RECEIVING

INSPECTOR
RESPONSIBILITIES
AIRCRAFT PARTS
INSPECTION SYSTEM

INSPECTIONS

1 Receiving Inspection
Incoming Inspection
Preliminary Inspection
Hidden Damage Inspection
In-Progress Inspection
Final Inspection/Approval for Return To

Service

Receiving Inspection
Ensures product received from vendor
satisfies Purchase Order requirements
A.
B.
C.

Part Number
Quantity
Shipping Damage

Incoming Inspection
Ensures product received satisfies
airworthiness requirements
A.

Documentation:

Certification- 8130-3 or Certificate of Conformance

B.
Conformity to specification and acceptable
quality
C.
Shelf Life
D.
E.

Shipping Damage
Preservation

Advisory Circular 20-62D

Eligibility, Quality and Identification of
Aeronautical Parts Eligible Parts
Approved
Parts PMA
TSO
Type Certificated Product Acceptable
Parts Standard Parts
Owner/Operator Produced Conformed
by Certificated Person

QUALITY
Condition for Safe Operation
Factors
Shelf Life
Storage Time
Fabric
Dope,
Paint,
Sealants
and
Adhesives
Internal Seals
Rotating
Components

Factors
Manufacturing
Rejects Damaged
Aircraft Rebuilt
Engines Heat & Fire
Corrosives

IDENTIFICATION/MARKINGS
Airworthiness Approval Tag
FAA Form 8130-3, EASA Form 1 FAA PMA Symbol

FAA TSO Marking

Shipping Ticket from PAH (Production Approval
Holder)
Direct Ship Authority
Maintenance Release Document
FAA Form 337, 8130-3, Work Order, Yellow Tag

ACCEPTABLE DOCUMENTS
OMB Control No. 2120-0018 09/30/2007
I. Approving National Aviation
Authority/Country:

2.

3. Form Tracking Number:

AUTHORIZED RELEASE CERTIFICATE

FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG

4. Organization Name and Address:

6. Item:

7.

Description:

8.

Part Number:

9.

Eligibility: *

10. Quantity:

5. Work Order /Con tr act/ Invoice

Number:
11. Serial/Batch Number:

12.

Status/Work:

13. Remarks:

14. Certifies the Items identified above were manufactured In conformity to:
19.
l~~l
I~1

Approved design data and are in a condition for safe operation.

Non-approved design data specified in Block 13.

14 CFR 43.9 Return to Service

Other regulation specified in Block 13

Certifies that unless otherwise specified in Block 13, the work identified In Block 12 and described In
Block 13 was accomplished in accordance with Title 14, Code of
Federal Regulations, part 43 and in respect to that work, the Items are approved for return to service.

15. Authorized Signature:

16. Approval/Authorization No.:

20. Authorized Signature:

21. Approval/Certlficate No.:

17. Name (Typed or Printed):

18. Date (m/d/y):

22. Name (Typed or Printed):

23. Date (m/d/y):

User/Installer Responsibilities
It is important to understand that the existence of this document alone does not automatically constitute authority to install the part/component/assembly.
Where the user/installer performs work 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 ensures that his/her airworthiness authority accepts parts/components/assemblies from the airworthiness authority of the country specified in
Block 1.
Statements in Blocks 14 and 19 do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in accordance with the national regulations by the
user/installer before the aircraft may be flown.
FAA Form 8130-3 (6-01)

'"Installer must cross-check eligibility with applicable technical data.

NSN: 0052-00-012-9005

Paperwork Reduction Act Statement:

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 associated with this collection of information is 2120-0018. Comments concneming 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 OFlicer, ABA-20.

Part Ticket with

Certificate of Conformity
VALKYRIES AVIATION L.L.C
PO#
P/N

200112

M83519/1-3
TV
Qty

14

Bin Location

102000

2011
11730

Pull Tkt#:

P282183

Trace# Qty 102000 812

102000

11730

UNACCEPTABLE
DOCUMENTS

PART OR MATERIAL CERTIFICA^TI

RTIF,CAT|

ON FORM

ASSET CONVERSION SERVICES

^**5Rnto---------!J At,!fr5S^^^r~----------------------------------------------------- 1 . ~
5A w
)-----------_ M I

9^ivoico(SMm

------------^2______._______^ -
tX

*i 4H

---------

rT----------~2g_ L g^W'BjjSrSTI

Part Numtxf

ewoT
-----------------

^ ^ government or military sourt

LAST OPIH
I_____________________ ENGINE SN
1

^B ObtamedFrofn

------------ i -------------------------------------------13C Last

MESA AIRLINES

Certification Agency:

signature attests mat tftepartWwSntified

I' Us<1<1 RtWiitd or Surplus PartsCemteatiorTTN;------------------(wre) manufactured and inspected In accord#***
s<nature attests that the documentation speoflad I
the code of the Feder.i^co^,^. ^!^
** hatched ,s accurate wh regart lothTaS
Rfpj,rr<J
Airworthiness Authority of the Country of ortain antt'or
P*rt* conform and were inspected in
TMaNiVMinijuu.yj.us
^
"0
'FMt'*1 RfS"l','' w i
^ 01 "* CouWfT 01 on*i and
------------------------------ approved for return to service

r 15 Signature

19

5. Name (Typed or K~7 Dale* printed)

1L------------------------------------------------------

Signature- \ f

_______///
20

tor agiw* on thm form a t* Ot^jn

and r\ try wit nvrvrtHK Hvtrro

Name (TnxM or PrinlMjTsi bale ~

MARIO JORDAN

10/8/2003

iw^h ihitlatyiaeiOhowi^ittnapore SNMU e* wte or a twi a mra r*ir-s*w P-TNOM than IN* aha iwa, f* MM to* *0* ixy*-*r< *M n KV

Invoice
Certification
Form
ATA 106 Form

ATA 106 Form

Unacceptable Statements
Remarks Block 13:
The above parts have not been subjected to extreme
stress (as in a major engine failure, accident or fire) and
it was not obtained from any US government or military
source.

ATA 106 Form

Unacceptable
Statements
Block 15: New Parts Certification:
The following signature attests that the part (s)
identified above was (were) manufactured and
inspected in accordance with the code of the Federal
Regulations 14 or the AIRWORTHINESS Authority of
the Country of origin and/or established industry or U.S
specifications

Block 16: Used, Repaired or Surplus

Parts:

ATA 106 Form

Unacceptable Statements
The following signature attests that the documentation
specified above or attached is accurate with regard to the
item (s) described. Repaired parts conform and were
inspected in accordance with the Code of Federal
Regulations 14 or the Airworthiness Authority of the Country
of origin and are approved for return to service

M & M Aerospace Hardware, Inc

P 0 0o 025263. Uam. Fl 33102-5263 . T*i 305
PWMLocWOn: 1W00 NW 1 !* Time*,

^vxfTviuefOCom

DO NOT
DESTROY

Accredited Distributor

CERTIFICATION
Material fortification
The items set forth on the purchase order referred to below have been

visually

inspected and the dimensions thereof have; been measured by us. and based

Must be accredited by
industry
Must have quality
system
Must retain records
Must make records
available

aforesaid, as well as the representation

upon the

mane to us by the manufacturers of the items

subject of such purchase order, we hereby certify that such items are in conformity with
all current government and manufacturer s requirements, specifications, and drawings.

Sald il6ms are in new condition and have not been obtained from any U.S. Government
or Military source and are traceable to M & M Aerospace Hardware. Inc.
FIRM :

EXELTECH

YOUR PURCHASE ORDER U :

EX-4015-BH

:-o
c_
n

no
an

Terry Bond
Vico Prosidont of Quality Assurance

NON CERTIFICATED PERSON

Someone without a FAA certificate (individual or
organization)
When a Non Certificated person states that they are
shipping the correct part ordered, the ONLY thing they
are stating is that the part number agrees with the
purchase order, NOT the status of FAA acceptability
of the part.

Preliminary Inspection
Determines status of product received for
maintenance
A.
B.
C.
D.
E.
F.
G.

Documentation, identification, traceability

Shipping damage
Preservation
Life Limits
ADs Service Bulletins
Functional tests/teardown inspections
Determination of repairs/scope of work

Hidden Damage Inspection

Inspection of article involved in accident for

Hidden Damage before maintenance is
performed.
A. Includes inspections of adjacent
areas B. May not be required in all
cases.

In-Progress Inspections
Inspections/tests performed at various
stages of teardown, maintenance and
assembly.
May include tests, measurements,
calibrations while work is in progress.

Final Inspection and Approval for

Return To Service

r Ensures inspection, testing, and/or

calibration, including documentation is
completed at the completion of maintenance.

Includes Final Sign Off, Log Book Entry.

CALIBRATION SYSTEM
System to control and perform calibration of
tools and test equipment used to make an
airworthiness determination.
Traceable to a standard acceptable to the FAA,
NIST or other national authority.

Maintenance of Records

CALIBRATED TOOLS
ONLY for tooling used to make Airworthiness
determination
Markings:
Must Have Calibration Sticker
Calibration Not Required

Users Responsibility to Verify Before Use

CORRECTIVE ACTIONS
Used to remedy an undesirable situation.
Found before article released to service Found
after article released to service

Not Quality Assurance System.

SUSPECTED UNAPPROVED

PARTS
SUSPECTED UNAPPROVED PARTDefinition: A part, component or material that is
SUSPECTED of not meeting the requirements of an
APPROVED PART.

UNAPPROVED PART
A part that does not meet the requirements of an
APPROVED PART.

APPROVED PART
Those which are produced in accordance with a FAA
Approved Manufacturing and Inspection System. TC,
PC, STC, PMA, TSO
Meet applicable design standards
Maintained IAW FAR Part 43 and/or 145
Manufactured by a repair station during alteration IAW
STC

ACCEPTABLE PART
Standard Parts that conform to established industry or
U.S. specification
9 Owner/Operator Produced
Fabricated by a person qualified to RTS Aircraft,
Powerplant or propeller
Parts for which inspections and tests have been
accomplished by appropriately certificated persons
authorized to determine conformity to FAA-approved
design data.

DETECTION
Use of approved vendors
Screening potential vendors
Prices to good to be true
Unrealistic delivery schedules
No/Inadequate documentation
Markings Appearance

SHELF LIFE CONTROL

Adhesives, Sealants, Paints, Seals, etc.

Manufacturers Markings Storage Procedures
Check before use.
Date of Manufacture/Date of Opening
Temperature Controlled

ELECTRO STATIC DISCHAGE

Used for equipment marked as ESDS

sensitive.

Properly Identified and Bagged.

Handling/Storage
Wrist straps for installation/removal

FAR Part 43.3

43.3 Persons authorized to perform maintenance, preventive
maintenance, rebuilding, and alterations.
(b) The holder of a mechanic certificate
(c) The holder of a repairman certificate
(d) A person working under the supervision of a holder of a mechanic or
repairman certificate
(e) The holder of a repair station certificate

FAR Part 43.5

43.5 Approval for return to service after
maintenance, preventive maintenance,
rebuilding, or alteration.
No person may approve for return to service any
aircraft, airframe, aircraft engine, propeller, or
appliance, that has undergone maintenance,
preventive maintenance, rebuilding, or alteration

unless (a) The maintenance record entry required by 43.9 or

43.11, as appropriate, has been made;

FAR Part 43.7

43.7 Persons authorized to approve aircraft,
airframes, aircraft engines, propellers,
appliances, or component parts for return to
service after maintenance, preventive
maintenance, rebuilding, or alteration.
(b)
The holder of a mechanic certificate or an
inspection authorization

(c)

The holder of a repair station certificate

FAR Part 43.9

43.9 Content, form, and disposition of maintenance,
preventive maintenance, rebuilding, and alteration
records
(1)
A description (or reference to data acceptable to the
Administrator) of work performed.
(2)
The date of completion of the work performed.

(3)
The name of the person performing the work if other than
the person specified in paragraph (a)(4) of this section.
(4)
If the work performed on the aircraft, airframe, aircraft
engine, propeller, appliance, or component part has been performed
satisfactorily, the signature, certificate number, and kind of certificate
held by the person approving the work.

43.12 Maintenance Records:

Falsification, reproduction, or alteration.

(a) No person may make or cause to be made:

(1) Any fraudulent or intentionally false entry in any record or report that is
required to be made, kept, or used to show compliance with any requirement
under this part;
(2) Any reproduction, for fraudulent purpose, of any record or report under
this part; or

 (3) Any alteration, for fraudulent purpose, of any record or report under this
part.
(b) The commission by any person of an act prohibited under paragraph (a) of
this section is a basis for suspending or revoking the applicable airman,
operator, or production certificate, Technical Standard Order Authorization,
FAA-Parts Manufacturer Approval, or Product and Process Specification
issued by the Administrator and held by that person.

NOMAD
FORMS

Parts Request Ticket

Work order Over &

Above Tally
Sheet Part
Traveler

8130-3

Tags

SIGNATURE REQUIREMENTS
Technicians:
Legible Signature
Legible Printed First & Last Name, Signature

Inspector:
Legible Signature
Legible Printed First & Last Name, Signature
P Stamp

Approval for Return To Service

Legible Signature and Certificate Number ONLY

CRS#

NOMAD AVIATION 4151

Centerline Lane Sanford,
FI 32773

CUSTOMER WORI
W/O#

2E

-'AGE

PHONE |

QPFN DATF
MODEL
SERIAL#
INioMbU
PRINTED

Aircraft Registration #
Manufacturer Model
Serial #

PRELIMINARY
INSPECTION

HIDDEN DAMAGE
INSPECTION

Scope of Work

CORRECTIVE
ACTION

PARTS USED

THE AIRCRAFT. PROPELLER OR APPLIANCE IDENTIFIED ABOVE WAS REPAIRED IN ACCORDANCE

WITH CURRENT FEDERAL AVIATION REGULATIONS AND IS HEREBY APPROVED FOR RETURN TO
SERVICE WITH RESPECT TO THE WORK PERFORMED

Corrective Action

Date

Nomad Aviation Over and Above Authorization

Aircraft

T raveler

PiscpafTC7/Suggested Corrective Action*

Description
of Work

Aircraft
Registration #

five Action:

Corrective
Action
Parts- Use
back if
more than
one

Part#

Serial #

Part#

Serial #

DATE"

:HNICIAN:

Attach ALL parts

tags and FAA
Form 8130-3s to
WO.

DATE
Labor:
Engineering

LEGIBLE
Signature -or
Legible
Printed Name
and signature

O & A Number,
Work Order #
and Yes or No if
Traveler
required

Approved:

Date:

Declined:

Date:

NA 0018 RevO

Request Inspection
when all blocks are
completed and
technician has signed !

Aircraft
Registration #
Work Description
Traveler Number

Tally Sheet. Inventory of

Documents in Work Order

Work Order #

Part Traveler

Used to track part removed

for maintenance and
control fabricated part.
Complete applicable
blocks
DWG/SRM Ref

Aircraft & WO #
Parts/Materials Used
Work Step(s)

Final Inspection Sign Off

part

Part Serial
Number

Green Tag used for

Repairable part ALL
Removed Parts MUST
be tagged

Aircraft
Registration #
Mechanics Name

Work Order #

FAA Form 8130-3

OMB Control No. 2120-0018 09/30/2007
1. Approving National Aviation
Authority/Country:

2.

3. Form Tracking Number:

AUTHORIZED RELEASE CERTIFICATE

FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG

4. Organization Name and Address:

6. Item:

7.

Description:

8.

Part Number:

9.

Eligibility: *

10. Quantity:

5. Work Order/Con tract/hi voice

Number:
11. Serlal/Batch Number:

12.

Status/Work:

13. Remarks:

MUST be retained and made a part

of aircraft records
14. Certifies the items identified above were manufactured in conformity to:
19.
11
11

Approved design data and are in a condition for safe operation.

Non-approved design data specified in Block 13.

14 CFR 43.9 Return to Service

Other regulation specified in Block 13

Certifies that unless otherwise specified In Block 13, the work identified In Block 12 and described in
Block 13 was accomplished in accordance wiili Title 14, Code of
Federal Regulations, part 43 and in respect to that work, the items are approved for return to service.

15. Authorized Signature:

16. Approval/Authorization No.:

20. Authorized Signature:

21. Approval/Certificate No.:

17. Name (Typed or Printed):

18. Date (m/d/y):

22. Name (Typed or Printed):

23. Date (m/d/y):

User/Installer Responsibilities
It is Important to understand that the existence of this document alone does not automatically constitute authority to Install the part/component/assembly.
Where the user/installer performs work 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 ensures that his/her airworthiness authority accepts purts/couiponents/assemblies from the airworthiness authority of the country specified in
Block 1.
Statements in Blocks 14 and 19 do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in accordance with the national regulations by the
user/installer before the aircraft may be flown.
FAA Form 8130-3 (6-01)

'"Installer must cross-check eligibility with applicable technical data.

NSN: 0052-00-012-9005

Paperwork Reduction Act Statement:

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 associated with this collection of Information is 2120-0018. Comments concneming 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.

Part Tag MUST be Retained for

aircraft records
VALKYRIES AVIATION L.L.C
PO#
P/N

200112

M83519/1-3
TV
Bin Location

14

2011

Qty
Trace# Qty 102000 812

PullTkt#:

P282183

Date
Parts Issued _WO#
N#
Part#

Discrepancy#

Description
QTY

Requestor,
Remarks

Parts Request Tag:

Used to Request Part from Stockroom.
White copy stays in Stockroom for inventory control Yellow copy goes to technician with
part. May be used to return excess items to Stock.

c
REPAIR/PARTS REQUEST
w.o#

N#

PO#

MAKE

MODEL

Check One: Shop Materials O Inventory for later sale

REQUESTED BY_______________________________ APPROVED BY__________________________________ DATE REQUESTED
SER# 1.______________________________2._________________________________3.__________________________________ 4. _
DISC
#

QTY.

PART NO.

DESCRIPTION CONDITION

PRICE
EACH

LIST
PRICE

P&AORDER
PAYMENT

VENDOR
P.O.C

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER

P&A
ORDER