Reporting Schemes | Belize Department of Civil Aviation

BELIZE DEPARTMENT OF CIVIL AVIATION

PHILIP S. W. GOLDSON INTERNATIONAL, LADYVILLE

P.O. BOX 367, BELIZE CITY, BELIZE

All fields maked with (*) are REQUIRED

Operator

Aircraft Make/Model

Engine Make/Model

Aircraft Registration

Date

Aerodrome/Location (if known)

Aircraft Time out of Service hours

Estimated cost of repairs or replacement USD $ (in thousands)

Estimated other costs USD $ (in thousands) (e.g. loss of revenue, fuel, hotels)

Send all bird remains including feather fragments to:

Reported by:

Engine position number		1	2	3	4
Reason for failure/shutdown
	uncontained failure
	fire
	shutdown - vibration
	shutdown - temperature
	shutdown - fire warning
	shutdown - other (specify)
	shutdown - unknown
	Estimated percentage of thrust loss
	Estimated number of birds ingested

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