COMPANY INFORMATION: Company
Name: Sub of: Survey: Date of
Address (Street, City, State)
Other Property Locations: Telephone:
Website:
Repair Station Certificate No. With Class Rating:
Date of Last FAA Audit: ODA Authority:
Yes No PMA /TSO
Authority:
Yes No
OEM – If yes, for what prime Mfg:
Yes No
KEY MANAGEMENT CONTACTS AT YOUR LOCATION:
Q.A.: Engineering:
Admin: Other:
Email Address: TYPE OF BUSINESS:
Repair / Overhaul Distributor / Supplier
Manufacturer Other
Principal Products & Services
PRINCIPAL CUSTOMERS:
FACILITIES:
Own Lease Employees (Give Number Of)
Type: Inspection Admin
Total Area (Sq. Ft) Production
Mfg.- Ovhl/Rpr Engr / Tech Other
PROGRAMS: (CHECK IF CERTIFICATED – MUST INCLUDE COPY) ISO 9000 SERIES
C.A.S.E. STANDARDS F.A.R. 145 (Repair Station)
DOT/FAA Drug/Alcohol Program (Required by repair stations, non-certificated manufacturers producing safety-sensitive parts, non-certificated processors performing safety sensitive functions) Other: (List all applicable)
PROCESSING FACILITIES AND CONTROLLING SPEC:
Heat Treating Welding
Plating Chemical Films
Peening Stripping / Cleaning
Finish Other
NON-DESTRUCTIVE TESTING AND CONTROLLING SPEC:
Magnetic Particle Penetrant
Radiographic Ultrasonic
Eddy Current Hardness
Pressure Test Other
INSPECTIONS:
Jet Aviation, our Customers, FAA and Regulatory Offices must have the right of access to your facility and
documentation for on-site audit purposes.
Agree - Yes
Disagree -No
(You must be in agreement with this statement)
Date of last Government Inspection: Name of Government Representative: Name of FAA PMI: Has the FAA ever investigated your facility (other than an audit)?
Please list customer including Government agencies, major contracts, and names of their representatives who have inspected your operation and accepted your Quality Program in the last year. (Add attachment, if necessary)
A. QUALITY SYSTEMS:
YES NO N/A
1. Is there a Quality Program in place? 2. Is there a Quality Procedures Manual? 3. Is a copy issued to inspector and supervisors? 4. Are QA/QC and production functions separated?
5. Is there a roster of supervisory and inspection personnel maintained with samples of signatures, initials, and stamps?
6. Is all work including inspection and tests performed in accordance with FAA approved technical data? 7. Are work instructions (travelers) used for documenting production, inspection, and testing operations
A. QUALITY SYSTEMS: (Continued)
YES NO N/A
8. Are all incoming materials and parts subjected to a documented receiving inspection (including hidden damage as applicable)?
9. Are all inspections and tests documented?
10. Is there a system for the segregation and disposition of non-conforming items?
11. Does the vendor have a documented procedure describing how they report defects and un-airworthy conditions to the customer and the FAA (if applicable)?
12. Are procedures in place for maintenance, preventive maintenance, alterations and inspections? 13. Are procedures in place to assure the work documents returned from a subcontractor (at any tier) are
adequate to support a major/minor determination?
If you answered “No” or “N/A” to any of the questions above, please explain:
B. TECHNICAL DATA
YES NO N/A
1. Is there a procedure for preparation, maintenance and control of drawings, specifications, work instructions and other technical data?
2. Do procedures assure that obsolete, illegible, or marked up technical data is not used?
3. Are changes in technical data effectively identified and followed up for incorporation in your procedures?
4. When Blueprints are provided to build and or assembly product, are your technicians trained in Blueprint reading and interpretation to build?
If you answered “No” or “N/A” to any of the questions above, please explain:
C. TRAINING
YES NO N/A
1. Is there an established training program for inspection, production, and other personnel including: a. Indoctrination training?
b. Proficiency training and testing? c. Recurrent training?
2. Are individual employee’s training records maintained? 3. Are NDT/NDI personnel certificated as I/A/W by NAS 410?
If you answered “No” or “N/A” to any of the questions above, please explain:
D. TOOLS AND TEST EQUIPMENT
YES NO N/A
1. Is there a system to assure tools and test equipment was maintained in a serviceable and calibrated condition?
2. Are tools and test equipment calibration traceable to the N.I.S.T. (formerly N.B.S.) If you answered “No” or “N/A” to any of the questions above, please explain:
E. GENERAL
YES NO N/A
1. Is there a sufficient fire protection system, i.e. sprinkler system and/or fire extinguisher of the proper class in adequate numbers and locations?
2. Is your facility and operations in compliance with all applicable OSHA and EPA requirements? 3. Is provision made to segregate and identify parts and material throughout facility?
If you answered “No” or “N/A” to any of the questions above, please explain:
F. STORAGE
YES NO N/A
1. Are there remote storage areas for finished parts, raw stock, hardware, etc., separate from areas where work is performed?
2. Are customer owned parts and materials identified from other parts and materials including those of the same type?
3. Are procedures in place to assure that damaged or unacceptable parts and materials are not issued for use?
4. Is there a system for control of shelf life materials?
If you answered “No” or “N/A” to any of the questions above, please explain:
G. RECORDS
YES NO N/A
1. Are records of work and/or material/parts conformity maintained a minimum of two years?
2. Are records traceable by job number, repair or purchase order number, and is referenced on documents provided to customer?
3. Do records include the name of those performing or supervising the work and those inspecting work?
If you answered “No” or “N/A” to any of the questions above, please explain:
H. ANTI-DRUG AND ALCOHOL MISUSE PREVENTION PROGRAM: (If your company does not perform safety-sensitive maintenance functions as defined in 14 CFR, Part 120, Subpart E and F, please circle N/A and skip to next section.
YES NO N/A
1. Do you confirm that each of your employees (and/or subcontractors) received a “Verified Negative” pre-employment drug test result prior to being hired to perform a safety sensitive function or prior to being transferred from a non safety-sensitive function to a safety-sensitive function?
2. If the answer to question 1 is “YES”, do you confirm that your company complies with the FAA and DOT regulation covering Anti-drug and Alcohol Misuse Prevention Programs?
3. Upon our request, is your company readily prepared to present a list of the employees (and/or subcontractors) assigned to work on our aircraft, or aircraft parts / components, with the dates the pre-employment drug test results were received?
4. Does your company ensure that all your safety-sensitive employees are subject to all testing listed 14 CFR Part 120 Subpart E & F, including random drug and alcohol testing requirements?
5. Has more than 180 days elapsed since any of your employees (and/or subcontractors) received a verified negative drug test result or been hired or transferred into a safety-sensitive function.
6. Has more than 180 days elapsed since any of your employees (and / or subcontractors) been hired or transferred into a safety-sensitive function?
7. If the answer to question 5 or 6 is “YES” have the subject employees (and / or subcontractors) received a “Verified Negative” pre-employment drug test result?
E. GENERH. AAMPP (Continued)
YES NO N/A
9. Does your company audit or confirm that sub-contract suppliers and / or maintenance technicians that perform safety-sensitive functions are in compliance with 14 CFR Part 120 Subpart E & F, including random drug and alcohol testing requirements?
10. Does your company use any sub-contract suppliers and/or maintenance technicians to perform safety-sensitive functions that are not in compliance with 14 CFR Part 120 Subpart E & F, including random drug and alcohol testing requirements?
11. Do you subcontract any safety-sensitive functions (maintenance/preventative maintenance)? Note: if your answer to this question is “YES” please include an example of the letter distributed to your sub-tier suppliers exhibiting the flow-down requirement for compliance to the FAA Final rule amending the anti-drug and alcohol misuse testing program.
If you answered “No” or “N/A” to any of the questions above, please explain:
I. THE DODD-FRANK ACT WALL STREET REFORM AND CONSUMER PROTECTION ACT
YES NO N/A
1. Has your company adopted a policy on minerals from conflict areas? 2. Does your company procure Conflict Minerals from covered countries?
3. Does supplier further certify that it has not provided, and will not provide, Jet Aviation with any products or materials that contain such “Conflict Minerals”.
3. Have you conducted an inquiry to determine whether or not your suppliers procure Conflict Minerals from covered countries?
Please be sure the following documents (as applicable) are supplied with the return of this survey:
1. Air Agency Certificate and Operation Specifications
2. FAA Anti-Drug Program Approval Letter (If you subcontract safety-sensitive functions, please also include a copy of the letter distributed to your sub-tier suppliers exhibiting the flow-down requirement for compliance to the FAA Final Rule of October 10, 2006)
3. FAA PMA or TSO Approvals, etc.
4. Documentation to support Quality Control Program
5. Roster or list, including sample signatures of those authorized to sign Maintenance Release, Certificates of Conformance, and other records.
6. Organizational Chart.
Outsourced Services Documentation:
1. If contracted for DER, DAR, Auditor, please include copy of resume, Letter of Designation from the FAA, Inspection Authorization, etc. 2. Engineers – Professional Certificates showing certifications and qualifications
3. Certificate of Insurance if performing a repair on Jet Aviation Property
All vendors approved to Jet Aviation’s Approved Vendor List will remain approved on the list
as long as your performance continues to meet our standards with quality products,
on-time deliveries and satisfactory services. This approval shall remain in force until
suspended or revoked as long as a quality product continues to be delivered
Please provide Jet Aviation notification of any changes to your operations, management, or
certificates. Copies should be provided as soon as possible.
I hereby certify to the best of my knowledge, the information supplied herein is accurate, complete
and current. I am an authorized representative to sign this certification.
Return Survey to:
Jet Aviation St. Louis, Inc.
Quality Assurance Department
Attention: Janet Parvin
6400 Curtiss-Steinberg Drive,
Cahokia, IL 62206-1445
Phone: 618-646-8501
FAX to: (618) 646-8851
E-mail:
[email protected]
Documentation Requirements (As Applicable)
YES NO N/A
1. Air Agency Certificate and Operation Specifications
2. FAA Anti-Drug Program Approval Letter (If you subcontract safety-sensitive functions, please also include a copy of the letter distributed to your sub-tier suppliers exhibiting the flow-down requirement for compliance to the FAA Final Rule of October 10, 2006)
3. FAA PMA or TSO Approvals, etc.
4. Documentation to support Quality Control Program
5. Roster or list, including sample signatures of those authorized to sign Maintenance Release, Certificates of Conformance, and other records.
6. Organizational Chart.
Outsourced Services Documentation:
YES NO N/A
1. If contracted for DER, DAR, Auditor, please include copy of resume, Letter of Designation from the FAA, certificates, Inspection Authorization, etc.
2. Engineers – Professional certificates showing certifications and qualifications 3. Certificate of Insurance if performing a repair on Jet Aviation Property
