605-35-005 Rev01

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SERVICE BULLETIN

REVISION TRANSMITTAL SHEET


MODEL CL−600−2B16

Discard the Basic Issue of this Service Bulletin dated Jun 29/2018, and the Information
Sheets dated Jul 26/2019 and Sep 30/2020 and replace in its entirety with this
Revision 01.

Service Bulletin No. 605−35−005

Date of Basic Issue Jun 29/2018

Revision No. 01 Dated Jun 28/2023

This revision has no effect for aircraft on which the Basic Issue of this Service
Bulletin was done thus no other action is necessary. Do not sign the log book if you
have not done this revision. Keep the previous log book entry. You may make an
entry as "Not Applicable" for this revision.

This revision is issued to:

1. Incorporated Info Sheet dated Jul 26/2019, in Paragraph 1, to add Notes 3 to 6.

2. Change, in Paragraph 1.D., and 2.C., to revise the standard Note as per latest template.

3. Change, in Paragraph 1.K., to revise the Restriction and/or Special Instruction (RSI) to
Rev. G.

4. Delete, in Paragraph 2.A., and 2.D., a standard Note as per latest template.

5. Change, in Paragraph 2.E., to revise the recording statement as per latest template.

6. Incorporated Info Sheet dated Sep 30/2020, in Paragraph 3.A., to revise the Kit table.

7. Make miscellaneous minor changes, as necessary, with no change of context.

605−35−005
Page 1 of 1
SERVICE BULLETIN SUMMARY
This Service Bulletin is available at:
my.businessaircraft.bombardier.com
MODEL CL−600−2B16
ATA 35−00

OXYGEN

MODIFICATION – PORTABLE OXYGEN BOTTLE – BRACKET REPLACEMENT

The information below is provided for your reference. For full details, including labor and part
coverage, please see corresponding paragraph contained within this bulletin.

RECOMMENDED COMPLIANCE TIME


SPECIFIED TIME COMPLIANCE 60 months from SB release date
(Basic Issue)
EFFECTIVITY: Refer to Paragraph 1.A.

MANPOWER: 2.5 man−hours, for each portable oxygen bottle installation


CONTINUED AIRWORTHINESS (CAW)
FLEET CAMPAIGN YES NO

TLMC, CH 5 AFFECTED YES NO


KITS and/or PARTS YES NO
TOOLING/GSE YES NO
PLANNING INFORMATION: See important
information at the start of Paragraph 1. YES NO

DEDICATED SCHEDULE YES NO


PREREQUISITE SERVICE BULLETINS: N/A
NOTE: This Service Bulletin may be subject to an Airworthiness Directive which will make
it necessary to implement this Service Bulletin.
To place an order for parts or kits, please call Bombardier Aviation Parts Services at:
514−855−2999 or 1−866−538−1247

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 1 of 1
SERVICE BULLETIN
This Service Bulletin is available at:
my.businessaircraft.bombardier.com
MODEL CL−600−2B16
ATA 35−00

OXYGEN

MODIFICATION – PORTABLE OXYGEN BOTTLE – BRACKET REPLACEMENT

1. PLANNING INFORMATION
NOTES: 1. Before you do this Service Bulletin, examine all STC, STA or
equivalent action changes to make sure that this Service Bulletin can
be completed.

2. Existing installation, location and quantity within the aircraft cabin may
vary. This Service Bulletin must be performed on each applicable
installation. Refer to the applicable aircraft specific IPC or SIPC for more
details.
3. All removal and installation operations must be performed in a Part 145
workshop and by certified personnel.
4. Some aircraft may appear in the applicability of TCCA AD−CF−2019−26
but not in the Service Bulletin Effectivity for one of two reasons:

a) The Aircraft has a Bombardier−owned Interior Supplemental Type


Certificate (STC) and it is known by Bombardier to NOT have the
affected bracket part number 36758−02/−12 or H3−2091−1 with
5500 or 5600 Series 11 cu. ft portable oxygen bottles installed. The
TCCA Airworthiness Directive (AD) applies only to Challenger
aircraft models with bracket part number 36758−02/−12 or
H3−2091−1 and with 5500 or 5600 Series 11 cu. ft portable oxygen
bottles installed. Refer to NOTE 5.

Refer to applicable governmental agency regulations and requirements and make sure that the work described in this
Service Bulletin is performed in compliance with manufacturer’s recommendations and/or acceptable industry standards.

This document is proprietary to Bombardier Inc. and/or its affiliates and may not be reproduced or copied in any form or
by any means without the prior written consent of Bombardier Inc. and/or its affiliates.
 2018−2023 Bombardier Inc. All rights reserved
Learjet, Challenger, Global, are registered trademarks of Bombardier Inc. or its subsidiaries.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 1 of 15
MODEL CL−600−2B16

b) The Aircraft has a third−party Interior STC (e.g. Midcoast/Jet


Aviation, Flying Colours Corp, KC Aviation or other). The
Bombardier Service Bulletin can only cover Aircraft for which
Bombardier is the STC holder. Such third−party STCs may or may
not have installed the affected bracket part number 36758−02/−12
or H3−2091−1 with 5500 or 5600 Series 11 cu. ft portable oxygen
bottles. Refer to NOTE 6.

5. Aircraft with a Bombardier−owned Interior STC may be excluded from the


SB effectivity if Bombardier’s engineering records show that they have
another bracket part number that is not subject to the AD, usually part
number 801726. This bracket is installed at the top of the bottle regulator,
and not at the bottle neck. If you wish to verify, do the following:

a) Obtain access to the portable oxygen bottle bracket installation.

(i) If the upper bracket is installed at the top of the regulator, then it
is not the affected bracket and is therefore not subject to the
TCCA AD CF−2019−16 and is correctly excluded from the
Bombardier Service Bulletin.

(ii) If the upper bracket is installed around the neck of the bottle, then
the Aircraft may have been erroneously excluded from the
Service Bulletin or may have been modified after original delivery
by third−party engineering of which Bombardier is not aware.
Raise an SRPSA with Bombardier Customer Services for
disposition.

6. Aircraft with a third−party (non−Bombardier) Interior STC and has the


affected bracket part number 36758−02/−12 or H3−2091−1 with 5500 or
5600 Series 11 cu. ft portable oxygen bottles can comply with the AD in
the following ways:

a) Raise a chargeable SRPSA with Bombardier Customer Services to


obtain a permission letter to use the STC and the STC data
package. Incorporation of Bombardier−owned TCCA STC SA17−93
(FAA ST04028NY, EASA 10064297).

b) If you do not wish to purchase the STC from Bombardier Aviation,


you may contact the STC holder for an alternate disposition and to
contact your local regulatory agency for an Alternate Means of
Compliance (AMOC).

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 2 of 15
MODEL CL−600−2B16
A. Effectivity

CL−600−2B16 aircraft Serial No. 5824, 5825, 5832 to 5839, 5842 to 5853, 5856,
5857, 5859 to 5863, 5865 to 5881, 5883 to 5894, 5896 to 5898, 5900 to 5906, 5908
to 5911, 5913 to 5938, 5940 to 5947, 5949 to 5980, 5982 to 5985, 5987 and 5988.
NOTES: 1. If the aircraft is not listed in the above effectivity and the aircraft has
the same portable O2 bottle/installation discrepancy, contact
Bombardier Aviation to receive disposition and approvals for the
applicable installation. Submit a Service Request for Product Support
Action (SRPSA) by e−mail to: SRPSA@aero.bombardier.com.

2. The instructions given in this Service Bulletin are only applicable to


the systems and parts installed at the time of delivery of the aircraft or
as changed by Bombardier Aviation Service Bulletin(s).

B. Reason
On some aircraft, fast and easy retrieval of the portable oxygen bottle has been
prevented due to the latch of the upper bracket assembly catching on the pressure
gauge tube or on the pressure gauge bezel of the portable oxygen bottle.

This Service Bulletin gives instructions to inspect the portable oxygen bottle upper
bracket assembly and instructions to install a new or modified top bracket and new
middle bracket which will improve the access to the portable oxygen bottle.

C. Description
NOTE: Existing installation, location and quantity within the aircraft cabin may
vary. This Service Bulletin must be performed on each applicable
installation. Refer to the applicable aircraft specific IPC or SIPC for more
details.

This Service Bulletin gives instructions to:


− Get access to the portable oxygen bottle,
− Inspect the portable oxygen bottle upper bracket assembly installation to
determine if the affected bracket Part No. 36758−02, Part No. 36758−12 or Part
No. H3−2091−1 is present,
− If corrective action is necessary, remove and modify the portable oxygen bottle
upper bracket,
− Install the new upper bracket assembly,
− Install the new middle bracket assembly,
− Install the portable oxygen bottle.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 3 of 15
MODEL CL−600−2B16
D. Compliance

Recommended within 60 months from this Service Bulletin release date (Basic
Issue).
NOTE: If it is not possible to complete all the instructions in this Service Bulletin
because of the configuration of the aircraft, submit an SRPSA for analysis
and to get an approved disposition to complete this Service Bulletin.
Standard SRPSA fees may apply. Refer to the Services section of the
Bombardier customer portal for the latest prices, rates and fees.

E. Approval
The technical content of this Service Bulletin has been approved under the
authority of Transport Canada STC number SA17−93, FAA STC number
ST04028NY, EASA STC number 10064297.

F. Manpower
NOTES: 1. The man−hours given are to help you schedule the tasks given in this
bulletin. The man−hours are for direct labor performed by an
experienced crew and do not include the time for familiarization,
planning, aircraft preparation in hangar such as towing and
positioning of scaffolds, removal of interior furnishings, repainting,
supervision and inspection.
For more information related to the manpower, refer to
SB 605−00−002.

2. This Service Bulletin may require consumable materials that have


specific curing times (refer to Paragraph 3). The accumulated curing
time is not included in the man−hours and should be considered for
planning purposes before you schedule this Service Bulletin.

2.5 man−hours, for each portable oxygen bottle installation is necessary to do this
modification.
The labor required to do this Service Bulletin is at no cost if:
− The work is done during completion warranty period or for aircraft that have
complied with SB 605−35−004, and
− The work is done at Bombardier Business Aviation Services (BBAS) or
Authorized Service Facilities (ASF), and
− This Service Bulletin is scheduled in less than 12 months from its release date
(Basic Issue).

Bombardier Aviation does not pay for the labor to do this Service Bulletin for aircraft
out of completion warranty.

G. Material − Cost and Availability


The kit 650K35−001 is necessary to do this modification for each portable oxygen
bottle installation.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 4 of 15
MODEL CL−600−2B16

KIT NO. PRICE

Please contact Bombardier Aviation Parts Services,


650K35−001 in Montreal, for delivery lead times and confirmation
of prices.

The part listed in Paragraph 3.B. may be necessary to do this modification.

For all parts transactions, Bombardier Aviation’s current Spare Parts and
Component Repair Price Catalogue general terms and conditions apply. These
terms and conditions are found on the Bombardier Customer Portal at:

my.businessaircraft.bombardier.com
The kit and/or parts are available at no cost if:
− Aircraft have already complied with SB 605−35−004 or if ordered during
completion warranty, and
− a no−charge purchase order is sent to Bombardier Aviation in less than 12
months from the release date of this Service Bulletin (Basic Issue).

Bombardier Aviation does not pay for the kit and/or parts to do this modification for
aircraft out of completion warranty.

During or after the above free period, Smart Parts Plus does not pay for the kit and
parts.

H. Tooling
No equipment or special tools are necessary.

I. Weight and Balance

It is the responsibility of the maintenance facility incorporating this change to


calculate weight and balance impact for this installation and update the aircraft
weight and balance report accordingly. Refer to NOTE 4 of Drawing BAS63038403.

WEIGHT OF PARTS

Middle Bracket Assy 0.17lb (0.078kg)


Part No. H3−2178−1

(If applicable)
Adaptor Plate Assy 0.61lb (0.28kg)
Part No. BAS63038402−101

J. Electrical Load Data

No change.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 5 of 15
MODEL CL−600−2B16
K. References
− Bombardier Aviation, Restriction and/or Special Instruction (RSI), C−4132,
Rev. G.
− Bombardier Aviation, Kit Drawing BAS63038403, Rev. NC.
− CL−605 Aircraft Maintenance Manual (AMM), Chapters 6 and 35.
− CL−605 Supplemental Maintenance Manual (SMM), Chapters 25 and 35.
− CL−605 Standard Practices Manual (SPM), Chapter 20.
− CL−605 Structural Repair Manual (SRM), Chapter 51.
− Bombardier Aviation, Instructions for Continued Airworthiness,
BAS63058026 (attached).

L. Other Publications Affected


− Bombardier Aviation, Supplemental Maintenance Manual (SMM), Chapter 35.
− Bombardier Aviation, Supplemental Illustrated Parts Catalog (SIPC),
Chapter 35.

M. Equivalent Service Bulletins


− For the Challenger 600 aircraft, use SB 600−0772.
− For the Challenger 601 aircraft, use SB 601−0646.
− For the Challenger 604 aircraft, use SB 604−35−006.
− For the Challenger 650 aircraft, use SB 650−35−001.

2. ACCOMPLISHMENT INSTRUCTIONS
NOTES: 1. All TASKs given in the procedures that follow are from the CL−605 Aircraft
Maintenance Manual (AMM) unless otherwise specified.
2. All references made to zones, access panels and/or doors, are from the
CL−605 Aircraft Maintenance Manual (AMM), Chapter 6.
A. Aircraft Setup
NOTE: Existing installation, location and quantity within the aircraft cabin may
vary. This Service Bulletin is to be performed on each applicable
installation. Refer to the applicable aircraft specific IPC or SIPC for more
details.

(1) Get access to the portable oxygen bottle.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 6 of 15
MODEL CL−600−2B16
B. PART A – Special Check

(1) Inspect each applicable portable oxygen bottle installation as follows:

(a) If the bottle is manufactured by Scott (Avox/Zodiac) and is a 5500 or 5600


series 11 cu. ft. bottle, with upper bracket Part No. is 36758−02 or Part
No. 36758−12 or Part No. H3−2091−1 installed at the neck of the bottle,
proceed to PART B in Paragraph 2.C.
(b) If the portable oxygen bottle installation is as per BAS63038403−3 INSTL,
View−A in Sheet 5 of Drawing BAS63038403, no further action is required.
Proceed to Close−Out in Paragraph 2.D.
NOTE: The BAS63038403−3 installation represents a configuration that
does not require modification per this Service Bulletin.
C. PART B – Modification
NOTES: 1. If it is not possible to complete all the instructions of this Service
Bulletin because of the configuration of the aircraft, submit an SRPSA
for analysis and to get an approved disposition to complete this
Service Bulletin. Standard SRPSA fees may apply. Refer to the
Services section of the Bombardier customer portal for the latest
prices, rates and fees.

2. Existing installation and location within the aircraft cabin may vary.
Refer to the applicable aircraft specific IPC or SIPC for more details.
WARNING: OBEY ALL THE OXYGEN SAFETY PRECAUTIONS WHEN YOU DO
MAINTENANCE ON THE OXYGEN SYSTEM AND OXYGEN
SYSTEM COMPONENTS. IF YOU DO NOT OBEY THE SAFETY
PRECAUTIONS, YOU CAN CAUSE A FIRE OR AN EXPLOSION.
THIS CAN CAUSE INJURY TO PERSONS AND DAMAGE TO
EQUIPMENT.

WARNING: DO NOT LET OIL, GREASE OR SOLVENTS GET ON YOUR


HANDS, CLOTHING OR THE EQUIPMENT USED TO DO WORK
ON THE OXYGEN SYSTEM. IF OXYGEN TOUCHES GREASE, OIL
OR SOLVENTS, THEY CAN START TO BURN.

(1) Remove and retain the Scott 5500 or 5600 series 11 cu. ft. portable oxygen
bottle from the mounting bracket assembly. Keep the oxygen bottle to reinstall
post modification.
(2) If the existing upper bracket configuration is a −3 INSTL per View−A
(Pre−Modification) in Sheet 5 of Drawing BAS63038403, proceed to close−out.
(3) If the existing upper bracket configuration is a −1 INSTL per View−A
(Pre−Modification) in Sheet 3 of Drawing BAS63038403, do as follows:

(a) Remove and rework the old mounting upper bracket assembly Part
No. 36758−02 or 36758−12 or H3−2091−1 per NOTE 8 and VIEW−A in
Sheet 3 of Drawing BAS63038403. Retain the washers and screws to
reinstall later.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 7 of 15
MODEL CL−600−2B16
(4) If the existing lower bracket configuration is a −1 INSTL as shown in Sheet 3 of
Drawing BAS63038403, do as follows:

(a) Remove and keep the lower bracket assembly Part No. 36758−01 or
36758−11. Keep the mounting hardware to reinstall later.
(5) Install the adaptor plate Part No. BAS63038402−101 and middle bracket assy
Part No. H3−2178−1 per VIEW−A (Post−Modification) in Sheet 3 of Drawing
BAS63038403. Refer to NOTE 15 and all applicable NOTES in Drawing
BAS63038403.
NOTE: It is permitted to omit installation of the adaptor plate Part No.
BAS63038402−101, for wardrobe installations only (wardrobe panel
minimum thickness 0.25in (6.35mm)).
(6) Install the upper bracket Part No. BAS63038403−10 and lower bracket Part
No. 36758−01 or 36758−11 per VIEW−A (Post−Modification) in Sheet 3 of
Drawing BAS63038403. Refer to all applicable NOTES in Drawing
BAS63038403.
(7) Install the portable oxygen bottle to the new support bracket installation.

D. Close−out

(1) Make sure all applicable portable oxygen bottle installations have been
inspected and modified as necessary before closing this Service Bulletin.
(2) Remove all tools, equipment and unwanted materials from the aircraft.

E. Recording

When this Service Bulletin is completed, make an entry in the aircraft log and send
the attached Incorporation Notice to Bombardier Business Aircraft Customer
Services (BBACS).

For information, correction(s), comment(s) and/or feedback regarding Service


Bulletins released on the Customer Portal, please contact the Service Bulletin
Group at the following email address:
bbad_SBgroup@aero.bombardier.com

3. MATERIAL INFORMATION
A. Kits
Kit 650K35−001 is necessary to do this modification for each portable oxygen bottle
installation and contains the parts that follow:

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 8 of 15
MODEL CL−600−2B16

USED INSTRUCTIONS
NEW PART NO. QTY ITEM PART NO. - DISPOSITION

Bracket Assembly,
H3−2178−1 1 Middle, Oxygen − −
(See NOTE 3) Bottle

MS21042L3 2 Nut − −

NAS623−3−2 7 Screw, Pan Head − −

NAS1149F0332P 7 Washer, Flat − −

NAS1581F3T2 2 Screw, Csk, − −


Reduced Head

NAS1836−3−14 2 Insert − −

NOTES: 1. In case of discrepancy between this list and the “Service Bulletin Kit
Parts List” contained in the respective kit, then the latter list prevails.
2. The actual quantity for some of the hardware contained in the kit can
be greater than the amount shown in the table as items are supplied
in prepackaged quantities.
3. Refer to NOTE 15 of Drawing BAS63038403.

B. Parts

The part that follows may be necessary to do this modification for each portable
oxygen bottle installation and is available from Bombardier Aviation Parts Services,
Montreal:

USED PART INSTRUCTIONS


NEW PART NO. QTY ITEM NO. - DISPOSITION

Required for
BAS63038402−101 1 Adaptor Plate − non−wardrobe
(See NOTE) locations.

NOTE: Refer to NOTE 15 of Drawing BAS63038403.

C. Material

The materials that follow, or equivalent, are necessary to do this Service Bulletin.
These can be purchased from a local supplier. Bombardier Aviation does not pay
for these consumables.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 9 of 15
MODEL CL−600−2B16

SUPPLIER
PART
DESCRIPTION SPECIFICATION QUANTITY
NO./NAME
(SEE NOTE)

Brush Conversion MIL−DTL−81706,


− As Necessary
Coating Method B

Touch−up−Fluid
− BAMS 565−001 As Necessary
Resistant Primer Code: A

Fluid Resistant
Polyurethane − BAMS 565−002 As Necessary
Topcoat

NOTES: 1. Refer to the table that follows for each supplier’s address listed by
codes.

2. The curing Time (CT), if applicable, for each consumable material is


indicated with the description of each product.

3. At time of release of this Service Bulletin, the information on the


supplier was valid and accurate. In the event that this information has
changed, the operator is encouraged to use the World Wide Web to
find a local supplier.

SUPPLIERS ADDRESSES BY CODES

Code: A
PRC Desoto/PPG
11601 United Street
Mojave, CA 93501
USA
Tel.: 661−824−4532
www.prc−desoto.com

D. Publications

No publications required.

Basic Issue: Jun 29/2018 605−35−005


Revision 01: Jun 28/2023 Page 10 of 15
SB604−35−000−38403−NC−S1
BAS63038403 − Portable Oxygen Bottle Installation − Bracket Replacement
(Sheet 1 of 5, Rev. NC)
Basic Issue: Jun 29/2018 605−35−005
Revision 01: Jun 28/2023 Page 11 of 15
SB604−35−000−38403−NC−S2
BAS63038403 − Portable Oxygen Bottle Installation − Bracket Replacement
(Sheet 2 of 5, Rev. NC)
Basic Issue: Jun 29/2018 605−35−005
Revision 01: Jun 28/2023 Page 12 of 15
SB604−35−000−38403−NC−S3
BAS63038403 − Portable Oxygen Bottle Installation − Bracket Replacement
(Sheet 3 of 5, Rev. NC)
Basic Issue: Jun 29/2018 605−35−005
Revision 01: Jun 28/2023 Page 13 of 15
SB604−35−000−38403−NC−S4
BAS63038403 − Portable Oxygen Bottle Installation − Bracket Replacement
(Sheet 4 of 5, Rev. NC)
Basic Issue: Jun 29/2018 605−35−005
Revision 01: Jun 28/2023 Page 14 of 15
SB604−35−000−38403−NC−S5
BAS63038403 − Portable Oxygen Bottle Installation − Bracket Replacement
(Sheet 5 of 5, Rev. NC)
Basic Issue: Jun 29/2018 605−35−005
Revision 01: Jun 28/2023 Page 15 of 15
SERVICE BULLETIN EVALUATION FORM
(Your ideas will help us provide better bulletins)

SERVICE BULLETIN: 605−35−005 ISSUE: Rev. 01 DATED: Jun 28/2023

TITLE: MODIFICATION – PORTABLE OXYGEN BOTTLE – BRACKET


REPLACEMENT

For any information, correction(s), comment(s) and/or feedback regarding Service


Bulletins released on the Customer Portal, please contact the Service Bulletin Group
at the following email address:

bbad_SBgroup@aero.bombardier.com

NOTE: Please use Salesforce only for troubleshooting issues or when Engineering
deviation is necessary to accomplish the Service Bulletin modification.
SERVICE BULLETIN INCORPORATION SHEET − "605−35−005"
BOMBARDIER

Upon completion of the Service Bulletin, please fill−in, fax to


SUBMISSION

(514) 855−8798 or e−mail to Fracas at fracas.montreal@aero.bombardier.com

If you’re reporting Service Bulletin (SB) Incorporations to CAMP, sending


this Incorporation Sheet to Bombardier is not mandatory. If your aircraft is
on another tracking system, please contact Bombardier to make arrangements
for automated data submission.

COMPLIED WITH
Service Bulletin Rev. * Parts YES NO N/A Remarks/Reason
Number Completed (Mandatory if N/A)

605−35−005 01

Actual hours to accomplish Service Bulletin:

* NOTES: 1. Where the Service Bulletin is divided into a number of parts (e.g., PARTS A,
B, C, D, etc.) which can be carried out separately, indicate only those parts
completed at this time.
2. For repetitive checks (usually PART A) only the initial check should be
reported unless otherwise stated in the Service Bulletin.
3. When more than one part is carried out at the same time, each part should
be reported.
4. Fill in ’Remark/Reason’ to explain compliance method when N/A is selected.(E.g. Part
not installed, N/A by effectivity, N/A by Part Serial Number, etc.
5. PCW means ’Previously Complied With’.

Aircraft Serial No. Aircraft Reg. No.

Airframe Hours: Airframe Landings


S.B. Incorporation Date Service Order No.
(dd/mm/yy)

Facility incorporating S.B.

Name Signature Date


Signature not required if sent by E−Mail (dd/mm/yy)

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