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a) Manufacturer: fill in the manufacturers’ name corresponding with the airframe, power plant, propeller or parts;
b) Type/model: fill in the type or part number corresponding with the airframe, power plant, propeller or parts;
c) Serial number: fill in the serial number or batch number corresponding with the airframe, power plant, propeller or parts;
d) Owner: fill in the operator of the aircraft on which the airframe, power AC-145-4 - 5 -
Maintenance Records and Reports
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plant, propeller or parts are installed.
(3) Fill in the cause of defect and unairworthy conditions and detailed information about defect and unairworthy conditions:
a) Name: enter the name of malfunction or defect part. The nomenclature in IIIustrated Part Catalogue (IPC) shall be used preferably;
b) Part number: enter the part number of malfunction or defect part. The part number in IPC shall be used;
c) ATA Chapter: enter the ATA chapter number which includes the system the malfunction or defect parts belongs to;
d) Location of malfunction or defect part;
e) The consequence or signs of consequence caused by defect and unairworthy conditions, some factors such as the time period and circumstances (if applicable) shall be described first. Then describe the maintenance work being performed, the work time of discovering malfunction or defect part, trouble-shooting or repair work of defect and unairworthy conditions. Explain the cause of defect and unairworthy conditions which has been analyzed and tested and put forward the suggestion about how to prevent such defect and unairworthy conditions from reoccurring.
(4) Information of organization reporting defect or unairworthy conditions:
a) Reporter: quality manager of the maintenance organization or the personnel authorized by him. His name shall be printed formally first then autographic signature must be used;
b) Report date: fill in the date on which the form is entered;
c) Report organization: fill in the full name of the maintenance organization and its maintenance certificate number.
Maintenance Records and Reports
Attachment 1
1. Country
2. CAAC □ Conformity □ Airworthiness
AUTHORIZED RELEASE CERTIFICATE/AIRWORTHINESS APPROVAL TAG
3.Form Tracking No.
4. Organization
5. Work Order/Contract/Invoice
6.Item
7.Description
8.Part No.
9.Eligibility
10.Qty
11.Serial/Batch No.
12.Status/Work
13. 備注 Remarks
14.New Parts
Certifies that the Part(s) identified above except as otherwise specified in block 13 was(were) manufactured/inspected in accordance with the airworthiness regulations of the stated country and/or in the case of parts to be exported with the approved design data and with the notified special requirements of the importing country.
15. Used Parts
Certifies that the work specified above except as specified in block 13 was carried out in accordance with the airworthiness regulations of the stated country and the notified special requirements of the importing country and in respect to that work, the part(s) is (are) in condition for safe operation and considered ready for release to service. (over)
16.Signature
18.Date
17.Name(Printed)
19. Issued by or on behalf of the CAAC
AC-145-4 - 7 -
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AUTHORIZED RELEASE CERTIFICATE/AIRWORTHINESS APPROVAL TAG
USER/INSTALLER RESPONSIBILITIES
(1) It is important to understand that the existence of this document alone does not automatically constitute authority to install the part/component/assembly.
(2) Where the user/installer works in accordance with the national regulations of an Airworthiness Authority different than the Airworthiness Authority of the country specified in block 1 it is essential that the user/installer ensure that his/her Airworthiness Authority accepts parts/components/assemblies from the Airworthiness Authority of the country specified in block 1.
(3) Statements 14 and 15 do not constitute installation certification. In all cases the aircraft maintenance record must contain an installation certification issued in accordance with the national regulation by the user/installer before the aircraft may be flown.
Maintenance Records and Reports
Attachment 2
Civil Aviation Authority of China
MAJOR REPAIR AND ALTERATION
（Airframe, Powerplant, Propeller, or Appliance）
155 Dongsi-east street
Beijing China（100710）
Fax: 86-10-64030987
1．Owner
2．Owner Address
3．Repair or Alteration Items
Airframe□ Powerplant□ Propeller□ Appliance□
Type
Name
Manufacturer
Type number
Serial Number
Repair
Alteration
4．Conformity Statement
Name and Address of Maintenance Organization
Maintenance License Number
　
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