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

OPERATORS NAME: .............................................................

EFFECT ON FLIGHT

AIRCRAFT TYPE:

NONE

AIRCRAFT REG. NO. : .............................................................

ABORTED TAKE OFF

FLIGHT NO.: ........................

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

PRECAUTIONARY LANDING

DATE: ......................................................................................

ENGINES SHUT DOWN

LOCAL / UTC TIME OF BIRD HIT: ...........................................

DELAY (SPECIFY HOURS):....................................................

DESTINATION .....................

AERODROME NAME: ........................

WEATHER CONDITION: ...........................................................
RUNWAY USED: .........................
GROUND LOCATION: .............
HEIGHT AGL: ...........................ft

BIRD SPECIES: ....................................................................

NUMBER OF BIRDS SEEN / STRUCK:........................
SIZE OF BIRD
SMALL

MEDIUM

LARGE

PART (S) OF AIRCRAFT AFFECTED:

SPEED (IAS): ...........................kt

PHASE OF FLIGHT: ...................................................................

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

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

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

REMARKS : DESCRIBE DAMAGE, INJURIES AND OTHER PERTINENT INFORMATION:

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

REPORTED BY (OPERATORS NAME & SIGN): ............................TIME.................. DATED:...................

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

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

01/01/2012

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.

Page 1 of 1

APPENDIX C TO ANO-002-SBXX-1.0