FORM FAA Approved Repair Station A1YY277N 005 · 2015. 2. 27. · Nayak Aircraft Services Italy Srl...
Transcript of FORM FAA Approved Repair Station A1YY277N 005 · 2015. 2. 27. · Nayak Aircraft Services Italy Srl...
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Nayak Aircraft Services Italy SrlAeroporto Roma Fiumicino-Building 33A-00054 Fiumicino (RM) ItalyFAA Approved Repair Station A1YY277N
FORM005
INFO LETTERNumber Subject
2015-011-A DIRTY DOZEN - PRESSURE
NASIT_FAA_FORM_005 REV 1 DATE 12-12-12 Page 1 of 3
QUALITY SAFETY SECURITY TRAINING RISK CLASS LRO MRO HRO
OR # N/A DATE 27 FEB 2015 FEEDBACK REQUIRED Y N
SUBJECT DIRTY DOZEN - PRESSURE
APPLICABILITY All Nayak Aircraft Services Italy SrL staff
SUMMARYPresent document have been created to increase awareness among Nayak personnel by sending every month an edition of theAviation Dirty Dozens. Differences in the standard dirty dozens and Nayak editions is constituted by the fact that Nayak DirtyDozen make use of the content of the incidents report over the last years.
INVESTIGATION REQUIRED Y N INVESTIGATION DUE DATE N/A
Hazard IdentificationN/A
Safety Action: Y N Department N/A Due Date : N/AAccepted Y N Name N/A Date : N/A
Corrective Action / Preventive Action Closing dateThe respective Department Manager must print and affix the pdf poster in the informationboard located on each working department (Line Station, Rest Rooms, etc…)
15-MAR-2015
All staff is requested to sign form in Appendix 1, 15-MAR-2015
Staff is requested to sign form in Appendix 2, 15-MAR-2015
Closed Y N by Date:Extended Y N by Date:
Accountable Manager Quality & Safety Manager H&S Workers’ Rep. (If Applicable)
N/A
Stamp + Signature Stamp + Signature Stamp + Signature
Received Y N by Date
Name Surname Signature + Stamp dd-mmm-yyyTHIS FIELD MUST BE SIGNED BY DEPARTMENT MANAGER OR RESPONSIBLE PERSON AS CONFIRMATION THAT INFO LETTER CONTENTS HAVE
TRANSFERRED TO ALL STAFFER. INDIVIDUAL R&S MUST BE CERTIFIED ON DEDICATED PAGE AT THE END OF THIS DOCUMENT
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Nayak Aircraft Services Italy SrlAeroporto Roma Fiumicino-Building 33A-00054 Fiumicino (RM) ItalyFAA Approved Repair Station A1YY277N
FORM005
INFO LETTERNumber Subject
2015-011-A DIRTY DOZEN - PRESSURE
NAYAK AIRCRAFT SERVICES ITALY S.r.l. socio unicoFAA Authorized Repair Station – Approval n° A1YY277NSede Legale | Head Office ITALY C.Fisc. & P.IVA | VAT : Filiale Estera | Foreign Branch FRANCE
Edificio 33A Lato Pista - Varco Doganale 1 IT-08313041009 Porte de l’Arenas, Hall C - 455, Promenade des AnglaisVia Francesco de Pinedo snc Tel. +39.06.65.29.066 06299 – NICE – Cedex 3 – FRANCE00054 – Fiumicino Aeroporto (Roma) - ITALY Tel. +39.06.69.30.56.95 SIREN: 792301004–SIRET: 792301000400026-APE: 5223ZCCIAA – ROMA REA n° 1088805 Fax. +39.06.60.51.36.11 TVA: FR-86792301004 - Fax: +33 (0) 4.89.88.65.48Cap. Soc. | Share Cap. € 281.792,22 E-Mail IT: [email protected] IBAN : FR 76 1910 6006 9743 6351 4965 693IBAN : IT 96 L 08327 03398 000000013200 E-Mail FR: [email protected] BIC : AGRIFRPP891BIC : ROMAITRR Web: www.nayak.aero Pag. 2 / 3
APPENDIX 1
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Nayak Aircraft Services Italy SrlAeroporto Roma Fiumicino-Building 33A-00054 Fiumicino (RM) ItalyFAA Approved Repair Station A1YY277N
FORM005
INFO LETTERNumber Subject
2015-011-A DIRTY DOZEN - PRESSURE
NAYAK AIRCRAFT SERVICES ITALY S.r.l. socio unicoFAA Authorized Repair Station – Approval n° A1YY277NSede Legale | Head Office ITALY C.Fisc. & P.IVA | VAT : Filiale Estera | Foreign Branch FRANCE
Edificio 33A Lato Pista - Varco Doganale 1 IT-08313041009 Porte de l’Arenas, Hall C - 455, Promenade des AnglaisVia Francesco de Pinedo snc Tel. +39.06.65.29.066 06299 – NICE – Cedex 3 – FRANCE00054 – Fiumicino Aeroporto (Roma) - ITALY Tel. +39.06.69.30.56.95 SIREN: 792301004–SIRET: 792301000400026-APE: 5223ZCCIAA – ROMA REA n° 1088805 Fax. +39.06.60.51.36.11 TVA: FR-86792301004 - Fax: +33 (0) 4.89.88.65.48Cap. Soc. | Share Cap. € 281.792,22 E-Mail IT: [email protected] IBAN : FR 76 1910 6006 9743 6351 4965 693IBAN : IT 96 L 08327 03398 000000013200 E-Mail FR: [email protected] BIC : AGRIFRPP891BIC : ROMAITRR Web: www.nayak.aero Pag. 3 / 3
APPENDIX 2DICHIARAZIONE DI AVVENUTA INFORMAZIONE E FORMAZIONE
TRAINING & INFORMATION STATEMENTai sensi degli articoli 36 e 37 del D.Lgs. 81-2008 e smi (Italia)
ai sensi dell’articolo L4121-1 del “Code du Travail” (Francia) e smiai sensi del “Arbeitsschutzgesetz” (Germania)
as per Italian Health & Safety Law DLGS 81/2008 art. 36 & 37 an following modificationsas per French Health & Safety Law Code du Travail article L4121-1 and following modifications
as per German Health & Safety Law “Arbeitsschutzgesetz” and following modification
Io sottoscrittoI undersigned __________________________________________________
Nato aBorn in _______________________________
In dataAt date ____\____\________
DICHIARO / STATES
di aver ricevuto debita formazione/informazione sui contenuti delle pubblicazioni sotto riportatenonché copia di esse :to have received information/training about the contents of the publications below reported andcopy of the same :
Info Letter 2015-011-A “DIRTY DOZEN - PRESSURE”
Dichiaro quindi di essere stato informato dal datore di lavoro sui contenuti della suddettacomunicazione informativa e di averne compreso i contenuti.
I declare, therefore, to have been informed by the employer on the contents of this communicationand information to understand the contents.
In good faith
/Date & Signature
After reading please sign the Appendix 2 and send a scan copy [email protected]; [email protected]; [email protected]