EUROPEAN UNION
FSTD assessment report form
NOTE: The completed assessment form should be kept in the FSTD record.
1. Details of the Approved Training Organisation (ATO)Name of the ATO :
BE/ATO-
2. Details of the FSTD operator (if applicable)
Name of the FSTD operator :
Address :
Compliance monitoring manager
Name : / Surname :
Email : / Mobile :
Simulator manager
Name : / Surname :
Email : / Mobile :
3. Details of the FSTD
☐ / Airplane (A) / ☐ / Helicopter (H) / ☐ / Sailplane (S) / ☐ / Balloon (B) / ☐ / Airship (As)
Identification (Member State FSTD code / EASA FSTD code) :
Type and variant of aircraft :
Class of aeroplane / type of helicopter :
FSTD level :
Address of the FSTD (if applicable) :
Remarks:
4. The FSTD will be used in the following training course(s)
☐ / LAPL/PPL, SPL or BPL / ☐ / CPL/ATPL / ☐ / IR-SE / ☐ / IR-ME / ☐ / EIR-SE / ☐ / EIR-ME
☐ / Type rating/Class rating / ☐ / Night Rating
☐ / FI / ☐ / IRI / ☐ / CRI / ☐ / TRI / ☐ / Other (specify in “Remarks”)
Remarks:
5. Assessment of the FSTD
☐ / The FSTD is equipped as required in the training specifications concerning the course(s) in which it is used.
☐ / The FSTD comply with the relevant requirements of Part-FCL
☐ / In the case of full flight simulator (FFS), that the FFS adequately represents the relevant type of aircraft
☐ / The latest FSTD qualification certificate does not present any limitations or restrictions
☐ / The latest FSDT qualification certificate mention to adequate level of qualification in regards of the training course(s) in which it is used.
☐ / The latest FSTD evaluation report does not mention any items in the “Unacceptable”, “Unserviceability” or “Restriction”. Or those items are already corrected by the FSTD operator.
☐ / The FSTD operator has put in place a configuration control procedure of the device. It is foreseen in this procedure to warn the FSTD user of any modifications that may affect the training specifications concerning the course(s) in which it is used.
☐ / A system to adequately monitor changes to the FSTD and to ensure that those changes do not affect the adequacy of the training programme is in place within the ATO.
Remarks :
5. FSTD records
☐ / Latest FSTD certificate.
☐ / Latest evaluation report.
☐ / FSTD difference list between the device and the A/C in use in the ATO.
☐ / Agreement between the FSTD operator and the ATO, if applicable.
☐ / Procedure to monitor FSTD changes and defects ensuring that it will not affect the adequacy of the training programme.
Remarks :
6. Acceptance of the FSTD by the ATO
Head of Training or nominated deputy :
Name : / Surname :
Signature: / Date:
Compliance Monitoring Manager :
Name : / Surname :
Signature: / Date:
Training Department Procedures – Mission L-TRA/01 / LA/L-TRA/0155D52E / Vers: / 1.0 / Issued : / 29/07/2015
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