Composite Panel Checklist

Company Name:
Contact Name:
Phone: / Fax: / E-Mail:
Date Sent: / P.O. #:
Date 8110-3 Needed: / A/C Completion Date:
Aircraft Make: / Model:
S/N #: / Tail #:
Test Data is in support of:
1) Supplemental Type Certificate (STC) / 2) DAS Designated Airworthiness Station
3) Technical Standard Order (TSO) / 4) Other:
FAA Project # (if applicable):
We are required to contact your local FSDO office regarding our use of FAA Form 8130-9 for conformity of your test specimens.
Does Skandia have your permission to fabricate test specimens and issue FAA 8130-9 forms on your
behalf? / Yes / No

FABRICATION PROCEDURES

FABRICATING NEW / COVERING OR MODIFYING EXISTING

Are you:

This panel is / BULKHEAD / TABLE
being used / HEADLINER / CARD TABLE
as: / WINDOW REVEL / UPPER SIDE WALL
CABINETRY / LOWER SIDE WALL
COUNTERTOP / OTHER:
Is any part of this test taken directly from the aircraft? / YES / NO

ITEMS REQUIRED TO COMPLETE BURN TEST

1.  Copies of Invoice or Packing Lists providing traceability for all fabricating components including

panels (Nomex, wood, aluminum, fiberglass, etc.), laminates, veneers, foam, finishes, poly coats,

leather, fabric, vinyl, mirror, adhesives, flame retardant/treatments and all other materials used in production.

2.  Sketch or production drawing of each different production assembly.

3.  Original FAA form 8130-9 for each set of fabricated test specimens submitted.

4.  Vertical Burn Test, 12 – or 60 – Second: Three (3) panels fabricated to represent production usage.

Panels must be 3” x 12”. If panels have a woven surface (i.e., fabric, carpet, etc.) three panels of

both warp and fill are required.

5.  45° Angle Burn Test (FAR 25.853 (d) ): Three (3) panels fabricated to represent production usage;

panels must be 8 ½” x 8 ½”.

COMPOSITE PANEL CHECKLIST MATRIX

FOR PRODUCTION ARTICLES

To select the appropriate CHECK box, hit ENTER; tab to next

CHECK APPLICABILITY
VENDOR / PART NUMBER / INVOICES or PACKING SLIPS
ENCLOSED / BULK HEAD / CABINET / TABLE / OTHER: / FLAME
TREATMENT
LAMINATE/VENEER
LAMINATE/VENEER
NOMEX PANEL
ALUMINUM PANEL
WOOD
POLY COAT
DECORATIVE COVER
FABRIC
EDGEFILLER
ADHESIVE
OTHER
OTHER
OTHER
OTHER

COMMENTS:

FL 106-05 Rev. G Release Date: 10-05-12

Skandia, Inc. • 5000 N. Highway 251 • Davis Junction, IL 61020 • 815-393-4600 • 815-393-3205 fax •