BIRD/ANIMAL HIT REPORT

APPENDIX ‘C’ TO
INCIDENT REPORTING SYSTEM
CAAF-002-SBXX-1.1
BIRD / ANIMAL HIT REPORTING PROFORMA
TO,

SAFETY INVESTIGATION BOARD

PAKISTAN CIVIL AVIATION AUTHORITY
TERMINAL-1, JIAP, KARACHI
FAX: 0092 21 9924 2760 & 9924 2788
EMAIL: psib@caapakistan.com.pk
sib.info@caapakistan.com.pk

OPERATOR’S NAME: ............................................................. EFFECT ON FLIGHT

AIRCRAFT TYPE: ............................................................. NONE …
AIRCRAFT REG. NO. : ............................................................. ABORTED TAKE OFF …
FLIGHT NO.: ........................ DESTINATION ..................... PRECAUTIONARY LANDING …
DATE: ENGINES SHUT DOWN
…
......................................................................................
LOCAL / UTC TIME OF BIRD HIT: ........................................... DELAY (SPECIFY HOURS):....................................................
AERODROME NAME: ……...................…………………….....
BIRD SPECIES: ....................................................................
WEATHER CONDITION: ...........................................................
NUMBER OF BIRDS SEEN / STRUCK:........................
RUNWAY USED: …………….................……………………........
SIZE OF BIRD
GROUND LOCATION: …..…………………………………........... SMALL … MEDIUM … LARGE …
HEIGHT AGL: …………………………….....................……......ft
PART (S) OF AIRCRAFT AFFECTED:
SPEED (IAS): ………………………………......................….....kt
PHASE OF FLIGHT: ................................................................... ......................................................................................................
.................................................................................................... .................................................................................................
.

REMARKS : DESCRIBE DAMAGE, INJURIES AND OTHER PERTINENT INFORMATION:

....................................................................................................................................................................................................................
....................................................................................................................................................................................................................
....................................................................................................................................................................................................................

REPORTED BY (OPERATOR’S NAME & SIGN): ………………………………............................TIME.................. DATED:...................

VERIFIED BY DUTY AIRWORTHINESS SURVEYOR (NAME & SIGN): ……………................................................DATED: ................

VERIFIED BY DUTY AIRSIDE INSPECTOR (NAME & SIGN): …..……………….....................................................DATED:.............,,,,,.

• The Proforma is to be raised by Operator within maximum of 24 hours.

• The report is to be submitted to SIB by Operator within maximum of 48 hours.

01/01/2012 Page 1 of 1 APPENDIX ‘C’ TO ANO-002-SBXX-1.0