BML01 B4721 SEQ 10

MODIFICATION
CUSTOMER
PHILIPPINE AIRLINES, INC.
A/C TYPE A/C TAIL TITLE TASK CARD NUMBER TASK CODE
AIRBUS A330-343 RP-C8781
SOURCE REFERENCE MSN CHECK ATA ZONE AREA
1460 FOR TESTING ONLY
START EST MH PAGE STOP
BILLING GRP SKILL CODE
B-ADN 1/1
797160S 797160C
PART USAGE

BATCH NO. / SPARE REQ.

DESCRIPTION PART NO. (or APN) QTY UOM SN ON SN OFF PLANNER
INSPECTION LOT NO. BY

CALIBRATED TOOL USAGE: INDICATE NIL IF NONE REQUIRED

TOOL DESCRIPTION PART NO. SERIAL NO. CAL. DUE DATE LIC. STAMP

TASK DESCRIPTION STAMP/SIGN

MECH LIC/AUTH
ZONE:

ACCESS:

REFERENCE:

REV. NO. & DATE:

NOTE: CRITICAL TASK INSPECTION CERTIFICATION DONE IN ACCORDANCE WITH APPLICABLE

CUSTOMER MCM AND/OR SIAEP MOE, EPM PROCEDURES. (WRITE N/A IF NOT APPLICABLE)
DUPLICATE INSPECTION RII CRITICAL TASK SIGN OFF:
INDEPENDENT INSPECTION (SIGN / STAMP / DATE)

CERTIFIES THAT THE WORK SPECIFIED, EXCEPT AS OTHERWISE SPECIFIED, WAS CARRIED OUT IN CARD SIGN-OFF
ACCORDANCE WITH SAR-145 AND THE AIR NAVIGATION ORDER AND IN RESPECT TO THAT WORK THE
AIRCRAFT / AIRCRAFT COMPONENT IS CONSIDERED READY FOR RELEASE TO SERVICE. DATE COMPLETED

FULLY NO/PARTIALLY FOUND CFWD REFERENCE NO.

MODIFICATION INCORPORATED INCORPORATED INCORPORATED
STATUS:

REPORT FORM:
**1. has been accomplished on this aircraft.

**2. has been partially incorporated.

The outstanding work required is:

**Annotate items 1 or 2 above as appropriate.

LAE/LIC SIGN DATE

PPC-FRM-019C | ISS-REV: 01-00 | Print Date: 24 May 2024 Produced by Quantum Control