Title: 8110-26
Subject: page 6
Author: Allan C Hamann
Last saved by: AVR Enterprise
Company: American Eurocopter

U.S Department of
Transportation

Federal Aviation
Administration

	

	SUPPLEMENTAL TYPE INSPECTION REPORT (STIR)

TIA No. | Date
Product |
Make |
Model |
Identification and Serial No. |
Serial Nos. Eligible |
Product Specification or TC Data Sheet | Rev. No.
Certification Basis (Part and Amendments) |

Applicant

Address

Modifier   
          
Address

Description of Modification |
Attachments |
Inspection Conducted By |
Report Prepared By | Date
Report Reviewed By | Date
Report Approved By | Date
   FAA Form 8110-26 Computer Generated(10-83)                                                                                                      Page 1 

Supplemental Type 
Inspection Report                                                     General Instructions

This form provides a means whereby inspectors may record the results of inspections and/or tests, on modified products presented for supplemental type certificates, accomplished in accordance with instructions contained in the Type Inspection Authorization (TIA).

A.	Answer each question on this form by placing an "X" in the appropriate "YES" , "NO", or "NA" (Not  Applicable) block, or by filling in the answer, as appropriate.  When an answer requires an explanation, record the explanation under "REMARKS" or on page 4, (TIA comments).

B.	The applicant's weight and balance report may be used in lieu of the weight and dimensional page of this form, provided it contains all the information requested.  Weight and balance should be included in attachment section of report, when required.

C.	Original FAA Form 8130-9 (317) and FAA Form 8100-1 should be part of the attachments section of this report.

Table of Regulations  * | |
FAR | CAR | SUBJECT
| Balloon | Cert'n | N.U.A. | T-Cat | Glider | N-Rotor | T-Rotor | Eng. | Prop | --------
21.31 | | | 3.14  ^2 | 4b.14 ^2 | | 6.14 ^2 | 7.14 ^2 | | | Type Design
21.33 | | 1.15(a) | 3.15 | 4b.15 | 5.15 | 6.15 | 7.15 | 13.15 | 14.15 | Insp. & Tests
21.35 | | | 3.16(b) | 4b.16 | 5.16 | 6.16 | 7.16 | | | Flight Tests
.29 | | | 3.73 ^2 | 4b.104 | | 6.104 | 7.104 | | | Empty Wt. & C. G.
.31 | 31.51 | | 3.72 | 4b.105 | | 6.105 | 7.105 | | | Removable Ballast
.605 | 31.35 | | 3.293 | 4b.302 | | 6.302 | 7.302 | | | Fabrication Method
.871 | | | 3.401 | 4b.391 | | 6.390 | 7.390 | | | Leveling Means
.1301(a)(4) | | | 3.652 | | | | | | | Equip - Label
.1301(b) | | | | 4b.601(b) | | 6.601(b) | 7.601(b) | | | Equip - Label
.1301(c) | | | | 4b.601(c) | | 6.601(c) | 7.601(c) | | | Equip Install.
.1351(b)(1) | | | 3.681 | | | 6.617 | | | | Elec - Haz & Prot'n
.1351(b)(2) | 31.71(b) | | | 4b.622(b)(2) | | | 7.622(b)(2) | | | Elec - Haz/Mal. Fail
.1431 | | | 3.721 | | | | | | | Elec - Hazard
.1431(a) | | | | | | | 7.653(a) | | | Elec - Hazard
.1431(b) | | | | | | | 7.653(b) | | | Electronic Effect
.1431(c) | | | | 4b.650(c) | | | | | | Electronic Effect

*   All regulations are those in effect on or preceding date  of recondification.

^1   For airworthiness standards, except balloons, a missing FAR denotes a generic requirement, Eg. FAR 23, 25, 27, 29.

^2   In part, see CFR Redesignation Tables.

FAA Form 8110-26 (10-83)                                                                                                                                               Page2

Supplemental Type
Inspection Report                                   Administrative Data

A.  Period of Inspection  from   ____________   to _______________ | |
B.  Where conducted? | |
C.  Number of conformity inspections conducted and recorded on FAA Form 8100-1 and recorded in project file. | |
D.  Were design changes needed to correct deficiencies revealed by FAA Inspection?  If yes, identify changes on page 4 (TIA comments), or on attachment. | ☐ Yes | ☐  No
E.  Have all products/articles subjected  to inspections and/or tests been properly recorded by part number(s), serial number(s), or registration number(s), as appropriate, on page 1, or in attachment? | ☐ Yes | ☐   No
F.  Does the applicant have on file inspection records showing conformity to the type design and acceptable quality of the product? | ☐ Yes | ☐   No

G.  Check appropriate blocks for any FAA forms that have been submitted by the applicant prior to, or at the time of application.

	☐    FAA Form 8110-12    Date  ____________              ☐   FAA Form 8130-6             Date  ____________
	
	☐    FAA Form 337           Date  ____________              ☐   FAA Form 8130-9 (317)   Date   __________

H.  Is supplemental type approval recommended? | ☐   Yes | ☐   No

Remarks

If  "Yes", items should be explained under appropriate TIA comments.

  FAA Form 8110-26 Computer Generated (10-83)                                                                                                           Page 3

Supplemental Type
Inspection Report                                 TIA Comments

The following comments are made with respect to special inspections and/or tests conducted by reason of instructions contained in Section 18 of the TIA, and are identified in accordance with TIA numbering.  Additional pages may be used as needed.

Item 18 - Part I:

1.0  Empty Weight and Corresponding Center of Gravity | | |

1.1  Describe Leveling Marks or Means   

Ref:  § .871

1.2  Location of Datum | | |

1.3  Horizontal Distance (Inches) From Datum to Average Front Main Scale CL _________________________.
       Horizontal Distance (Inches) From Datum  to Average Rear Main Scale CL _________________________.
       Horizontal Distance (Inches) From Datum to Auxiliary Scale CL __________________________________.

1.4  Empty Weight | | |
| Scale Reading | Tare | Net Weight
Forward Left Main Scale | | |
Forward Right Main Scale | | |
Rear Left Main Scale | | |
Rear Right Main Scale | | |
Auxiliary Scale | | |
Empty Weight | | |

NOTE:	The empty weight and corresponding center of gravity must be determined by weighing the aircraft with --
	(1) 	Fixed Ballast
	(2)	Unusable Fuel
	(3)	Full operating fluids, including (i) oil  (ii) hydraulic fluid and  (iii) other fluids required for normal operation of aircraft systems, except potable water, lavatory precharge water, and water intended for injection in the engines.

Center of Gravity  is  _______________________ inches            ☐  Forward        ☐  Aft of Datum
                                                                                                                                                                                                               Ref: § .29

 FAA Form 8110-26 Computer Generated(10-83)                                                                                                                          Page 4

Supplemental Type
Inspection Report                                                2.0  Removable Ballast

2.1	If removable ballast is used to show compliance with the flight requirements, is the place for carrying ballast installed and marked in accordance with the change to the type design?

								                  Ref. § .31

Yes

No

N/A

3.0 Fabrication Process | | |
3.1	a.	Has the applicant shown that materials, products, parts, processes, construction, and assemblies conform to the specifications and drawings shown in the change to the type design? | | |
b.	Has the product been changed between the time it was shown to comply with item 3.1.a. of this report and the time it was presented for FAA Inspection?  Record any changes on FAA Form 8100-1. | | |

c.	Has the applicant made all inspections and tests necessary to determine --
		(1)	Compliance with the applicable airworthiness and noise/emission requirements;
		(2)	That the materials and products conform to the specifications in the changed type design;
		(3)	That the parts of the product conform to the drawings in the    changed type design;
		(4)	That the manufacturing processes, construction, and assembly conform to those specified in the type design?
								
                                                                                                                                           Ref. § 21..33

3.2	Has the suitability and durability of materials used for parts, the failure of which could adversely affect safety:

	a.	Been established by experience or tests?
	b.	Been established through approved specifications that ensure their having the strength and other properties assumed in the design data? and
	c.	Been evaluated to take into account the affects of environmental conditions, such as temperature and humidity, expected in service?
								
                                                                                                                                           Ref. § .603(a)

3.3	Have high standards of workmanship been used in the fabrication of parts?

								            Ref. § .603(b)

4.0 Fuselage and Wing | | |

4.1	Are changes to the fuselage or wing in conformity to the change in type design?

								              Ref. § 21.31

5.0 Control System | | |
5.1	Are changes to the control system in conformity to the change in type design? | | |

5.2	Do the control surface travels conform to the change in type design?

								          Ref. § 21.31(a)

6.0 Personnel and Cargo Accommodations | | |

6.1	Are changes to the personnel and cargo compartments in conformity with the change to the type design?
								          Ref. § 21.31(a)

7.0 Powerplant Installation | | |

7.1	Does the powerplant installation conform to the change to the type design?
								
                                                                                                                                        Ref. § 21.31(a)

8.0 Equipment | | |

8.1        Are changes to the installed equipment in conformity to the change in type design?

                                                                                                                                        Ref. § 21.31(a)

  FAA Form 8110-26 Computer Generated(10-83)                                                                                                                               Page 5

Supplemental Type
Inspection Report                                       8.0 Equipment (continued)

8.2	Is each item of equipment installed in accordance with the change in type design --

	a.	Labeled as to the identification, or operation limitations, or any applicable combination of these factors; and

	b.	Installed according to limitations specified for that equipment?

							            Ref. § .1301 (b) and (c)

Yes

No

NA

8.3	Are the electrical, radio, and electronic systems included in or affected by the change in the type design free from hazards in themselves, in their method of operation, and in their effects on other components?

						     Ref. § .1351(b)(1)(i), .1431 or .1431(a)

8.4	Are electrical cables and wire bundles included in or affected by the change in type design protected from fuel, oil, water, and other detrimental substances, and from mechanical damage?

							                Ref. § .1351(b)(1)(ii)

8.5	Are the changes to the radio and electronic equipment, controls, and wiring installed so that operation of any one unit or system of units will not adversely affect the simultaneous operation of any other radio or electronic unit or system of units required by the airworthiness or operation rules?

							                Ref. § 1431(b) or (c)

9.0 Function and Reliability Testing | | |

9.1	Did the change in type design necessitate F & R tests?

							                             Ref. § 21.35

9.2	Did the altered systems and installations function satisfactorily during the F & R tests?

							                             Ref. § 21.35

  FAA Form 8110-26 Computer Generated(10-83)                                                                                                                                Page 6