n H H to 17 7J 0 H rn rn 0 C rn 3D ,0 7S G.) 7S I-1 co .s.° 2 1-s 6) LIr 0 CD_ F-1 IpJ UNITED STATES of AMERICA DEPARTMENT OF TRANSPORTATION-FEDERAL AVIATION ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE 1 NATIONALITY AND REGISTRATION MARKS N212JE 2 MANUFACTURER AND MODEL Culfstream Aerospace Corporation 6V-SP (C550) 3 AIRCRAFT SERIAL NUMBER 5(73 4 CATEGORY 5 AUTHORITY AND BASIS FOR ISSUANCE This airworthiness certificate is issued pursuant to 49 U S C § 44704 and certifies that, as of the date of issuance, the aircraft to which issued has been inspected and found to conform to the type certificate therefor, to be in condition for safe operation, and has been shown to meet the reouirements of the applicable comprehensive and detailed airworthiness code as provided by Annex 8 to the Convention on International Gve Aviation, except as noted herein Exception" Trans p ort Exemption No. 7946 I FAR 25.813 (c) I. Mid-Cabin Doors Between Passenger Compartments. Exemption No. 8004, 8142 I FAR 25.901 (c) j, Uncontrollable High Thrust Failure Conditions. Exemption No. 10044 I FAR 25.1447 (c) (I) 1, Passenger Oxygen Equipment Deployed at 15,000 feet. 6 TERMS AND CONDITIONS Unless sooner surrendered, suspended. revoked. or a termination date is otherwise estaolished by the FAA, this airworthiness certificate s effective as tong as the maintenance. preventative maintenance, and alterafions are performed in accordance with Parts 21, 43, and 91 of the Federal Aviation Regutations. as appropriate. and the aircraft is registered m the Unled States DATE OF ISSUANCE R 07 MAR 2008 FAA REPRESENTATIVE Brent Archibald DESIGNATION NUMBER ODA-511131-CE Any ale:abort reproduction, or misuse of this certificate may be punishable by a fine not exceeding $1.000 or imprisonment not exceeding 3 years or both. THIS CERTIFICATE MUST BE DISPLAYED IN THE AIRCRAFT IN ACCORDANCE WITH APPLICABLE FEDERAL AVIATION REGULATIONS. FAA Form 8100.2 (04.11) Supersedes Previous Edition ISOZ/LZ/xdS SV Pind000S EFTA01329067
SDNY_GM_02757283 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244205 EFTA01329068
UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION-FEDERAL AVIATION ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE i NArawrymm /534TMONYATIAB N550GP > tosteFauFFRA•40 VOLN . - 11 GULFSTREAM AEROSPACE GV-SP ' (6550) .. . . YBPATI51-4.1/4 roily . 5173 4 BATBOY', Transport 5 AUROMITYMO GAY FOR .300AABC. . • ma ancontiess t °dhow a s'und ons.art q.9 usc g Loos ar., cedar, un, 'memo6ot oe issoinca.vmo amen MS WY YeerTe24442 Ton, RY 10010,0 IA Ye bedneel• ere be a ecoleol Tor Oil. CfneCt The Yea. ..e Os owybernelte ol Me applouls mt... itorrt.% tlaneards 4.1 Line. 8 iota c.r....aarn on Intones...CO &Tay oaf* OA Oka - NONE i CO • b \ ,-, • A YEANIMOCONINTIONi Li. . saws:Mel susFebaNircreote4. ix a utrinnewn din a edureee esmieNNIIIN IPA FAANM ornOtlheeSS maga% A ore v. as lora Ay ea:Nonsrce. PreStith, mantinros. ens gleenblepureyelbenid par no aponana• FOOTS YMCA ICY ird Ito astrat a reabind ate WOO Yalee. , Y. OAT, or IMAVAIOI il- °ThANt2ce3 VIATOM • _ e, 3 , Or UGT.Albro 'RAY° WP-21 RAI FSDO RICARDO HERNANDEZ JR Dretty merest by RICARDO TIBINANICF2 IX Dec 202101 It I 1613 a , 7 F -i 7 177 r Ill - r My ateNion. matubt ot IOPPLC.001 of NA Nos fic Fr* foistmabipipbcpcsei4y be A-41Sb. by °NINNY revalaNWATY. rd .or mobererer, OTIS CERTIFICATE MAT BE MONO° IN THE AIRCRAFT PER pc *Pascua FEDERAL AVIATION REGUIATONS. FM Fern10S 2 (9 22I 9) NAN cos ENNA Nay lbe UAW OVA DKIMIO SON Y_GM_02757284 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 noshz/xdv so readspav EFTA 00244206 EFTA01329069
SDNY_GM_02757285 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244207 EFTA01329070
SZOZ/LZ/xdV so Pelde**If SDNY_GM_02757286 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244208 EFTA01329071
SDNY_GM_02757287 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244209 EFTA01329072
0 U.S. Doptimant el TiGriportston Federal Arleta:in arithastratiou ASSIGNMENT OF SPECIAL REGISTRATION NUMBERS Special Registration Number N550GP Aircraft Make and Model GULFSTREAM AEROSPACE GV-SP (G350) Present Registration Number N2I2JE Serial Number 5173 Issue Date: Feb 24, 2021 ICAO AIRCRAFT ADDRESS CODE FOR NSSOGP - 516C0017 N550GP LLC 2131 E CONVENTION CENTER WAY STE 222 ONTARIO CA 91764-5496 ILl IlliiiiilliiiIiilililiiliillildilliililiilil Ill This is you au homy to change the United States registration ameba on the above describe! aircraft to the special registration number shoat Carry duplicate of this form aircraft together with the old registration certificate as wain authority to opus the aircraft pending receipt of revised certificate of aircraft registraticrs The taint FAA Perm $1 30.6, Appliestion For Airworthiness oat tile is dated: Mar 07.7005 The atrworth inns dossilkatket and category: SID TRANSP INSTRUCTIONS: SIGN AND RETURN THE ORIGINAL of ibis form to the Civil Aviation Registry, Aircraft Registration Branch, within S days after the special registration amber is placed on the aircrafL A revised certificate of aircraft registration will then be Swat Obtain a revised certificate of airworthiness from your newest Flied Standards District Office. The authority to use the special amber expira: Feb 24, 2022 CERTIFICATION: trendy ire the aircraft described above. Signature of Owner. ....----7 that the special registration number wan placed RETURN FORM TO: Civil Aviation Registry Aircraft Registration Branch P.O. Box 25504 Oklahoma City, Oklahoma 73125-0504 _ _,---C< ? Tide of Owner Cp/s/- n e.;4216(47 VCI(4' Date Placed on Averaft: 3 - I 9 -*Val AC FORM 505044 (5/2005) faipsooln rftlietti ESSu SDNY_GM_02757288 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 Y • a. 67 to SZOZ/LZ/xdV EFTA 00244210 EFTA01329073
SDNY_GM_02757289 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024421 I EFTA01329074
9 I un co rn n H H O 10 70 O H m H m n CD m 73 70 Gl 70 1D 00 Sri 1 co I-s REGISTRATION NOT TRANSFE UNITED STATES OF NOWA DEPARTMENT Of TRANWORTATICN - FEDERAL AVIATION ADMNISTRATION CERTIFICATE OF AIRCRAFT REGISTRATION lliSsONECIN• Must Co in eta M. emit Mum OPIDNOP7 NATIONALITY AND REGISTRATION MARKS N 2121E AIRCRAFT SERIAL NO $173 MANUFACTURER AND MANUFACTURERS DESIGNATION OF AIRCRAFT GULFSTREAM AEROSPACE GY-SP fG5SO) ICAO Akan AbatesCa $0340675 i S S U E 0 T 0 NS$OGP Lit 2151 E CONVENTION CENTER WAY STE 222 ONTARIO CA 91764-5496 LLC The tatilltsfa et Mu*, ler Mitigation Nooses only MCI es rOt 4 Otnifate of ii• Pm, Pcsle•M Axiom AdinerflialiOn 600$ na Osonnine emnh of or"Inlyp as belvregn meals li is anemia thin ow Ann dosCrad Emelt nn ben enterer on IN maim Ot Pm FoSival Aviation Aanwistrabon, Undaci SUSS Cd ArMeiCs. Caw AcCatlinco with itCOnventen On IMOrnatemi CM *widen DARN 0•Cernbef 7, 1844. end wain Tree 49, UMW SUMS CON, NJ nSPAsUonS awn Peteumer U.S. Department of Trannotiabem Federal *Nab= Administmom we OF RSA February 24, 2021 EAPPIATION DATE February 29, 2024 I /: / ,./....... AOINNISTRA TOR p.n. MIN 01:01% Semis. r.esnets U.S. Departrnenl Of Transporlabon Federal Aviation Administration Miltxo Replay PU. EN 21504 Omorassess OF 7317S00 Official Ilinin•O• Peak, roe Ilifiviele Use WM AC rem seasaitanstiplm TO: NSSOCP Ix( 2151 E CONY! STE 222 ONTARIO CA 9 TZ0Z/LVidEf SG PoldaDDV EFTA01329075
SDNY_GM_02757291 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244213 EFTA01329076
ft, U.S. Opt want el Tgenportston Federal Aviatkm Atirainistranon ASSIGNMENT OF SPECIAL REGISTRATION NUMBERS Special Registration Number N550OP Aircraft Make and Model GULFSTREAM AEROSPACE GV-SP (G350) Patient Registration Number N212JE Serial Nienbee 5173 Issue Date: Feb24, 2021 ICAO AIRCRAFT ADDRESS CODE FOR N550GP - 51600017 N550GP LLC 2131 E CONVENTION CENTER WAY STE 222 ONTARIO CA 91764-5496 ILL Illinlilluiliiiililsiliilisliiilliilihilil Ill This rs you Authority to change the United States (saner:Sion number on the above describe] aircraft to the special registration number sham Carry duplicate of this hew in the aircraft *saber with the old regurtneicei certifeate as maim authority to opus the aircraft median receipt of raised certificate of aircraft registration. The bent FAA Form $1 304, Appal:melon For Airworthiness 0 fie is dated: Mar 07.2005 The airworth inns death:Wks and category: TIM TRANSP INSTRUCTIONS: SIGN AND RETURN THE ORIGCNA I. of this form to the Civil Aviation Registry, Aircraft Registration Branch, within 5 days after the special registration wisher is placed on the aircraft. A revised certificate of aircraft registration will then be Issued. Obtain a revised certificate of airworthiness from your nearest Flight Standards Dania Office. The authority to use the special amber capita: Feb 24, 2022 CERTIFICATION: locality m the aircraft desniboil stove. Sigissiure of Oweet .....--- 7 that the special registration nuenba was pawed RETURN FORM TO: Civil Aviation Registry Aircraft Registration Branch P.O. Box 25504 Oklahoma City, Oklahoma 73125-0504 _ ___,--S< ? Title of Owner CHISF bidA.244(4? O/Were Date Placed on Ammar 3-i 9 - 01Da I AC FORM 505044 (54•05) Sopenales ?mists Edam SDNY_GM_02757292 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 Accepted GS Apr/27/2021 EFTA 00244214 EFTA01329077
SDNY_GM_02757293 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244215 EFTA01329078
N550GP, LLC 2151 E. Convention center Way #222 Ontario, Ca 91764 March 18, 2021 Khera Turner, Chief Inspector Aviation Maintenance Group, Inc. 8352 Kimball Avenue Chino, Ca 91708 Subject: Special Power of Attorney Dear Khera: The undersigned is the owner of the certain Gulfstream Aerospace aircraft, GV-SP (G550), serial no. 5173, tail no. N212JE (the Aircraft). This letter will authorize Khera Turner, Chief Inspector for Aviation Maintenance Group, Inc. as the Company's legal representative to sign for all FAA applications and other document necessary to obtain the requested standard Airworthiness Certificate. The undersigned hereby certifies to be the Company's Chief Financial Officer and is authorized in the governing documents of the company to grant authorities set forth above and is authorized to act independently in connection with all FAA related matters. If you have any question, do not hesitate to contact the undersigned. Sincerely, ./.., Richard Munkvold Chief Financial Officer {Notary page follows} SDNY_GM_02 757294 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 i 1 2 szoz4z/xdv EFTA_002442 1 6 EFTA01329079
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness. accuracy, a validity of that document State of California , ) County of 3O1v-t been cIrdi no t ) On niClienk lel 00)? before me, zfl 1-4;IIS'f 1 0 ncria pith7l(r, Date Hero Insert Name and nt of he I Officer personally appeared I) 1 Cik a 1421 ill Wel i'S \ID (01 Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(es), and that by his/her/thoir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 1,1 G. Li0i VET:Edema 14. Nsoitanr Commission yeertard'in.„ co6uenz comm. Expires Oct IS. 2020 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. " -111c. noti Corn cn6Ston Signature eiCkeenckeol utuerk— -1-t) u EXCL.L.--tn c,areteif /4-• . Place Notary Seal Above OP77ONAL Signature of of Notary Public Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signerts) Signer's Name: O Corporate Officer — litle(s): O Partner — O Limited O General O Individual O Attorney in Fact O Trustee O Guardian or Conservator O Other: Signer Is Representing: Signer's Name: O Corporate Officer — Title(s): O Partner — O Limited O General O Individual O Attorney in Fact O Trustee O Guardian or Conservator O Other: Signer Is Representing: O2016 National Notary Association • www.NationalNotary.org - 1-800-US NOTARY (1.800.876.6827) Item 15907 SDNY_GM_02757295 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244217 EFTA01329080
45 US Department MAJOR REPAIR AND ALTERATION Of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration corm hopo..a OIABN3 2123-0023 1 irsorroor_ . F leaCrot i ,”.Pg Wind"' For FAA Use Only INSTRUCTIONS: Print or type all entries. See rite 14 CFR § 43.9, Pal 43 Appendix B. and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. §44701). Faure to report can result in a civil penalty for each such violation. 49 U.S.C. §46301(a)) Nationality and Registration Mark N212JE Serial No. 5173 1. Aircraft Make Gulfsbearn Model G550 Series i Name (As shown on registration certificate) 2. Owner I PLAN D LLC Address (As shown on registration certificate) 6100 RED HOOK QUARTER B3 ST THOMAS VIRGIN ISLANDS USA 00802 3. For FAA Use Only 4. Type 5. Unit Identification Repair Alteration Unit Make Model Serial No. • Z AIRFRAME (As Oast:1100d in Item 1 above) 0 0 POWERPLANT ID 0 PROPELLER 0 0 APPLIANCE Type Manufacturer 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency U.S. Certificated Mechanic I Manufacbser GA.C. GLYNCO Foreign certificated Mechanic C. Certificate No. 550 CONNOLE STREET X Certificated Repair Station BRUNSWICK, GA 31525 Certificated Maintenance Organization FAA CRS GR4D216M E. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and deserted on the reverse or attachments hereto have been made in accordance with the requirements of Pert 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and coifed to the best of my knowledge. Extended range fuel per 14 CFR ID Part 43 App. Et Signature/Date of Authorized Individual r Jason Tighe / 01/15/20 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by The Administrator of the federal Aviation Administration and is al Approved O Rejected BY FAA Flt Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport FAA Designee X Repair Station Inspection Authorization Other (Specify) Certificate or Designation No. FAA CRS GRAD216.4 Signature/Date of Authorized Individual Jason Tighe / 01/15/20 FM Form 337 twee) SDNY_GM_02757296 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244218 EFTA01329081
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft recad. An alteration must be compatible with all previous alteration to assure continued conformity with the applicable alnvorthiness requirements. 8. Degeriptbe of Work Accomplished: (If more space is required, attach additional sheets. Identify Mt, aircraft nabonatity and registration mark and des Wok *mottled.) MODEL: G550 SERIAL NO.: 5173 REGISTRATION NO.: N212JE ACTT: 5747.2 ACTL: 1348 DATE COMPLETED: 01115120 Reference: Gulfstream Aerospace Corporation Workorder Number: SC5270 Item 7.3 = Per Customer Request Return LH Divan, LH Divan Cabinets, LH And RH #3 Fwd Facing Seats And LH Cabin Ledge To Original Configuration. Resolution: Complied with interior reconfiguration to original interior installation per drawing CE528000057- SA rev B. Ref 8110-3 dated 12/20/2019 END K Additional Sheets Are Attached FAA Fon 337 (1OM) SDNY_GM_02757297 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241219 EFTA01329082
0 US Deportment MAJOR REPAIR AND ALTERATION Of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Arleen Administration r e . P o w e a d C M O S ; 1 1 3 0 , X 0 0 r &Mel eon new kis For FAA Use Only INSTRUCTIONS: Print or trio all mutes. See Tee 14 CFR § 43.9. Part 43 Appendix B. rd AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. Ibis mat is roared by law (49 U.S.C. §44701). Failure to report can result in s civil penalty for each such *Aston. (9 U.S.C. §46301(s)) I. Aircraft Nationality and Reglebalto Mark I4212JE Serial No. 5173 Make Gulfatream Model I Sobs 0550 l 2. Owner Name (As shone on regkindion colikete) ELAN D US Address (As crown on registrabon certficafe) 6100 RED HOOK QUARTER B3 ST THOMAS VIRGIN ISLANDS USA 00602 S. Fer FAA Use Only 4. Typo & Unit Identification Unit Make Mode Segal No. Repair Alteration a D b I AIRFRAME (As dented nem abom) 0 0 POWERPLANT 0 0 PROPELLER IN O Type APPUANCE Martibitaxer Il. Cenktrmity Stained A.Ajencys Name and Address B. land of Agency U.S. Carat SI MacMrec j Manufacturer GAS. GLYNCO Canceled Meohanc C. Cerligtate No. 550 CONNOLE STREET X GAeoed Repair Station BRUNSWICK, GA. 31525 Cortilloswo stainienanca Orem/moor FAA CRS GRUM 641 E. Icy* mat the war anOor alteration made to the units) kienefled in Item 5 stove anc demand on the reverse or attachments hereto have been made In accordance et the requirements of Poi 43 of the U.S. Fedene Av Won Regulations and that the iniormebon &meshed herein is bus and correct to the best of my knoMedge. Extended range fuel per 14 CFR 0 Part 43 App. B Signature/Date of Authorized Individual Jason Tighe / 01/15/20 7. Approval for Return to Service Pursuant to the authority given persons specified below. the unit identified in item 5 was inspected in the manner prescribed by One Administrator of the federal Aviation Administration end is CC Approved 0 Rejected se FAA Flt. Standards Inspector Manufacturer Maintenance Organization PS110111S Approved by Canadian Department Of Transport FM Neches X Repair Station • losptelon Aultodzetton Other (Spicily) Corncrib or Oesignetbn No. FAA CRS OR4021041 Signature/Date of Authorized Individual Jason Tighe I 01/1920 ager \ FM Fats 337 (1 ) SDNY_DM_027572913 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244220 EFTA01329083
r cor N0TICE Weep:* and Waft, CV °Dorothy Inteflon dung's WWI be entered in the appropriate aloe mord. An stenefon must be npotoble nes ell preNous alterations to assure continued confer/My nett the applicable einrathiness requirements. 8. Description of Wont Actunplishsci: Of awe spas Is rawarod. math addlaxial flak Identify War alrorart nationalty and reglerralica mark and OM work compkilad.) MODEL: G550 SERIAL NO.: 5173 REGISTRATION NO.: N212JE ACTT: 5747.2 ACTL: 1348 DATE COMPLETED: 01/15/20 Reference: Gulfstream Aerospace Corporation Workorder Number: SC5270 Item 7.3 = Per Customer Request Return LH Divan, LH Divan Cabinets, LH And RH e3 Fwd Facing Scats And LH Cabin Ledge To Original Configuration. Resolution: Complied with interior reconfiguration to original interior installation per drawing CE528000057- SA rev B. Ref 8110-3 dated 12/20/2019 0 Additional Shoe Ne Matched tee cam 337 (10-03) SDNY_GM_02757299 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241221 EFTA01329084
CERTO 69 08 2019GV-SP SN5173-01 U.S. DEPARTMENT Of TRANSPORTATION FEDERAL AVIATION AMINISTRATON STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS il OATC 12/20/2019 AMCRAFT OR AIRCRAFT COMPONENT MOMRCATIO6 3 MAK! GuEstmern 3 NO0EL NO GV-SP 4 rriTe Wren, Redid. Iffiltopao elc.I Aimlane I NAM! Or APPLICANT GULFSTREA)A AEROSPACE IJST OF DATA C. IOINTIFICA non r TALI CE528000()STSA REV: 8 12/20/2019 __END— FLOORPLAN SN 5173 END Notes. for engineering design data only. It indicates the data listed above only with the regulates' specified by paragraph and below as 'Applicable Requirements? (Compliance with not listed here may be reqt ired). This form does not constitute all the engineering design data sacessary for substantiation of requirements for the entire atteration/repair. aspects of the data listed abode are approved herein Electrical included in this approval. 1. This approval is demonstrates compliance subparagraph listed additional regulations FM approval of compliance to necessary 2. Only the structural aspects are not • PURPOSE Or 04TA In support of major alteration on Guffstream GV-SP SN 5173. I APPLICAILE RIOutREmINTS iii•• AH40 4 Two440 14 CFR Parts 25.601 And' 25-0 25.609 (at 11. (2) (3) (b) ands 25-3 25.603(a) (b) Ccl And' 25-46 25.611 Aadt 25-23 25.605(a) Amdt 25-46 10. CERTIFICATION of appointment wide applicable requireme l flAtaiTheretcee -Under 14 is or authority vested by direction of the Administrator and in accordance with conditions and limitations CFR 133, dam listed above and on attached sheets numbeted g, hays bean examined in accordance with the Airworthiness Standards listed. Recommend apploval of these data Approve these data tia•••• X III.WatAlUalell OF EtMONATED ENOMEERIC REARESERTATIYMM 12. oasomnota it OASSIFICATIOrethe Noss D. Rot laqh DERT -510267-CP Structures FAA FORM 11104 (03,10) SUPERSEDES PREVIOUS EDITION SDNY_GM_02757300 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244222 EFTA01329085
SDNY_GM_02757301 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244223 EFTA01329086
0 US Department MAJOR REPAIR AND ALTERATION Of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration Gem ma 2120.0020 "mot Eliistuciriuuruhune For FAA Us* Only INSTRUCTIONS: Prin or type all entries See Title 14 CFR § 43.9. Part 43 Appendix B. and AC 419-1 (or subsequent revision thereof) for instructions and disposition of this form This report is required by law (49 U.S.C. §44701). Failure to report can result in a civil penalty for each such violation. (49 U.S.C. §46301(a)) Nationality and Registration Mark N212JE Serial No. 6173 1. Aircraft Make Gulfstream Model 6660 Serves 2. Owner Name (As shown on registration certificate) PLAN CI LSO Address (As shown on registration certificate) 6100 RED HOOK QUARTER B3 ST THOMAS VIRGIN ISLANDS USA 00802 3. For FAA Use Only 4. Type 6. Unit Identification Repair Alteration Unit Make Model Serial No. El AIRFRAME (As described in Horn 1 above) • • POYiERRANT 0 0 PROPELLER 0 • Type APPLIANCE Manufacturer 6. Confomilty Statement A. Agency's Name and Address B. Kind of Agency U.S. Certificated Mechanic I Manufacturer G.A.C. GLYNCO Foreign Certificated Mechanic C. Certificate No. 550 CONNOLE STREET X Certificated Ran! Station BRUNSWICK, GA. 31525 Certificated Maintenance Organization FAA CRS GR413216M D I certify that the repair andror alteration made to the und(s) identified in item S above and described on the reverse a attachments hereto have been made in accordance with the requirements of Pan 43 of the U.S Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Extended range fuel per 14 CFR Part 43 App. El O Signature/Date of Authorized Individual Jason Tighe I 01/15/20 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item S was Inspected in the manner presated by the Administrator of the federal Aviation Administration and is ID Approved 0 Rejected ler FAA Flt. Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport FAA Designee X Repair Station Inspection Authorization Other (Specify) Certificate or Designation No. FAA CRS GR4D216M Signature/Date of Authorized Individual Jason Tighe I 0M5/20 orm SDNY_GM_02757302 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244224 EFTA01329087
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished: Of more spaces reputed. attach additional sheets Identify with aircraft nattonakty and registration mark and date work completed ) MODEL: G550 SERIAL NO.: 5173 REGISTRATION NO.: N212JE ACTT: 5747.2 ACTL: 1348 DATE COMPLETED: 01/15/20 Reference: Gulfstream Aerospace Corporation Workorder Number: SC5270 Item 37.3 = R/H Zone I Rib 9 outbd rib foot aft stgr 13 has area of disbond. Resolution: Trimmed out area as per RFA RFA No.CS613899-2.4.I. Fabricated -11 filler from 0.050 2024-13 Lot number LT19-201086.I PO number DAPO19-05366.2 as per SE55502139 REV -. Installed -11 filler per Notes 9 and 19. Inspected for disbonds 5.0 in. around each rivet installed in the —T4 temper per model specific NDTPM 05-00-00 Procedure I, "Horizontal Stabilizer Lowe rSkin Resonance C-Scan - NDT Procedure with no defects noted. 8100-9 In Support. END 0 Additional Sheets Are Attached FM Form 337 (10-06) SDNY_GM_02757303 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244225 EFTA01329088
0 us orimmen MAJOR REPAIR AND ALTERATION or Trap:moon (Airframe. Powerplent, Propeller, or Appliance) leant Avinlen Aanintstradea O i l i O W 2 I 2 S 0 0 2 0 bp eaMOIII ElettORICTIOdlite MIAMI w mauls Only INSTRUCTIONS: Print or type at entries. See Title 14 CFR §43.9, Part 43 Appendix B. and AC 43.9-1 (or subsequeM revision thereof) for instructions and disposban of 0* form. This report Is required by law (49 U.S.C. §44701). Failure to report can react in a civil penalty for each such violation. (49 U.S.C. §46301(a)) 1. Aircraft Nationality and Regestrabon Mark N212JE, USA - -- - Serial No. 5173 G ke GULFSTREAM AEROSPACE MOdel GV-SP (G550) Series G550 2. Owner Name (As shown or:registration certiacate) Plan D, L.W. Address (As shown on reg)sfradon certificate) Moms 6100 Red Heat Oa ael cc, Sr neap Sena uSIA Li, 00002 can" um 3. For FAA IJSCOnN 4. Typo 5. Unit Idendfication Repair Alteration Una Make Model Serial No. O 0 AIRFRAME OutESTIREAuranOSACE 5173 (As Oasalbed in Item 1 above) O O PONERPLANT O • PROPELLER O o APPLIANCE Type Illanulactuzer 5 Conformity Statement A. Agency's Name and Address B. Knit of Agency MY,* Lividan Jai Carle U S Certificated Methane I alartheterer Actarri. 4"••••••••••• Foreign Graft-Med ME'I(C C. Certificate No. my Towson, Am PO UnkindRepair Staten liaiROS.IF CRS IMJR053F bat 07•01 taro* USA Connoted itarterence Organization D. fortify that the repair ander alteration made to the unids) identified in kern 5 above arid described on the reverse or atm itmems hereto have been made In accordance vAth the requirements of Part 43 of MS U.S. Federal Meatier, Regulatices and that the information furnished herein is true and correct to the best el my knot/edge. Extended range fuel per 14 CFR Part 43 O App. B Signatse/Dete of Authorized Individual - /eilakif 7. Approval for Return to Service Pursuant to the authority green persons spected below, the unit Idenbfied In tem S was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is fl Approved TT/erected BY FM Fri. Standards Inspector M anufacturer Maintenance Organization Peace's ApptewedlarCanadan Depettmers a Tramoort FAA Designee X Repair Station Inspection ALthenzabon Other (Specify) Certificate or Signature/Date of Authorized Individual Designation No. CRS IMJR053F a 017/0 , /0/7 FAA Form 337 (10/06) Page I SDNY_GM_02757304 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244226 EFTA01329089
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the aPPliCablesiAsnfrnineSs requirements. e. Description of Work Accomplished 0 more space o requited attach eddelonel sheets. (dente win Werth nationeMy and registrebon men end Me week completed.) Go-So (0550)-5173 5731.5AFTT 1315 CYC USA- Netea 06firnAte Nationality end Registration Mark Coto Incorporated STC ST02893AT- Installation of LoPresti (Whelen) Taxi Lighting system (LSM-500-125 Rev K dated 01/28/19). This Alteration replaces the existing taxi lights (3) with new assemblies. The functionality of the systems remain unaltered. Airworthiness Limitations: There are no new or additional airworthiness limitations associated with this equipment or installation. There is no required Airplane Flight Manual Supplement required for this Alteration. There is no effect to the MEL for relief, the systems are functionally the same as the existing taxi and landing light systems. Instructions for Continued Airworthiness: Reference the LoPresti (Whelen) Instructions for Continued Airworthiness section of Installation Manuals LSM-500-125 Rev K, or later. This Supplemental Type Certificate is designed to satisfy the requirements of 14 CFR 25.1529 "Instructions for Continued Airworthiness" associated with this design. Refer to the Aircraft Maintenance Manual for the Aircraft Scheduled Maintenance Program otherwise the scope and detail of FAR 43, Appendix 0 will apply. Weight and balance changes: Taxi lights- (-3 installation) +2.74 lbs, moment +315.46 in-lbs. The aircraft Weight and balance has been revised for this Alteration. Electrical Load Analysis: Taxi lights- (-3 installation) Reduction of 17.49 amps to system. Wiring changes have been incorporated into the aircraft records and noted on the Load Analysys. Accomplished an evaluation of the inter-relationship between the systems listed above and the Type Certificated produce in accordance with 14 CFR Parts 25.1301(d), 25.1431(c) and they have been found to be operating satisfactory and that there is no adverse effect on any other component, system, or the airworthiness of this aircraft. - - - END------- ClAcidtbonal Sheets Aro Attached FM Form 337 (10/06) Page 2 SDNY_GM_02757305 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244227 EFTA01329090
l iir e MAJOR REPAIR AND ALTERATION uS 0444404.4 Cr rh , en" (Airframe, Powerplant, Propeller, or Appliance) fan Minion Aclaryilsbalon OM No 200.0020 Op. SOI/2016 recicac iruicag r4,,,,bn roe FAA Use Oar INSTRUCTIONS. Print or type all entries. See Title 14 CFR §43.9. Part 43 Appendix S. and AC 43.9-1 (or subsequent revision thereof) for instructions nd disposition of this form. This report is required by law (49 U.S.C. §44701). Failure to report can resift in a civi penalty for each such violation (49 U.S.C. §46301(a)) 1. Aircraft Nationality and Registration Mark N212JE, USA Serial No. 5173 Make GULFSTREAM AEROSPACE Model GV-SP (G550) Senes G550 2. owner Name (As snown on regiztratron cectIcate) Plan D. LLC. Address (As shown on registration ceaficore) X40(0411 6100 Rid 1400i Curie 145 Cry St Donn Sad USVI 20 40402 Catty USvl 3. For FAA Use Only 4. Type S. Unit Identification Repair Alteration Una Make Model Serial No. . El AIRFRAME GUIYSTREAMM ROSPACE (As desaibod In born l above) SliS D p POWERPLANT • • PROPELLER 0 0 APPLIANCE Type runtrectunw 6. Conformity Statement A_ Agency's Name and Address B. Kind of Agency eon mosso Merle U. S Crylifcaled Methane I Marciedurer Mans Is 44444 •4"4 Emir Cecoccaleci Methane C. Certificate No. XXXITXXO NJ Crated Row Staten CRS IMJR053F WO 2. 01604 Casey USA CMIC0100 morrenence CfSIOnaryOn D. !certify that the repair andlor alteration made to the unit(s) identified in tem S above and described on the reveru or attachments hereto have been made In accordance wah the requirements of Part 43 of the U.S. Federal Aviation Regutabons and that the information furnished herein Is true and correct to the best of my knowledge. Extended range fuel K poy 148 CFR Part 43 AM Signature/Da of Authonzed Intl dual A l gO l, T. Approval for Return to Service Pursuant to the authority given persons specified below. the unit identified in tem 5 was inspected n the manner prescribed by the Administrator of the Federal Aviation Administration and it plApproved Rejected BY FAA Fs Standards Inspector Manufacturer Maintenance Organization Persons APpromobyConecian Oepstrrert of Transpart FAA Designee x Repair Station Inspection Authorization Other (Speofy) Cattaloor lo No. CRS IMJR053F Signature/Date - Authorized Individual • /1/.3 0/9..0 ICI_ FAA Form 337 (10/06) Page I SDNY_GM_02 757306 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244228 EFTA01329091
NOTICE Weight and balance or operating larefelien changes shot be entered el the 0,00,00/ate aircraft record An aeration min be compatible with all previous alterations to assure continued conformity with the applicable airocithiness requirements. 8. Description of Work Accomplished gt more sone is required. attach addgonal sheets. Identify loth naafi netienahly and registration mark end dale teak comp/elect) Gv4P 0550)ain 5173 599].5 asp UMW* USA M212£ 30 Aft. 2019 Nalonakty and Ftegisusbon Mstk Dais Incorporated STC ST02893AT- Installation of LoPresti (Whelen) Landing Light System (Installation Manual LSM-500-126 Rev J dated 01/29/19, -3 installation kit). This Alteration replaces the existing Landing lights (2) with new assemblies and installs new power converters and Ballasts. The functionality of the system remain unaltered. Airworthiness Limitations: There are no new or additional airworthiness limitations associated with this equipment or installation. There is no required Airplane Flight Manual Supplement required for this Alteration. There is no effect to the MEL as for relief, the system is functionally the same as the existing landing light system. Instructions for Continued Airworthiness: Reference the LoPresti (Whelen) Instructions for Continued Airworthiness section of Installation Manual LSM-500-126 Rev J, or later. This Supplemental Type Certificate is designed to satisfy the requirements of 14 CFR 25.1529 "Instructions for Continued Airworthiness" associated with this design. Refer to the Aircraft Maintenance Manual for the Aircraft Scheduled Maintenance Program. Weight and balance changes: The aircraft Weight and balance has been revised for this Alteration. Electrical Load Analysis: Landing lights- (-3 installation) Reduction of 4.9 amps to system. Wiring changes have been incorporated into the aircraft records and noted on the Load Analysis. The STC and provided documentation have been added to the permanent aircraft records. Accomplished an evaluation of the inter-relationship between the systems listed above and the Type Certificated product in accordance with 14 CFR Parts 25.1301(a) and 25.1431(c) and they have been found to be operating satisfactory and that there is no adverse effect on any other component, system, or the airworthiness of this aircraft. --END =Additional Sheets Aro Attafled FM Form 337 (10/06) Parr ") SDNYGivl_02757307 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244229 EFTA01329092
MAJOR REPAIR AND ALTERATION SW (Airframe, Powerplant, Propeller, or Appliance) SW - 31A6 No. 2120-0020 Exp W3112014 - electienie Tense rine Fat FM Ine Onif US 01*.irmeal 0 Panto-boon Federal Anneon Adraniattalon I INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix B, and AC 43.9-1 (o subsequent revision thereof) for instructions and disposition of this form. This report is required by law (19 U.S.C. 44701). Failure to report can result in a civil penally for each such violation. (49 U.S.C. 46301(a)). 1. Aircraft Nationality and Registration Mark Serial No. USA N212JE 5173 Model Series Mike l Gulfstream Aerospace GV-SP (G550) 2. Owner Name (As shown on registration certificate) Plan D LLC Address (As shown on registration certificate) Address 6100 Red Hook Quarter B3 city St Thomas sm. Foreign zio 00802 Cowry Virgin Islands 3. For FAA Use Only , : I I 4. Type 6. Unit Identification Repair AlteratIo Unit Make Model Serial No AIRFRAME ------- (As described in item 1 above) O O POWERPLANT K D PROPELLER O O APPLIANCE It" laisiesineow 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency Manufacturer International Jet Interiors U.S. Certificated Mechanic C. Certificate No. 2221 Smithtown Ave Foreign Certificated Mechanic Ronkonkoma, New York X Certificated Repair Station I CRS 11JR439Y 11779 USA Certificated Maintenance i D. I certify that the repair and/or alteration made to the unit(s) identified in Item 6 above and described on the reverse or attachments here to have been made In accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein Is true and correct to the best of my knowledge. Extended range fuel per 14 CFR Pan 43 O App. B Signature/Date d Jay Masser 9127/2018 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item 6 was nspected In the manner prescribed by the Administrator of the Federal Aviation Administration and is 0 APPROVED 0 REJECTED FAA Ftt. Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Departmeot of Transport BY FAA Designee X Repair Station Inspection Authorization Other (Speed)) Certificate or Designation No. CRS I1JR439Y Signature/Date of Authoriz Thomas Norden 9/27/2018 ividual ( IL FAA Form 337 !IOC*) SDNY_GM_02757308 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244230 EFTA01329093
NOTICE Weight and balance or operating limitation changes shall bo entered in the appropriate aircraft record. An alteration must be compatible with a/I previous alterations to assure continued conformity with the applicable airworthiness requirements 8. Description (If more It Accomplished the FAA/DER 2) Removed Dwg Switch 3) Fabricated 7/11/18. 4) Removed panels 211007 329681-17 5) Reupholstered accordance dated 8/2/18 6) The 116. 02FP FANDER (DERT-230453-CE). 7) Installed Twilight dated 8) Stripped Bum Biberstein 9) Stripped 348675.18 (DERV 10) Fabricated Dwg Landing". II) Removed LED "Installation of Work Accomplished space is required, attach additional shoots, identify with aircraft nationality and registration mark and date work accomplished) USA N2I2JE Date 9/27/2018 Nationality and Registration Mark the following modifications/alterations as listed below to an existing executive interior in accordance with below listed International Jet Interiors Drawings. All listed Structural drawings below were approved via (attached) Form 8110-3 dated 9/24/2018, (attached) by Robert F. Clossin (DERT-230227-CE). Ul wall 25- via TP DRAWING NUMBER REV TITLE OR DESCRIPTION 111-G550-5173-02 IR INSTL-LEDGE-SIDEWALL MOD 111.0550.$173-03 IR 1NSTL-DIVAN MOD 1754-ST-001 IR INTERIOR MODIFICATIONS - GULFSTREAM MODEL GV-SP, SN 5173 the existing R/H Cabin Divan (P/N 2523.700.0I-(04)) and End Arms and modified ledge in accordance with No. 1.11-G530-5173,433; Rev R. dated 7/11118. Stowed the existing RAI and UH Ledge Cabin Audio/Call/Shade panels (8 Ea. Rockwell Collins P/N 2501-2) behind Lower side wall panels LH & RH side at FS 420.0. new replacement LH Cabin Divan End Arms in accordance with 111 Dwg No. IJI.0550.5173-03. Rev IR. dated the existing RH Cabin Fwd. Side Wall Table Frame and Side Wall Bump Out Panel and fabricated new side in accordance with Ill Dwg No. 111-6550.5173-02, Rev IR, dated 7/I 1/18. Composite material Hermes Fabric M 16 — Toile Decoration Grege, (same material) has been previously burnt, reference Skandia burn report TPt/ dated 8/22/17. the LH Divan (Outer Dress Cover Only) with Cowtan & Tout Fabric: 18905-01, EMI Natural. In with Aviation Consulting & Engineering Solutions Inc. Substantiation Report No. A072618-01SR Rev IR 8/2/18, ACES drawing No. A0100001 Rev R dated 1/23/13, and ACES drawing No. GVSP-090039 Rev IR dated approved via FAA/DER 8110.3 dated 2/7/18 (attached) by David S. Molnar (DERT-510260-CE). cabin Divan seat cushions have been fireblocked in accordance with FAA Title 14 CFR 25.853 (a) (c) amendment Reference Aviation Consulting & Engineering Solutions Inc. (ACES) fire blocking Test Plan report No. A072518. Rev IR dated 7/25/18 and Oil Burner Test Results report No. A072518-02FR Rev IR dated ft/3/18 and approved form 8110-3 (attached) dated 7/25/18 and 9/6/18 by Jeff A. White (DERT-230318-CE and Herschel E. Loepp new Replacement Floor Covering in the Main Cabin with Glen Eden Carpet: 5201 Hand-Tufted Color: B788 and 8789 Twilight. Reference Certificate of Flammability Testing by CA Aviation, LLC. Test Report No. 83278 7/30/18 in accordance with FAA Title 14 CFR 25.853 (a) Arndt 25-116 Appendex F, Part 1(a) (I) (ii). and recovered existing Headliner and PSU Panels with Lao Piana Fabric: A8730RS 001, Panjab Shaded White. report TP 348675-18 Rev A dated 9/17/18 approved via FAA/DER Form 8110-3 dated 9/17/18 (attached) by Jane (DERV-832780-CE). Skandia Inc. composite burn spec No. I. and recovered existing Aft Lavatory Storage Area with Tapis Fabric: 0263 Woodhue Grospoint. Burn report Rev A dated 9/17/18 approved via FAA/DER Form 8110-3 dated 9/17/18 (attached) by Jane Biberstein -832780-CE). Skandia Inc. composite bum spec No. 8. a LH mid-cabin removable (Loose Equipment) divider at the forward divan arm rest in accordance with Ill No. 111-6550-5173-03, Rev IR, dated 7/11/18. Divider placarded "Must be Stowed During Taxi, Takeoff and the existing WE Aerospace Cabin 5800 Series Fluorescent Lamps and installed Aircraft Lighting International Lamps (L5800-XXX-YY series) and Lamp Holders (PN N5120B) on yin accordance with ALI Aerospace Instructions" Rev A, dated 11120/17. 0 Additional Sheets No Attached cam SDNY_GM_02757309 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0O24423 I EFTA01329094
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record An alteration must be compatible with all previous alterations fo assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished (If more space is required, attach additional sheets. Identity with aircraft nationality and registration mark and date work accomplished ) USA N2I2JE Nationality and Registration Mark Dater/27/2018 12) The Aircrafts Weight & Balance Manual has been updated (report dated 9/20/2018) and a Supplement to Cabin Interior Equipment List has been provided to customer. 13) A logbook entry has been made reflecting this alteration. 14) This Refurbishment/Repair/Alteration to the existing Cabin Interior furnishings requires No Schedqled Maintenance Tasks or Airworthiness Limitations, refer to the OEM Maintenance Manual, and all other existing !CA's. fflie Aircraft's Scheduled Maintenance Program is not altered by this repair/refurbishment. The work described, has been founcho'be in conformity with the above mentioned approved data and continues to meet the airworthiness criteria under which it was originally certificated. Work Order No. 18147, on file at this agency, covers the above described work. NO FURTHER ENTRIES 0 Additional Sheets Are Attached FAA Form 337 (10-06) SDNY_GM_02757310 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244232 EFTA01329095
SDNY_GM_02757311 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244233 EFTA01329096
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION , STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE • July 25. 2018 AIRCRAFT OR AJRCRAFT COMPONENT IDENTIFICATION 2 MARE Gulfstream Aerospace Corporation 3 MODEL NO. GV-SP 4 TYPE Minya Engine. Piraper. at) Aircraft 1 S. NAME OF APPLICANT ' International Jet Interiors I UST OF DATA 6. IDENTIFICATION 7, tins REPORT: A072518-02FP Rev. IR 07/25/18 ....m...t. END i FLAMMABILITY AND OIL BURNER TEST PLAN - 4-PLACE DIVAN - GULFSTREAM AEROSPACE CORPORATION MODEL GV-SP SN 5173 Note: 1. Approval of test results Is required. . _ at. = =====. END .... Za .akaa ...... ',Zan I PURPOSE OF DATA i Test pan approval only. In support of a major alteration to Gulfstream Aerospace Corporation Model GV-SP SN 5173. 9 APPLICABLE REOLAREMENTS psi spectie weans) 14 CFR §§ 25.853(aXc) at Amendment 25-116 I 10. CERTIFICATION Pat 153. dada Wed Nova win appIcatio metwanioNa (FOAM Then:40M -)Mar adhonly veiled by drecOon Of Ma Arinator and ii Accordance althccochnora arid lenlaiensolapponlmenl under 14 CFR and on idladvd Omits nuntiesad Nov_ bre been mandned m accordance *IN talablehed onxiadwes and lound lo comply al de Alestellansa Standards bled. 0 INcomniand approval of these data I CD APPIAN' Ness Beta I. SIGNATURE(S) OF DESIGNATED ENGINEERNO REPRESENTATNEIS) 12. DESIGNATION NUWERNS) II. CLASSIFICATIONS) Aviation Consulting 4 Engineering Solutions. Inc. Jeff A. White 22 /0 DEBT-230318-CE I Structures r h i FAA Fonn11104 (03/11) SUPERSEDES PREVIOUS EDITION RU SDNY_GM_02757312 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244234 EFTA01329097
• SDNY_GM_02757313 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244235 EFTA01329098
V S DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION AOMNGTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE August 8, 2018 ARC RAFT OR AIRCRAFT COMPONENT CENTRIC-ARON I 2. MAKE Gulfstream Aerospace Corporation 3. MODEL NO. GV-SP 4. TYPE (Ain% &Va. Pr0Peae. a) Aircraft 5. NAME OF APPLICANT International Jet Interiors LIST OF DATA 6. rDENTWICATION 7. TITLE REPORT: A072518-02FR Rev. IR 08/03/18 END := an FLAMMABILITY AND OIL BURNER TEST RESULTS - 4-PLACE DIVAN - GULFSTREAM AEROSPACE CORPORATION MODEL GV-SP SN 5173 Notes: 1. The flammability aspects only of the above listed data we approved hemin I . This approval is for the engineering design data only. It indicates tho data listed above deMonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as 'Applicable Requirements' 2. This form does not constitute FM approval of all the engineering dateinecessary for substantiation of compliance to necessary requirements for tie entire alteration/repair. Compliance with additional regulations is required. I iii=== == = = END 2====rallelatillirMS4Vill2 =se == mem= . ---__—_- - - a - == I i I S. PURPOSE OF DATA In support of a major alteration to Guffstream Aerospace Corporation Model GV-SP SN 5173. 9. APPLICABLE REQUIREMENTS (Lisi WeediC Seeter0) 14 CFR 55 25.853(e)(c) at Amendment 25-116 10 CERTIFICATION41Mo eutheAly vested by *coon d the Adrowistralw and in oceofeanc• win creates and Imitators of aopeoratrent under II CFR Pan lel data rated stove and on stashed sheets renew) Note have been eawraled in wares who esinashed procrehret and toted to comely wet apleable rechiremetts of to Alwordlnen StandaritS Wed 0 Repairenend approval of thole data I I Ave) Thertdare 0 APPrOVII then fin II. SIGNATUREIS)OF DES TED ENGINEERING REPRFtENTATIVE(S) 12. DESIGNATION NuMBERS(S) 13. CLASSIFICATION(SI Structires I Potable Certsultong & "oils Inc.t gif He E. Loepp 5. aree4-PP DERT-230453-CE I FAA EOM 81104 Mlle) SUPERSEDES PREVIOUS EIXTVON RLI SDNY_GM_02757314 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244236 EFTA01329099
SDNY_GM02757315 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244237 EFTA01329100
U.S. DEPARTMENT OF TRANSPORTKRON FEDERAL AVATION ADM NISIRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS I DATE I AugustZ 2018 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION I 2. MACE Gulfstream Aerospace Corporation 3. MOOEL NO. GV-SP 4. TYPE (Ant Enema Propel or, eta) Aircraft I NAME OF APPLICANT. internatioilal Jet Interiors LLST OF DATA B.I0ENTIFCATON 7. TITLE • Report: A072818-01SR Rev. IR 08/02/18 Drawings: GVSP-090039 Rev. IR 08/02/18 A0100001 Rev. R 01/23113 ENO .c......mr..., I -SUBSTANTIATION REPORT-DRESS COVER REPLACEMENT-4-?LACE DIVAN - GULFSTREAM AEROSPACE CORPORATION MODEL GV-SP SN 5173 GULFSTREAM GV-SP DRESS COVER REPLACEMENT 4-PLACE DISN 'PLACARDS i Notes: 1. Structural approval of the seat installations is not included as part of this 8110-3. 2. This approval is for engineering design data only. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as 'Applicable Requirements.' 3. This form does not constitute FAA approval of all the engineering data necessary for substantiation of compliance to necessary requirements for the en* alteration/repair. Compliance with additional regulations such as 14 CFR §§ 25.803(a), 25.813(c2ii), 25.815, 25.853(a)(c), 25.1411(b), and 25.1561(c) are beyond the scope of this design data. Additional approvals may be required. END r. — NWERNMI:M====.170=95=======laZtaa,tittrIZ:=2flattl1=1.=. I I S. PURPOSE OF OATA In support of a major alteration to Gulfstream Aerospace Corporation Model GV-SP SN 5173. 9. APPLICABLE REQUIREMENTS (Liss spatifie saclons) 14 CFR §§25.561(b1). .562(a1),. .603(a), .785(b)(c), and .1541(a1Xb1)(b2) through Amendment 25r98. 10. CERTIFICATION Grdef bueneelty Pad M. din listed abOve and en beached Sib apples/ nipulremend of Ts Airworthiness 0 Ratammead I elm Thorekrts el Approve these vested try tInctien of VseAdmenslralor arch In SCCOnlanCe shoe Tendered none_ have been eicarrined vAil ConallOnS and linflabom of smonlmatft under 14 CFR in ace0tdanCe with eStabithed priXeCluree WC bird 10 <elf* i I Standards IfsPel approval of NOS! data data II SIGNATURES) OF DESIGNATED ENGINEERING REPRESENTABVE(S) 12. DESIGNATOR NUMBERS(S) 13. CLASSIFICATION(S) DAVID S. MOLNAR .2x2 t.oc---i icz ..„. DERT-510260-CE STRUCTURES ..----- i I FAA Form 81 104 (03110) SUPERSEDES PREVIOUS EDITION SDNY_GM_02757316 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244238 EFTA01329101
SDNY_GM_02757317 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244239 EFTA01329102
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1.DATr September 24, 2018 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION I 2 MAKE Gulfstream 3.MODEL NO. GV- SP 4 TYPE p.m,* hone, reepron, ere) Aircraft 5.NAME OF APPLICANT International )et Interiors Ronkbnkcima, NY LIST OF DATA 6.IDENTIFICATION I 7.TITLE Document IJI-G550-5173-02 Rev. IR, 7/11/18 IM-G550-5173-03 Rev. IR, 7/11/18 Report: 1754-ST-001 Rev. IR, 9/24/18 Title Instl-Ledge-Sidewall Mod Instl-Divan Arm Mod Interior Modifications - Gulfstream Model GV-SP, S/N 5173 Note(s): 1. This approval is for engineering design data only. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as Applicable Requirements. This form may not constitute FAA approval of all the engineering data necessary for substantiation of compliance to necessary requirements for the entire alteration. 2. This approval is for Gulfstream GV-SP, S/N 5173 only. I I 8.PURPOSE OF DATA To present the irate for modification data in support of a major alteration on Gulfstream Model GV-SP, S/N 5173. 9.APPLICABLE REQUIREMENTS (List specific sections) I 14 CFR Part 25.301(a)(c) [Arndt. 25-23), 25.303 [Amdt. 25-23), 25.305(a)(b) [Arndt. 25-86], 25.307(a) [Arndt. 25.72), 25.341(a) [Arndt. 25.72], 25.561(a)(b)(c)(d) [Arndt. 25-91), 25.601 (No Arndt.), 25.603(a)(b)(c) (Amdt. 25-46), 25.605(a) [Arndt. 25-46), 25.607(a)(b) [Arndt. 25-23), 25.609(a)(b) (No Amdt.], 25.625(a)(b)(c) [Amdt.25-72), 25.787 (a)(b) [Amdt. 25.51), 25.789(a)(Amdt. 25-46), and 25.1541(a)(b) [No Arndt.) Ref TCDS AI2EA, Rev. 49 10. CERTIFICATION • Under authority vested by direction of appointment under III CFR Part IX). dais listed above accordance will, established procedures and found to O Recommend approval of these of the Administrator and on attached comply with applicable data end in accordance with conditions sheets numbered N/A liav:e and limitations been examined in Standards listed. requirements of the Airworthiness I (ve) Therefore r Approve these dais I I SIGNATUREMOFDESIGNATEDENGINEERINGREPRESENTAINE(S) 52 DESIGNATi0NNUMBERSM 53 CLASSIFICATIONS) Robert F. Clossin e.,444. - I DERT-230227-CE Strtictures - Interiors 14 CFR Part 23 & 25 • FAA Form 8110.3 13510) SUPERSIOES PREVIOUS 1DITION SDNY_GM_02757318 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244240 EFTA01329103
SDNY_GM_02757319 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244241 EFTA01329104
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS ST 1. DATE 09/17/2018 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Gull stream 3. MODEL NO. G550 / Typo (Ampere. Enght. Propels.. et) Airplane S. NAME OF APPLICANT International Jet Interiors LIST OF DATA & IDENTIFICATION 7.11TLE TP 348675-18 Rev A Dated 9/17/2018 Skanda, Inc. Flammability Test Report Bunsen Burner Testing: Test Specimen Part Numbers: P/N 01 (Represents: Headliner and PSU Panels) P/N 08 (Represents: Aft Lay Closets) Notes: i 1) Work accomplished under Skandia Inc. WO N 348675-18. Ref Document ID 101649. 2) Flammability test witnessing only, does nal constitute installation approval of the materials. 8. PURPOSE OF DATA Demonstration of compliance with material flammability requirements in support of Major Repair & Al eration for SIN 5173 9. APPUCABLE REOUREMENTS (List speck Sections) 14 CFR Pan 25.853 (a) Arnd 25-116 Appendix F Pan I (a)(1)(i) la CERTIFICATION • Under authority vested by direction of the Administrator appoiMment under 14 CFR Part 183, data listed above arid on attached in accordance with established procedures and found to comply meth applicable O Recommend approval of these data I ( Therefore X Approve these data and in accordance with conditions sheets numbered and limitations al ' have Dean examined Standards listed. ; TIC requirements of the Ainvonhiness 13. CIANNFICAMS) 11. SI TURE(S) OF DE t4GINEERING REPR AT IVE DESIGNATION 12. NUMSER(S) C X IIIIPI DR netB rstein DERV-832780-CE Structural Special FAA Fo 0-3 man SUPERSEDES PREVIOUS EDITION SDNY_GM_02757320 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244242 EFTA01329105
SDNY_GM_02757321 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244243 EFTA01329106
CERTIFICATE OF FLAMMABILITY TESTING CC AVIATION, LLC. BRIAN FOSS 242 SERRA DR. WHITE LAKE, MI 48386 E-MAIL TEST REPORT NO: 83278 TEMP: 73° HUMID: 51% FLAME 15156° CONDITIONING DATE: 07/27118 CONDITIONING TIME: 9:30 AM TF.ST DATE: 07/30/18 TEST TIME: 10:00 AM MATERIAL IDENTIFICATION: Carpet: Glen Eden Wool Carpet: Custom 5201 Hand-Tufted Color: 0788 Custom Twilight-Wool. B789 Custom Twilight-Wool RoII' 76979 APPLICATION: DATA SHEET/ PON 7944 CUSTOMER: INTERNATIONAL JET 12 Second Vertical Ignition: 14 CFR 25.853 (a) Amdt. 25-116 Appendix F. Pan I (a) (1) (ii). Requirements: IS see. extinguish time: 8 inch bum length: 5 sec drip extinguish time: Extinguish Time: 0.0 Burn Length: 0.1 : Drip Extinguish Time: None Extinguish Time: 0.0 Bum Length: 0.1 Drip Extinguish Time: None Extinguish Time: 0.0 Bum Length: 0.1 Drip Extinguish Time: None Extinguish Time: Bum Length: Drip Extinguish Time: Extinguish Time: Burn Length: Drip Extinguish Time: Extinguish Time: Bum Length: Drip Extinguish Time: AVERAGE 0.00 COMMENTS: PASSED: X AVERAGE 0.10 FAILED: AVERAGE 0.00 Testing Witnessed and Approved By: Brian Foss Engineering Designee: Structures (Flammability Only) SDNY_GM_02757322 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0O244244 EFTA01329107
SDNY_GM_02757323 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244245 EFTA01329108
AIRCRAFT LIGHTING INTERNATIONAL 1 I I 105 I NGIN - IWALJ nnut N Y 11 int, INSTALLATION INSTRUCTIONS FOR AIRCRAFT LIGHTING INTERNATIONAL 5800 LED LAMP, P/N L5800-XXX-YY and N5120B Lamp Holder Manufactured By: AIRCRAFT LIGHTING INTERNATIONAL REV A November 20, 2017 Aircraft Lighting International, Corporation, PROPRIETARY NOTICE This document contains information of a confidential and proprietary nature to Aircraft Lighiing International, Corporation (-ALI), constitutes trade secret for the purpose of the Trade Seciket and Freedom of Information Act, and is provided in confidence for the sole purpose of enabling the recipient to evaluate the information disclosed by ALI for the sole purpose of installation of part number 15800- XX.Ar-YY. The recipient assumes custody and contra and agrees that this document and its aicompanying enclosures/exhibits will not be copied, manufactured, sold, used for Inventions or discovery, reproduced, in whole or in part, nor its contents revealed or disclosed in any manner to any third party without prior written consent of ALL As oldie date of this cover letter no right has, now, currently or in the future, been granted to disclose or use any information contained In this document. @Copyright 2017 Aircraft lighting International. Corporation. all rights reserved. Page 1 of 7 Document No.IINST4.5800 SDNY_GM_02757324 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244246 EFTA01329109
SDNY_GM_02757325 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244247 EFTA01329110
IMO PAM 0, •Isf DEPAKTIONT Of TRAM PORTA11011-FEDERAL AVIATION ACOMSTRA11001 STANDARD AIRWORTHINESS CERTIFICATE 1 X41'414. virtrit.., MID I imatAKTACI)0600:4( ) ./A0017 WM. 1 cow*. Sot Gain. Aeov.e 0.00•00, MI= Cv41 $17) Trwspsn I *CAW) Lad, WA SWSCI W. ~Familia ileilats•40.1K n awe.. be ear s noi• aid Mimi Nositimi ideranansh/en• 11101.4111011•••••••••••••• 10••••••••••••••••••••••••••••••• ••••••••••• .11010 fibliOs hie C•••••••••••••0. 101•••••••S.O. IF lamas Nall* I FAA WU KU. 10.001) 000) 00•••• ray. CompitesiAL Ealep0•• 1/11.11431 FAR 23301101 Ussiost RM ) 000 Men 00110100. Capin Phi IOU I FY WM 40 10 I. Prom Pyin Lidsera.Delbyel M asap St ts. reenielli. aloe lied 011•••••••••••••••••••0•00.0eMemeil. •••••We••••••••••posatainintafarels•••••••• •••••T an • nor. Ininlopfaln .-wrr.••••.I.rry. DINO ISSWCJI ImMis,0000At A e Ka ION ono Artlidd /f4 ItitfearglaMIGI 00A <I I •••••••••••• • aorosina rt. inns* ant m.100••••.... is inns& bott27161000.••••• Asa tes. emit Mint: a t'q inor inappioctspi/.11VAPPKVO W•WINILoOt SDNY_GM_02757326 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244248 EFTA01329111
SONY_GM_02757327 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244249 EFTA01329112
..entD MRS 0111/11CA DEPARTMENT OF TRAHSPCRTATIONJEDERAL AVIATION STANDARD AIRWORTHINE int wm NIISLM .rsgTN4bo tirCOIL Gairia GV • avi, r. Ma rbrC at* tut•loaszs•Illt allItsIMI Swig alliml•SIbIl• kl in3 ••••••••1•••••••••••• Cowan imprint,' Dawn N. 71•11, (t) gy p. N. MN 3S101 Ltiapeln Ns. Ma 40 Mµ Mon a 70•4110 CO•01%. Ulaestawils. Idellearo• •POMAII••••••= IMPIMISOMISIIII•ASII eat Vann.. 4 2A Just P. Len WP-27 AK . 1: 11.70 u•••••• !sm.- •••••1 1k116. Isom. Finie, CIATCAllialtOlealliMMOMM•COISOWriradilliVINONAIMIWYJAM PothmelS20•111•••••••••••ineika SDNY_GM_02757328 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244250 EFTA01329113
SONY_GM_02757329 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_0024425 I EFTA01329114
Plan D LLC 6100 Red Hook Quarter B3 St Thomas VI VI 00802 To: Brent Archibald ODA-511131-CE Gul (stream Aerospace Corporation Savannah, Georgia 31402-2206 Subject: Request for Replacement Standard Airworthiness Certificate. As the owner /certificate operator of Gulfstream Aerospace Corporation GV-SP (G550) , Serial Number 5173, registration N415LM, I am requesting a Replacement Standard Airworthiness Certificate due to change of Registration from N4I5LM to N212JE as authorized by AC form 8050-64 issued on 23 AUG 2017. The registration markings have ban affixed to the aircraft in accordance with 14 CFR 45, subpart C. Regards, Title: m 4W Ag Est RAN A ac. Date c -/ S —01-O/ SDNY_GM_02757330 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244252 EFTA01329115
SDNY_GM_02757331 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA _00244253 EFTA01329116
Gulfstream A OONORAL OYNAPAICS COMPANY 27 FEB 2018 ODA-GR4R-2018-08 Mr. Brian Cole Aviation Safety Inspector (AW) DOT/FAA/ATL FSDO-11 1701 Columbia Ave College Park, GA 30337 Subject: Replacement Standard Airworthiness Certificate for Gulfstrearn Aerospace Corporation, Aircraft Model GV-SP(G550), Serial No. 5173, registration N415LM, due to registration change to N212JE. Attachments: Replacement 8100-2 data package. A Replacement Standard Airworthiness Certificate was issued for subject aircraft due to registration change on 27 FEB 2018. Brent Archibald ODA-511131-CE Gulfstream Aerospace Corporation Savannah, Ga. ATL FSDO-1 I •I 1 3 201$ P.O. Boa 2206 • Savannah. GA 31002-2206 USA • Telephone (912) 965-3000 • gulfatrom.com SDNY_GM_02757332 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFFA_00244254 EFTA01329117
[I 1 i -O:124 . ITA • SONY GM 02i57333.: SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244255 EFTA01329118
Memorandum Date: To: From: Subject: Federal Aviation Administration March 14, 2018 Aircraft Registry, AFS-750 Fdmundo Rolon, ASI; SO-11 Reissued Airworthiness Certificate Please be advised that a replacement Airworthiness Certificate was issued by Brent Archibald, ODA-511131-CE, fora Gulfstream G550 aircraft, S/N 5173, due to an "N" number change from N415LM to N212JE. A copy of the FAA Form 8100-2 and the letter authorizing an agent to sign for the owner, are attached. kNY_GM_02757a34 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244256 EFTA01329119
SDNY_GM_02757335 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244257 EFTA01329120
0 MAJOR REPAIR AND ALTERATION US Dammam el ingspatuma (Airframe, Powerplant. Propeller, or Appliance) Rectal Midge Mosisigracke Form Approved OMB No. 2120-0020 II/302007 Electronic Tracking Number For FAA La Only INSTRUCTIONS: Print or type all entries. See Title la CFR 643.9. Pan 43 Appendix B. and AC 43.9-I (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 444701). Failure to report can result in a civil pawky for each such violation. (49 U.S.C. 446301(d) I. Aircraft Nationality and Registration Mask N4I5LM Serial No. $173 Make GULFSTREAM Model GV-SP (0550) Series 2. Owner Name (As shown on reisislrodon canficate) PLAN D LLC. Address (At shown on registration eenilierue) Address 6100 RED HOOK Quarter 93 City St. Thomas Virgin Island Zip 00802 Country USA 3. For FAA Use Only 4. Type 5. Unit Identification Repair Alteration Unit Make Model Serial No. 0 AIRFRAME (4, descnbed in hem I abate) 0 0 POWERPLANT 0 0 PROPELLER 0 APPLIANCE Type • Manufacturer 6. Conformity Statement A. Agency's Name nd Address B. Kind of Agency Name Address City Zip Gulfstream At-manes C0ro0rati00 U.S. Certified Mechanic I Manufacturer Cifts_ennUct_SUPP9BBoad ,avannah State Foreign Cati fled Mechanic C. Certificate No. GA X Certificated Repair Station FAA CRS GR4R216M 31408 Country USA Certificated Maintenance Organization D. I entity dm the repair enclitic alteration made to the trans identified in item 5 above and described on he reverse or attachments hereto have been made in accordance with the requirements of Pan 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and comet to the best of my knowledge. Extended range fud pa 14 CFR Part 43 App. B ❑0 Signature/Date of Authorized Individual_ • , leci ‘ tC4.._ 0 .•:- ' t Carlos A. Davila 03/082018 7. Approval for Return to Service Pursuant to the authority given persons specified below, he unit identified in item S was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is El APPROVED 0 REJECTED BY FAA Flt. Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport FAA Designee X Repair Station Inspection Authorizations Other (S),een59 Certificate or Designation No. FAA CRS GR4R2 I 6M SignamrdDate of Authorized Individual Carlos A. Davila 03/08/2018 I cm 3371mmem EQF 100 -(CG) 04/16 SDNY_GM_02757336 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244258 EFTA01329121
NOTICE Weight and balance or operating kmitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable sinronniness requirements. 8. Description of Work Accomplished more space is recurred. enact ackstronal shoots Identity with avatar nationarity and registration mark and date wore canna:Sod 01118.1201 8 Nstonalny and Raga:mon Mark Dale Reference: Gulfstream Aerospace Corporation Work Order No. SC521661 1. Installed JetConneX (ICA-Band) High Speed Data System with Satcom Direct Router in accordance with STC No. ST03238AT-D, under Index List No. GC41 3038007, Rev. R, using Configuration List Nos. GC5I 3038034, Rev. A and GC5I 3038035, Rev. NC, with minor deviations under Gulfstream Engineering Drawing List No(s). CE51 4960797, Rev. B-E. (electrical) and CE52 005173, Rev. C (mechanical). • Reference Gulfstream Document No. GC51 303A004, Rev. F for Maintenance Requirements — Instructions for Continued Airworthiness. • Airplane Flight Manual Supplement No. GC51 303M005, Rev. F applies and has been inserted into the Airplane Flight Manual. • Reference Gulfstream Document No(s). GC51 3030007, Rev. NC for the Ground Test Plan. • Reference Electrical Load Analysis No. GC5I 4696768, Rev. NC and GC41 429G002, Rev. NC for details of electrical loads from modifications accomplished under this work order. 2. Updated the Equipment List section of the Weight and Balance Manual. 3. Weight and Balance data has been revised and inserted into the Weight and Balance Manual. End K Additional Sheets Are Attached FM Fpm 337 poos) EQF 100 - (CG) 04/16 SDNY_GM_02 757337 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244259 EFTA01329122
MAJOR REPAIR AND ALTERATION 0_, mi. • (Airframe, Powerplant, Propeller, or Appliance) US Depanmen ce 1 qtnicefietcn hen, known Admaistrahon OMB No 2120.0020 Eva'S/31/2014 7,800'91.nel FM FAA use eery INSTRUCTIONS: Print or type all entries. See FAR 43.9 Appendix El, and AC 43.9.1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. 44701). Failure to report can result in a civil penalty for each such violation. (49 U.S.C. 46301(a)). 1. Aircraft Nationality and Registration Mark USA N415LM I Serial No. 5173 Model Series Make Gulfstream Aerospace GV-SP (G550) 2. Owner Name (As shown on registration certificate) Plan 0 LLC Address (As shown on registration certificate) ACI*••• 6100 Red Hook Quarter 83 car St Thomas slat Foreign nn 00Ma rn.nwViroin island% 3. For FAA Use Only 4. Type 6. Unit Identification Repair Altered° Unit Make Model Serial No. 0 -- e 0 AIRFRAME --------- (As described in Item 1 above) 0 POWERPLANT 0 0 PROPELLER 0 0 APPLIANCE Tn. tiwwww 6. Con entity Statement A. Agency's Name and Address B. Kind of Agency I Manufacturer International Jet Interiors 2221 Smithtown Ave Ronkonkoma, New York 11779 USA U.S. Certificated Mechanic C. Certificate No. Foreign Certificated Mechanic CRS I1JR439Y X Certificated Repair Station Certificated Maintenance D. I certify that the repair and/or alteration made to the unit(s) identified in item S above and described on the reverse or attachments here to have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of nowiedge. Extended range fuel per 14 CFR Part 43 0 App. B Signature/Date of Authori In idu Jay Massar 8/31/2017 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit Identified in item 6 was nspected in the manner prescribed by the Administrator of the Federal Aviation Administration and Is (8) APPROVED 0 REJECTED FAA Flt. Standards Inspector I Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport BY FAA Designee X Repair Station Other (Specify) Inspection Authorization Cent Designation cute or No. Signature/Date of Autho ize ndivid CRS I1JR439V Thomas Norden 8/3112 01 7 IL\IV L-- FAA Form 337 ,i, SDNYGtvl_02757338 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244260 EFTA01329123
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record An alteration must be compatible with all previous alterations to assure continued conformity with the appiscaM airworthiness requirements 8. Description of Work Accomplished (If more space is required. attach additional sheets. Identity with aircraft nationality and registration mark and date work accomplished) USA 'NM 5LM Date 8! 1/2017 Nationality and Registration Mari I) Accomplished the following modifications/alterations/refurbishment as listed below to an existing executive interior in accordance with the below listed International Jo Interiors Drawings. All listed Structural drawings were approved via (attached) DRAWING NUMBER REV TITLE OR DESCRIPTION IMMO I13 IR INTERIOR MOD INSTL IRGSSOSIMA IR. ARMREST COVER INSTL•DIVAN CABINET UIGSSOSIMB IR LH FWD CREW GALLEY MOO INSTL IlIGSSOSIMC IR MONITOR MOD INSII.LII FWD IlIGSSOSIMD IR SEAT MOD INSTL IIIGSSOSI TIE IR SWITCH MOD INSTIANVAN ARMREST LIICMOSI LW IR LH AFT GALLEY MOO /NM UIGSSOSI73G IR MI AFT GALLEY MOD INSTL UIGSSOSIMH IR AST VANITY MOD INSTL UIGSSOSIM) IR PLACARD MOD INSTL 2) Reupholstered the eight (8) existing Single Cabin Seats with Spinneybeck leather: P/N 0457VPI 12235FT, Velluto Pelle Color 0457, D/L I12235FT. In accordance with Aviation Consulting & Engineering Solutions Inc. Substantiation Report No. A061917-03SR Rev IR dated 8252017, ACES drawing No. CV-010039 Rev A dated 2/28/2017 and ACES drawing A0100001 Rev R dated 1/23/13, and approved via FAA/DER 8110-3 dated 8/28/2017 (attached) by David S. Molnar (DERT-510260-CE). 3) Reupholstered the LH & RH Divan with Nobilis Fabric: 10493-05, Stella and Spinneybeck leather: P/N 0457VP112235FT, Velluto Pelle Color 0457, D/L I I2235FT. In accordance with Aviation Consulting & Engineering Solutions Inc. Substantiation Report No. A061917-03SR Rev IR dated 8252017, ACES drawing No. CV-010019 Rev H dated 2/28/2017 and ACES drawing A0100001 Rev R dated 1/23/13, and approved via FAA/DER 8110-3 dated 8282017 (attached) by David S. Molnar (DERT-510260-CE). 4) All eight (8) cabin single passenger seats, Two (2) divans, and one (I) observer scat cushions have been fireblocked in accordance with FAA Title 14 CFR 25.853 (a) (c) amendment 25.116. Reference Aviation Consulting & Engineering Solutions Inc. (ACES) fire blocking Test Plan report No. A061917-03FP Rev A dated 8/16/2017 and Oil Burner Tat Results report No. A061917-03-0I FR Rev IR dated 8/21/2017 approved via FAA/DER form 8110-3 (attached) dated 8/17/2017 and 8/21/2017 by Herschel E. Loepp (DERT-230453-CE). 5) The existing cockpit crew seats were reupholstered (outer cover only) with Spinneybeck Leather: PN 0457VPI12235FT- Velluto Pelle, Color 0457, D/L. 112235Ff Deadatus and Garrett Sheepskin: Shearling-White PN S510, D/L 85847. In accordance with Aviation Consulting & Engineering Solutions Inc. Substantiation Report No. A061917-03SR Rev IR dated 8/25/2017, and ACES drawing GVSP-090024 Rev IR dated 8/25/2017. and approved via FAA/DER 8110-3 dated 828/2017 (attached) by David S. Molnar (DERT-510260-CE). 6) All cabin PAX seats and Crew restraints have been re-webbed by C&M Marine Aviation Services Inc. (FAA/CRS V05R749Y) Reference 8130-3 dated 7/8/17 and 6/14/17. Each belt is tagged and identified as meeting FAA-MO-Cite, requirements. 7) The existing cockpit observer seat was reupholstered (outer cover only) with Spinneybeck Leather: PN 6043ADI I 2152FT- Andes Color 6043 D/L 11215217. In accordance with Aviation Consulting & Engineering Solutions Inc. Substantiation Report No. A0619I7-03SR Rev IR dated 8/25/2017, and ACES drawing GVSP-090024 Rev IR dated 8/25/2017, and approved via FAA/DER 8110-3 dated 828/2017 (attached) by David S. Molnar (DERT-510260-CE). 8) Stripped and recovered the existing Fwd Cabin Bulkheads, Fwd Cabin Pocket Door, Cabin Lower Side wall Panels, and Magazine Racks with Hermes Fabric: 211007 MI6 — Toile Decoration Grege. Burn report TPN 329681-17 Rev A dated 8/22/17 approved via FAA/DER Form 8110.3 dated 8/22/17 (attached) by Jane Biberstein (DERY-832780-CE). Skandia Inc. composite burn spec No. 4 and 18. 0 Additional Sheets Are Attached FAA Form 337 00-00 SDNY_GM_02757339 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244261 EFTA01329124
NOTICE Weight and belanCe or operating limitation changes shaft be entered in the appropnate aircraft record. An alteration must be compatible with aThowvious alterations to assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished (If more space is required, attach additional sheets, Identify with aircraft nationality and registration mark and date wont accomplished ) USA N 10415LAI Nationality and Registration Mark 9) Covered the existing veneered handrails on the PSUNalance Panels in the Cabin area with Tapis Ultraleather: YLIR3145 — Parchment, Lot: N, Roll #136. Bum report TP# 329681-17 Rev A dated 8/22/I7 approved via FAA/DER Form 8110-3 dated 8/22/17 (attached) by Jane Biberstein (DERV-832780-CE). Skandia Inc. composite burn spec No. 13. le) Stripped and recovered the existing Fwd and Aft Lavatory Potty Seat with Spinneybeck leather: PN 0457VP I 12235FT - Velluto Pelle Color 0457 D/L II2235Ff. Burn report TPH 329681-17 Rev A dated 8/22/I7 approved via FAA/DER Form • 8110.3 dated 8/22/17 (attached) by Jane Biberstein (DERY-832780-CE). Skandia Inc. composite burn spec No. 3. II) Stripped and recovered the existing Aft Lavatory Deck with Wisonan Laminate: I 573KF2133548120 - Frosty White. Burn report TN( 329681.17 Rev A dated 8/24/17 approved via FAA/DER Form 8110-3 dated 8/24/17 (attached) by Jane Biberstein (DERY-832780-CE). Skandia Inc. composite bum spec No. 15. 12) Upholstered the new Divan End Arm Covers with Spinneybeck leather: PM 0457VP1 I 2235FT, Velluto Pelle Color 0457. D/L I I2235FT. Bum report TPN 329681-17 Rev A dated 8/22/17 approved via FAA/DER Form 8110-3 dated 8/22/17 (attached) by Jane Biberstein (DERV-832780-CE). Skandia Inc. composite burn spec No. 3. 13) Installed new Replacement Floor Covering in the Entryway, Main Cabin, Galley, Lavatory, and Floor Ducts with Glen Eden Carpet: Custom 5201 Hand-Tufted and solid Cut Pile, Color: W037 Twilight-Wool. Burn report 'FPO 329681-17 Rev A dated 8/22/17 approved via FAA/DER Form 8110-3 dated 8/22/17 (attached) by Jane Biberstein (DERV-832780-CE). Skandia Inc. composite burn spec No. 6 & 7. 14) Stripped and recovered the Entry Door/Airstair with AerMat ST/1 003/1003/20R/54 Ribbed Black. Burn report IPM 329681.17 Rev A dated 8/22/I7 approved via FAA/DER Form 8110-3 dated 8122/17 (attached) by Jane Biberstein (DERV- 832780-CE). Skandia Inc. composite burn spec No. 2. 15) Fabricated a new replacement Mid and All Cabin Curtain with Hennes Fabric: 211007 M 16 - Toile Decoration Gregc. Burn report TIM 329681.17 Rev A dated 8/22/17 approved via FAA/DER Form 8110.3 dated 8/22/17 (attached) by Jane Biberstein (DER Y-832780-CE). Skandia Inc. composite bum spec No. 5 and 17. 16) Modified the Fwd Crew Galley Sleeve to accommodate a Small Coffee Maker (loose Equipment). Installed a new IlOv/60Hz provisional outlet. Wiring was performed by Hawthorne Global Aviation Services (FAA/CRS EW7R379W) WO 24798 Logbook Supplement dated 8/25/2017. I7) Complied with BIE Service Bulletin No. SB-2524.524.25.355 Rev A. Title: "Replacement footrest with legrest" to the existing (2Ea) cabin scats P/N 2524.524.01-50809. SN 071219-07 and P/N 2524.524.01.5031 A, SN 071219.04. Date 8/31/2017 IS) All affected areas of the aircraft interior have been placarded in accordance with applicable FAA regulations. 19) The aircraft's Weight & Balance Manual has been updated (report dated 8/31/2017) and has been provided to customer. 20) A logbook entry has been made reflecting this alteration. 21) this Refurbishment/Repair/Alteration to the existing Cabin Interior furnishings requires No Scheduled Maintenance Tasks or Airworthiness Limitations, refer to the OEM Maintenance Manual, and all other existing ICA's. The Aircraft's Scheduled Maintenance Program is not altered by this repair/refurbishment. 22) The work described, has been found to be in conformity with the above mentioned approved data and continues to meet the airworthiness criteria under which it was originally certificated. Work Order No. 17126, on file at this agency, covers the above described work. NO FURTHER ENTRIES Ea Additional Sheets Are Attached FAA Form 332 (10.061 SDNY_GM_02757340 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244262 EFTA01329125
SDNY_GM02757341 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244263 EFTA01329126
g. 5 U.S. DEPARTMENT OF TRANSPORTATION I. FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS I. DATE August 17, 2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Gulfstream Aerospace Corporation 3 MOOD NO. GV-SP 4 TYPE Meese Enda,. Pap s... at) Aircraft S NAME OF APPLICANT International Jet Interiors 1ST OF DATA B. CERTIFICATION 7 TITLE REPORT: A061917-03FP Rev. A 08/16/17 END = _ FLAMMABILITY AND OIL BURNER TEST PLAN - INTERIOR REFURBISHMENT - GULFSTREAM AEROSPACE CORPORATION MODEL GV-SP (G550) SN 5173 Note: 1. Approval of test results is required. END _ B. PURPOSE OF DATA Test plan approval only, in support of a major alteration to Gutfstrearn Aerospace Corporation Model GVSP (0550) SN 5173. 9 APPLICABLE REOUIREMENTS (List specAc sections) 14 CFR SS 25.853(a)(c) at Amendment 25-116 10. CERTIFICATION -Under onset Psi M. dRa ailed above and on aPeched eel appireble reeve weer Owe Anneethiness 0 R•Ecennassri vested by deecten dine AdintrosIndor and In accordance se tandems and Illyamreare ol appcliemonl wider 14 GEN sheets numbered None . have been examined In natant with established procedures and lows] to campy Standards kited. approval of these data data i two Thonsem 0 Approve these II. SIGNATURE(S)OF DES TED ENmsEERING R I PIMSENTeuvElei 12 DESIGNATION NUMBERSIS) is. mASSiFICATIONIel Aeabon Consulting oep a idnc. Herschel E L p anti) DERT-230453-CE Structures C. FAA Pone 01104 (03/10) SUPERSEDES PREVIOUS EDITION RLI SDNY_GM_02757342 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244264 EFTA01329127
SDNY_GM_02757343 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244265 EFTA01329128
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATOR STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE August 21. 2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENT1FICATKM 2. MAKE Gulfstream Aerospace Corporation 3 MODEL NO GV-SP 4. TYPE (Aka**. Engine Propel, etc.) Aircraft 5. NAME Of APPLICANT International Jet Interiors UST OF DATA 6. IDENTIFICATION 7. TITLE REPORT: A081917-03FR Rev. IR 08/21(17 == .c. END ===vssessrvves FLAMMABILITY AND OIL BURNER TEST RESULTS - INTERIOR REFURBISHMENT - GULFSTREAM AEROSPACE CORPORATION MODEL GV-SP (6550) SN 5173 Notes: 1. The flammability aspects only of the above list&J data are approved herein. This approval is only for the engineering data. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as 'Applicable Requirements.' 2. This form does not constitute FAA approval of all the engineering data necessary for substantiation of compliance to necessary requirements for the entire aeration/repair. Compbance with additional regulations is required. =2=.11” saaaaaramalinazsavax3 m a mmm atazaza ......... END ass= ==riiiir.unnsualv .. atri==a =C arc= O. PURPOSE OF OATA In support of a major alteration to Gulfstream Aerospace Corporation Model GV-SP (6550) SN 5173. 9 APPLICABLE REQUIREMENTS (Um specific actions) 14 CFR §§25.853(aXc) at Amendment 25-118 10 CERTIFICATION Under aufhority Prt 153, data Stied abaft and en scathed we. MOWS. eknaresnefts of ihe einvonhinares K Recommed I (Wo ThowelOrt 0 Approve vested by *amen a/ the Ado narrator and in scccedance shams wawa! Rao° have been ciamarl with ceneldnen and Imeallons Of appoternenl unece le CFR in accoMaxa worn MINIMS procedures and found to =trek , Stantanis aped. approval of these data than data II. SIGNATURES) OF DESIGNATED ENGINEERING REPRESENTATIVE(S) 12 DESIGNATION NUMBERS(S) 13. CLASSEIGATIOM51 Amason Consulting re:n citolibosa, InE. I) Herschel E Loops) I t. DERT-230453-CE Structures FAA Form $110.3 (03110) SUPERSEDES PREVIOUS EENTION Rio SDNY_GM_02757344 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244266 EFTA01329129
SDNY_GM_02757345 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244267 EFTA01329130
VS DEPAH imtN I OF TRANSPORTATON FEDERAL AAATION ADMINISTRATOR STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS I DATE August 28, 2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2 MAKE Gulfstream Aerospace Corporation 3 MODEL NO GV-SP 4. I TrE (Asa* Engine. Propels v, 04c) Aircraft 5 NOISE OF APPLICANT International Jet Interiors LIST OF DATA 0 IDENTIFICATION 7 WILE Report: A061917-03SR Rev. IR 08/25/I7 Drawings: GVSP-090024 Rev IR 0825/17 GV-010019 Rev. H 02/28/17 CV-010020 Rev. A 11/30/12 (3V4110039 Rev. A 02/28/17 G1/010040 Rev. IR 03/02/15 A0100001 Rev R 01/23/13 END se SUBSTANTIATION REPORT - SEAT CUSHION a DRESS COVER REPLACEMENT - SEATING PRODUCTS - GULFSTREAM AEROSPACE CORPORATION MODEL GV•SP SN 5173 GULFSTREAM GV-SP DRESS COVER REPLACEMENT SEATING PRODUCTS GULFSTREAM GV/GV•SP CUSHION ASSY 4 PLACE DIVAN GULFSTREAM GV CUSHION ASSY 4 PLACE DIVAN TOOLS GULFSTREAM GV 8 UV-SP CUSHION ASSY PASSENGER SINGLE SEAT GULFSTREAM GV 8 GV-SP CUSHION ASSY TOOLS PASSENGER SINGLE SEAT PLACARDS Notes: I. Structural approval of the seal installations is not included as pan of this 8110-3. 2. This aPPrOual is for engineering design data only. It indicates the data listed above demonstrates Compliance Only with the legUlahOns Speafiecl by paragraph and subparagraph listed below as • -Applicable Requirements." 3. This form does not constitute FAA approval of all the engineering data necessary for substantiation of compliance to necessary, JequIrements for the entire allerationfrepair. Compliance with additional regulations such as 14 CFR §§ 25.803(a). 25.813(021). 25.815, 25.853(a)(c). 25.1411(b), and 25.1561(c) are beyond the scope of this design data. Additional approvals may De required. ..woo .s so ae PND . 37.xam:r.zacs= -- - - a. PURPOSE OF DATA In support of a major alteration to Gulfstream Aerospace Corporation Model GV-SP SN 5173. 9. APPLICABLE REOUIRE ME NTS (tsI Sosonit sonars) 14 CFR §§ 25.561(b1). .562(a1), .603(a). .785(b)(c). and .1541(a1)(b1)(02) through Amendment 25-98. lo Cenretcshou •lirter aultienly ,w.3“1 by freCtion 01 the Arlin:Ws*, 3n.14., arityd4eiC4 will coodoons KO Imiabons ii apvontencoi Life( 14 (JR Pan 153. data kited NARK ono on aMthtO sheets numbered Ne • Ktve been enmir4:4 . OCC140JeWa' wtri 44.1.0600,1POCUIL49. 4430 bona ID WM* A4I, opplca14.9 teVollierrOMS a 33 Anon/5mm Standards kmans 0 Ref Ommend approval of these data I fne.) Maeda gi Approve these data I1 SIGNATURE(S) OE DESIGNATED ENGINEERING REPRESENI Ai rvp(s) I2 DESIGNATION NUMSERS(S) U. CLASSIFICATONISI DAVID S MOLNAR - Ca ..\ _ • b r i tsk...Th- --... DERT-510260CE STRUCTURES FAA Form at les (031101 SUPERSEDES PREVIOUS EDITION SDNY_GM_02757346 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244268 EFTA01329131
SDNY_GM_02757347 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244269 EFTA01329132
U.S. DEPARTMENT Or MIANSPORTATICH FEDERAL AVIATION ADMIMSTPATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1 DATE August 24, 2017 MRCRAFT OR MRCRAFT COMPONENT IDENTIFICATION 2. SAKE Gulfstream Aerospace Corporation 3. MODEL NO. 4 TYPE OFF144. EnPnv. Pone. wai GV-SP s/n 5173 Airplane 6. NAME OF APPLICANT International Jet Interiors Ronkonkona, NY LIST OF DATA 6 IDENTIFICATION 1 TIME Drawings: IJIG5505173A Rev IR IJIG55051738 Rev IR IJIG5505173C Rev IR Reports: IJIG5505173SA Rev IR Addendum A 08/22/17 IJIG5505173SA Rev IR Addendum B 08/22/17 IJIG5505015SA Rev IR Addendum C 08/22/17 Structures Note: Armrest Cover Inge - Divan Cabinet sht 1 -4 dated 07/06/17 LH Fwd Crew Galley Mod Insti sht 1 -4 dated 07/06/17 Monitor Mod Intl - LH Fwd sht 1 - 5 dated 07/06/17 Structural Analysis Divan Cabinet Armrest Cover Installation Gulfstream Aerospace Corporation GVSP Structural Analysis LH Fwd Crew Galley Mod Installation Gutfstream Aerospace Corporation GV-SP Structural Analysis LH Fwd Monitor Mod Installation Gulfstream Aerospace Corporation GV-SP 1) The structural aspects only of the above listed data are approved herein. This approval is only for the engineering data. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as 'Applicable Requirements". 2) This form does not constitute FAA approval of all the engineering design data necessary for substantiation of compliance to necessary requirements for the entire alteration. The requirements of Electrical Systems and Equipment and Flammabiity are not included in this approval and may require separate approval. 3) Satre interior compliance inspection is not included in this approval and requires separate approval. a. PURPOSE OF DATA To provide type data for FAA approval of structure In support of major alteration for Gulfitream OV-SP ski 5173. a AP/VC...MILE REDIAREMENTE (Larl Spica emPard) 14 CFR Part 25, Arndt 25-1 through 25-98 as specified in TCDS Al2EA; Paragraphs: 25.301(a-b) Arndt 25-23, 25.303 Amdt 25-23, 25.305(a, b) Arndt 25-54, 25.307(a) Amdt 25-72. 25.341 Arndt 25-0, 25.561 Arndt 25-23, 25.601 Amdt 25-0, 25.603 Arndt 25-46, 25.605(a) Arndt 25-46, 25.609(a) Amdt 25-0, 25.611 Arndt 25-23, 25.613(a. b, d) Arndt 25-72, 25.619 Arndt 25.23, 25.625(a-c) Amdt 25-72, 25.787(a, b) Arndt 25-51, 25.789(a) Amdt 25-46. 10. CERTIFICATC14 • Under audiattry vested by ditacdon a/ Ms Adrriammor end in &Call:WOO with conalbons and radiant d addffinnad andel 14 CFR PM 163. daft lad Wove and an Mailed WIWI Oufabelecl j hem been canned in accordance wan establahml precedunes end band lo comply Mn applicable dapandnard; al Me Anscrtnhess Stands/0s Wed 0 Recommend approval al these data 1 Or1/41) Therefore 23 Appian these data It. SIONATUFtE/SI OF DESIGNATED ENGINEERING REPRESENTATivEi31 12. OEM:NATION NUMBERSO) IF CIAERIFICATIONiF 1 Donald E. Shepherd, Jr. I 6..m.e.1/14,01.4.4c,77 DERT-230307-CE Structures FAA Form 6110.3 (03/10) SUPERSEDES PREVIOUS EDITOR Ist-INIO -A. SDNYGlvl02757348 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244270 EFTA01329133
SDNY_GM_02757349 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244271 EFTA01329134
VS DEPARTMENT OF11TANSPORTATION FEDERAL AVATIONADMNISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE August 23, 2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Gulfstream Aerospace Corporation 3. MODEL NO. GV-SP s/n 5173 4. TYPE (Alm* Erre. ProteNo. No) Airplane & NAME OF APPLICANT International Jet Interiors Ronkonkona, NY UST OF DATA 6. IDENTIFICATION 7 ?ME Drawings: IJIG5505173D Rev IR IJIG5505173E Rev IR IJIG5505173F Rev IR Reports: IJIG5505173SA Rev IR Addendum D 08/22/17 IJIG5505173SA Rev IR Addendum E 08/18/17 IJIG5505015SA Rev IR Addendum F 08/18/17 Structures Note: Seat Mod Instl sht 1 - 5 dated 08/04/17 Switch Mod Ins!' - Divan sht 1 - 4 dated 07/31/17 LH Aft Galley Mod Insti sht 1 - 4 dated 07/06/17 Structural Analysis Cabin Pallet Installation Gulfstream Aerospace Corporation GV-SP Structural Analysis Passenger Switch Relocation in Cabin of Gulfstream Aerospace Corporation GV-SP Structural Analysis LH Aft Galley Mod Installation Gulf stream Aerospace Corporation GVSP 1) The structural aspects only of the above listed data are approved herein. This approval is only for the engineering data. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as "Applicable Requirements". 2) This form does not constitute FAA approval of all the engineering design data necessary for substantiation of compliance to necessary requirements for the entire alteration. The requirements of Electrical Systems and Equipment and Flammability are not included In this approval and may require separate approval. 3) Aircraft interior compliance inspection is not included in this approval and requires separate approval. PURPOSE OF DATA To provide type data for FM approval of structure in support of major alteration for Gulistream GV-SP sin 5173. to. AMICABLE REQUIREMENTS (IM Meta ) 14 CFR Part 25, Arndt 25-1 through 25-98 as specified in TCOS Al2EA Paragraphs: 25.301(a-b) Arndt 25-23. 25.303 Amdt 25-23, 25.305(a. b) Amdt 25-54, 25.307(a) Amdt 25-72. 25.341 Amdt 25-0, 25.561 Amdt 25-23, 25.601 Amdt 25-0, 25.603 Amdt 25-46, 25.605(a) Amdt 25-48, 25.609(a) Amdt 25-0, 25.611 Arndt 25-23, 25.613(a, b, d) Amdt 25-72. 25.619 Amdt 25-23, 25.625(a-c) Amdt 25-72, 25.787(a, b) Amdt 25-51, 25.789(a) Arndt 25-46. 10. CERTIFCATION - Meet whom Ponies. dam Mad Move ana an visaed Om Ma/oddness vesle6 by doecur d the MeraNalmta and m acecederee MI maims an0 iteltaloas of aceoldnmni tat 14 CFR ahem n mewed Sa_ ham ten emend M accadanca MI establahad mamelures and lend to mayfly wah SUAdvds ad. approval of that dab that data MIMS repuernane of 0 Racommand I vs) Thmiora 0 Approve II. SONATURE(3) OF DESIGNATED ENGINEERING REPRESENTATIVE(31 12. DESIGMADON tdulAKRIM(S) IS CIASSIFICATICMS, Donald E. Shepherd, Jr. leuditgeritad",./ . DERT-230307-CE Structures FM Fens 5110-3 (03/10) SUPERSEDES PREviOuSENTION SDNY_GM_02757350 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244272 EFTA01329135
SDNY_GM_02757351 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244273 EFTA01329136
U.S. DEPARTIAENT OF TRANSPORTATION FEDERAL AVIATICN ADIAINSTRATICte STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE August 24, 2017 MRCRAFT OR MRCRAFT COMPONENT IDENTIFICATION Z MARE Gulfstream Aerospace Corporation 3. MODEL NO. GVSP s/n 5173 4. TYPE (Ant•P. Eight Prom,* ea) Airplane 5. MIMEO F APPLICANT International Jet Interiors Ronkonkona, NY UST OF DATA 7 TITLE t IDEMIFICATCM Drawings: IJIG5505173 Rev IR IJIG5505173J Rev IR IJIG5505173G Rev IR IJIG5505173H Rev IR Reports: IJIG5505173SA Rev IR dated 08/23/17 IJIG5505173SA Rev IR Addendum G 08/22/17 IJIG5505015SA Rev IR Addendum H 08/22/17 Structures Note: Interior Mod Intl sht 1 - 3 dated 07/24/17 Placard Mod Watt slit 1 - 5 dated 08/01/17 RH Aft Galley Mod Intl slit 1 -5 dated 07/06/17 Alt Vanity Mod Intl slit 1 -7 dated 08103/17 Structural Analysis Interior Mod Instl Gulfstream Aerospace Corporation GV-SP Structural Analysis RH Aft Galley Mod Installation Gulfstream Aerospace Corporation GV-SP Structural Analysis Aft Vanity Mod Installation Gulfstream Aerospace Corporation GV- SP 1) The structural aspects only of the above listed data are approved herein. This approval is only for the engineering data. It indicates the data listed above demonstrates compliance only with the regulations specified by paragraph and subparagraph listed below as "Applicable Requirements'. 2) This form does not constitute FAA approval of all the engineering design data necessary for substantiation of compliance to necessary requirements for the entire alteration. The requirements of Electrical Systems and Equipment and Flammability are not included in this approval and may require separate approval. 3) Aircraft interior compliance inspection is not included in this approval and requires separate approval. a. PURPOSE OF DATA To provide type data for FAA approval of structure in support of major alteration for Gulf stream GV-SP sin 5173. Et APPLICABLE RECRARVAENTS (UN Wale seellene) 14 CFR Part 25, Arndt 25-1 through 25-98 as specified In TCDS Al2EA: Paragraphs: 25.301(a-b) Amdt 25-23, 25.303 Amdt 25.23.25.305(a, b) Arndt 25-54, 25.307(a) Amdt 25-72, 25.341 Amdt 25-0, 25.561 Arndt 25-23, 26.601 Arndt 25-0, 25.603 Arndt 25-46, 25.605(a) Arndt 25-46. 25.609(a) Arndt 25-0, 25.611 Arndt 25-23, 25.613(a, 0. 0) Arndt 25-72, 25.619 Arndt 25-23, 25.625(a-c) Amdt 25-72, 25.787(a. b) Arndt 25-51. 25.789(a) Amdt 25-48, 25.1541(a, b) Amdt 25-0. 10. CERTIFICATION - Uncle DuPont,/ heated try datcp0a 0 Re Adrninarsafior and In acceedarce eld, Conlon. and *maroons Of apeoteneant are- II CFR PIK 103. data brad above and on atta:',ea 5heetsrumbeed jEd... have teen 'ammo In accoptanot wen eatablished Noce:Non and found ba comply wet boplabee rectiwnents of PO Ainsten -.ass Standards Latta H Recommend approval of thine data I (04TherelOre w Approve these data 11. SIGNATUREISI Of DESIGNATED ENGINEERING REPRESENTATNEIS) 12. DESIGNATION NUMBERS(S) 13. CLASSIFICATIONIS) Done E. d, dints( DERT-230307-CE Structures FAA Form 51104 (0110) SUPERSEDES PREVIOUS MOON ninP3 SDNY GM_02757352 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244274 EFTA01329137
SONY_GM02757353 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244275 EFTA01329138
U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS I. DATE 08/24/2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Gulf stream Aerospace 3. MODEL NO. GV-SP 4. Type 049,44,4. fare. &cosh.. etc I Airplane 5. NAME OF APPUCANT International Jet Interiors UST OF DATA 9. IDENTIFICATION 7. TITLE TP 329681.17 Rev A Dated 8/24/2017 Skandia, Inc. Flammability Test Report . Bunsen Burner Testing Test Specimen Pan Number 15 (Represents Potty Deck) Notes: 1) Work accomplished under Skandia Inc. WO tg 329681.17. Ref Document ID 100619 2) Flammability test witnessing only, does not constitute installation approval of the materials. 8. PURPOSE OF DATA Demonstration al Compliance with matenal flammability requirements in support of Major Repair 8 Alteration for Sitil 5173 9. APPLICABLE REOUIREMENTS (List spec& sections) 14 CFR Pan 25.853 (a) Arndt 25.118 Appendix F Part I (8)(1)(0) 10. CERTIFICATION - Under authority vested by direction appointment under 14 CFR Part 183. data listed above in accordance with established procedures and found to O Recommend approval of those ( e) Therefore $,.. Approve these data of the Administrator and in accordance with conditions and on attached sheets numbered and limitations of have been examined Standards hstcd. comply with applicable requirements of the Airworthiness data it S NATURE(S) OF DE RATED NGINEERING IL DESIGNATION NUMBERS) 13. CLASSIFICATION(S) A REPRESEIMATIVE CA - Ja o Bib° rstein LAL —ORRY-832790-CE Structural Special FAA Form P£RSEDES PREVIOUS EDITION SDNY_GM_02757354 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0O244276 EFTA01329139
SDNY_GM_02757355 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244277 EFTA01329140
U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS 1. DATE 08/22/2017 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION 2. MAKE Gulf stream Aerospace 3. MOOEL NO. GV-SP & Type (4mrils Err" Thaler. it) Airplane & NAME OF APPLICANT International Jet Interiors UST OF DATA 6. IDENTIFICATION E TITLE TP 329681.17 Rev A Dated 8/22/2017 Skancha, Inc. Flammability Test Report Bunsen Burner Testing Test Specimen Part Numbers 2 (Represents Airstair) 3 (Represents Potty Seats. Divan End Arms) 4 (Represents Lower Side Panels) 5 (Represents Mid Cabin Curtain) 6 (Represents Floor Covering) 7 (Represents Floor Covering - Ducts) 13 (Represents Handrails, Galley 8 Alt Lay and PSUs) 14 (Represents Galley 8 Lay Countertops) 16 (Represents Tables) 17 (Represents Aft Cabin Curtain) 18 (Represents Cabin Bulkhead Covers) Notes: 1) Work accomplished under Skandia Inc. WO II 329681-17, Ref Document ID 100611. 2) Flammability test witnessing only, does not constitute installation approval of the materials. S. PURPOSE OF DATA Demonstration 01 compliance with material flammability requirements in Support of Major Repair 8 Alteration for SiN 5173 9. APPLICABLE REOUREMENTS (Lisf spec& sections) 14 CFR Part 25.853 (a) Arndt 25-116 Appendix F Part I (a)(1)(i) 14 CFR Part 25.853 (a) Arndt 25-116 Apex F Part I (a)(1Kii) la CERTIFICATION - Under authority vested by direction of the Administrator appointment under 14 CFR Pail 183, data listed above and on attached in accordance with established procedures and found to comply with applicable 0 Recommend approval of these data ON Thereon) ‘)3( Approve these data and in accordance with conditions sheets numbered and limitations of have been examined Standards listed. requirements Of the Airworthiness 11. SI TURE(S) OF Dian En ENGINEERING REPRESE ATIVE Ia.DESIGNATION NUMEIER(S) 13. CLASSIFICATION(S) i,4 )1/4t\> ti \CS : CAS ) D a n@ Biberstein DERV-832780-CE Structural Special FAA Form (03/10) SUPcRSEDES PREVIOUS EDITION' SDNY_GM_02757356 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA _00244278 EFTA01329141
SDNYGM02757357 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244279 EFTA01329142
MAJOR REPAIR AND ALTERATION ale (Airframe, Powerplant. Propeller, or Appliance) US 0irotivorl ci Troosponolol Fidefill AVilififlei AdmInisiration ;)Me NO. 2120-0020 leiscooNo ExpS/31/2014 Troddrp Wirer For FAA LIM 0otr INSTRUCTIONS Print or type all entries. See FAR 43.9 Appendix 8, and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition o this form. This report is required by law (49 U.S.C. 44701). Failure to report can result in a civil penalty for each well violation (49 U.S C. 48301(a)). 1. Aircraft Nationally and Registration Mark USA N415LM Serial No. 5173 Model GV-SP Series G550 Make Gutfstream Aerospace 2 Owner Name (As shown on registration certificate) Plan D LLC Address (As shown on registration militate) Mem 6100 Red Hook Quarter 83 city ST Thomas wax Virgin Islands to 00802 roux,. USA 3. For FAA Use Only 4. Type 6. Unit Identification Repair Alteration Unit Make Model Serial No. 0 0 AIRFRAME (As described in item 1 above) 0 0 POWERPLANT 0 0 PROPELLER CI CI APPLIANCE is" Vatholas S. Con onnity Statement A. Agency's Name and Address B Kind of Agency Manufacturer International Jet Interiors U.S. Certificated Mechanic C. Certificate No 2221 Smithtown Ave Foreign Certificated Mechanic Ronkonkoma, New York x Certificated Repair Station CRS 11JR439Y 11779 USA Certificated Maintenance Organization D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on tne reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge Extended range fuel per Signature/Date of Authorized I I 14 CFR Pan 43 0 APR B Jay Massar 5/5/2017 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the Administrator of the Federal Aviation Administration and is ES) APPROVED 0 REJECTED FM Fil Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport BY FM Designee X Repair Station Inspection Authorization Other (Specify) Cenifi ate or Designation No Signature/Date of Authorized In widual CRS I1JR439Y Thomas Norden 5/5/2017 FAA Form 337 'co. SDNY_Gli4_02757358 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244280 EFTA01329143
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft recoil/ An alteration must be compatible with all previous alterations to assure continued Conformity with the applicable airworthiness requirements 8. Description of Work Accomplished of more SpaCe is required. attach additional sheets. Identify with aircraft nationality and registration mark and date work accomplished USA N4151.M Date Nationality and Registration Mark 515i2017 I) Temporarily removed the RH Number 6 Passenger Single Seat for maintenance AMP P/N 2524.524.01(5067A). (GAC P/N GC522080749.05). 2) Calculated a new aircraft W & B report dated 5/5/2017 for the removal of the R/H Number 6 Passenger Single Seat. establishing new Basic Empty Weight and CG. 3) The airerafts updated Weight and Balance report has been provided to customer. 4) A logbook entry has been made reflecting this alteration. 5) Work Order No. 17124, on file at this agency, covers the above described work. No further entries. K Additional Sheets Are Attached FAA Form 337 (10-06) SDNY_GM_02757359 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024428 I EFTA01329144
La* stain duet ,. CEPARTIOENT a TRANSPORTATICSFEDERAL AMMON ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE mthlealf, asd) I 1 IniNY.I It•SM 1•50. MIKAN Colinas GV.SP(65511) 101CAYT WU, IMMO 5173 • CARebb Triune 0 *daft •••,11a4 litulaCt ftisseinie slaw ••••••••••DIC IWNIPII•Va•t MONO. no.. *1~ 4. 0 ...".""'"a""•••••••••••••••••••• •••••••••• ewes awn isa••••••••••••••••••allainaiscas mei.' Ike — OWN Coder•Mrenail Cat rilnoramanris Karin No. TM MU NOW Ist•••• Pommel, egg•Pirengsb 14,0 0 0. IN4 ISM OS. nee" Oilin tiepin Ha SIC MN IMO It* CONS • R•100•200001,04 anitimnine monla •••••••••••••Monat (R.1497/21.511 So mat ••••••1••••••••=adgat• opeagennall.lan • t•SCINWS• VA'S 1•10000•44:04ma Ind ~ASS Fgt.% sealiteMaall ba gairfrioelmf.•••411n ars readenill•••M illas.•••••••• Sipiratogam•••••••• InSll 4•• inetoto fa Mil0111••• Ands P. Low 1004401 WP-27.0AN SON Y_GM_02757360 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244282 EFTA01329145
SDNY_GA4_02757361 ECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, at EFTA_00244283 EFTA01329146
.007.0 suns C. MOW DEPARTMENT OF GW4PORTATION-FEDEM. AVIATION ADMINSTPASON STANDARD AIRWORTHINESS CERTIFICATE :Pin We 01111.00. NMI N4011.0 .....c.....Mo Golfstream GV-SP (GSSS) 14/Cla Min KS: Tramper, API • %Mai 4.1.11:4 onimionna antinne ISC Faro,. nal tonnund WM lining do fon Unit 14•0•00:1/ din. Lumpish TN. "a Lapdog Ns. NW Facapila?4. lannunklinninne art:fl 'Wm IS MY:NO ann.* anal Iv ME .M1 Senn planet tIMIPOn•011b SY* Fakes OS'S (t) Se Fain Obeli Inn In:I Ina*: •OrmientlitO.0041.0%inflera inigt nine n :One Nunn: ea/Mr • Yana (k) no/NM Sinn II In nteinfon WIN ••14 spiii/•=bation.MODJOXIINt MM. IMMO* e Tu Na Pan tower ••••••• SIM /26•8 Jostle P. Lea 27-OAK SONY GM 02757362 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244284 EFTA01329147
SONY_G6.4_02757363 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244285 EFTA01329148
SIC STOI822AT-D APU fire bottle I con Aaron., OM No 21204:020 I imam isactronclralting Nunts MAJOR REPAIR AND ALTERATION US Department Department For FAA Use Only Of Of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation ministration INSTRUCTIONS: Prin or type all entries. See Title 14 CFR § 43.9. Part 43 Appendix e. and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. §44701). Failure to report can result in a civil penalty for each such violation (il9 U S C §48301(a)) 1. Aircraft Nationality and Registration Mark N401HB Serial No. 5173 Make Gulfstream Aerospace Model GV-SP (G650) Series N/A 2. Owner Name (As shown on registration certificate) CHEVRON USA INC. Address (As shown on registration certificate) 7799 EARHART RD. OAKLAND, CA UNITED STATES 94621-4543 3. For FAA Us* Only 4. Type 5. Unit Identification Repair Alteration Unit Make Model Serial No. 0 0I AIRFRAME (As described in Item I above) ) 0 0 POWERPLANT 0 • PROPELLER 0 0 Type APPLIANCE Manufacturer 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency Gulfstream Aerospace Corporation 4150 Donald Douglas Drive Long Beach, CA 90808 USA U.S. Certificated Mechanic I Manufacturer Foreign Certificated Mechanic C. Certificate No. X Certificated Repair Station FAA CRS EC3R470L Airframe Class 4, Limited Powerplant, Limited Accessory. Limited NOT, Radio Class 1.2.3 Certificated Maintenance Organization D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto have been made in accordance vrith the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Extended range fuel per 14 CFR 0 Part 43 App. B Signature/Date of Authorized rKlividUal Calvin Lewis . June 28, 2013 ..-1.4 7. Approval for Rittu to Service Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the Administrator of the federal Aviation Administration and is IXI Approved 0 Rejected et FAA Ft Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport Designee X Repair Station Inspection Authorization Other (Specify) Cenifi ( eatFeMor Designation No. FAA CRS EC3R470L Signature/Date o Authorized Individual Rene Omelet; COr June 28, 2013 'arm I SDNV_GM_02757364 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244286 EFTA01329149
NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft retonl. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. • 8. Description of Work Accomplished: (If more space q required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.) MODEL: GV-SP (G550) ACTT: 3,708.6 SERIAL NO.: 5173 ACTL: 816 TAIL NO.: N401HB DATE BEGUN: June 24, 2013 WORK ORDER NO.: SC12946 DATE COMPLETED: June 28, 2013 Relocated previously installed spare APU Fire Bottle in accordance with Gulfstream Aerospace Corporation Index List GC514428001 Rev 'P' (-507 Configuration) and STC ST01822AT-D amended July 13, 2011. Reference Gulfstream Aerospace Corporation CB 133A and ACB 10A • There are no cockpit procedural changes as a result of this installation. • Instructions for Continued Airworthiness contained in Gulfstream Aerospace Corporation document CE52442A000 Rev 'A' has been provide to the operator. The aircrafts weight and balance / equipment list has been revised. Reference Gulfstream Aerospace Corporation report no. CE550WR5173 Rev 'B'. The impact of this change on aircraft electrical load is negligible. This system found not to interfere with other existing onboard systems. THE END K Additional Seems Aro Attached FAA Form 337 (1046) SDNY_GM02 757365 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244287 EFTA01329150
Nniteb Stales of America !nutriment of fEransportation - Xeberal Ablation Atuninistration Supplemental `Tuve Tertificate (giontittuation Sheet) ./Viendese ST01822AT-D Date Amended: July 31, 2011 ifsiejearthiv, The Certification Basis for Gulfstream Model CV is defined as: (I) Title 14 CFR Part 25 dated February I, 1965, including Amendments 25.1 through 25.81 as defined by the TCDS Al2EA for all areas not affected by the change. (2) Title 14 CFR Part 25 dated February I, 1965, including Amendments 25-I through 25.98 for the change and all areas affected by the change. The following lists the Federal Aviation Regulations complied with through Amendment Level 25.98: 25.1, 25.29, 25.301, 25.303, 25.305, 25.307, 25.561, 25.601, 25.603, 25.605, 25.609, 25.613, 25.619, 25.625, 25.901, 25.903 .25.1195, 25.1197, 25.1199, 25.1201, 25.B01,25.1309, 25.1316, 25.1321, 25.1322, 25.1351, 25.1353,25.1357,25.1431, 25.1438, 25.1519, 25.1529, 25.1541, 25.1581, 25.1585. The Certification Basis for Culfstream Model CV-SP is defined as: Title 14 CFR Part 25 dated February 1,1965, including Amendments 25-1 through 25-98 as defined by the TCDS Al2EA. ...END... Any alttr.ttw sun of ant • not • Mt I Y• • w tell, MA Pool alt0-3-3110-63) HMI 3 or 3 P Thin 07 b• Ceinfiffer•O In OCCONalia WICI. tM .31.43. SDNY_GM_02757366 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00 2 44288 EFTA01329151
SDNY_GM02757367 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244289 EFTA01329152
,United Aloes of America Pepartmeot of Zrironsportntion AebernI cAbiation Aontinistratian Supplemental Zupe Certificate ..46mAie ST01822AT-D ..eks aen44ar.le 44valle Gulfstream Aerospace Corporation 500 Gulfstream Road Savannah, GA 31408 ceotra• (Aar is 44 pa dia.*•/4 , 44,4avaiwro4edwal 44 tanlahaa4 anal aoaalhivaa 4(v tea w y "1; A arolatiVI nolo4 44 amore.-414,64"3,44,easaa4 Vglity o/.64 Federal Aviation gariet4a. ..9g. ti e 4 £la/s ..9revi A I 2EA rearle4, ca•hAteataw 444 astatagitteed.s.k. Ataakt. _attack. *See Page 3 deiodrie A 12EA Gulfstream GV & GV-SP given/44a.* a/Sre EZWira arearnyfll' Installation of an APU Fire Bottle in accordance with Gulfstream Aerospace Corporation Index List GC5 14428001 Rev 1, dated July 31, 2011 or later FAA approved revision. FAA accepted Airplane Flight Manual Supplement, GC51442M00 I, dated April 8, 1999 or later FAA approved revision is required for fully operational configurations (non-spare). For the model GV, Instructions for Continued Airworthiness, GC51442A001, Revision C, dated September 28, 2010 or later FAA accepted revision is required, and must be made available to the operator at the time of installation. For the model GV-SP, Instructions for Continued Airworthiness, CE52442A000, Revision A, dated October 04, 2010 or later FAA accepted revision is required, and must be made available to the operator at the time of installation. ZeP14/0404.1 and feed4414,a4: I. The installer must determine whether this design change is compatible with previously approved modifications. 2. If the holder agrees to permit another person to use this certificate to alter a product, the holder must give the other person written evidence of that permission. (4.44ea/s cat e44 ..ileyseohisfr dais ea 4:14 444,.. sa/norataaerecnvada en 40174e/oelie 2649 al/Innattlialna' January 19, 1999 ge41, •o4aral eAl.ieurikaa. April 08, 1999 Javroa Jairsevosead nave a ionsenallea dale Ooteweil0 P.Volaate60 410 ../georthaaaateto vv. ark. eaie....4/ July 11, 2011 ,.4,. aaite.4tai 0/44./.5,i4,:”Lidaat• (Signarant) William S WhitIo Jr. ODA Lad Adminisntor. ODA-511'31.CE Gultsarcam Aerospace Coiperala Savannah. Georgia (Tide) Any OICerotle• Of Chin ceri177Z:iir it paalahabla by a lino or not fAceediag Al.000. or InprIonsinan nO) taCnOing ) mere. or Nth. .4 taw itte•ms•uo a.; cat* say ore bran err lame. SDNY_GM_02757368 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244290 EFTA01329153
SDNYGM02757369 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024429 I EFTA01329154
VAIL Vane Mena DEPARTMENT OF TFWGPORTADONfi(D91AL AVIATION ACOAINISIPATION STANDARD AIRWORTHINESS CERTIFICATE I I SWIJACIUM11410110X1 I ArralMiall. 4 taw,40“ litartIWOCONSICI man NMIHII GeNNyesis GV-SP (GSM M73 Tramped Elan:MT MO iffaii•Cf rs••••••••••••••ommi soon SOH OS nalloall as Vs darano.lo oohs* oloilliolsocaltorTatimS• Nolo olluirbroinals Imillurerob war. Slabs Ono bane wren too mono ailonuou. to aim "whom Fro *not 40••••••• Cannon. roe. mac nun. 'ASKS, o. , 940 15.1113 K) Door Mime pornefler coops Monti • re prim %cc NM 13,1101 (I) Nagle taste ( stria Liar.* Ne.114,115001 Syr CrIttalt Its. AIDOTOTOIS Ulna moan( amola 4.•••• Islas •flefolni Mar In nootailleolli 1.840.1604•0•14.1.411 Somas% nars.•••••••• ea4• 21. 41. 4 • miliolo k Met [...EdStoma umnoci. imam (N) 03/074001 Jut II'. Lmw wP-27-0NC Iasi "SI. • ole .0•WIN.I.maigliSown• limn\ r.4017% , nr It ce.}.". WI. 414:101**),:ftlia troltatai~o0/00000/.. 2011 Taati.h*IiidolsionoawasIdiee SDNY_GM_02757370 I TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244292 EFTA01329155
SONY_Ghl_02757371 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244293 EFTA01329156
Of•Aftl•CO of • PAMICOZZ;01..1471MZ.4714,141/14 *COWIN, ***** WWI STANDARD AIRWORTRINESS CERTIFICATE • •••••••••• ••• nuns. 1••••••••• GnOnteinnGV•SINGISIft I.m Tension lo•ms.otant• Noe Well M t ^ w , • • • • • ••••••••••• noon. •••••••••••••••.••••••• ono. ••• own. P.. • • ••• oloni mann Ow bail in SO Waal Ivo Ms S..n* a+, *wow. NO SM.= ow N. anew •••••4. In mo eanil000m aftge worse. al bet to. •••••••ooks ••••••••••• ••••••4 o•o•on•••• •••••• ow. •• NS. C - . • - • nn••••••ttn M ISSMO Deo Yawl mar, anonnemb beep one% a NM LUOI mina rant -60S 4.4.111•11l4nIne M940 N.JIM • ••••fax014.1•Tiese Oa*. •••••••••••••••••. wands.. ••••••d.o. • in••••• • lib.. Aar ii MM.* ••••••••• In •••••••.•••••• •••••••4 Ma S.W. Ion. inno.n.o.0.•••••••••• unto h. it 4. ewe fl ee Ow ••••••••••• eeeseieeS gloVell a nuptial the SOO. SW. eatt CO Ma.. I tea eintenvirl St Cl.te•••:* ..•••• • 114002007 Jain D. PM. $MIDV 4RTIOMINT or now.. ••••••••••••• ••••••• ••••• ••••• .• •••••••• • •••• e• S IS% Cie 'WI air N. &WAIT. Mg Iee ...Klan no MCOC• iLuCt Won •7011C•at MIMI. WIPIMOdi WOW FAAnallIM4,a. na...••••-•.”••• SDNY_GM 02757372 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00244294 EFTA01329157
SONY_Ghl_02757373 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA _00244295 EFTA01329158
Fece7Zmi 700 5 -0 • . . --.---Ow•TED y•TrirtS •• fl rr A OCP•OTMENT Or TrIANSOORTATION-rEOCRAL AVIATION ADPAINitifIl•TiON STANDARD AIRWORTHINESS CERTIFICATE • ...0.".• • ..2 ..:asisal•o• ..... N401H8 , ... v ac ••••• •••2•001• II ••••c••• t ft , num.* Gulfstream GY-SP (G550) I 517.3 I (illytrAT Transport s ni soa.i • no mic.is 100 iSyysatti li...• ...oak.... •••t.f•••• :•••••••• ••••••••• iv ••• 1•4••01 .4'. ar 0 ma 6. 4 1. 61••• 11•••. •• •1 •••• •••• •• ;,....... ••• ..•••••• i• •••• ..... hos %era .•mar.ni and faro. •• 4••••••• ' .6. ••••• •••••/•••• .NN... . •• bo •• •••••"-••• 1. wry atinSa. as No• arra is... ea so ..,. .s........• .i at ow anal-sire ioss......;.• es eieS.is o..nner.sii an in renting 61 " sr. I ••• 0.0 C" .1^60" " ........ 4 ' 0 C:" I ••••••••• •••••• •• Prod 1••••••• 6•••• 606.. Etenstkin No. 7946 26.111) (e) Door Snnen p ger consannie an . Carnation No. 8004 251101 (c) Slade Failure Crania raemption Ma. 8142 25.901 (C) Slagle fa tare Criteria • 11...5 •••0 tti.TI•0•.% y.k.„ ...... is,....,, Ad ,.....da, ...OH . 2, . 1.•••••••••••• dogs P., .....ik.•••• •••••1•••• .• •••••••• . long at s•••••••••••••• ern 1.4.•4 4. ,110•40.1* wok ra.i. 71. 0. •••• 11. • 1k. I,.. ....flak .• ••••••••••1 6. SA 1.1••••••,•••••• •• 01...1•••••••10.0••4 p• .... IN •••• .1•••••••• ..... I v. ..., NI ^Ir. • 9.4, 6, .....• :•••• ••• 14...1..e., . •••••••••!.. ••••• .6. 11••• Or ISH•••(1 RIO/31/2007 file+ airi.1500.1.1 James D. Prentiss • Oe..c..A1•2•• ...WO DAPT100271WP •-• an.... .••. •••••I...i.•. In ...orb* *I ts o..t .,........,..• ... (1,.• •• 1•••/.. 1141% elf it •14(1 yells AIIitC•411 11D OM ret•ficry tity• fl ••••• be pi", •11. be • fat • ...... •••• I1.000. I.. ••• Call nal II DiSrian0 , N 7.1 MOM" , IM A(COO 1.4% FAA Form 8100.2ov. or...cat.- na r o e "" ......... ....—............... I find that the aircraft meets the requirements for, and have reinstated the standard airworthiness certificate shown above in accordance with order 8130.29 dated June 29, 2007. SDNY_GM_02757374 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_OO244296 EFTA01329159
SDNY_GM02757375 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244297 EFTA01329160
Batman Safety Handle 0 US Department MAJOR REPAIR AND ALTERATION Of Transportation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration Fen ACOnY*4 OMB Ho 21/0.0020 11/30/7C07 ekOant Tatar, Mine For FAA Use Onty INSTRUCTIONS: Prin or type all entries. See Title 14 CFR § 43.9. Part 43 Appendix D. and AC 43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U.S.C. §44701). Failure to report can result in a civil penalty ter each such violation. (49 U.S.C. §46301(a)) 1. Aircraft Nationalityand Registration Mark N401HB Serial No. 6173 Make Gulfstream Aerospace Model GV-SP (G660) Series N/A 2. Owner Name (As shown on registralion cerlicale) Chevron USA Inc. Address (As shown on regis(refionantbeele) 6001 Bollinger Canyon RD San Ramon, CA 94583-2324 United States 3. For FAA Use Only 4. Type 5. Unit Identification Repair Alteration Unit Make Model Serial No. El gil AIRFRAME (As described in Item I above) 0 0 POWERPUVIT 0 0 PROPELLER 0 El APPUMCE Type Manufacturer 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency Gulfstream Aerospace Corporation 4150 Donald Douglas Drive Long Beach, CA 90808 USA U.S. Certificated Mechanic I Manufacturer Foreign Certificated Mechanic C. Certificate No. X Certificated Repair Station FAA CRS EC3R470L Airframe Class 4. Limited Powerplant. Limited Accessory, Limited NOT. Radio Class 1,2.3 Certificated Maintenance Organization D. I certify that the repair and/or alteration made to the unfts) identified in item 5 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Extended range fuel per 14 CFR Part Part 43 App. B • Signature/Date of Authorized) . . ual —.....2 B= - David A. Cecil, Airworthiness Inspector February 25, 2011 7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the Administrator of the federal Aviation Administration and is El Approved 0 Rejected ay FAA Ft Standards Inspector Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport FAA Designee X Repair Station Inspection Aut • on (SPOCitY) Certificate or Designation No. FAA CRS EC3R470L Signature/Date of Au hotized Individ <I • Ronald S. Reece, Quality Control Anal February 25. 2011 FAA Form 337 (10-06) SONYGfil_02757376 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA _00/4-4198 EFTA01329161
NOTICE Weight and balance oroperaling limitation changes shall be entered in fhe appropnate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable sinvorthiness requirements. 8. Description of Work Accomplished: of more space is required. attach additional sheets. Identify with aircraft nationality and registratte mark and date work completed.) MODEL: GV-SP (G550) SERIAL NO.: 5173 TAIL NO.: N40 I FIB WORK ORDER NO.: SC9549 ACTT: 2.0.).).4 ACTL: 457 DATE BEGUN: February 19, 201 1 DATE COMPLETED: February 25, 2011 Accomplished modification to the Baggage Compartment to incorporate 2 new Safety Handles P/N: 682-3000 at fuselage stations 693.32 and 735.58 WL 106.08 in accordance with Gulfstream Aerospace Corporation FAA DER approved data list CE524960076 Rev. 'A', 'Data List — Interior /Avionics / Mechanical (Service,1'. Above structure modification (Baggage Compartment Safety Handle) data approved under ODA -511131-CE project no. TA-04-2011-0010. FAA form 8100-9 data approval by FAA AR-E- I 076, (Structure). Aircraft weight and balance has been revised and is contained in Gulfstream Aerospace Corporation Report No. CESSOWR5173 Rev. `--1. Aircraft equipment list remains unchanged. The impact of these changes on aircraft electrical load is negligible. These systems found not to interfere with other existing onboard systems. The End K Additional Sheets Are Attached FAA Form 337 (1046) SDNY_GM_02757377 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244299 EFTA01329162
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATOR ADMINISTRATION STATEMENT OF COMPLIANCE WITH AIRWORTHINESS STANDARDS FAA Prefect NO TA-04-2011-0010 AIRCRAFT OR AIRCRAFT COMPONENT IDENTIFICATION MAKE Gulfs tress MODEL NO. CV-SP TYPE (Mane. Erne. Putonr, Mt) Aircraft NAME OF AFFontrumffi4ONZATION In Gulfsnen laarespaess Corporation ODA-511131-CE LIST OF DATA IDENTIFICATION TTTLE GAC Data Data List - Interior /Avionics / Mechanical 'Service) End of Data 01524960076 Rev A Dated: 2/24/11 mete: leas °airstream Organization Doslipeataan Authorisation approves tans data. This constitute. Plea lippreval of the sales alteration data listed and an not intallstion data. The systems an equipannt ninon on not inland . Valid only for adlatraas CV-SP all 51.71. Pont In structural, aspects only of the shove l lend data ass approvid herein. Rota: 7113.0 approval is any fox the toginserirq design data end is not instellatioe data. mote: Din alteration hap no impact on the in (structural spelt.). PURPOIII OF DATA Support of Major Alteration to Gulfstream GV-S? SN 5173 to accomplish the Safety Handle Installation in the Baggage Compartment. APPUCABLE REOUNIPATENTS Oat stink anon laCM Part 25, Paragraphs 25.301, 25.303, 25 .305 (a) (b) , 25.603, 25.605 and 25.607. &wept aa noted, all applicable requirements are to amendment 25-1 through 26.9E as established in SODS Allah, Pension 35. ant In accordance .tan toe ocadkicoli and Imitators rumbaed None Inv boon oinantid In °cup/dam:Own of auttionzatkm unit 1.1 CFR. data eindshed procedures and found CERTIFICADM - At diNtlad by theAdmit/debtor Wed above ad on ettached note to canary WM usalcable requirements a the Airsortheates Standards Med. approval of these data these data . Recommend I (I4ITIntrafera: l: Apprise ego nX.5) or aro Rineallawninvars) HAAR cintantaincere DAIS JJ . Jon O. Nguyen IP AR-E-1076 Stiurtme rem 24,201: pinta gam ODA-511131-CH FAA farm 81004 (242) SDNY_GM_02757378 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244300 EFTA01329163
SDNY_GM_02757379 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244301 EFTA01329164
(A* 0 US Department MAJOR REPAIR AND ALTERATION Of Transponation (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration r o a n A . * r t . c 0/40 No 21 TO-0O20 11/30/007 Nevem. incite wire For FAA use Only INSTRUCTIONS: Print or type al entries. See Title 14 CFR § 43.9, Part 43 Appendix B. and AC 43.9.1 (or subsequent revision thereof) for instructions and disposition of this form. This report is required by law (49 U S.C. §44701). Failure to report can result in a civil penalty for each such violation. (49 U.S.C. §463O1(a)) Nationality and Registration Mani 4O1HB Serial No. 5173 1. Akar* Make GULFSTREAM AEROSPACE Model I Series GV-SP (G55O) 2. Owner Name (As shown on registrabon certificate) CHEVRON USA INC Address (As show, on registration certificate) 6001 BOLLINGER CANYON RD SAN RAMON CA 94583.2324 3. For FAA Use Only 4. Type 5. Unit Identification Repair Alteration tine Make Model Serial Nc O a NRFRAME described in Item 1 above' (As 0 0 wowEFtMANT 0 El PROPELLER • O Type APPLIANCE manufactufer 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency Guifstream Aerospace Corporation W6365 Discovery Drive Appleton, WI 54914 U.S. Certificated Mechanic I Manufacturer Foreign Certificated Mechanic C. Certificate No. X Certificated Repair Station G1FR1OOY Certificated Maintenance Organization D. leerily that the repair anctior alteration made to the units) identified in item 5 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Pan 43 of the U.S. Federal Aviation Regulations and that the hibernation furnished herein is true and correct to the best of my knowledge. Extended range fuel per 14 CFR O Part 43 App. B Signature/Date of Authorized Individual David L. Wellnitz i0, 46•2 1e,...ezi4) • 01722/2010 7. Approval for Return to vio Pursuant to the authority given persons specified below, the unit identified in item 5 was Inspected in the manner prescribed by the Administrator of the federal Aviation Administration and is tR1 Approved O Rejected BY FM Fit. Standards Inspector I Manufacturer Maintenance Organization Persons Approved by Canadian Department of Transport FAA Designee X Repair Station Inspection Authorization . Other (Specify) Certificate or Designation No. G1FR1OOY Signature/Date of Authorized Individual David L weenie44,4e-be h )814:-.. 07/2212010 FAA Farm 337 (10-06) SDNY_Givi02757380 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00244302 EFTA01329165
NOTICE Weight and balance limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous aerations to assure continued conformity with the applicable airworthiness requirements. a Description of Work Accomplished (ti more soave is remised. attach additional sheets wen* with aircraft nationality and registration mark and one work completed; installed a HoneyweiVEMS HD-710 combined SATCOM Swill Broadband High Sneed Oata System in accordance with Gulfstream Aerospace STC ST03737AT-D issued 10/09/2009. Instructions for Continued Airworthiness Reference Gulfsrrearn Aerospace Corp instructions for Continued AirworMiness Document No. GCSI 303A011 dated 09/16/2009 Deviations are DER approved on the following listed GAC Drawing by Peter Jobe . AR-E-1063 on FAA 0100-B form dated 0122/2010. pRAWING SYSTEM GC51 1030304. key B SATCOM Modified Galley Cabinet Trash Container removing lid in accordance with GAC Engineering NIECO-A09371 - NIECO to GC528200509 - Placard Location and NIECO A09369 • NIECO to GPM30800158i -301 - Galley Assy. Aft Uri of WIWI are DER approved by Bill Riley. AR•E-1067 on FM 8100-9 form dated 01/22/2010. Reference GAC Fire Containment Similarity Report No. CE528023003 dated °Imam. Modified Cabin Audio System in accordance with GAC Engineering Drawing GC51 5010326, Rev. A - Cabin Audio of which are DER approved by Peter Jobe . AR-E-1063 on FAA 8100-9 form dated 01122/2010. Modified Cabin Drnvash and Downwash Lighting In accordance with GAC Engineering Drawing GC5810316. Rev. A - Cabin Effect Lights of which are DER approved by Peter Jobe , AR-E-1063 on FAA 8100-9 town dated 0122/2010. Reworked Cabin Curtain In accordance With GAC Engineering NIECO-L02208 - NIECO to GC522880035 (A) • Pnvacy Curtain Installation of which are DER approved by Sill Riley. AR•E-1067 on FM 8100-9 form dated 01/2212010. The Aircraft Weight & Balance is negligible. END Additions( Sheets are attached. SDNY_GM_02757381 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00244303 EFTA01329166

















