AFS-11-123-E March 25, 2011

Exemption No. 7118H Regulatory Docket No. FAA-2002-11655

Mr. William E. Butts IHC Health Services, Inc. d.b.a. Intermountain Life Flight

250 North 2370 West Salt Lake City, UT 84116

Dear Mr. Butts:

This letter is to inform you that we have amended Exemption No. 7118, as amended. It transmits our decision, explains its basis, and gives you the revised conditions and limitations of the exemption, including the date it ends.

The Basis for Our Decision

On December 29, 2010, IHC Health Services, Inc. d.b.a. Intermountain Life Flight wrote the Federal Aviation Administration (FAA) requesting to modify Condition No. 4.

With regard to Condition No. 4, the FAA understa nds that the configuration of the Agusta A109K2 prevents recovery of the rescue target into the aircraft. As such, we have amended

Condition No. 4 as follows:

The pilot in command (PIC) for such rescue operations must have a minimum of 25 hours of flight time as PIC in the Agusta A109K2. A dditionally, each PIC must have successfully conducted 20 separate rescue hoist operations in the A109K2, either simulated or actual. Each of these hoist operations shall be conducted at an altitude that requires the aircraft to hover out of ground effect. Each hoist operation shall encompass the following elements: approach to the pickup site; establishment of a hover out of ground effect; establishment of a hoist lift where the rescue target is hoisted from the surface and is retrieved to a position next to the aircraft; repositioning flight to the nearest suitable landing zone to land the rotorcraft and load the rescue target in the rotorcraft; and departure from the landing zone. Flights2

between the rescue location and the nearest suitable landing zone must be conducted at a speed that allows for maximum control of the rescue target during its time outside of the

passenger compartment.

Our Decision

The FAA has determined that the justification for the issuance of Exemption No. 7118, as amended, remains valid with respect to this exemption and is in the public interest. Therefore, under the authority provided by 49 U.S.C. 40113 and 44701, which the FAA Administrator has delegated to me, I grant your petition, subject to the following revised

conditions and limitations.

Conditions and Limitations

1. Intermountain Life Flight will conduct training for pilots and crewmembers in accordance with a Class D external load training program accepted by the Administrator before commencing the conduct of Class D rotorcraft load combination operations. The training program will include initial and recurrent training for pilots and other crewmembers, in accordance with § 133.37.

2. Intermountain Life Flight must submit a re quest to the certificate-holding district office (CHDO) for an amendment to its Cla ss D authorization and training program to allow the conduct of Class D external load rescue operations with these additional

limitations.

3. The rotorcraft used in such rescue operations will be equipped with Arriel 1K1 turbine engines.

4. The PIC for such rescue operations must have a minimum of 25 hours of flight time as PIC in the Agusta A109K2. Additionally, each PIC must have successfully conducted 20 separate rescue hoist operations in the A109K2, either simulated or actual. Each of these hoist operations shall be conducted at an altitude that requires the aircraft to hover out of ground effect. Each hoist operation shall encompass the following elements: approach to the pickup site; establishment of a hover out of ground effect; establishment of a hoist lift where the rescue target is hoisted from the surface and is retrieved to a position next to the aircraft; repositioning flight to the nearest suitable landing zone to land the rotorcraft and load the rescue target in the rotorcraft; and departure from the landing zone. Flights between the rescue location and the nearest suitable landing zone must be conducted at a speed that allows for maximum control of the rescue target during its time outside of the passenger compartment.3

5. s conducted below 2,500 feet mean sea level.

6. This exemption is valid only for rescue operations undertaken to reduce or eliminate a significant imminent threat to human health or life and when no other civil aircraft is reasonably available that meets the requirements of § 133.45(e):

a. In evaluating whether a threat is “significant and imminent,” Intermountain Life Flight, in consultation with appropriate and qualified rescue or medical personnel, must reasonably determine that a threat of serious injury or death is present; and

b. In evaluating whether any other civil aircraft is “reasonably available,” Intermountain Life Flight must determine that, at the time of the rescue operation, no other civil aircraft meeting the requirements of § 133.45(e) is available and capable of responding to the threat in a timely manner.

7. Prior to any flight conducted under this exemption, Intermountain Life Flight must conduct and document a risk assessment to determine that the operation can be safely conducted. A copy of each completed risk assessment must be retained for 2 years and made available on request to the CHDO.

8. Intermountain Life Flight, in consultation with the appropriate rescue or medical personnel, must reasonably determine that an external load hoist operation is necessary to respond to the threat in that the rotorcraft external load hoist operation offers the best opportunity to reduce or eliminate the threat to human health or life.

9. Transport of passengers rescued under this exemption must be conducted in accordance with the requirements of Intermountain Life Flight’s part 135 operating certificate (Certificate No. I7LA073J) and operations specification paragraph A021.

10. Intermountain Life Flight must provide the FAA with current information on the status of its helicopter replacement project. This information must include an expected timeline for fleet replacement. This information must be provided to the CHDO on a yearly basis, beginning August 30, 2011.

The termination date remains August 31, 2012, unless sooner superseded or rescinded.

Sincerely,

/s/

John W. McGraw Acting Director, Flight Standards

Service