Bailey Moyes 912 Dragonfly, Руководство по обслуживанию

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Page 190
Safety of Flight & Service Difficulty Report Form
Mail to: Pitman Air, 1840 Airport Blvd., Red Bluff, CA 96080 OR Online at: www.pitmanair.com/dragonfly/
Check One
Item of
Concern Safety of Flight
Service
Difficulty
Reporting Party Contact
Information
Name
Address
City
ST
Zip Code
Day Phone #
FAX #
email address
Check Appropriate
Owner Operator LSRI LSRM A&P
Other Explain:
Aircraft Specific Information
Aircraft Information
Engine
Information
Make Make
Model Model
Serial Number Serial Number
N-Number Gearbox Ratio
Date of Mfg. Propeller Mfg
Propeller Serial #
Date of Problem Discovery dd/mm/yyyy
Description:
Comments
Signature___________________________________________-
Date_______________________dd/mm/yyyy
End of Maintenance Manual