Aviation

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OWNER/OPERATOR INFORMATION Registered Aircraft Owner Name: __________________________________________________________________ Fractional Ownership Aircraft: Yes No Operator of Aircraft Same As Registered Owner Owner Address City: ____________________________________ State: ___________ ZIP: ____________ Country: _________________________________ Operator Address Same As Registered Owner Name: __________________________________________________________________ Doing Business As: _______________________________________________________ Air Carrier/Operator Designator (4 Character Code): _______________ Regulation Flight Conducted Under FAR 91 FAR 129 FAR 91 Special Flight Public Use (select type) FAR 103 FAR 133 Non-US, Commercial Federal State Local FAR 121 FAR 135 Non-US, Non-commercial Unknown FAR 125 FAR 137 Armed Forces Purpose of Flight for FAR 91, 103, 133, 137 Personal Business Executive/Corporate Other Work Use Instructional Ferry Positioning Aerial Application Aerial Observation Air Drop Air Race / Show Flight Test Public Use Unknown (Select one) Revenue Operation for FAR 121, 125, 129, 135 Scheduled or Commuter Non-Scheduled or Air Taxi Domestic or International Domestic International (Select one) Cargo Operation Passenger/Cargo Passenger ____________How many? Cargo ______________ lbs Mail City: ____________________________________ State: ___________ ZIP: ____________ Country: _________________________________ Revenue Sightseeing Flight Yes No Air Medical Flight Yes No Type of Commercial Operating Certificate Held (Check all that apply) None Flag Carrier Operating Certificate (121) Supplemental Air Cargo Foreign Air Carriers (129) Commuter Air Carrier (135) On-Demand Air Taxi (135) Large Helicopter (127) Rotorcraft External Load (133) - or - Agricultural Aircraft (137) Other Operator of Large Aircraft OTHER AIRCRAFT – COLLISION (If air or ground collision occurred, complete this section for other aircraft) Aircraft Registration Number _________________________ Manufacturer: ___________________________________________________ Model: __________________________________________________________ Damage to Other Aircraft Destroyed Minor Substantial None Registered Owner of Other Aircraft First Name: ___________________________________________________ City: _________________________________________________ Middle Initial: _________ State: ___________ ZIP: ____________ Last Name: ___________________________________________________ Country: ______________________________________________ Pilot of Other Aircraft First Name: ___________________________________________________ City: _________________________________________________ Middle Initial: _________ State: ___________ ZIP: ____________ Last Name: ___________________________________________________ Country: ______________________________________________ MECHANICAL MALFUNCTION/FAILURE (If more space is needed, continue on separate sheet) Was there Mechanical Malfunction/Failure? Yes No Unknown (If yes, list the name of the part, manufacturer, part no., serial no., and describe the failure.) Total Time/Cycles On Part ______________ Hours ______________ Cycles Time Since This Part Inspected/Overhauled ______________ Hours DAMAGE TO AIRCRAFT AND OTHER PROPERTY Aircraft Damage Aircraft Fire None Substantial None Both Ground and In-Flight Minor Destroyed In-Flight Unknown Origin On-Ground 4 Aircraft Explosion None In-Flight On-Ground Both Ground and In-Flight Unknown Origin
Description of Damage to Aircraft and Other Property (use additional sheet if necessary) AIRPORT INFORMATION (If the accident/incident occurred on approach, takeoff or within 3 miles of an airport, complete this section) Airport Identifier: ________________________________________ Airport Name: __________________________________________________ Distance From Airport Center: __________________SM Direction From Airport: ________________ degrees MAG Proximity to Airport Off Airport/Airstrip On Airport On Airstrip Airport Elevation: __________________________ ft. MSL Approach Segment (Select one) On Instrument Approach Landing Base leg Final Go Around Crosswind Downwind Low Approach Aborted Landing (after touchdown) IFR Approach (Check all that apply) VFR Approach (Check all that apply) None PAR MLS Practice None Stop and Go ADF/NDB Sidestep LDA GPS Traffic Pattern Touch and Go SDF ILS ASR Loran Straight-In Simulated Forced Landing VOR/TVOR Localizer Only Visual Unknown Valley/Terrain Following Forced Landing VOR/DME LOC-back course Contact Go Around Precautionary Landing TACAN RNAV Circling Full Stop Unknown Runway Information Condition of Runway/Landing Surface (Check all that apply) Runway ID: ____________(L/R/C) Length: ____________ft Width: ____________ft Dry Snow-Compacted Water-Calm Holes Snow-Crusted Water-Choppy Ice Covered Snow-Dry Water-Glassy Rough Snow-Wet Wet Runway/Landing Surface (Check all that apply) Asphalt Grass/Turf Macadam Water Concrete Gravel Metal/Wood Unknown Dirt Ice Snow FLIGHT ITINERARY INFORMATION Last Departure Point Time of Departure Airport ID: _______________ City: ________________________________ Time: _____________ State: ____________________ Time Zone:_________ Country: _____________________________ Rubber Deposits Soft Unknown Slush Covered Vegetation Destination Airport ID: ___________________ City: _________________________________ State: ________________________ Country: ______________________________ Type Flight Plan Filed None VFR/IFR Company VFR IFR Military VFR Unknown VFR Activated? Yes No Type of ATC Clearance/Service (Check all that apply) None Special VFR Special IFR VFR Flight Following Cruise VFR IFR VFR On Top Traffic Advisory Unknown / NA Airspace where the accident/incident occurred (Check all that apply) Class A Class E Prohibited Area Jet Training Area Special Class B Class G Restricted Area TRSA Air Traffic Control Area Class C Demo Area Military Operations Area (MOA) FAR 93 Unknown Class D Warning Area Airport Advisory Area Aircraft Load Description (Check all that apply) None Towing Glider Parachutists Livestock Passengers Towing Banner Water Unknown Cargo Other External Chemical/Fertilizer/Seeds FUEL & SERVICES INFORMATION Fuel on Board at Last Takeoff (convert from pounds, as necessary) ____________________________ Gallons Other Services, if Any, Prior to Departure Fuel Type 80/87 115/145 JP3 Other, specify _________________________ 100 Low Lead Jet A JP4 100/130 Automotive JP5 5
Page 1 and 2: Aviation Emergency Response Handboo
Page 3 and 4: Table of Contents Initial Response
Page 5 and 6: In general, the following priority
Page 7 and 8: Preserve Aircraft Wreckage • The
Page 9 and 10: • Law Enforcement. Be mindful tha
Page 11 and 12: SUPPLEMENTAL CHECKLIST FOR ACCIDENT
Page 13 and 14: Provide Representation to Interview
Page 15 and 16: o Consider security measures at hot
Page 17 and 18: answered by the airline, and which
Page 19 and 20: coordinated, consistent and orderly
Page 21 and 22: The accident: When the airline wa
Page 23 and 24: After the On-Scene Investigation Wh
Page 25 and 26: NTSB DOCUMENT COLLECTION/PRODUCTION
Page 27 and 28: 6. A list of all maintenance and no
Page 29 and 30: FORM APPROVED FOR USE THROUGH 09/30
Page 31: NATIONAL TRANSPORTATION SAFETY BOAR
Page 35 and 36: PILOT “A” INFORMATION Pilot “
Page 37 and 38: ADDITIONAL FLIGHT CREW MEMBERS (Exc
Page 39 and 40: ADDITIONAL INFORMATION (Please type
Page 41 and 42: Government, or an aircraft owned an
Page 43 and 44: (i) Lands or departs on a taxiway,
Page 45 and 46: OVERVIEW OF THE AVIATION DISASTER F
Page 47 and 48: FEDERAL FAMILY ASSISTANCE PLAN FOR
Page 49 and 50: APPENDIX D-Joint Family Support Ope
Page 51 and 52: Operations Center (JFSOC) to partic
Page 53 and 54: GENERAL MISSION TASKS The family as
Page 55 and 56: VICTIM SUPPORT TASK 1-National Tran
Page 57 and 58: 15. If the accident is determined t
Page 59 and 60: 15. Provide logistical support to f
Page 61 and 62: VICTIM SUPPORT TASK 3-American Red
Page 63 and 64: 8. Using a specially trained FAC te
Page 65 and 66: VICTIM SUPPORT TASK 7-Department of
Page 67 and 68: COORDINATING INSTRUCTIONS 1. The po
Page 69 and 70: APPENDIX A Aviation Disaster Family
Page 71 and 72: “(2) are individually informed of
Page 73 and 74: passenger, any possession of the pa
Page 75 and 76: (A); (C) an analysis of any inconve
Page 77 and 78: (regardless of its condition) of th
Page 79 and 80: day.” (2) Enforcement.--Section 1
Page 81 and 82: (a) Inclusion of Nonrevenue Passeng
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“(18) An assurance that, in the c
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Schematic of a Family Assistance Ce
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6. Maintain locations and telephone
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developments. If foreign consulate
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APPENDIX E Sample Format for an Aft
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APPENDIX G Victim Support Tasks-Che
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Victim Support Tasks Air Carrier Ta
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Victim Support Tasks Air Carrier Ta
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Victim Support Tasks - Victim Ident
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Victim Support Tasks - Assisting Fa
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Victim Support Tasks - Assisting Vi
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Air Carriers Who constitutes a fami
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Due to the physical dangers and psy
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The American Red Cross can also ass
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Who is considered a family member f
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For more information, a brochure, t
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coordinated with the NTSB Major Inv
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What is the FBI ERT? The FBI Eviden
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APPENDIX J References 1. Presidenti
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VST Victim Support Task - 75 - Fede
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• Some plans offer education and
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COPING STRATEGIES SELF-ASSESSMENT D
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• Provide name and number of dire
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• As soon as personal effects are
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(5) To arrange a suitable memorial
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(2) Board assistance. - If this sec
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(7) An assurance that any unclaimed
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Subsec. (c). Pub. L. 106-181, Sec.
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TITLE 49 - TRANSPORTATION SUBTITLE
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(13) Resources for plan. - An assur
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I. GENERAL CONSIDERATIONS YOUR PART
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Attachment CONFIDENTIAL COMMUNICATI
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OVERVIEW OF NTSB ACCIDENT INVESTIGA
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Accident within the United States S
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• Immunizations for rescue worker
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NTSB STATUTORY AUTHORITY AND RELATE
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(A) any report of a confirmed posit
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paragraph (1) may have been caused
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(c) Avoiding Unnecessary Interferen
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(d) Pa se nge r Lists.— (1) Re qu
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(b ) CivilActionsb y Attorne y Ge n
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ecorder recording is not available.
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TITLE 49--TRANSPORTATION CHAPTER VI
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Sec. 831.5 Priority of Board invest
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epresentative of the Board and pres
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Sec. 831.12 Access to and release o
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TITLE 49 -- TRANSPORTATION SUBTITLE
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HISTORY: [49 FR 32853, Aug. 17, 198
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49 CFR 845.22 § 845.22 Te ch nical
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HISTORY: 44 FR 34419, June 14, 1979
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(b ) W h e n a p e tition for re co
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SECTIONS OF OSHA REGULATIONS RELEVA
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PRINCIPLES OF L*DERSTANDING BETWEEN
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other on an on-going basis, especia
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September 30, 1999 Mr. Dan Campbell
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49 USC Section 1155 Aviation Penalt
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ATTORNEY-CLIENT AND WORK PRODUCT PR
Page 197 and 198:
SAMPLE INTERNAL MEMO RE: WORK PRODU
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e. Documents that might otherwise b
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DISCOVERY OF ELECTRONICALLY STORED
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___ hard copies of documents ___ el
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FEDERAL RULE OF EVIDENCE 407 Rule 4
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I. Airline Accidents Result in Crim
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Since 1909, courts have held corpor
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ADVICE TO EMPLOYEES ON GOVERNMENT I
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The Entry: The Witnesses: The Searc
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f. The identity of the place to be
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TITLE 18 - CRIMES AND CRIMINAL PROC
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shall be fined under this title or
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concluding provisions. Subsec. (d).
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FEDERAL GUIDELINES FOR TREATMENT OF
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FAA CERTIFICATE ACTIONS AGAINST AN
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must contain the name and address o
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The Ninth Circuit first addressed t
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NATIONAL TRANSPORTATION SAFETY BOAR
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FOREWORD NOTE: This manual is a Nat
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3.6 Group Chairmen Responsibilities
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A. IIC Checklist B. Cockpit Voice R
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1. Pre-Investigation Preparation 1.
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(3) notify GA, PA, and TDA; (4) not
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accidents of this type, location of
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If an FAA airplane is available, th
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The backup IIC or another AS-10 sta
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confirm that the rental costs are i
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• Introduce the participants of t
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As the investigative groups are for
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All Safety Board personnel travelin
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that each member of the group has r
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the group chairmen on the implicati
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answer questions following the brie
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investigation and any particular pr
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eports. Other tasks to be performed
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Each group chairman will submit a P
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they exist. It is NTSB policy to re
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The IIC/hearing officer is responsi
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exhibit are made and prepared for d
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Typically, the prehearing conferenc
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likely to have need for issuing a s
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4.10 Party Submissions Although the
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Directors’ draft. At each level o
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Even if the issue under discussion
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4.15 Petition for Reconsideration A
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When working on an overseas investi
Page 289 and 290:
states that the Safety Board would
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iefings will occur daily and will l
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TABLE OF CONTENTS FOREWORD ........
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FOREWORD Historical background Stan
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Contracting States are invited to k
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Table A. Amendments to Annex 13 Ame
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INTERNATIONAL STANDARDS AND RECOMME
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asis, the States constituting the a
Page 305 and 306:
CHAPTER 3. GENERAL Note.— Guidanc
Page 307 and 308:
CHAPTER 4. NOTIFICATION Note 1.—
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4.5 Recommendation.— The State of
Page 311 and 312:
CHAPTER 5. INVESTIGATION RESPONSIBI
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Flight recorders — Accidents and
Page 315 and 316:
5.16 When an aircraft involved in a
Page 317 and 318:
g) participate in off-scene investi
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6.3.2 Recommendation.— The State
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CHAPTER 7. ADREP REPORTING Note 1.
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CHAPTER 8. ACCIDENT PREVENTION MEAS
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APPENDIX. FORMAT OF THE FINAL REPOR
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1.11 Flight recorders. Location of
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ATTACHMENT B. NOTIFICATION AND REPO
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ATTACHMENT C. LIST OF EXAMPLES OF S
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The flight data recorder and the co
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(4) supervise the expenditures of t
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consistency because the authority t
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NOTES: Code of Federal Regulations:
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(C) If a Federal law enforcement ag
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In this section, the word "conditio
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National Transportation Safety Boar
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Alcohol Testing: § 120.215 Covered
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□ □ □ 1.07.09 Do you make the
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7 FAM Exhibit 1830(A): Checklist of
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(1) The identifying abbreviation "A
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7 FAM 1831 INTRODUCTION (CT:CON-212
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(1) Twelve Mile Limit: On December
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. Other Legislation Relating to Tra
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(c) (d) Command center at home offi
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(2) Sensitivity Training from the F
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sources that are free to report uns
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• New Zealand - Transportation Ac
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(b) (c) Post convenes post's Emerge
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(1) Check local hospitals, morgues
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Note : Forcountrie sth at are p art
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the effects to a third party, such
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(2) The Department is recognized as
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(e) The Parties will exercise dilig
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Federal Register of August 2, 1995,
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Aviation

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