2

Pack List Number: 13070

Ph:1.206.695.8000 Fax:1.206.695.8011 www.avtcorp.com

s UNI AIRWAYS, ENG & MAINT DEPT h C/O ROUND THE WORLD LOGISTICS (USA)

WEST COAST/LOS ANGELES BRANCH 1440 FRANCISCO ST

i p

TORRANCE CA 90501 T UNITED STATES 0

FEDERAL EXPRESS 2ND DAY 448623043359

Shippi ng instructions

Item number Rel

J8 - l -2 1

ACCT# 2213-1062-4

Item description

FACTORY CERTIFIED REPAIR

** End of Packing List**

Ship Date ... : 4/21 /1 ~i Shipment number : 13979

Packed qty/ U/M Backorder qty U/ M

1. 00 0 EA .000 EA

AIRWORTHINESS CERTIFICATION/CERTIFICATION OF CONFORMANCE It is hereby ceriified that (a) the paris and/or materials reflected herein were produced under a Federal Aviation Administration approved manufacturing and quality assuarance system/method, as set for in Federal Aviation Regulation Par, 21, Sub-Par, K, Paragraph 21 .303. or Sub-P. and all paris/or mate · re cer1ified new. conform to the design data, and are in airworihy condition.

--- -I. Approving Competent Authority/Country 2. AUTHORISED RE J_,EASE CERTU I CATE 3. Fonn Trackmg Number

CAA-NL I THE NETHERLANDS EASAFORM I 1316008197

--·-4. Approved Organisation Fokker Services 8. V. Location Oude Meer

Name and Address : Hoekstccn 40 2132 MS Hoofddorp THE NETHERLANDS

-

--+-----~ --=··1 5. Work Order/ Contract/ Invoice

9-95578

--------'----------+------ 11 6. Item 7. Description 8. Part No -i Q" -I AUDIO CONTROL UN IT 5261- 1

EA

an:~--~ crial No 11 . Status/Work

240 REPAIRED

-12. Remarks - USED MAINTENANCE DATA:

CMM:23-50-29 ORIGINAL ISSUE DATED 1-MAR-199 1.

I The work identi ~~-~I ficd in Block 11 and described herein has

been accomplis heel in accordance wi th 14 CFR part 43 and in vork. the items arc appnwed for return to CRAR-0304 ISSU E 2 DATED 27-SEP-20 16.

THIS COMPONENT ELIGIBLE FOR AIRCRAFf TYPE(S) DAS H 8-1 00/200/300.

- Accompanying shopfinding report is part of this EASA Fonn I -

respect lo that \ > service under cc1t ificatc no. NQ I Y357K.

Pcrtment details of the repair are on file at tl11s repair station under the order number referenced in block 3.

· 1cs that the items identified above were manufactured in conf~nnity to: .:> I 14a~ f.xJ Part-145.A.50 Release to Service Ix) Other regulation specified in Block 12

ign data and are in condition for safe operation Certitie

1

s that un less otherwise specified in block 12, the work identified in block 11 and described

a specified in block 12 ; . in blod: 12, was accomplished in accordance with Part-145 and in respect to that work the items

r;-;;--;--;--:-;---:-;-;:;-,,----------:::-----=----..:::,.-.::::-:-::--:-----:-:-:---.,.,.--:--c,--7:""--;--! / a re con·:~lcred ready for release to service.

7'4b. Autl;~ :·is-:d Signature 14c. Ce11ifica tc/ Approval Ref. No

r.c;;-;-~----:::,,--"'::::__-----------t-:-=--::::----;-;-;-:-:,,-'?.:--:=---,------ii-:-:-:-:-:- --- --1~~~~~------J_.!N~L~~-~1~45~-~11~74.,..,..,.,....,..... _ _ __ _ 14e. Date (dd MMM yyyy)

07 OCT 2016

I USER/INSTALLER RESPONSIBILITIES This ce1ti ficate docs not automatically consti tute authority to install the item(s). I

I Where the us<·r/installcr pc1fonns work in accordance with rc1;ulations of an air.rnrthincss authority difTerc 1t that the airwnrthin~s authority specified 111 block I, it is essential that the user/ insta ller ensures t:·,at his/her a i1wo11hinL-ss authority accepts items from the airwo11niness authority specified in block I.

Stnt,::n::nts in blocks 13a and 14a do not constitute installation ccrtilication. In aH cases aircraft maintcnan•:c records mus: w ntain an installation certification issued in accordance with the nationa l regulatinm by the user/ installer before the a ircraft may be nown.

I _ _ _I

EASAFonn I-MF/145 lssue2

Fokker :3ervices B.V. Location Oude Meer Hoeksteen 40 2132 MS H1,ofddorp

~ GKN AEROSPACE THE NETHERI.ANDS Internet: www.fokkerservices. com

hop Finding Report WORK ORDER No. 1316008197

- DURING INTERNAL INSPECTION FOUND: NO EVIDENCE OF FAILURE.

- REASON FOR REMOVAL CONFIRMED.

- INTERNAL INSTRUCTION:- AWi, A-05933 REV 3.

- USED MAINTENANCE DATA: CMM:23-50-29 ORIGINAL ISSUE DATED 1-MAR-1991 . CRAR-0304 ISSUE 2 DATED 27-SEP-2016.

Action Taken LOWER LEFT DZUS FASTENER REPLACED.

i · PA~TS & MATERIALS I • I ••

26 ' A123K12KZQ SWITCH, TOGGLE

30 F0N7-5343 STUD (PART FASTENER)

31 F0N7-5344 CUP

32 F0N7-5345 SPRING (PART FASTENER)

Copyright (c) PENTAGON 2000 Software, Inc. Ser ~pno~ 70119! Ver 9.00 n3 81,iln , r,

Date:

Part S tatus

I

. 32 - Installed Component! 1

32 - Installed Cmnponent 1

32 - Installed Cr,mponent 1

32 - Installed Component 1

Sign: ~

-----

Qty Cond

EA NE

EA NE

EA NE

EA NE

Page: 2 of 2

Discrepancy / Disposition

Disc.: Disp.: Disc.: Disp. : Disc. : Disp.: Disc. : Disp.:

Fokker Services B.V. Location Oude Meer

Hoeksteen 40 2132 MS H ,otddorp THE NETHER _ANDS

Internet: www.fokkerservices.com

Cillll GKN AEROSPACE

Page : 1 of 2

Shop Finding Report Technician I Delivery :

1COMMUTAIR I A.ttn: Manuel Chucaragua 1 85 SICKER ROAD

j 121 10 NY LATHAM USA i Tel. : ::S18-620-33136

I

I I

f--- ·

1 For Customer : COMMUTAIR

S.O. No. : 2516022876 Line No. :

Cust P.O. : 9-95578 P/N :5261 -1 · Batch/Lot Our Ref# Desc : AUDIO CONTF:( l'_ UNIT Cust.Ref Contract# : AG-003477 S/N · 240 Werk Perf. Vend Ref# : R0482016 MFG : AVTECHTYEE Manual Project# : N837CA Qty . 1.00000 Cond As:sv Revision C~mpleted P/N: 5261-1 ______ ! SIN A'; : 240 l"!to Blr. Lo:: :

._C_o __ m~p_an~y _ _ :_1 _ _ _ _ .,._Division : 12 I Department : 2500 C'c!1tract No. : AG-003477 _ T pe : Exchanl e I Re air / Lea.,e, Stock Orcler Date : Sep-05-201 6 Received Date : S.!p-05-29].6 I Due Date : Oct-04-2015 ,.,.

'.l':CHK ORDEH No. 1316008197 Contract No. AG-003477 _ · Exchange / Repair / Lease St)Ck Reported By Customer #2 COMM PANEL HOT MIC SWITCH BROKEN

UNIT SUBMITTED FOR REPAIR AND f~ETURN TO SER\ ICE REPAIR TO LATEST MOD STATUS Receiving Condition UPON RECEIPT FOUND HOT MIC SWITCH BROKEN A~D BENT ALSO LOWER LEFTHAND QUICK DISCONNECT BROKE.N OFF Inspection · DURING PRELIMINARY INSPECTION FOUND:

LOWER LEFT DZUS FASTENER BROKEN. HOT MIC SWITCH BROKEN.

· DURING FUNCTIONAL TEST FOUND: NO EVIDENCE OF FAILURE.

Name: lo<-1.... 6.t.~

Copyright (c) PENTAGON 2000 Software, Inc. Str tt:[2001 7012~1Ver900 n1 B11iM 7~

Date: Sign: ~

·------

I Print Dat!! : Oct-07-2016

Continued on next page ...

.. ----·- - - , ------ ------ -------

I. Approving Competent Autho:ity/Country 2. AUTHORISED RELEASE CERTIF1CATE 3. Fonn Tracking Number

CAA-NL I THE NETHERLANDS EASAFORM I 1317000168

4. Approwd Organisation

Name and AddrL-SS :

Fokker Services B.V. Hoekstcen 40 2132 MS Hoofddorp THE NETIIERLANDS

Location Oude Meer 5. Work Order/ Contract/ Invoice

R0712916

------ -- ---------6. Item 7. Description 8. Part No

--+---- ----- - --<-------------- -AUD IO CONTROL UN IT 5261-1

12. Remarks Doc uments use;.-d : USED MAINTENANC E DATA: CMM: 23 -50-29 MAR I , 199 1 SB 526 1-23-904 REV 00 1 AUG 10. 20 16

NEW MOD STAT US : MOD C.

. Accompanying shoptinding report is part o f this EASA Fonn I •

CJ. Quantity 10. Serial No 11 . Status/Work

---- - ------ - 1------- -------,1---

l EA

----- -~--- -

260 MODIFIED

The work identified in Block 11 and described herein has been accomplished in accordance with 14 CFR part 43 and in r1;.-spc.-cl to that work, the items are approved for return to service under certificate no. NQ I Y357K. Pc11inen1 deta ils of the repair arc on tile al this repai r station under the order number refercncL-<l in b lock 3 .

~-----------------------------------~~------------------------ ------~ crtifies that the items identified above were manufactured in conformity to:

• • ig n d ata and are in condition for safe operation

ta specified in block 12

Approval' Authorisation Number

14a. Ix] Part-145.A.50 Release to Service Ix] Other regulat ion specified in Block 12

~ert ifics that 11nlcss o therwise speci fied in block 12, the work identified in block 11 and describ~d

in block 12, was accomplished in accordance w ith Part-1 45 a nd 111 respect to that work the items

are considcre,! read y for release to service.

- -- --------,---------14b. Authorised S;gnaturc /£ , LJ_,___- 1 4c. Certificate/ Approval Ref. No ~-

~ · NL.145.1174 l--:-,:-,-~---=..-,::C'------------+--;-;;---;:::--:---;--;-;~~::::----"'7'-- - -t------

l4d. Name ( ~ A ~I? 14c. Date (dd MMM yyyy)

Cock Bakker \1'43371 ) 02 FEB 2017 ___ _c,f;c.;·:;..,1,,·~ -"-----------~--

---- --------- - ------ ------ ---------------- -- - ---1

USER/INSTALLER RESPONSIBILITIES _ This certili calc d o(.-S not automat ically constitute authority to install the itcm(s).

Whcrc the user/ installer pcrfonns work in accordance with regulations of an a iiworthinL"SS authority di fferent that the: ai rwC':~hincss authority spccifi~-d in block I , it is (.-Ssential that the user/insta ller ensures that

his/her aiiworthiness authority accepts items from the aiiworthinL-SS autho rity specified in block I.

Statcmcnls in blocks 13a and 14a do not constitute installat ion certification. In all cases aircraft maintenance records must contain an installation certi fication issued in accordance with the national regulations by

the uscr/installcr before the ai rcrnli may b.: flown.

EASAFonn l -MF/ 145 lssue2

'

Fokker Services B.V. Location Oude Meer Hoeksteen 40 2132 MS Hoofddorp

.._ GKNAE~OSPACE THE NETHERLANDS Internet: www.fokkerservices.com

Shop Finding Report Page: 1 of 2

Technician Delivery : COMMUTAIR Attn: MANUEL 85 SICKER ROAD 12110 NY LATHAM USA Tel. : +1 518 690 9080

For Customer : COMMUTAIR S.O. No. : 2517000275 Line No. :

Cust P.O. : R0712916 P/N : 5261-1 Batch/Lot Our Ref# Desc : AUDIO CONTROL UNIT Gust.Ref Contract# :AG-003477 S/N :260 Work Pert. --Vend Ref# MFG : AVTECHTYEE Manual : 23-50-29 Project# : N351PH Qty : 1.00000 Cond As:sv I Revision : 0 I Mar-01-1991 Completed P/N: 5261-1 S/N As : 260 I Into Bin Loe : Companv : 1 Division : 12 I Department : 2500 Contract No. :AG-003477 Type : Exchanqe / Repair/Service / Lease Stock Cirder Date : Jan-05-2017 Received Date: Jan-05-2017 Due Date : Mav-06-2017 I Print Date : Feb-02-2017

WORK ORDER No. 1317000168 (':,ntract No. AG-003477 _ - Exchange/ Repair/Service/ Lease Stock Reported By Customer JUMPSEAT AUDIO CONTROL PANEL KNOB INOP Receiving Condition UPON RECEIPT NO VISUAL DAMAGE Inspection - DURING PRELIMINARY INSPECTION FOUND: MIC SELECT KNOB ROTATING AND STUCK IN POSITION "VHF 1".

- DURING FUNCTIONAL TEST FOUND: UNIT STUCK IN POSITION "VHF 1".

- DURING INTERNAL INSPECTION FOUND: SET SCREWS KNOB AND AXIS MIC SELECT SWITCH WORN.

- REASON FOR REMOVAL CONFIRMED

Name: ~ I.(_ 6,dl , ,,?..

Copyright (c) PENT AGON2000 Software, Inc.

Continued on next page ...

• Ser #:(2003.70129) Ver 9.00.04 Build 10

Fokker Services B.V. Location Oude Meer Hoeksteen 40 2132 MS Hoofddorp

...- GKNAEROSPACE THE NETHERLANDS Internet: www.fokkerservices .com

Shop Finding Report

- USED INTERNAL INSTRUCTION: AWi: A-05933 REV 3

- USED MAINTENANCE DATA: CMM: 23-50-29 MAR 1, 1991 SB 5261-23-904 REV 001 AUG 10, 2016

Action Taken MODIFICATION: INSTALLED MOD "C". MARKED OUT "C" ON BACK SIDE UNIT. NEW MOD STATUS: MOD C.

WORK ORDER No. 1317000168

QURING FINAL TEST 1 PANEL LAMP WENT DEFECT WHEN POWER TO PANEL LAMPS WAS SWITCHED ON. REPLACED PANEL LAMP. PASSED FINAL TEST.

Page: 2 of 2

Item Part Number/ Description Part Status Qty Cond Discrepancy/ Disposition

PARTS & MATERIALS

37 5061-36 KNOB MOD"C"

21 SCD510-39-2 SWITCH, ROTARY MOiJ'"C".

38 SCD280-64-8 SCREW

5 SCD390-1-2 LAMP, INCANDESCENT

[ Copyright (c) PENTAGON2000Software, Inc. Ser #:[2003.70129] Ver 9.00.04 Build 10

32 - Installed Componer t1 EA NE Disc.: Disp. :

32 - Installed Compone,

1

t1 EA NE Disc.: Disp. :

I I

32 - Installed Componer EA NE 1 Disc. : Disp. :

32 - Installed Compone t1 EA NE Disc. : Disp. :

I

I

I . Approving Competent Authority/Country

CAA-NL I THE NETHERLANDS 2. AUTHORISED RELEASE CERTIFICATE

EASAFORM I

3. Fonn Tracking Number

1317005866

4. Approved Organisation

Name and Address :

6 . Item 7. Description

Fokker Services 8 .V. Hoeksleen 40 2132 MS Hoofddorp THE NETHERLANDS

AUDIO CONTROL UNIT

Location Oude Meer (NL)

8. Part No

5261-1

12. Remarks USED MAINTENANCE DATA: C MM : 23-50-29 MAR I , 1991 SB 5261-23-904 REV 00 I AUG I 0, 2016

- Accompanying shopfinding report is part of this EASA Fonn I -

· 1es that the items identified above were manufactured in conformity to:

ign data and are in condition for safe operation

ta specified in block 12

USER/INSTALLER RESPONSIBILITIES This certificate does not automatically constitute authority to install the itcm(s).

5. Work Order/ Contract/ Invoice

Rl000717

-9. Quantity 10. Serial No 11. Status/Work

546 REPAIRED EA

The work identi fied in Block I I and dt.-scribed herein has been accomplished in accordance with 14 CFR part 43 and in respect to that work, the items arc approved for return to service under certificate no. NQ I Y357K. Pertinent deta ils of the repair arc on tile at this repair station under the order number referenced in block 3.

14a. [xi Part-145.A.50 Release to Service [xi Other reg ulation specified in Block 12

Certifies that :nlcss o therwise specified in block 12, the work identified in bl ock 11 a nd dcscri b d in bl ock 12, \I :is acco mplished in accorda nce with Part-145 and in respect to that work the items arc cons idered ready for release to servi<.:c.

14b. Authoris,-d Signature

14d. Name

Cock Bakker

14c. Certificate/ Approval Ref. No

NL.145.1174 14e. Date (dd MMM yyyy)

16 MAY 2017

Where the user/installer pcrfonns work in accordance with regulations of an airworthiness authority d ifferent that the airwrnthiness authority specifi(.,-d in bloc k I, it is essential that the user/installer ensures that his/ her ai1worthiness authority accepts items from the a irworthiness authority specified in block I.

Statements in blocks 13a and 14a do not constitute installation certification. In all cases aircraft maintenance rt-cords must contain an installation certification issued in accordance with the national regulations by the ust:r/installcr before the aircraft may be nown.

EASAFonn 1-MF/ 145 lssuc2

Fokker Services B.V. Location Oude Meer (NL) Hoeksteen 40 2132 MS Hoofddorp

Cil DI GKN AEROSPACE THE NETHERLANDS Internet: www.fokkerservices.com

Shop Finding Report Page : 1 of 2

Technician Delivery: COMMUTAIR Attn: MANUEL 85 SICKER ROAD 12110 NY LATHAM USA Tel. : +1 518 690 9080

For Customer : COMMUTAIR S.O. No. : 2517012172 Line No. :

Cust P.O. : R1000717 P/N :5261-1 Batch/Lot Our Ref# Desc : AUDIO CONTROL UNIT Cust.Ref Contract# : AG-003477 S/N : 546 Work Perf. Vend Ref# MFG : AVTECHTYEE Manual Project# : N838CA Qty : 1.00000 Cond As: SV I Revision

~ ~mpleted P/N: 5261-1 S/N As : 546 Into Bin Loe : Cornoanv : 1 Division : 12 I Department : 2500 Contract No. : AG-003477 Tvoe : Exchanoe / Reoair/Service / Lease Stock

1 Order Date : May-03-2017 Received Date: Mav-03-2017 Due Date : Mav-20-2017 . WORK ORDER No. 1317005866

! Contract No. AG-003477 _ - Exchange/ Repair/Service/ Lease Stock I Reported By Customer ALL FO'S PUSH TO TALK SWITCHES INOP Receiving Condition UPON RECEIPT FOUND SELECTOR KNOB MISSING

'l Inspection - DURING PRELIMINARY INSPECTION FOUND: KNOB OF MIC SELECT SWITCH MISSING.

- DURING FUNCTIONAL TEST FOUND:

- DURING INTERNAL INSPECTION FOUND: GROUND WIRE BROKEN OFF FROM MIC SELECT SWITCH.

Copyright (c) PENT AGON2000 Software, Inc. Ser #:[2003.70129) Ver 9.00.04 Build 13

1 6 MAY 2017 Sign:~

-~

I Print Date : Mav-16-2017

Continued on next page ...

Fokker Services B.V. Location Oude Meer (NL) Hoeksteen 40 2132 MS Hoofddorp

~ GKNAEAOSPACE THE NETHERLANDS Internet: www.fokkerservices.com

Shop Finding Report WORK ORDER No. 1317005866

- REASON FOR REMOVAL CONFIRMED

- USED INTERNAL INSTRUCTION: AWi: A-05933 REV 3

- USED MAINTENANCE DATA: CMM: 23-50-29 MAR 1, 1991 SB 5261-23-904 REV 001 AUG 10, 2016

Action Taken REPAIR: PLACED NEW KNOB. RECONNECTED GROUND WIRE TO MIC SELECT SWITCH. PASSED FINAL TEST. Item Part Number/ Description

PARTS & MATERIALS

37 5061-36 KNOB

I,

Name: G:>e,~ Dt\.,\(,\t.£\! \ 0 ~ 1- r:: ( A -Ir

,_43371) '" ' v1c't'-"'

Copyright (c) PENTAGON2000Software, Inc. Ser #:(2003.70129) Ver 9.00.04 Build 13

Part Status Qty

32 - Installed Compone11t1

I

I

Date: Sign: ,, 1 6 MAY 2017 ~ --~

Cond

EA NE

Page : 2 of 2

Discrepancy / Disposition

Disc. : Disp. :

..x·re t u , ,..... , /-? J._y 11 ,-,-/ t= 7e , -;;:,l.,d :--;/ hu Cc //. ·a ,.,.- i

c!,iL- x;.;__ ~;, ·c O'.X?ooa / 2:2.J..·CJ 77'2-'-192 I

u,a, · T /e ,tt'. 5 /9:T

J_ I ,:7; i

'.i-!'iJJ.i7c1stt:-r.10,~:--10,;$:E"'c.o~·l'.:rit!J;El)JBX'iNSI'.Ji:~JQW;'t'O:·.IU'.:.t,Esfi),:;r 1iifESi'.¢Yt(.tsttr~ES:_•:~i=;i:Qto)'¢..EE;1:;:fQN·Qftfy'.QR'.!(~:'~·itt:

T N t.S~ J

·:r .0.;,_;,i:cab!,_ :::1,er t,:nei,yc,e J a, :=:c:-:na::c~. -.:-~:c'-' . YES D ~ O 0 TSO cs: :-1;,

C·, r.~=:·. J a:e

CA-, C0.,1P01'"£.\E T RET UR.'- TO SER\"l(E RECORD PAGE1 Ol< 2

REV 20 I 0/2:115

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Champlain Enterprises * *

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Pro Lie II ompute r As is ted Tes t Pro g ram CPN 523 -0 777 - 533 , Edit i on SB

Tes t Dat a f or Collins CTL-22C VHF Communication Control CPN 8 2 2- 1120-001

Seria l Number : 15354 Service Bul let ins : - 8 , 10 , 11 , 1i,-17 , 21 22 , 25 , 26 , 31

Cus t ome r : hamp lain Enterpr i s es Ai:::-c:::-a::t rumbe :::- : N/A

Te st e d By : RJD Test Date : Fe bruary 22 , 2016

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The above e q uip men t has been tested and complies with the per f ormance req irements of Rockwell Intern a tiona l Collins Avionics in accordance with regula t io~s of t he Federal Aviation Administration and is approved f or~?? =vice .

Verified By : &LJJ Cer ti ficate No : ~?;201/¼" 7

FAA Repair S t a . No : N/ro- Work Order No :

Dat e Repair Comp l : d-~/1/(, Dat e Returned To Cus tomer : ,2.~7 .?.-~ / ;

Carrier : %/4 Sh i pping Orde:::- 1 o : ___ (Y,--+--,M~~---

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CTL-22C Test Resul t s for Unit '5354

CSDB I/0

1 . 1 Transmission

1 . 7 • 1 Bus

1 . 1 • 2 Bus 2

1 .2 Recept ion

1 . 2 . 1 Bus

1 . 2 . 2 Bus 2

2 Discrete Inputs

45 of 4 5 t ests passed .

2 . 1

2 . 2

2 . 3

2 . 4

2 . 5

2 . 6

2 . 7

Comm Select

Sel f - Test

Self - Test I nh ibit

Transfer

Transfer Inhibit

Memo ry Rec a l l

Knob Select 8 . 33 kHz Discre te =nput

3 Pushbuttons

3 . 1 TEST

3 . 2 ACT

3 . 3 STO

4 XFR /MEM Swi tch

4 . 1 XFR Position

4 . 2 MEM Posi tio ..

Page 2

Passed

Passed

Passed

Passed

Passed

Passed

Passe d

Passe d

Passed

Passed

Passed

Passed

Passed

Passed

Pas sed

Passed

CTL-22C Test Res l ts for Unit 1 53 54 Page 3

5 Disp::_ay

5 . 1 Uppe.::- Display Passed

5 . 2 Lower Di splay Passed

5 . 3 MEM Annunciator Passed

5 . 4 ACT Annunciator Passed

5 . 5 TX Annunciator Pc:tssed

5 . 6 RMT Annu:1ciator Passed

5 . 7 Flashing Di s play Passed

5 . 8 Panel Lighting Passed

5 . 9 Dark Condi t ions Passed

Recorded : 1 . 4 0 0 V de Expected : 1 . 4 00 +- 0 . 100 V de

5 . 1 0 Brigh t Light Conditions Passed

Recorded : 4 . 140 V de ~xpected : >= 2 . 000 V de

5 . 1 1 Relative Br igh t ness Pas sed

5 . 1 2 Max Brightne ss Passed

6 Funct i on Knob

6 . 1 OFF Passed

6 . 2 ON ?assed

6 . 3 SQ OFF Passed

CTL-22C Tes t Resul t s f o r Un i t 1 5354

7 Volume Contro l

7 . 1 Max CCW

Not applicabl e

7 . 2 Max CW

No t appl i cab l e

8 Tuni ng Knob

8 . 1 La rge ( Inner ) Knob Tests

8 . 1 . 1 cw

8 . 1 . 2 ccw

8 . 2 Smal l (Oute r) Knob Tes ts

8 . 2 . 1 cw

8 . ~ . 2 ccw

8 . 3 E~t e nd e d Frequency Range

9 Channe! Memory

1 0 Low Ve l t a ge Opera t i o n

1 0 . 1 + 11 Vdc

10 . 2 +1 6 Vdc

11 CSDB Outp u t Quality

11 . 1 Bus 1

11 . 1 . 1 Signal Quali t y - 1 -A

'1 . 1 . 2 Signal Quali ty - 1 - B

11 . 2 Bus 2

11 . 2 . 1 Signal Quality - 2 - A

11 . 2 . 2 Signal Quality - 2-B

Page 4

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Passed

Pas s e d

11111111111111111 II II I Ill 2 3 93 Mat Class

R

Installation / Serviceable Description

HEAD, CONTROL VHF COMM Partnumber

822-1120-001 Serial- / Batchnurnber

15354 Plate Mod Status

Manuf Date

UNK Owner

UCA003 Remarks

Certifying Company

Cert1fy1ng Number

8-30012 Supplier

ATA Chapter

23-00-00 Cond1t1on

R

TSN CSN

35346 37380 Shelf Life Expiry

Cert1fy1ng Date

COMMUTAIR ALB HANGAR Ordernumber

R0106816

Ch.!1;1pla1:1 Enlcrpnscs Inc D/B/A Com:nJtA;r

IJS A

Received at Station / Store / Location

ALB/ ALB MAIN/G1D03 Rece1v1ng Date Cert1fy1ng Stamp

22 . Feb.2016

Received by

200317

-II I I Ill II 1111111111111111 2393

Description

Spec Counter 2

Remova l Text

Name

FAA 121