TECHNICAL SERVICES REQUEST FORM

PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 1 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

ORIGINATOR: Accountable
Name: STEPHEN MESMIN Manager’s
Title: L.A.M.E Signature:
[email protected]
Email/Phone: Date:
PRIORITY: AOG URGENT ROUTINE OTHER
(Please tick) ✔
(1-3 Days) (3-10 Days) (30 Days) (Please enter a required response date)

REQUEST TYPE:
(Please tick) Part Number Alternate Part Temporary Repair Engineering Order

Request for Data MEL Change Reliability Drawings / RD’s ✔ Maint Specification

Recurring Defects Open Defect Fleet Inspections Tooling / Equipment Audit Findings

Other (Please specify) NOTES:

DHC8 AMM & ATR JIC - do they support the use of Anti-Static Wipes? 1. Recurring defects are one’s that occur 3 or more times in a 4 week period.
2. All Defect reference numbers must be included in this form, e.g. DHS (103, 105s, etc.)
3. Include item part / serial, part description of defective / subject parts.

REGO: PART NUMBER SERIAL NUMBER DESCRIPTION ATA

P2 - ATR MIL-S-53021A N/A BIOBOR JF 28

REFERENCE DATA:
(In order to ensure prompt action by Technical Services, ALL references used by maintenance/originator have to be filled in.)

AMM Reference MEL Reference

IPC Reference Aircraft Location (STN no.)

CMM Reference EO Number

SRM Reference RD Number

Defect Log Ref’s SB Number

Audit / Safety
Other references SL ATR72-28-6000
Occurrence Report No.
Examples: AMM 28-11-02 Pg. 4, IPC 25-31-02 Fig 1 Item 20, EO CG-DH6-35-001, Wing STN 74.4, etc.
NOTE: If possible a digital photo should be taken using the digital camera and attach any other relevant / substantiating data to this form.

REASON FOR TECHNICAL SERVICES REQUEST:

(Originator to enter reason for Technical Services Request - to be approved by Originator's Accountable Manager and then submitted to Tech Servics Mailbox)

1.1. Increased downtime required for to carry out Biobor or microbiological treatment of fuel tanks. Minimum of 48 hours on ground.

Request;

1) Defer task to be carried out at A-check or higher check designated with more time, or else extending Weekly Check by at least 48
hours if task is included on Weekly Check, and
2) Seek information on allowance to carry out Biobor application as per Biobor manual ( as we are doing with our Dash 8's), or
3) Or seek info from manufacture on alternative methods of microbiological prevention method.

PNGA 1001 March 2020 Revision-03

 TECHNICAL SERVICES REQUEST FORM
PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 2 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

MAINTENANCE ACTION(S) TAKEN:

(Originator / Tech Services to list any Maintenance Actions - If Applicable - Leave this section empty if none)

2.1.

PNGA 1001 March 2020 Revision-03

 TECHNICAL SERVICES REQUEST FORM
PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 3 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

TECHNICAL SERVICES RECOMMENDATION(S):

(Tech Services Engineer to complete this Section)

PNGA 1001 March 2020 Revision-03

 TECHNICAL SERVICES REQUEST FORM
PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 4 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

TECHNICAL SERVICES RECOMMENDATION(S): (Cont’d)

(Tech Services Engineer to complete this Section)

PNGA 1001 March 2020 Revision-03

 TECHNICAL SERVICES REQUEST FORM
PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 5 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

FOLLOW UP ACTION(S):
(Tech Services Engineer to complete this Section)

PNGA 1001 March 2020 Revision-03

 TECHNICAL SERVICES REQUEST FORM
PNGA 1001
Revision-03
Part-119 | Vol- 22 | Continuing Airworthiness Management Manual (CAMM) | Chapter: 10.1.7.
Part-119 | Vol- 26 | Technical Service Manuals (TSM) |Chapter: 12.1. Page 6 of 6

TSR No:
(For TSE use only) Date:

SUBJECT:

FOLLOW UP ACTION(S): (Cont’d)

(Tech Services Engineer to complete this Section)

SPECIALIST Jaco De Klerk DATE:

(TECHNICAL SERVICES) (TSE-AVIONICS) (ACTIONED)
(Signature)

MANAGER DATE:
(TECHNICAL SERVICES) (CLOSED)
(Signature)

PNGA 1001 March 2020 Revision-03