Fillable AIRCRAFT OCCURRENCE REPORT (Bermuda Civil Aviation Authority)

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AIRCRAFT OCCURRENCE REPORT (Bermuda Civil Aviation Authority)

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bcaa.bm
1
Form
No.:
AW 209
Last
Updated:
18 Mar 2019
AIRCRAFT OCCURRENCE REPORT
Comp
ilation Notes:
Item 6 – Use Waypoint, Geographical Feature, Lat/Long or Runway/Taxiway designator. Report No:
Items 9 & 10 – Use ICAO designator rather than IATA. (KJFK in preference to JFK)
Item 17 – Copy most recent METAR or SPECI into Item 31 BCAA No:
Item 19 – Can only be commented on following Pilot report
THIS
IS A WEB-BASED INTERACTIVE FORM WITH A NUMBER OF DROP DOWN MENUS. OPEN CLOSED
1. A/C Type & Series
2. A/C
Regn
3. Serial no:
4. Operator
5. Date
6. Loc./ Pos./ Runway
7. Time (UTC)
8. FLIGHT REPORT
Fligh
t No.
9. Route from
10. Route to
11. FL/ Alt/ Ht ft)
Feet
12. IAS (kts)/
Mach.No.
13. ETOPS?
n/a
14. NATURE OF
FLIGHT
Sche
duled Airline
FLIGHT
PHASE
15.
(UTC)
(attach latest report to Item
31 if available)
18. Runway State:
18a. Icing:
16.
19. FLIGHT CONDITIONS
20. Flight Rules
21. Surface Wind
°
22. Visibility:
23. Cloud cover
at
at
at
24. Precipitation:
26. Min Separation
Horiz:
Vert
ical: ft.
27. ACAS/TCAS Alert :
(as advised by Flight Crew)
28. Traffic info given by ATC?
29. Avoiding action given by
ATC?
30. Brief Title:
31. Description of Occurrence:
32. Remedial Action:
Submitter
Organisation
Name
Position
Date
33. 34. 35. 36.
37. If report is voluntary (ie not
subject to mandatory
requirements), can the information
be published in the interests of
safety?
38. Address and Tel No.
(if reporter wishes to be contacted privately)
39. BCAA Actions:
Forward to A.S.S.I.
A/W Inspector info:
Enter in database.
Re
port on file
Feedback
Transm
ission Details: Send as email attachment to: Your contact Airworthiness Inspector plus occurrences@bcaa.bm
Yes No
Yes No
Yes No
Yes No
Select
Select
Select
Select
Select
Select
Select
m.p.h.
metres
Sky Clear
99,999
Select
Sky Clear
99,999
Select
Select
Sky Clear
99,999
Select
Nm
Address
Telephone
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AIRCRAFT OCCURRENCE REPORT (Bermuda Civil Aviation Authority)

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Completed 22 July 2021

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