Fillable UWL Unmanned Aircraft Systems (Drones) Use Checklist Utilize (University of Wisconsin - LaCrosse)

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UWL Unmanned Aircraft Systems (Drones) Use Checklist Utilize (University of Wisconsin - LaCrosse)

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BUSINESS SERVICES
125 Graff Main Hall
1725 State St. | La Crosse, WI 54601 USA
An affirmative action/equal opportunity employer
phone 608.785.8554
fax 608.785.8544
www.uwlax.edu/business-services/
Surround yourself with UW-La Crosse
UWL Unmanned Aircraft Systems (Drones) Use Checklist
Utilize this checklist to ensure that operators have met all requirements to operate an unmanned aircraft
system (UAS) or “drone” while on University of Wisconsin-La Crosse (UWL) lands or the air space above
UWL lands.
Name of UAS activity or event: ___________________________________________________
Date of activity or event: ________________________________________________________
Location of UAS activity: ________________________________________________________
Name of Operator: _____________________________________________________________
Use of the UAS is by:
University employee or student for university-related activity or research
Third party
Hobbyist
Operator properly trained in UAS operation. Responsible Dept.: _________________
** University employee, student, or unit purchasing a UAS (or parts to assemble a UAS), or UAS
services with university funds or funds being disbursed through a university account, or grant
funds, must contact Risk Management and provide proof of a Part 107 license as Remote Pilot
Certificate or other proof of FAA approval
** Third parties or hobbyists planning to use a UAS must:
Provide proof of a Part 107 Remote Pilot Certificate or other proof of FAA approval
Be under a contract which holds the university harmless from any resulting claims or harm to
individuals and damage to university property
Provide Risk Management with certificate of insurance meeting requirements: General Liability
= $1,000,000 per occurrence; Aircraft Liability = $1,000,000
** Employees or students using his/her personally owned drone for university business must
provide proof of insurance as their personal insurance coverage is primary
Drones operated near residential buildings must remain 100 feet from the building or contact
Housing 24 hours in advance of flight and receive approval to be closer the building.
** Must be submitted with completed checklist for approval, if applicable
Approval of UAS Activity:
Risk Management: ______________________________________ Date: _________________
Police Department: _____________________________________ Date: _________________
Housing, if applicable: ___________________________________ Date: _________________
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Completed 24 July 2020

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