F-IPD-129 Approach Submission Form
- - Printed: December 25, 2018
Aeronautical Information Management
Approach Submission Form
1.DGN Filename / 2.CRC Number / 3.Reference Number(s)4.Catalogue / 5.Design Process / 6.New or Revised / 7.Requested Effective Date
- Canada Air PilotRestricted CAP / - Manual DesignAutomated Design / - NewRevised
8.Procedure Identification / 9.Aerodrome Name / 10.ICAO Identifier
- ILSLOCLOC (BC)VORVOR/DMENDBNDB/DMERNAV (GNSS)RNAV (RNP)VISUAL APPROACH
- LPVLNAV/VNAVLNAVSee Landing Minima for GNSS types
Charted Proc. Ident. if Combined / 11.Community Name / 12.Field Elevation
’
Proc. Ident. For COPTER Only / 13.Aerodrome Geometric Centre Coordinate (press F1 for resolution requirement)
COPTER - ILSLOCLOC (BC)VORVOR/DMENDBNDB/DMERNAV (GNSS)RNAV (RNP)
- LPVLNAV/VNAVLNAVSee Landing Minima for GNSS types / DD:MM:SS.SSSS►NAD 83
14.Communication Blocks
Automated Wx System / Arrival System / Tower System / Ground System
- ATISAUTOLWISMETAR AUTO / - CTRARRTMLRADIOPAR / - TWRRADIOUNICOMAPRT RADIOTFC / - GND
DRCO
/ DRCO
- ATISAUTOLWISMETAR AUTO / - CTRARRTMLRADIOPAR / - TWRRADIOUNICOMAPRT RADIOTFC / - GND
DRCO
/ DRCO
/ MF / *
/ ATF / *
Notes:
15.Approach Summary
Safe Altitude 100 NM / Navigation Type / Final Approach Course / FAF Altitude / Landing Dist. Available / Lighting
SAFE ALT 100 NM / - NDBVORLOCRNAVWAAS / APCH
CRS / - MIN ALTGP / - LDAHELIPAD
LOC / FAC Offset Arrow Required / Amount Offset & Direction
Notes:
16. Missed Approach Instruction (F) / 17.Missed Approach Climb Gradient
MISSED APPROACH / FT/NM º
GS / 90 / 120 / 140 / 160 / 180 / 200 / 250 / 300
FPM
18.Procedure Turn Instruction / 19. GPA / CDA Angle / 20. TCH
Procedure turn - LEFTRIGHT within NM of / ►º / ►
Procedure turn NOT AUTHORIZED
Not Applicable
21.Variation / Declination
AGCC
Variationº - EW
Year
NDA / VOR
Declinationº - EW
NDA / VOR
Declinationº - EW
NDA
Notes:
22.Operational Notes
a / Restricted (RCAP) / RESTRICTED
b / RNP AR / AUTHORIZATION REQUIRED
c / Maximum Wingspan for RNP AR / Procedure not auth for acft with wingspans greater than 136’
(F)
d / IAWP or IWP Maximum Alignment Exceeded / Procedure not auth for arrival at onbound
Procedure not auth for arrivals on VOR airway radials - cwccw
(F)
e / LOC Only / LOC ONLY
NO GLIDE PATH
BACK COURSE
NO GLIDE PATH
BACK COURSE
NO GLIDE PATH
IGNORE GLIDE
PATH INDICATIONS
f / Altimeter Setting
(1 RASS note box)
(2 plan view) / Altimeter setting 2
Limited altimeter availability. Prior to flight, contact operator listed in CFS to ensure altimeter avbl on arrival 2
Use 1
Use 1
When using add ’ 1
When using add ’ 1
When using add ’. Circling minima apply 1
Baro VNAV not auth when using remote altimeter2
Procedure not auth when local altimeter setting not received2
g / Wingspan / Aerodrome assessed for aircraft wingspans less than - 4979118171’
Rwy assessed for aircraft wingspans less than - 4979118171’
Rwy assessed for aircraft wingspans less than - 4979118171’
Circling to rwynot auth due to visual surfaces not assessed
(F)
h / Transitions / fromtoNM
fromtoNM
i / Weather Phenomena / (F)
22.Operational Notes Cont’
j / TemperatureLimit
(LNAV/VNAV – minima box)
(RNP AR – AR box) / (min. ºC)
(max. ºC)
k / LOC / GP Reliability / LOC reliable only within ºeither side of centreline
GP fluctuates outside DME. Do not intercept GP above ‘ ASL
(F)
l / LOC / FAC Offset / LOC offset º
LOC not aligned with rwy
m / VGSI Non Coincident / VGSI not coincident with the - glidepathRNAV glidepath
n / RF Required / RF Required / General plan view location, applies to entire procedure
Specific to a transition, chart adjacent to…
Specific to a transition, chart adjacent to…
Specific to a transition, chart adjacent to…
o / Additional NAVAIDs / RADAR Required
RNAV Required
RADAR or RNAV Required
Dual Required
When outbound from , change over to at mid-point
On missed approach, change over from to at mid-point
(F)
p / Obstacles / (F)
q / Restricted Airspace / Apch not auth when active
transition not auth when active above
Procedure turn not auth when active
(F)
r / Traffic / (F)
s / Restrictions / Rwy not assessed for circling procedures
(F)
t / Procedure Overlap / CAUTION: Procedure overlaps () procedures
CAUTION: Procedure overlaps () procedures
22.Operational Notes Cont’
u / Private NAVAID / Private unmonitored
Private unmonitored
v / Unmonitored NAVAID / unmonitored
w / WAAS Predictive NOTAM /
x / Shuttle Descent / As required, shuttle descent to at . All turns LEFT (max kt)
As required, shuttle descent to at (max kt)
(F)
y / Airspeed Restriction / kt / Chart adjacent to…
kt / Chart adjacent to…
kt / Chart adjacent to…
kt / Chart adjacent to…
kt / Chart adjacent to…
kt / Chart adjacent to…
z / Operational Altitude Restriction / - + (plus)- (minus)@B / Chart adjacent to…
- + (plus)- (minus)@B / Chart adjacent to…
- + (plus)- (minus)@B / Chart adjacent to…
- + (plus)- (minus)@B / Chart adjacent to…
- + (plus)- (minus)@B / Chart adjacent to…
- + (plus)- (minus)@B / Chart adjacent to…
aa / Non-standard RNP Value / RNP / Chart adjacent to…
RNP / Chart adjacent to…
RNP / Chart adjacent to…
bb / COPTER Point-in-Space
(profile view) / Proceed VFR
cc / COPTER Approach Speed
(final and missed approach segment – plan view) / (70 kt)
(F)
dd / Height Above Surface
(profile view) / (HAS - ’)
ee / Other Required Operational Notes / (F)
Comments:
23.Landing Minima
CAT
APP / DA / MDA DH / HAT / HATh / HAA VIS / RVR
A / COPTER / B / C / D / Above
- TDZThld
- TDZThld
- TDZThld
CIRCLING *
* Circling Restriction (Incl. affected A/C cats.)
Notes: / ½ SM Vis. Credit Applied
24.Timing Block (required only when MAP is defined by distance from FAF)
From / To / Distance / Kts / 70 / 90 / 110 / 130 / 150
NM / Min : Sec
Notes:
25. Constant Descent Angle
CDA depiction does not apply
CDA calculation method / - Straight-in approachCircling only - meets straight-in alignmentCircling only - Doesn't meet straight-in alignmentCOPTER only approach
Constant Descent Angle Anchor Point:
Profile View Procedural Altitudes: / Profile View Fix Ident / Procedural Altitude
Rate of Descent Table:
Kts / 70 / 90 / 110 / 130 / 150
ft / min
Distance / Altitude Table:
DIST FROM
DIST FROM DME ()
ALT (º APCH PATH)
Initial Descent Altitude – (To be Bolded)
Notes:
26. Check Altitudes (ILS and RNP AR)
Check Altitudes: / Fix Ident / Check Altitude
Notes:
27. Runway Threshold / End Information (Enter coordinates here using a space to separate degree, minutes and seconds)
Landing Threshold Point:Applicable to: 1. Straight-in procedures, and
2. Circling only procedures meeting straight-in alignment
Threshold / Latitude (NAD 83) / Longitude (NAD 83) / Elevation / TDZE
Rwy Disp / ‘ / ‘
Runway End Points:Applicable to:All approach procedures having circling minima
End Point / Latitude (NAD 83) / Longitude (NAD 83)
Rwy / Make this entry the runway end point that corresponds to the LTP specified above
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
Rwy
FPAP, if applicable: / ‘
Notes:
28.Safe Altitude 100 NM
Obstacle # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Altitude
‘ / - 1000'1500'2000' / ‘
Notes:
29.Minimum Sector Altitude (do not provide MSA if TAA will exist)
NAVAID / WPT: / - NAVAIDWaypoint / Type: / - VORTACTACANVOR/DMEVORNDBMAWP / Ident:
Sector / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Altitude
NW / ‘ / 1000‘ / ‘
NE / ‘ / 1000‘ / ‘
SE / ‘ / 1000‘ / ‘
SW / ‘ / 1000‘ / ‘
Specify MSA Radius if other than 25 NM
Notes:
30.NAVAID, Fix and Waypoint Information (Enter coordinates here using a space to separate degree, minutes and seconds)
NAVAID /
Fix / WPT / Type / Ident / Frequency
(if required) / Latitude
(NAD 83) / Longitude
(NAD 83) / Chart
Symbol
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXFWPWPTIAWPRIAWPLIAWPCIAWPIWPIAWP/IWPFAWPSDWPMAWPICWPMATWPMAHWPFACFFROP / - VORTACTACANVOR/DMEVORNDBDMEGPLOCINTXNIAFIFFAFMAPMAHPSDFFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
Notes:
List the names of any fixes to be defined by a crossing radial, bearing or distance
Fix Name / Name of Facility Providing Radial / Bearing / Dist. / Value of Radial / Bearing / Dist. to be Charted / Fix Name / Name of Facility Providing Radial / Bearing / Dist. / Value of Radial / Bearing / Dist. to be Charted
List the requirements for the charting of lead radial or bearing on conventional arcs
LR / LB / Name of Facility Providing Radial / Bearing / Value of Radial / Bearing to be Charted / LR / LB / Name of Facility Providing Radial / Bearing / Value of Radial / Bearing to be Charted
31.RNP Value and RF Segment Data(To be used for RNP AR or procedures using RF type segments)
From / To / RNP Value
(for RNP AR only) / Radius Length
(for RF only) / Radius Centre
(for RF only)
Latitude
(NAD 83) / Longitude
(NAD 83) / Ident
32. Terminal Arrival Area (do not provide TAA if MSA will exist)
Right Base Area:
Subdivision 1 / IAWPR Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 2 / IAWPR Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Notes:
Straight-in Area:
Subdivision 1 / IAWPC Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 2 / IAWPC Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 3 / IAWPC Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 4 / IAWPC Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 5 / IAWPC Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Notes:
Left Base Area:
Subdivision 1 / IAWPL Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Subdivision 2 / IAWPL Ident / Track From / Track To / Distance From / Distance To
Obst. # / Latitude / Longitude / Elev. (MSL) / ROC / Altitude1
- 1000'1500'2000'
Notes:
1 If the TAA altitude has been raised from the standard ‘obstacle plus ROC’ value, provide details.
33.Feeder Routes
From / To / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev.
(MSL) / ROC / Altitude
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
Notes:
34.RASS Adjustment
Altimeter Source Location
(ICAO) / Full Time / Part Time / RASS Factor
- Full TimePart Time / ‘
- Full TimePart Time / ‘
Notes:
35.Holding / Shuttle (For DME holds / shuttles, specify DME distances in the “Notes” section below)
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Notes:
36.Exemption From Criteria 2
Exemption Required / Reason: / (Attach Memorandum)
2Transport Canada exemption must accompany the design file and must be renewed for every cyclic / regulatory review.
37.Controlling Obstacles
Segment / Type / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev.
(MSL) / ROC / Minimum
Altitude3
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
‘ / ‘ ( - PrimarySecondary) / ‘
Highest Man Made Obstacle
(within 10NM of FAF – AGCC if no FAF) / ‘ / ‘R’ = Terrain
‘T’ = Tower or other Man Made Structure (Database)
‘C’ = Tower or other Man Made Structure (Topo Culture)
‘A’= Area
Plan View Obst. / ‘
Plan View Obst. / ‘
Plan View Obst. / ‘
3If the segment altitude has been raised from the standard ‘obstacle plus ROC’ value, provide details below.
Notes:
Does a ‘No PT’ altitude apply to the intermediate segment listed above? / Yes / No / If ‘Yes’ specify the intermediate segment ‘from’ fix and ‘to’ fix along with the value of the ‘No PT’ altitude
38.Flight Check Information
Notes to the Flight Check Pilot:
Design Constraints
(deviations, airspace, noise, etc.)
Customer Requirements
Obstacle Issues
Special Instructions for FIO Pilot
39.Aerodrome Data
Aerodrome Certification / Runway Certification
Certified
Registered4
No Status / Precision
Non-Precision
Non-Instrument
4An aerodrome operator attestation must accompany the design file if the aerodrome is ‘Registered’ and the procedure is published in the CAP.
40.Depiction Information
______
F-IPD-129 Version 15.5Page 1 of 2215 April 2015
- - Printed: December 25, 2018
Depiction notes forAIM SD Graphics and/or Publishing:CYA, CYR, Blasting Areas
If Restricted Instrument Procedure, specify the required page 2 conditions:
No Aerodrome Status / RESTRICTED INSTRUMENT PROCEDURE
Aerodrome visual surfaces not assessed.
The following conditions apply to this procedure:
- Crews must be familiar with aerodrome environment.
Missed Approach Climb Gradient / RESTRICTED INSTRUMENT PROCEDURE
This procedure requires a missed approach climb gradient of ft/NM to feet.
The following conditions apply to this procedure:
- A minimum climb gradient of ft/NM to feet must be maintained during the missed approach procedure.
- The aircraft weight shall not be greater than that necessary to meet the published climb gradient on the missed approach.
- When computing the aircraft weight, corrections shall be made for the pressure altitude, ambient temperature, wind components and any gradient loss associated with a turn at the planned time of approach.
Missed Approach Climb Gradient and No Aerodrome Status / RESTRICTED INSTRUMENT PROCEDURE
This procedure requires a missed approach climb gradient of ft/NM to feet and the aerodrome visual surfaces are not assessed.
The following conditions apply to this procedure:
- A minimum climb gradient of ft/NM to feet must be maintained during the missed approach procedure.
- The aircraft weight shall not be greater than that necessary to meet the published climb gradient on the missed approach.
- When computing the aircraft weight, corrections shall be made for the pressure altitude, ambient temperature, wind components and any gradient loss associated with a turn at the planned time of approach.
- Crews must be familiar with aerodrome environment.
Other (F)
Complementary Visual Approach Chart Requirement:
If a stand alone visual approach chart is required for ATC purposes, the relevant sections of a separate Approach Submission Form should be completed.
COPTER (MAP is not a runway threshold) / List the approach procedures to be overlaid:
Bearing from MAP to landing site: / Distance from MAP to landing site:
Notes:
41.Remarks
Criteria Used: / Tree Height Used:
42.Draft Depiction
Draft
Depiction
Included / A draft depiction of the plan and profile views shall accompany this submission form. This depiction need only communicate the basic layout of the instrument procedure. Special attention should be given to depicting features of the instrument procedure that may not be suitably communicated by a completed submission form. Avoid duplicating information already communicated by this submission form (i.e. operational notes, etc). A French draft depiction is not required for sites published in CAP5
43.Database Coding
Database
Coding
Included / Database coding information must be submitted for the instrument procedure. This information can be provided as a separate Excel file. (NAV CANADA use only)
44.Coordination
(S) Sponsor 5 / Name / Company / Telephone / Address
Signature / Date / E-mail
(D) Designer / Name / Company / Telephone / Address
Signature / Date / E-mail
(V) Independent
Reviewer / Name / Company / Telephone / Address
Signature / Date / E-mail
(A) Air Traffic
Services / Name / Company / Telephone / Address
Signature / Date / E-mail
(Q) Quality
Assurance 6 / Name / Company / Telephone / Address
Signature / Date / E-mail
5Sponsor signature required if the procedure is sponsored by a party other than NAV CANADA. A ‘Sponsor’s Responsibility Form’ must accompany the design file.
6Quality Assurance is performed based on a random sampling in accordance with the NAV CANADA IPDUProcedures Manual.
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F-IPD-129 Version 15.5Page 1 of 2215 April 2015
- - Printed: December 25, 2018
Summary of Coordinates
The following is intended to provide a starting point for ADC copy / paste. This may need to be adjusted to satisfy the AIRACrequirements.
NUMNAMEIDENTTYPELATITUDELONGITUDE
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1THLD------
2END------
3 - -
4 - -
5 - -
6 - -
7 - -
8 - -
9 - -
10 - -
11 - -
12 - -
13 - -
14 - -
15 - -
16 - -
17 - -
18 - -
19 - -
20 - -
21 - -
22 - -
23 - -
24 - -
RNP Value and RF Segment Data:
From / To / RNP Value / Radius Length / Radius CentreLatitude / Longitude / Ident
Instructions for Completing the Instrument Approach Submission Form