Free Service Difficulty Report - Aeronautical Equipment - Federal

FORM APPROVED OMB No. 2120-0039 06/30/2006

DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
U.S. Department
of Transportation
Federal Aviation
Administration


RIS- WS 8070-1
Control No.

Service Difficulty Report
AERONAUTICAL EQUIPMENT

ATA

Code

MAJOR EQUIPMENT IDENTITY
Enter pertinent data MANUFACTURER MODEL/SERIES SERIAL NUMBER

N

AIRCRAFT POWERPLANT PROPELLER

PROBLEM DESCRIPTION

DATE STATUS CARRIER ATA AIRCRAFT TYPE NCONTROL NO.

TEXT

SPECIFIC PART CAUSING PROBLEM PART NAME

MFG. PART NUMBER

PART CONDITION

PART/DEFECT LOCATION

COMPONENT/APPLIANCE ABOVE PART INSTALLED ON

COMP/APPL NAME

MANUFACTURER

Report whole hours MFG. MODEL/NUMBER

PART TT

PART TSO

SERIAL NO.

SUBMITTED BY

SUBMITTER (Check one)

A
CARRIER

B
REP STA.

C
OPER

D
MECH

E
AIR TAXI

F
MFG

G
FAA

H
OTHER

I
Spec.

P. S. L. ALERT

OPER/D.O.

PREC. PROC.

NATURE

STAGE

STAT

ROLL

Frame

SYS.

SYS.

ADDITIONAL COMMENTS

FAA Form 8070-1 (11-84) SUPERSEDES PREVIOUS EDITION

Shaded Areas are for FAA USE ONLY

All Submitters - Instructions for Completing FAA Form 8070-1
Major Equipment Identity TITLE Aircraft Powerplant Propeller N ENTRY Identify major equipment related to problem. Enter manufacturer, model, and serial number per FAA/MANUFACTURER type certificate data sheet. If amateur built, use plan or kit name. Use military model designators when appropriate. Avoid colloquial names and market titles. Aircraft Registration Number.

Problem Description Date Text Give date problem occurred (i.e., 7-1-84). Whenever possible, describe conditions subsequent to, or leading up to, the reported problem: (a) Identify the cause for malfunction and emergency measures execute. (b) Include com pliance or noncompliance with Airworthiness Directives, Service Bulletins, STC's, and PMA's. (c) Provide any significant fact you feel may help to reduce or eliminate recurrence (i.e., cycles, landings, and suggested changes). Skin, rib, shaft, Venturi, transistor, capacitor, etc. Avoid colloquial names. Alphanumeric part identifiers assigned by manufacturer. Cracked, bent, burned, corroded, shorted, etc. L.H. alternator, audio, R.H. outboard, range switch, etc. Total service time on part in whole hours (i.e., 00531). Service time on part since overhaul in whole hours (i.e., 00200) Fuselage, wing, alternator, carburetor, VOR receiver, etc. Comp/appl manufacturer: Beech, Cessna, Prestolite, Bendix, Collins, etc. Alphanumeric model and serial numbers or identifiers assigned by comp/appl manufacturer (i.e., ALU8403, NAS3A1, 51 RVII). Do not repeat ''MAJOR EQUIPMENT IDENTITY" in these locations.

Part Name Mfg. Part Number Part Condition Part/Defect Location Part TT Part TSO Comp/Appl Name Manufacturer Mfg. Model/Number, Serial Number

Submitted By
Submitter As noted on form.

FAA District Offices - Refer to FAA Order 8010.2

PAPERWORK REDUCTION ACT STATEMENT: The information collected on this form is required. This form reports occurrences or detection of each failure, malfunction, or defect in an aircraft. We estimate that it will take 1 hour to complete the form. No assurance of confidentiality is promised. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0039. Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Ave SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ABA-20
U.S. GOVERNMENT PRINTING OFFICE: 1984-461-823-21521