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Airnav Indonesia: Aerodrome Report Form

The document is an aerodrome report form notifying of a change in serviceability at WAQD aerodrome. It reports that on April 10, 2017 between 0400-0500 UTC, visibility was reduced to 2000 meters due to rain. The form requests that a NOTAM be issued and sent to the specified fax number and approvals are provided by the requested, prepared, and approved parties.

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52 views

Airnav Indonesia: Aerodrome Report Form

The document is an aerodrome report form notifying of a change in serviceability at WAQD aerodrome. It reports that on April 10, 2017 between 0400-0500 UTC, visibility was reduced to 2000 meters due to rain. The form requests that a NOTAM be issued and sent to the specified fax number and approvals are provided by the requested, prepared, and approved parties.

Uploaded by

airnavtjs
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Kantor Pelayanan Navigasi Penerbang

LPPNPI Tanjung Selor


Jl. Ulin, No.118, Tanjung Selor
Kalimantan Utara 77200
AirNav Indonesia Telp. 0811 5919 853
Fax. 0552-22470
  Email : airnav_tjs@yahoo.com

AERODROME REPORT FORM


Notification of Change to Serviceability of a Certified Aerodrome

NOTAM OFFICE PHONE : FAX :


AERODROME : WAQD
Time UTC (Preferred) (1) UTC (2) WST (3) CST (4) EST
Purpose Of Report ( ) PROVIDE NEW INFORMATION DETAILED BELLOW
( ) EXTEND PREVIOUS ADVICE (NOTAM No. ....................) Date ...............
( ) EXTEND PREVIOUS ADVICE (NOTAM No. ....................) Date ...............

Periode of Validity Permanent/Temorary NOTAM (Delete one)


Fr om 1704100400
To 1704100500
(Temporary NOTAM Only)
Note : If time estimated, contact NOTAM OFFICE at least 2 hour before estimated duration
time and advise if NOTAM is to be extended of cancelled
Daily duration or time schedule (if applicable)
From : .........................................
To : ......................................... Estimated (if finish time uncertained)
TEXT OF NOTAM
Visibility at 00.00 : 2000 meters due to rain
Please send NOTAM issued to originator by AFTN addres....................or FAX to no.....................
Approved and Acknowledge by : Requested by : Prepared by :

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


Kantor Pelayanan Navigasi Penerbangan Perum
LPPNPI Tanjung Selor
Jl. Ulin, No.118, Tanjung Selor
Kalimantan Utara 77200
Telp. 0811 5919 853
Fax. 0552-22470
Email : airnav_tjs@yahoo.com

rome

ore estimated duration


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

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