application for pbn operations approval

Application for PBN operations approval

The purpose of this form is to ensure that the specific PBN approvals meet the minimum requirements for approval in accordance with ICAO, IR-OPS and other applicable requirements.

To determine an Operators ability to obtain operational approval of a specific PBN capability, aircraft eligibility must be determined, appropriate flight crew procedures for navigation systems to be used, must be identified by the applicant and database use and operating procedures must be evaluated.

For multiple aircraft and/or Nav Specs we refer to the individual Job-Aids, as per Doc 9997 - PBN Operational Approvals Manual, those may be used instead of this application.

1. General

General Information on Company

No.:

City:

Fax:

General Information on contact person

No.:

City:

Fax:

Name:

Address:

Postal code:

Phone:

E-mail:

Name:

Address:

Postal code:

Phone:

E-mail:

FORM.965.030

Trafik-, Bygge- og Boligstyrelsen | Carsten Niebuhrs Gade 43 | 1577 København V www.tbst.dk | Tlf: +45 7221 8800 | [email protected]

Scope of Application

Airworthiness and operational approval in accordance with

Yes No

RNAV 10 AMC 20-12( )/Order 8400.12A ☐ ☐

RNP 4 Order 8400.33 ☐ ☐

RNAV 5 AMC 20-4/AC 90-96A ☐ ☐

RNAV 2 AC 90-100A ☐ ☐

RNAV 1 (P-RNAV) AC 90-100A/ TGL-10) ☐ ☐

RNP 1 AC 90-105 ☐ ☐

RNP APCH (LNAV & LNAV/VNAV)

AMC 20-27/AC 90-105 & AC 20-129, AC 20-138C/D

☐ ☐

RNP APCH (LPV) AMC 20-28/AC 91-107 ☐ ☐

RNP AR APCH AMC 20-26/AC 90-101() ☐ ☐

Aircraft manufacturer,

model and series

Registration number

Aircraft Serial number

Navigation system

manufacturer, model

and number

PBN Nav Spec

(RNAV10, RNP APCH etc.)

Side 1 af 7 TBST-CFL rev. 2 | 1/06-2018


2. Airworthiness

Type design approval for referenced aeroplane type designation

The Nav Spec compliance statement is reflected in:

☐AFM or POH ☐AFM Supplements ☐Type Certificate Data Sheet-TCDS

☐Supplemental Type Certificate-STC ☐Other i.e. Service Bullitin:

Database integrity Yes No

The navigation database is obtained from a supplier holding on EASA or FAA type 2 Letter of Acceptance (LOA), if applicable.

☐ ☐

Minimum Equipment List-MEL Yes No

Has the relevant parts of the MEL been revised to reflect system requirements for intended PBN

☐ ☐

Maintenance programme-MP Yes No

The applicant should have an established Maintenance Programme that contains all related maintenance requirements prescribed by the manufacturer or design organisation.

☐ ☐

Maintenance practices and procedures for operator with a maintenance organisation Depending on the type of the equipment the Applicant should establish the following procedures either as new procedures or as part of existing procedures:

Procedures are described in Maintenance procedures (ref.)

1. Handling and storage of PBN database files includinguploads to aircraft.

2. Maintenance training (initial and recurrent) of all personsconcerned.

3. Equipment for handling for PBN database (use of,handling, periodic testing, etc.)

4. Action for non-compliant airplane such as downgradingtech. log entries, corrective actions, placarding, release toservice, monitoring and reporting of repetitive defects,reporting to DTCA, etc.

3. OPERATION

Operating Practices and Procedures

The applicant must institute PBN Operating Practices and Procedures In accordance with the applicable requirements

To be completed by applicant PBN Operating Practices and Procedures are described in (add manual reference, chapter

Inspectors comments



found under the scope of the application These practices and procedures should cover the following subjects:

and sub-chapter):

1. Flight planning(verification ofaeroplane PBNapproval, PBN timelimits, ICAO Flight Planannotations,requirements for GPS(RAIM, FDE), operatingrestrictions related toPBN approval, etc.)

2. Pre-flight procedures(review of technical log,external inspection(navigation antennas),use of MEL), verificationof NAV databasevalidity, etc.).

3. En-route procedures(cross checkingprocedures to identifynavigation errors, useof INS/IRS navigationsystems withoutautomatic radionavigation updating,use of GPS, minimumnavigation andcommunication systemswhen entering PBNarea, alternate routings,position check beforeentering PBN area,etc.).

4. Procedures with respectto flight crew responseto abnormal situations(response to non-normal events,notification of ATC ofnavigation equipmentproblems, contingencyprocedures, selection ofother navigation aids incase of loss of PBNcapability, etc.).

5. Date base integrityassurance procedures(supplier evaluation,integrity checks(software tools),reporting ofdiscrepancies to



suppliers, notification of discrepancies to flight crews, updating process, etc.).

Flight Crew Training and Qualification

The Applicant is required to establish the following (covering subjects under 3.1 to 3.5):

To be completed by Applicant Description in (add manual reference, chapter and sub-chapter):

6. Flight crew qualificationrequirements

7. Description of initial andrecurrent training,checking and training-syllabi.

RNAV 10 – in accordance with AMC 20-12, Chapter 4.4.3 RNP 4 – in accordance with ICAO DOC 9613, Chapter 3.4.3.3 RNAV 5 – in accordance with AMC 20-4, Chapter 5 RNAV 2 – in accordance with ICAO DOC 9613, Chapter 3.4.3.3 RNAV 1 (P-RNAV) – in accordance with TGL-10, Chapter 10.5 RNP 1 – in accordance with ICAO DOC 9613, Chapter 3.4.3.3 RNP APCH (LNAV&LNAV/VNAV) – in accordance with AMC 20-27, Chapter 10.2 RNP APCH (LPV) – in accordance with AMC 20-28, Chapter 10.2 RNP AR APCH – in accordance with AMC 20-26, Chapter 10.3

4. APPLICATION PACKAGE

Documentation to be submitted to the DTCA Submitted? Yes No

1. Compliance statement which shows how the criteria of the applicablerequirements as mentioned in the scope have been satisfied.

☐ ☐

2. Relevant section(s) of the applicable document(s) (e.g. AFM/POH, STC datapackage, etc.) and other relevant documents that support installation of

☐ ☐



required system if installed through modification. 3. Copy of EASA or FAA type 2 Letter of Acceptance (LOA) of the supplier of the

navigation database.☐ ☐

4. Flight crew PBN training programmes and syllabi for initial and recurrenttraining.

☐ ☐

5. Operation manual and checklists that include specific PBN Nav Spec operatingpractices and procedures

☐ ☐

6. Minimum Equipment List (MEL) that include items pertinent to PBNOperations.

☐ ☐

7. Maintenance programme or revision thereof that includes items pertinent tospecific PBN Nav Spec equipment.

☐ ☐

Failure to include all relevant documentation may result in a delay in processing your application

5. APPLICANT’S STATEMENT

The undersigned certifies the above information to be correct and true and that aeroplane system installation, continuing airworthiness of systems, minimum equipment for dispatch, operating procedures and flight crew training comply with the applicable requirements referenced under section “General”.

NP Maintenance: Signature: Date:

………………………………………… NP Flight Operations: Signature: Date:

………………………………………… NP Crew Training: Signature: Date:

…………………………………………

The form is submitted to:

Trafik-, Bygge- og Boligstyrelsen | Edvard Thomsens Vej 14 | 2300 København S |



The undersigned certifies the above information to be correct and true and that aeroplane system installation, continuing airworthiness of systems, minimum equipment for dispatch, operating procedures and flight crew training comply with the applicable requirements referenced under section “General”.

NP Maintenance: Signature: Date:

NP Flight Operations: Signature: Date:

NP Crew Training: Signature: Date:

6. FOR OFFICIAL DTCA USE ONLY

Subject Responsible Date Signature

1. Application package checked forcompleteness

OPS

2. Airworthiness Approval granted(Appendix to Certificate ofAirworthiness).

AWI

3. Operational Approval granted(applicant’s operating practices,procedures and training programmeshave been found in compliance withapplicable requirements).

OPS

4. PBN approval process administrativelycompleted (OPS Update, Exchange ofCertificates).

OPS

Withdrawal of PBN Approval

Reason:

Name: Date: Signature:



Carsten Niebuhrs Gade 431577 København V

Telefon 7221 8800

Fax 7262 6790

[email protected]

www.tbst.dk

Personal Data Protection

According to the general data protection regulation (GDPR), we will

inform you how we handle the personal data we receive and process

about you.

We are the Data Controller - how to contact us

The Danish Transport, Construction and Housing Authority is the Data

Controller for the personal data we receive on you. If you have any

questions concerning processing of your personal data by the Authori-

ty, you are welcome to contact us or our independent data protection

adviser via the contact details below:

Contact details for the Authority:

Carsten Niebuhrs Gade 431577 København VTel.: 7221 8800

E-mail: [email protected]

CBR no.: 27186386

Contact details for our data protection adviser:

E-mail: [email protected]

Tel.: 41780531

The purpose of processing your personal data

The Authority processes personal data for the following purposes:

Information is collected for the purpose of assessing whether a com-

pany meets technical, training and operational requirements for PBN-

operations (Performance Based Navigation operations).

The legal basis for processing your personal data

The legal basis for processing your personal data comes from:

Regulation 965/2012 of 5 October 2012 laying down technical requi-

rements and administrative procedures related to air operations pur-

suant to Regulation (EC) 216/2008 of the European Parliament and

the Council, Part ARO, Part ORO, Part CAT and Part SPA.


mailto:[email protected]

mailto:[email protected]

Notat

Categories of personal data

The Authority processes the following categories of personal data on

you:

Name, company adress, telephone and e-mail.

Recipients or categories of recipients

The Authority discloses or gives your personal data to the following

recipients:

The Danish Transport, Construction and Housing Authority. Also, in

connection with the oversight of the Danish Transport, Construction

and Housing Authority, EASA (European Aviation Safety Agency) may

require documents containing your personal data delivered as part of

the audit. EASA is domiciled in Germany.

Transfer to recipients in other countries, including to interna-

tional organisations

In connection with the oversight of the Danish Transport, Construction

and Housing Authority, ICAO (International Civil Aviation organisation)

may require documents containing your personal data delivered as

part of the audit. ICAO is domiciled in Canada.

Storage of your personal data

The data the Authority may keep on record are regularly forwarded to

the Danish National Archives in accordance with the rules of the Ar-

chiving Act and the provisions laid down by the Danish National Ar-

chives. Data we receive that are not subject to the Authority’s duty to

keep records will be deleted when we no longer need them.

Your rights

According to the Data Protection Regulation, you have a number of

rights regarding the processing of your personal data by us. If you

want to exercise your rights, please contact us.

The right to see your data

You have the right to see the data we process on you (the right of ac-

cess to documents), or to apply for access to documents.

The right of correction

You have the right to have incorrect data on you corrected.

The right of deletion

In special instances, you have the right to have data we hold on you


Notat

deleted before the date on which we generally delete data. This only

applies to data which we are not obliged to record.

You can read more about your rights in the Danish Data Protection

Agency’s guide to data subject rights at www.datatilsynet.dk.

Complaints to the Danish Data Protection Agency

You have the right to complain to the Danish Data Protection Agency

if you are dissatisfied with the manner in which we process your per-

sonal data. You can find the Agency’s contact details at

www.datatilsynet.dk.


http://www.datatilsynet.dk/

http://www.datatilsynet.dk/

application for pbn operations approval

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