52
Aircraft Rego VH - Aircraft Serial No Aircraft Model No FH on Aircraft FC Report Date 21063529 210N Resolution Work Carried Out FL Airframe A/C FL Code ATA Eng No Maintenance Action Name Description AMO Job Number Due List Status CURRENT Updated Updated Updated Report Type 054 Aircraft History A/C FC Resolved Certification Date A/C FH Operator 11,084.50 2 Feb 2021 24 Nov 2020 BROOME AVIATION PTY LTD AMO Description SJG Entry Date Entered By Status MC Number 24 Nov 2020 2500 Equipme ELT Battery Carried out satisfactorily nil defects FL FH FC 24 Nov 2020 Broome Air Maintenance 2021131 11,084.5 Scott Carlson 30 Nov 2020 Closed Test 2020-1018 2500 Equipme ELT Battery Battery Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFF and ON FL FH FC 24 Nov 2020 Broome Air Maintenance 2021131 11,084.5 Scott Carlson 30 Nov 2020 Closed Replace 2020-1018 4 Nov 2020 6100 Propeller Propeller Hartzell PHC-J3YF-1RF Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFF and ON FL FH FC 1 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Overhaul 2020-0872 0505 Airworthin Fuel Injection Supply Lines AD/CON/60 amd 3 Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Inspect 2020-0872 2600 Fire Protectio Hand Held Fire Ext (Halon) Avtrac Form 05-010 Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Reweigh 2020-0872 0505 Airworthin Seat Adjustment Mechanism FAA AD/2011-10-09 Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Inspect 2020-0872 0505 Airworthin Horizontal Stabiliser Front Spar AD/C210/69 amd 2 Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Inspect 2020-0872 3700 Vacuum Vacuum System Hoses C210 MM Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Replace 2020-0872 3700 Vacuum E.D. Dry Vacuum Pump C210 MM Chapter 2 Carried out satisfactorily nil defects FL FH FC 1 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Inspect 2020-0872 0505 Airworthin Engine Performance Run AD/ENG/4 Amdt 11 Carried out satisfactorily nil defects FL FH FC 4 Nov 2020 Broome Air Maintenance 2021112 11,069.1 Scott Carlson 5 Nov 2020 Closed Inspect 2020-0872 Page 1 Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

24 Nov 2020 4 Nov 2020 - Avtrac

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Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

24 Nov 20202500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

24 Nov 2020

Broome Air Maintenance 2021131

11,084.5Scott Carlson30 Nov 2020

Closed

Test 2020-1018

2500Equipme

ELT BatteryBattery

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC

24 Nov 2020

Broome Air Maintenance 2021131

11,084.5Scott Carlson30 Nov 2020

Closed

Replace 2020-1018

4 Nov 20206100Propeller

Propeller HartzellPHC-J3YF-1RF

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Overhaul 2020-0872

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Reweigh 2020-0872

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

3700Vacuum

Vacuum System HosesC210 MM

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Replace 2020-0872

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

Page 1Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Service 2020-0872

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

5700Wings

Spar Corrosion Protection SchemeEO TDE3486-01-R1

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

5700Wings SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

3300Lights

Landing Light and Beacon Light SwitchesTR D2057-3TR11

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Replace 2020-0872

2700Flight

Elevator and Trim Tab InspectionSEB85-7 R04

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

3200Landing

Nose Gear GuideP/N 9882024-1

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

Page 2Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

5700Wings

Wing Lower Spar Cap InspectionSID 57-11-04

Carried out satisfactorily nil defects

FL

FHFC

4 Nov 2020

Broome Air Maintenance 2021112

11,069.1Scott Carlson5 Nov 2020

Closed

Inspect 2020-0872

2300Communi

Static WickU/S

New wick installed

Scheduled FL

FHFC

4 Nov 2020

Broome Air Maintenance 20210112

11,069.1Scott Carlson5 Nov 2020

Closed

2020-0872

3200Landing

Shimmy Dampenerleaking

Resealed IAW C210 MM

Scheduled FL

FHFC

4 Nov 2020

Broome Air Maintenance 20210112

11,069.1Scott Carlson5 Nov 2020

Closed

2020-0872

FL

FHFC

4 Nov 2020

Broome Air Maintenance 20210112

11,069.1Scott Carlson5 Nov 2020

Closed

2020-0872

30 Jun 20202500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Test 2020-0439

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Replace 2020-0439

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

7400Engine

Magneto Bendix LH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

Page 3Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7400Engine

Magneto Bendix RH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Reweigh 2020-0439

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

7600Engine

Propeller ControlC210 MM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Service 2020-0439

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

2700Flight

Elevator Trailing Edge & Elevator Trim TabCAP 27-30-02

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

Page 4Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

2800 Fuel Quick Drain Valves - Fuel Reservoir & Fuel TanksCAP 28-30-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

2900Hydraulic

MLG Hydraulic Hose & Component ReplacementCAP 29-10-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Replace 2020-0439

3200Landing

Nose Gear Turning StopCAP 32-50-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

3900Electrical

Engine Compartment Wiring & Equipment InstallationCAP 39-00-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

3200Landing

Main Landing Gear Actuator Mounting BoltsCAP 32-30-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

3200Landing

Gear Warning/Fuel Pump Switch Control ImprovementCAP 32-60-01

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

5700Wings SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

5700Wings

Wing Structure Corrosion InspectionSID 57-11-02

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

2700Flight

Elevator and Trim Tab InspectionSEB85-7 R04

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0505Airworthin

Primary Flight Control Cable TerminalsAD/GENERAL/87 Amdt 1

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

Page 5Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

Nose Gear GuideP/N 9882024-1

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

200 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

0500Maintena

Electrical & Instrument InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

5700Wings

Wing Lower Spar Cap InspectionSID 57-11-04

Carried out satisfactorily nil defects

FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920230

10,971.6Scott Carlson

2 Jul 2020

Closed

Inspect 2020-0439

3200Landing

MLG WheelsBearings require lubrication

Cleaned, inspected, and greased as required

Unscheduled FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920320

10,971.6Scott Carlson

2 Jul 2020

Closed

2020-0439

3200Landing

NLG WheelBearings U/S

Bearings replaced

Unscheduled FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920320

10,971.6Scott Carlson

2 Jul 2020

Closed

2020-0439

2400Electrical

BatteryU/S

Replaced with new item

Unscheduled FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920320

10,971.6Scott Carlson

2 Jul 2020

Closed

2020-0439

Page 6Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7300Engine

Fuel BowlO-rings U/S

Replaced IAW C210 AMM

Unscheduled FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920320

10,971.6Scott Carlson

2 Jul 2020

Closed

2020-0439

7800Engine

Engine LH Exhaust MountBroken

Replaced IAW C210 MM

Unscheduled FL

FHFC

30 Jun 2020

Broome Air Maintenance 1920320

10,971.6Scott Carlson

2 Jul 2020

Closed

2020-0439

24 Jun 20205700Wings

Wings - Lower Main Spar Cap 2SID 57-11-03

Carried out satisfactorily nil defects

FL

FHFC

24 Jun 2020

Broome Air Maintenance 1920320

10,971.5Scott Carlson26 Jun 2020

Closed

Inspect 2020-0462

16 Mar 20206100Propeller

Propeller HartzellPHC-J3YF-1RF

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

16 Mar 2020

Broome Air Maintenance 1920

10,956.4Scott Carlson18 Mar 2020

Closed

Overhaul 2020-0202

27 Nov 20192300Communi

TransponderCAO 100.5 (14)

Carried out satisfactorily nil defects

FL

FHFC

27 Nov 2019

Broome Air Maintenance 1920181

10,906.5Scott Carlson17 Dec 2019

Closed

Test 2019-1203

3100Instrumen

LH AltimeterCAO 100.5 (4.4)

Carried out satisfactorily nil defects

FL

FHFC

27 Nov 2019

Broome Air Maintenance 1920181

10,906.5Scott Carlson17 Dec 2019

Closed

Test 2019-1203

3100Instrumen

Pitot Static TestCAO 100.5 (3.4)

Carried out satisfactorily nil defects

FL

FHFC

27 Nov 2019

Broome Air Maintenance 1920181

10,906.5Scott Carlson17 Dec 2019

Closed

Test 2019-1203

2300Communi

Automatic Altitude Encoder TestCAO 100.5 (4.7)

Carried out satisfactorily nil defects

FL

FHFC

27 Nov 2019

Broome Air Maintenance 1920181

10,906.5Scott Carlson17 Dec 2019

Closed

Test 2019-1203

5700Wings

Wing Front Spar InspectionSID 57-30-01

Carried out satisfactorily nil defects

FL

FHFC

27 Nov 2019

Broome Air Maintenance 1920181

10,906.5Scott Carlson17 Dec 2019

Closed

Inspect 2019-1203

Page 7Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

6 Nov 20192500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Test 2019-1062

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Reweigh 2019-1062

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

7100Power C210 MM

Carried out satisfactorily nil defects

FL

FHFC1

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Replace 2019-1062

7100Power

Engine Rubber HosesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Replace 2019-1062

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

Page 8Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Service 2019-1062

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5300Fuselage

Carry-Thru Spar Corrosion InspectionSID 53-11-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5300Fuselage

Cabin Interior Skin Panels Corrosion InspectionSID 53-30-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5700Wings

Wing Structure InspectionSID 57-11-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5700Wings

Wing Root Rib Corrosion InspectionSID 57-12-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

5700Wings

Flap Tracks Corrosion InspectionSID 57-53-01

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

Page 9Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3100Instrumen

LH AltimeterCAO 100.5 (4.4)

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Test 2019-1062

3100Instrumen

Pitot Static TestCAO 100.5 (3.4)

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Test 2019-1062

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

3200Landing

Nose Gear GuideP/N 9882024-1

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

0505Airworthin

ELT Inspection/Modification/ReplacementEASA AD 2019-0235

Carried out satisfactorily nil defects

FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

Inspect 2019-1062

2300Communi

1x Static WickU/S

Wick replaced

Unscheduled FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

2019-1062

3200Landing

Nose Gear Guide ShieldU/S

Shield replaced with new item

Unscheduled FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

2019-1062

Page 10Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7400Engine

12x Spark PlugsU/S

12 new spark plugs installed

Unscheduled FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

2019-1062

3300Lights

BeaconU/S

Globe replaced

Unscheduled FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

2019-1062

3100Instrumen

Static SystemLeak

Tightened loose fitting on the ASI & Altimeter

Unscheduled FL

FHFC

6 Nov 2019

Broome Air Maintenance 1920173

10,895.4Scott Carlson7 Nov 2019

Closed

2019-1062

14 Oct 20195700Wings

Wing Front Spar InspectionSID 57-30-01

Carried out satisfactorily nil defects

FL

FHFC

14 Oct 2019

Broome Air Maintenance M/R

10,851.0Scott Carlson7 Nov 2019

Closed

Inspect 2019-1114

25 Sep 20190505Airworthin

Primary Flight Control Cable TerminalsAD/GENERAL/87 Amdt 1

Carried out satisfactorily nil defects

FL

FHFC

25 Sep 2019

Broome Air Maintenance M/R S/NA222522

Scott Carlson7 Nov 2019

Closed

Inspect 2019-1123

25 Jul 20193100Instrumen

Air Speed IndicatorCAO 100.5 (5.4)

Carried out satisfactorily nil defects

FL

FHFC

25 Jul 2019

Broome Air Maintenance 1920053

10,823.6Scott Carlson1 Aug 2019

Closed

Test 2019-0746

3 Jul 20195700Wings Mandatory Service Bulletin

Carried out satisfactorily nil defects

FL

FHFC

3 Jul 2019

Broome Air Maintenance 1920004

10,808.1Scott Carlson

8 Jul 2019

Closed

Inspect 2019-0643

24 May 20192500Equipme Battery

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Test 2019-0449

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Replace 2019-0449

Page 11Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Reweigh 2019-0449

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

3200Landing

Wheel BearingsC210 MM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

3100Instrumen

Gyro Central Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

Page 12Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

Nose Gear Steering Collar & Upper Torque LinkCAP 32-50-02

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

3200Landing

Nose Gear GuideP/N 9882024-1

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

200 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

0500Maintena

Electrical & Instrument InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Inspect 2019-0449

Page 13Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

RH MLG Wheel BrakeCaliper Guide Pins worn

New pins installed

Unscheduled FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

2019-0449

8000Engine

Starter AdapterRequires replacement

Starter adapter & gasket replaced

Unscheduled FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

2019-0449

7500Engine

Engine Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

Replace 2019-0449

5600Windows

Vista VentWon’t open

New vent installed

Unscheduled FL

FHFC

24 May 2019

Broome Air Maintenance 1819331

10,794.2Scott Carlson29 May 2019

Closed

2019-0449

14 Dec 20182500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Test 2018-1292

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Reweigh 2018-1292

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3700Vacuum

Vacuum Relief Valve FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Replace 2018-1292

3200Landing

BrakesC210 MM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

Page 14Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3400Navigatio

Magnetic Compass CompensationC210 MM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

7500Engine

Engine Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Replace 2018-1292

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Record 2018-1292

3200Landing

Main Gear Downlock ActuatorCAP 32-30-02

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5700Wings

Spar Corrosion Protection SchemeEO TDE3486-01-R1

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

Page 15Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3200Landing

Main Landing Gear Retraction System InspectionSID 32-10-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3200Landing

Landing Gear Spring Corrosion InspectionSID 32-13-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3200Landing

Nose Gear Torque Link and Fork InspectionSID 32-20-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5300Fuselage

Firewall InspectionSID 53-12-02

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5300Fuselage

Seat Rails and Seat Rail Structure Corrosion InspectionSID 53-47-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5500Stabilsers

Horizontal Stabilizer, Elevator, and AttachmentsInspectionSID 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5500Stabilsers

Vertical Stabilizer, Rudder and Attachments InspectionSID 55-30-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

5700Wings

Aileron Support Structure InspectionSID 57-51-01

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

Page 16Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

Main Landing Gear ActuatorSEB01-02

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3200Landing

Nose Gear GuideP/N 9882024-1

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018Inspect 2018-1292

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

Inspect 2018-1292

3400Navigatio

Compass Cup (Holder)Melted

New holder installed

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

2300Communi

Comm 2 RadioMissing knob

Serviceable knob installed

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

5200Doors

Pilot’s Door Sill (Lower)U/S

New sill manufactured and installed

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

3300Lights

RH Strobe LightU/S

Globe replaced

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

3200Landing

RH MLG Wheel BrakePad missing

New pad installed

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

Page 17Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7800Engine

LH Exhaust ManifoldCracked

Repaired manifold installed

Unscheduled FL

FHFC

14 Dec 2018

Broome Air Maintenance 1819177

10,691.5Scott Carlson17 Dec 2018

Closed

2018-1292

27 Sep 20180505Airworthin

Primary Flight Control Cable TerminalsAD/GENERAL/87 Amdt 1

Carried out satisfactorily nil defects

FL

FHFC

27 Sep 2018

Broome Air Maintenance 1819098Scott Carlson12 Oct 2018

Closed

Inspect 2018-1091

2300Communi

2 Static Wicks U/S New wicks installed

Unscheduled FL

FHFC

27 Sep 2018

Broome Air Maintenance 1819098Scott Carlson12 Oct 2018

Closed

2018-1091

2700Flight

Wing FlapsAssymetrical (Pilot report)

Flaps re-rigged IAW C210 MM Ch 7

Unscheduled FL

FHFC

27 Sep 2018

Broome Air Maintenance 1819098Scott Carlson12 Oct 2018

Closed

2018-1091

16 Aug 20182500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Test 2018-0842

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Replace 2018-0842

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

Page 18Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

2500Equipme

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

3200Landing

Nose Gear GuideP/N 9882024-1

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018Inspect 2018-0842

0500Maintena

100 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0500Maintena

50 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

Page 19Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0500Maintena

Radio Periodic InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0500Maintena

Operational InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0500Maintena

200 Hour InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

0500Maintena

Electrical & Instrument InspectionBroome Aviation C210 SOM

Carried out satisfactorily nil defects

FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

Inspect 2018-0842

2800 Fuel Fuel StrainerNot shutting off

Adjusted IAW C210 AMM, no defect

Unscheduled FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

2018-0842

2400Electrical

AlternatorBelt loose

Tension adjusted IAW C210 AMM

Unscheduled FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

2018-0842

3200Landing

RH MLG Wheel BrakeOuter bearings and cup

Bearings and cup replaced IAW C210 AMM

Unscheduled FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

2018-0842

3200Landing

RH MLG Wheel BrakeInner Linings U/S

Linings replaced IAW C210 AMM

Unscheduled FL

FHFC

16 Aug 2018

Broome Air Maintenance 1819062

10,598.8Scott Carlson16 Aug 2018

Closed

2018-0842

6 Jun 20182500Equipme

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Test 2018-0491

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Replace 2018-0491

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

Page 20Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7400Engine

Magneto Bendix LH10-349350-4

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Overhaul 2018-0491

7400Engine

Magneto Bendix RH10-349350-5

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Overhaul 2018-0491

7400Engine

Magneto Bendix LH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

7400Engine

Magneto Bendix RH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Reweigh 2018-0491

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

Page 21Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

2800 Fuel Quick Drain Valves - Fuel Reservoir & Fuel TanksCAP 28-30-01

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Record 2018-0491

3200Landing

Main Landing Gear Actuator Mounting BoltsCAP 32-30-01

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

Inspect 2018-0491

3200Landing

Nose Gear GuideP/N 9882024-1

FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018Inspect 2018-0491

3200Landing

LH MLG Wheel AssemblyTire worn

New tire fitted

Unscheduled FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

2018-0491

3200Landing

RH NLG Flipper DoorEye-bolt U/S

New bolt installed

Unscheduled FL

FHFC

6 Jun 2018

Broome Air Maintenance 1718202

10,498.8Scott Carlson7 Jun 2018

Closed

2018-0491

Page 22Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3 Apr 20183200Landing

MLG “UP” LightNot working

Could not fault

Unscheduled FL

FHFC

3 Apr 2018

Jandakot Flight Center 180403

10,454.3Scott Carlson11 Apr 2018

Closed

2018-0297

3300Lights

Port Nav LightNot working

Replaced faulty globe and cleaned contacts. Cover also repalced

Unscheduled FL

FHFC

3 Apr 2018

Jandakot Flight Center 180403

10,454.3Scott Carlson11 Apr 2018

Closed

2018-0297

2500Equipme

Fuel GasculatorSticking

Joint cleaned and lubricated. Working satisfactorily

Unscheduled FL

FHFC

3 Apr 2018

Jandakot Flight Center 180403

10,454.3Scott Carlson11 Apr 2018

Closed

2018-0297

7800Engine

RH Exhaust CollectorCracked

Weld repairs made by Raindance Aero Works. Exhaust refitted with new gaskets

Unscheduled FL

FHFC

3 Apr 2018

Jandakot Flight Center 180403

10,454.3Scott Carlson11 Apr 2018

Closed

2018-0297

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

3 Apr 2018

Jandakot Flight Center 180403

10,454.3Scott Carlson11 Apr 2018

Closed

Inspect 2018-0292

16 Mar 20182400Electrical

Engine Compartment Wiring & Equipment InstallationCAP 39-00-01

Carried out satisfactorily nil defects

FL

FHFC

16 Mar 2018

Jandakot Flight Center 180316SJG

10,439.7Scott Carlson23 Mar 2018

Closed

Inspect 2018-0242

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

16 Mar 2018

Jandakot Flight Center 180316SJG

10,439.7Scott Carlson23 Mar 2018

Closed

Inspect 2018-0242

3300Lights

Port Nav LightIntermittent

No fault found

Unscheduled FL

FHFC

16 Mar 2018

Jandakot Flight Center 180316SJG

10,439.7Scott Carlson23 Mar 2018

Closed

2018-0242

3200Landing

Gear Warning HornSoft

Found that the pilot was not pressing the Test button hard enough

Unscheduled FL

FHFC

16 Mar 2018

Jandakot Flight Center 180316SJG

10,439.7Scott Carlson23 Mar 2018

Closed

2018-0242

5600Windows

WindowsSealant cracked and dry

Repalced cracked and dried sealant

Unscheduled FL

FHFC

16 Mar 2018

Jandakot Flight Center 180316SJG

10,439.7Scott Carlson23 Mar 2018

Closed

2018-0242

Page 23Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

31 Jan 20183100Instrumen

Fuel Quantity GaugesCAO 100.5 (6.4)

Carried out satisfactorily nil defects

FL

FHFC

31 Jan 2018

Jandakot Flight Center 180130SJG

10,418.7Scott Carlson15 Feb 2018

Closed

Record 2018-0118

2700Flight

MLG Indicator LightsInop

Replaced incorrectly positioned globes

Unscheduled FL

FHFC

31 Jan 2018

Jandakot Flight Center 180130SJG

10,418.7Scott Carlson15 Feb 2018

Closed

2018-0118

16 Jan 20180505Airworthin

TransponderCAO 100.5 (14)

Carried out satisfactorily nil defects

FL

FHFC

16 Jan 2018

Jandakot Flight Center M/RScott Carlson11 Apr 2018

Closed

Inspect 2018-0298

3100Instrumen

LH AltimeterCAO 100.5 (4.4)

Carried out satisfactorily nil defects

FL

FHFC

16 Jan 2018

Jandakot Flight Center M/RScott Carlson11 Apr 2018

Closed

Test 2018-0298

3100Instrumen

Pitot Static TestCAO 100.5 (3.4)

Carried out satisfactorily nil defects

FL

FHFC

16 Jan 2018

Jandakot Flight Center M/RScott Carlson11 Apr 2018

Closed

Test 2018-0298

3100Instrumen

Automatic Altitude Encoder TestCAO 100.5 (4.7)

Carried out satisfactorily nil defects

FL

FHFC

16 Jan 2018

Jandakot Flight Center M/RScott Carlson11 Apr 2018

Closed

Test 2018-0298

6 Dec 20172300Communi

TransponderNo ALT Mode

Transponder replaced, tested satis

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

2300Communi

Comm 1TR scratchy

Unit removed, repaired, and reinstalled

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

2300Communi

RadioStrobe noise evident

Advised customer of action to eliminate noise. Noise reduced to satis level

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

3100Instrumen

Turn CoordinatorRequires repair

TC replaced with satis unit (See OC Report for details Off/On)

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

Page 24Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3100Instrumen

AHRequires repair

Removed, repaired, and resinstalled

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

2700Flight

FlapsDropping in flight

Replaced Flap Lower Microswitch

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

2400Electrical

BatteryFlat

Battery replaced with new unit

Unscheduled FL

FHFC

6 Dec 2017

Jandakot Flight Center 171129SJG

10,410.4Scott Carlson15 Feb 2018

Closed

2018-0117

26 Oct 20172300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Test 2017-0816

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Replace 2017-0816

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Reweigh 2017-0816

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

Page 25Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

5700Wings

Flap Tracks Corrosion InspectionSID 57-53-01

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

Inspect 2017-0816

7400Engine

Spark Plugsx6 U/S

REPLACED X6 SPARK PLUGS IAW C210 MM

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

7900Engine

Engine Filler CapLeaking

Replaced gasket IAW C210 MM

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

7300Engine

Fuel StrainerBolw seeping

Replaced seals IAW C210 AMM, NIl defects evident

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

Page 26Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

RH MLG WheelBrake caliper pistons leaking

Replaced seals

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

3200Landing

NLGBearings U/S

New bearings installed

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

3200Landing

Shimmy DampenerLeaking

Re-sealed shimmy dampener

Unscheduled FL

FHFC

26 Oct 2017

Broome Air Maintenance 1718057

10,403.7Scott Carlson1 Nov 2017

Closed

2017-0816

21 Jul 20172300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Test 2017-0532

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Replace 2017-0532

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Reweigh 2017-0532

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

3200Landing

Wheel BearingsC210 MM

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

Page 27Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3700Vacuum

Gyro Central Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Record 2017-0532

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Inspect 2017-0532

Page 28Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3700Vacuum

E.D. Dry Vacuum Pump CouplingDrive Coupling

Carried out satisfactorily nil defects

FL

FHFC1

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 2017

Closed

Replace 2017-0532

7400Engine

Spark Plugsx6 U/S

Spark plugs replaced

Unscheduled FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 20172017-0532

2300Communi

Static Wicksx2 U/S

x2 static wicks replaced

Unscheduled FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 20172017-0532

3200Landing

LH MLGShell assembly U/S

New shell assembly installed

Unscheduled FL

FHFC

21 Jul 2017

Broome Air Maintenance 1718011

10,309.9Scott Carlson27 Jul 20172017-0532

17 May 20172300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Test 2017-0328

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Replace 2017-0328

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

3700Vacuum

Vacuum Relief Valve FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Replace 2017-0328

7500Engine

Engine Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Replace 2017-0328

Page 29Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

3200Landing

Gear Warning/Fuel Pump Switch Control ImprovementCAP 32-60-01

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

0500Maintena

Spar Corrosion Protection SchemeEO TDE3486-01-R1

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

2700Flight

Elevator Trim Pulley Bracket and Actuator BracketStructure InspectionSID 27-30-02

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

Page 30Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

Main Landing Gear Retraction System InspectionSID 32-10-01

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

3200Landing

Main Landing Gear ActuatorSEB01-02

Carried out satisfactorily nil defects

FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

Inspect 2017-0328

3200Landing

NLG WheelTire worn

New tire installed IAW C210 AMM

Unscheduled FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

2017-0328

3200Landing

LH Shell PadU/S

New pad installed IAW C210 AMM

Unscheduled FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

2017-0328

7400Engine

MagnetoTiming out 2 degrees at 20 degrees

MAgs retimed to 22 degress IAW C210 AMM

Unscheduled FL

FHFC

17 May 2017

Broome Air Maintenance 1617815

10,211.0Scott Carlson22 May 2017

Closed

2017-0328

12 May 20172400Electrical

AlternatorC611503-0102

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

12 May 2017

Broome Air Maintenance M/R

10,203.5Scott Carlson22 May 2017

Closed

Overhaul 2017-0385

8 Mar 20173200Landing

RH MLG BrakeCaliper leaking

Caliper Piston Seals replaced IAW C210 AMM

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

2300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Test 2017-0139

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Replace 2017-0139

Page 31Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

7400Engine

Magneto Bendix LH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

7400Engine

Magneto Bendix RH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Reweigh 2017-0139

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

Page 32Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Record 2017-0139

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

Inspect 2017-0139

3200Landing

RH MLG BRakeLinings worn

Linings replaced

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

5600Windows

Rear WindowRequires reseal

Rear window resealed

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

5600Windows

WindscreenRequires reseal

Windscreen resealed

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

2800 Fuel RH Fuel CapSeal requires replacement

Part on order

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

7800Engine

LH Forward BaffleSupport U/S

New baffle support installed

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

Page 33Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7300Engine

Engine Fuel DrainU/S

New drain installed

Unscheduled FL

FHFC

8 Mar 2017

Broome Air Maintenance 1617778

10,112.6Scott Carlson21 Mar 2017

Closed

2017-0139

20 Dec 20162300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Test 2016-0827

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Replace 2016-0827

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

2500Equipme

Copilot SeatsRestraint Assembly

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Replace 2016-0827

2500Equipme

Passenger SeatsRestraint Assembly

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Replace 2016-0827

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

Page 34Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

3200Landing

Nose Gear Turning StopCAP 32-50-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

3200Landing

Main Landing Gear Actuator Mounting BoltsCAP 32-30-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

5300Fuselage

Carry-Thru Spar Corrosion InspectionSID 53-11-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

5300Fuselage

Cabin Interior Skin Panels Corrosion InspectionSID 53-30-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

5700Wings

Wing Structure InspectionSID 57-11-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

Page 35Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

5700Wings

Wing Root Rib Corrosion InspectionSID 57-12-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

5700Wings

Wing Front Spar InspectionSID 57-30-01

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

2800 Fuel Dukes Fuel Pump18000-B

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Overhaul 2016-0827

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Inspect 2016-0827

7200Engine

Engine Cylinder InspectionFAA AD 2016-16-12

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016Inspect 2016-0827

3300Lights

LH StrobeU/S

New Power Supply fitted (See OC Report for details)

Unscheduled FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

2016-0827

3200Landing

NLGTorque Link extender stop loose

Torqued bolts

Unscheduled FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

2016-0827

2700Flight

Elevator TrimPulley U/S

New pulley fitted IAW C208 MM

Unscheduled FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

2016-0827

2300Communi

ELTAntenna U/S

New antenna fitted

Unscheduled FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

2016-0827

3200Landing

NLG DoorFwd bush U/S LH side

New bush installed

Unscheduled FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

2016-0827

3300Lights

Landing Light and Beacon Light SwitchesTR D2057-3TR11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Replace 2016-0827

Page 36Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3300Lights

Switch (Beacon Light)TR D2057-3TR11

Carried out satisfactorily nil defects

FL

FHFC

20 Dec 2016

Broome Air Maintenance 1617708

10,013.8Scott Carlson21 Dec 2016

Closed

Replace 2016-0827

8 Aug 20162300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Test 2016-0496

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Replace 2016-0496

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Reweigh 2016-0496

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

7600Engine

Engine Throttle ControlC210 MM

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Replace 2016-0496

0500Maintena

Periodic InspectionCASA Maintenance Schedule

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

Page 37Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

2800 Fuel Quick Drain Valves - Fuel Reservoir & Fuel TanksCAP 28-30-01

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Record 2016-0496

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 2016

Closed

Inspect 2016-0496

7900Engine

Oil CoolerLeaking

New gaskets isntalled

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

7400Engine

Spark Pluga(X6) U/S

New plugs installed

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

3200Landing

LH BrakeCaliper leaking

New caliper installed

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

Page 38Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

5600Windows

RH Rear WindowCrazed & U/S

New window fitted IAW C210 MM

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

3200Landing

RH MLH WheelTire U/S

New tire fitted IAW C210 MM

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

5600Windows

Pilot’s Side WindowCrazed

New window fitted IAW C210 MM

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

3100Instrumen

AHU/S

Overhauled AH installed IAW C210 MM (See OC Report for details)

Unscheduled FL

FHFC

8 Aug 2016

Broome Air Maintenance 1516597

9,914.1Scott Carlson15 Aug 20162016-0496

23 Mar 20162600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

23 Mar 2016

Broome Air Maintenance 1516522

9,814.1Scott Carlson31 Mar 2016

Closed

Reweigh 2016-0280

2400Electrical

Engine Compartment Wiring & Equipment InstallationCAP 39-00-01

Carried out satisfactorily nil defects

FL

FHFC

23 Mar 2016

Broome Air Maintenance 1516522

9,814.1Scott Carlson31 Mar 2016

Closed

Inspect 2016-0280

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

23 Mar 2016

Broome Air Maintenance 1516522

9,814.1Scott Carlson31 Mar 2016

Closed

Inspect 2016-0280

15 Jan 20162300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Test 2015-1271

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Replace 2015-1271

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

Page 39Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

3200Landing

Wheel BearingsC210 MM

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

3700Vacuum

Gyro Central Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0500Maintena

Periodic InspectionCASA Shedule 5

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

TransponderAD/RAD/47 amd 1

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

Page 40Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

5700Wings

Flap Tracks Corrosion InspectionSID 57-53-01

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Inspect 2015-1271

3100Instrumen

LH AltimeterCAO 100.5 (4.4)

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Test 2015-1271

3100Instrumen

Pitot Static TestCAO 100.5 (3.4)

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Test 2015-1271

3100Instrumen

Automatic Altitude Encoder TestCAO 100.5 (4.7)

Carried out satisfactorily nil defects

FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

Test 2015-1271

8000Engine

Starter Adapterfailed

New Starter Adapter fitted IAW IO 520 MM and tested satisfactory

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

3300Lights

Exterior Step LightsLH & RH inop

x2 new lamps fitted & tested satis IAW C210 MM

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

7800Engine

LH Exhaustshock mount U/S

New shock mount fitted IAW C210 MM

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

7200Engine

#6 Cylindermanifold gasket U/S

New gasket fitted IAW C210 MM

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

Page 41Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

2400Electrical

Alternatorbelt loose

Tightened Alternator Belt IAW C210 MM

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

3200Landing

Nose Wheel SteeringBungee U/S

New bungee installed IAW C210 MM

Unscheduled FL

FHFC

15 Jan 2016

Broome Air Maintenance 1516497

9,814.1Scott Carlson21 Jan 2016

Closed

2016-1271

25 Nov 20153200Landing

RH MLG Tireflat

RH tire changed

Unscheduled FL

FHFC

25 Nov 2015

Broome Air Maintenance M/R Pt 2

9,803.0Scott Carlson21 Jan 2016

Closed

2016-0105

2 Nov 20152600 FireProtectio

Hand Held Fire ExtAvtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Replace 2015-0985

2300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Test 2015-0985

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Replace 2015-0985

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 05-010

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Reweigh 2015-0985

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

Page 42Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3700Vacuum

Vacuum Relief Valve FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Replace 2015-0985

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

3200Landing

BrakesC210 MM

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

3100Instrumen

Magnetic Compass CompensationC210 MM

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

2700Flight

Elevator Trim Tab ActuatorP/N 1260238-2

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Overhaul 2015-0985

7500Engine

Engine Air FilterC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Replace 2015-0985

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0500Maintena

Periodic InspectionCASA Shedule 5

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

Page 43Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Record 2015-0985

3200Landing

Main Gear Downlock ActuatorCAP 32-30-02

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

0500Maintena

Spar Corrosion Protection SchemeEO TDE3486-01-R1

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

3200Landing

Main Landing Gear Retraction System InspectionSID 32-10-01

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

3200Landing

Main Landing Gear ActuatorSEB01-02

Carried out satisfactorily nil defects

FL

FHFC

2 Nov 2015

BAM 1516462

9,714.4Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

7400Engine

Spark Plugsx6 U/S

New spark plugs installed

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

3200Landing

LH MLG Tireworn

New tire fitted

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

Page 44Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

MLG Brake Calipersleaking around pistons

New O-rings fitted to pistons

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

3200Landing

NLGInner & outer bearings U/S

New wheel bearings fitted

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

3200Landing

NLGOleo leaking

New O-rings installed on collar. Oleo serviced IAW MM

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

3200Landing

NLGOleo Valve Assy U/S

New valve assy fitted

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

3200Landing

RH MLG Brakeleaking around leg attach bolt

New O-rings installed to plug in leg IAW MM

Unscheduled FL

FHFC

2 Nov 2015

BAM 1515462

9,714.4Scott Carlson6 Nov 2015

Closed

MC2015-0985

7400Engine

Magneto Bendix LH10-349350-4

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.5Scott Carlson6 Nov 2015

Closed

Overhaul 2015-0985

7400Engine

Magneto Bendix RH10-349350-5

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.5Scott Carlson6 Nov 2015

Closed

Overhaul 2015-0985

7400Engine

Magneto Bendix LH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.5Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

7400Engine

Magneto Bendix RH 500 HourTCM SB 643B

Carried out satisfactorily nil defects

FL

FHFC1

2 Nov 2015

BAM 1516462

9,714.5Scott Carlson6 Nov 2015

Closed

Inspect 2015-0985

28 Jul 20153100Instrumen

Air Speed IndicatorCAO 100.5 (5.4)

Carried out satisfactorily nil defects

FL

FHFC

28 Jul 2015

BAM 1415387

9,614.8Scott Carlson25 Aug 2015

Closed

Test 2015-0829

3100Instrumen

LH AltimeterCAO 100.5 (4.4)

Carried out satisfactorily nil defects

FL

FHFC

28 Jul 2015

BAM 1415387

9,614.8Scott Carlson25 Aug 2015

Closed

Test 2015-0829

Page 45Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3100Instrumen

Pitot Static TestCAO 100.5 (3.4)

Carried out satisfactorily nil defects

FL

FHFC

28 Jul 2015

BAM 1415387

9,614.8Scott Carlson25 Aug 2015

Closed

Test 2015-0829

3100Instrumen

Automatic Altitude Encoder TestCAO 100.5 (4.7)

Carried out satisfactorily nil defects

FL

FHFC

28 Jul 2015

BAM 1415387

9,614.8Scott Carlson25 Aug 2015

Closed

Test 2015-0829

24 Jul 20152300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Test 2015-0709

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Replace 2015-0709

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0500Maintena

Periodic InspectionCASA Shedule 5

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

Page 46Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

2800 Fuel Fuel Gauging SystemsCAP 28-40-01

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

Inspect 2015-0709

7900Engine

Oil Coolerleaking

New oil cooler gaskets fitted

Unscheduled FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

MC2015-0743

3200Landing

RH Brakeswivel leaking

new swivel installed and brakes bled

Unscheduled FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

MC2015-0743

3400Navigatio

DGprecessing

Serv O/H DG fitted. See OC file for details.

Unscheduled FL

FHFC

24 Jul 2015

BAM 1415376

9,614.8Scott Carlson30 Jul 2015

Closed

MC2015-0743

30 Apr 20152300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Test 2015-0368

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Replace 2015-0368

Page 47Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 010

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Reweigh 2015-0368

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

7600Engine

Propeller ControlC210 MM

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0500Maintena

Periodic InspectionCASA Shedule 5

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

Page 48Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

2900Hydraulic

MLG Hydraulic Hose & Component ReplacementCAP 29-10-01

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Replace 2015-0368

5500Stabilsers

Horizontal Stabilizer Aft Attach BracketCAP 55-10-01

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Record 2015-0368

3200Landing

Main Landing Gear Actuator Mounting BoltsCAP 32-30-01

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

Inspect 2015-0368

3200Landing

LH Downlock Actuatorleaking

Replaced seals IAW C210 SM. Gear rigging checks c/0.

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

3200Landing

RH MLG Wheel BoltsU/S

New bolts fitted

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

3200Landing

RH MLG Wheel Brake Liningsworn beyond limits

New brake linings fitted

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

3200Landing

RH MLG O/B Wheel Bearingcone & cup U/S

New bearing cone & cup fitted

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

Page 49Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

3200Landing

NLG Up Limit SwitchU/S

New switch installed IAW C210 MM

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

2700Flight

Rudder Trimstuck

Lubricated & checked, found satisfactory

Unscheduled FL

FHFC

30 Apr 2015

BAM 1415282

9,519.7Scott Carlson14 May 2015

Closed

MC2015-0368

17 Mar 20152400Electrical

AlternatorDOFF10300BR

Component changed - refer to Form 130 OSIP Card for Component S/N's and Times OFFand ON

FL

FHFC1

17 Mar 2015

BAM 1415248

9,465.8Scott Carlson

1 Apr 2015

Closed

Overhaul MC2015-0329

2400Electrical

Alternator 500 Hour InspectionElect Special Insp # 2

Carried out satisfactorily nil defects

FL

FHFC1

17 Mar 2015

BAM 1415248

9,465.8Scott Carlson

1 Apr 2015

Closed

Inspect MC2015-0329

15 Dec 20142300Communi

ELTBattery

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Test MC2014-1803

0500Maintena

Maintenance ReleaseCASA Form 918

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Replace MC2014-1803

0505Airworthin

Fuel Injection Supply LinesAD/CON/60 amd 3

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

2600 FireProtectio

Hand Held Fire Ext (Halon)Avtrac Form 010

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Reweigh MC2014-1803

0505Airworthin

Seat Adjustment MechanismFAA AD/2011-10-09

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0505Airworthin

Horizontal Stabiliser Front SparAD/C210/69 amd 2

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

Page 50Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

7300Engine

Fuel Injection NozzlesC210 MM

Carried out satisfactorily nil defects

FL

FHFC1

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

3700Vacuum

E.D. Dry Vacuum PumpC210 MM Chapter 2

Carried out satisfactorily nil defects

FL

FHFC1

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0500Maintena

Periodic InspectionCASA Shedule 5

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0505Airworthin

Engine Performance RunAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0505Airworthin

Engine Cylinder Leak CheckAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0505Airworthin

Engine Oil and Oil Filter ChangeAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0505Airworthin

Data ReviewAD/ENG/4 Amdt 11

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

0500Maintena

CD PlayerEO E1921-01R1

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

5700Wings

Wings - Lower Main Spar Cap 1SEL-57-01-R2

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

2700Flight

Elevator and Trim Tab InspectionSEB85-7

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

Inspect MC2014-1803

3200Landing

Nose Wheel BearingsU/S

Replaced cones & caps IAW C210 MM & tested OK

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

Page 51Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.

Aircraft Rego VH -

Aircraft Serial No Aircraft Model No

FH on Aircraft FC

Report Date

21063529 210N

ResolutionWork Carried Out

FL

Airframe

A/C FL

CodeATAEng No

Maintenance ActionNameDescription AMO Job Number

Due List StatusCURRENT

Updated Updated Updated

Report Type 054

Aircraft History

A/C FC

ResolvedCertification Date A/C FH

Operator

11,084.50

2 Feb 2021

24 Nov 2020BROOME AVIATION PTY LTD

AMODescription

SJG

Entry DateEntered By

Status

MC Number

2400Electrical

Battery Terminal Elec Nipples5 torn

Replaced IAW LTIO IPL DSM & tested OK

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

7700Engine

Oil Temp Indicationappears erroneous (from M/R)

Replaced probe & tested OK

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

2300Communi

Comm 1 & 2Intermittently unreadable

Audio Panel replaced & tested OK

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

5200Doors

Rear Door latchhard to close

Latch rigging adjusted & tested satis IAW C210 MM. NFF

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

2300Communi

TransponderUnder reads by 200 feet

Transponder reracked & op check c/o NFF

Unscheduled FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson5 Jan 2015

Closed

MC2014-1803

5300Fuselage

Carry-Thru Spar InspectionSID 53-11-02

Carried out satisfactorily nil defects

FL

FHFC

15 Dec 2014

BAM 1415181

9,420.5Scott Carlson27 Jan 2015

Closed

Inspect MC2014-1803

24 Nov 2014Refer to Log Books prior to 24/11/2014

FL

FHFC

24 Nov 2014Paul Carey

24 Nov 2014

Closed

End of Report

Page 52Form revision status: 2 Feb 2021 Legend: FH - Aircraft Flight Hours; MO - Months: FC - Aircraft Flight Cycles: FL - Aircraft Flight Landings.