Section 1 Operator name Aircraft make/model Engine make/model Aircraft registration Date Of Incident Local Time Of Incident Local Time Of Incident Dawn Dusk HR HR 01 02 03 04 05 06 07 08 09 10 11 12 MN 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 Local Time Of Incident2 Day Night am/pm am pm Airport Name Runway Used Location If En Route(Nearest town/reference and governorate) Height (AGL) Speed section 2 Phase Of Flight Parked Taxi Take-off Run Climp En Route Descent Approach Landing Roll Part(s) of Aircraft Struck or Damaged title Struck Damaged Radome Radome Struck Struck Radome_Damaged Damaged windshield windshield Struck Struck windshield_Damaged Damaged nose nose Struck Struck nose_Damaged Damaged Engin No 1 Engin No 1 Struck Struck Engin No 1_Damaged Damaged Engin No 2 Engin No 2 Struck Struck Engin No 2_Damaged Damaged Engin No 3 Engin No 3 Struck Struck Engin No 3_Damaged Damaged Engin No 4 Engin No 4 Struck Struck Engin No 4_Damaged Damaged Part(s) of Aircraft Struck or Damaged title Struck Damaged propeller propeller Struck Struck propeller_Damaged Damaged wing/rotor wing/rotor Struck Struck wing/rotor_Damaged Damaged fuselage fuselage Struck Struck fuselage_Damaged Damaged landing gear landing gear Struck Struck landing gear_Damaged Damaged tail tail Struck Struck tail_Damaged Damaged Lights Lights Struck Struck Lights_Damaged Damaged other section 3 Effect of Flight None Aborted Take-Off Precautionary Landing Engines Shut Down Other:(Specify) Sky Condition No Clouds Some Clouds Overcast Precipitation Fog Rain Snow None section 4 Pilot warned of Birds/Other Wildlife Strike Small Medium Large Bird/Other Wildlife Species Number of Birds/Other Wildlife seen and/or struck Number none 1 2 - 10 11 - 100 more than 100 عدد الطيور/الحياة البرية التي تمت مشاهدتها و/أو التي تعرضت لاصطدام مشاهدة اصطدام section 5 Pilot warned of Birds/Other Wildlife Strike Yes No Remarks(Describe damage,injuries and other pertinent information) DAMAGE / COST INFORMATION Aircraft time out of service(hours) Estimated cost of repais or replacement(JD) Estimated other costs(JD) (e.g. loss of revenue, fule, hotels): Reported by (Optional) Title Date CARC Form DOASS-6 Provide your email if you want to receive a copy of this report: هذا السؤال لاختبار ما إذا كنت زائرًا بشريًا أم لا ولمنع عمليات إرسال البريد العشوائي الآلية هذا السؤال مخصص لاختبار ما إذا كنت زائرًا بشريًا أم لا ولمنع عمليات الإرسال التلقائية للبريد العشوائي.
