This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a	separate	file	pursuant	to	14	C.F .R.	§	11.35(b) 

# UAS Standard Operating Procedures

PO	Box	1185

Tahoe	City,	CA	96145

Last Revision: 20160421UAS	Operations	Manual

Rev:1.0

Page 1 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) This	manual	has	 been	prepared	 for	 the exclusive	use	 of	CloudD8ta	 LLC,	under	 the

direction	and	authority	of	CloudD8ta	and	shall,	at	all	times,	remain	the	property	of

CloudD8ta.		The	holder	hereof	acknowledges	and	agrees	 that	 this	manual	contains

or	may	contain	trade	secrets,	copyrighted	materia l	and	commercial	and	proprietary

information,	 privileged	and	 confidential,	and	 the	 holder	 hereof	 further	agrees	 that

this	 manual	 may	 not	 be	 reproduced,	 distributed	 or	 copied,	 in	 whole	 or	 in	 part,

without	the	express	prior	written	consent	of	CloudD8ta.	In	t he	event	this	manual	is

sold	 or	 distributed	 to	 any	 other	 party,	 no	 warranty	 or	 guarantee,	 expressed	 or

implied,	 is	 made	 as	 to	 the	 accuracy,	 sufficiency	 or	 suitability	 of	 the	 materials

contained	herein	or	of	any	revision,	supplement	or	bulletin	hereto,	and CloudD8ta

shall	not	responsible	for	providing	revisions	for	this	manual	to	any	third

- party	that

this	manual	is	sold	or	distributed	to.		 It	is	understood	and	agreed	to	by	such	other

party	that	it	shall	release,	indemnify,	and	hold	CloudD8ta,	its	officers,	e mployees	and

agents	harmless	against	any	and	all	claims	or	actions	of	whatever	nature	which	may

arise	or	claim	to	arise	from	the	use	hereof.UAS	Operations	Manual

Rev:1.0

Page 2 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 

### Table	of	Contents

Purpose

................................ ................................ ................................ ................................ .......................... 3

Owner/Operator	&	Organization

................................ ................................ ................................ ........ 3

Persons	Authorized

................................ ................................ ................................ ................................ ... 3

Distribution	and	Revision	Procedures

................................ ................................ ............................. 3

Area	of	Operations

................................ ................................ ................................ ................................ ..... 3

Plan	of	Activities

................................ ................................ ................................ ................................ ......... 4

Permission	to	Operate

................................ ................................ ................................ ............................. 4

Security

................................ ................................ ................................ ................................ ........................... 5

Briefing	of	Flight	Personnel/Participating	Persons

................................ ................................ .... 5

Pilot	&	Visual	Observer	Minimum	Requirements

................................ ................................ ........ 6

Communications

................................ ................................ ................................ ................................ ........ 7

Accident	Notification

................................ ................................ ................................ ................................ 7

Recall/Stop	Procedures

................................ ................................ ................................ .......................... 7

Special	Provisions

................................ ................................ ................................ ................................ ...... 8

CloudD8ta	Organization

................................ ................................ ................................ .......................... 8

Appendix	A

- List	of	Approved	Pilots

................................ ................................ ............................... 10

Appendix	B

- List	of	Approved	UAS

................................ ................................ ................................ .. 11

Appendix	C

- Revision	Letter

................................ ................................ ................................ ............... 12

Appendix	D

- Revision	Control	Page

................................ ................................ ................................ 13

Appendix	E

- Location	Permission	Form

................................ ................................ ....................... 14

Appendix	F

- UAS	Operations	Manual	Pilot	Acknowledgment	and	Receipt

................... 15UAS	Operations	Manual

Rev:1.0

Page 3 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 

### Purpose

This	manual	has	been	developed	by	CloudD8ta	LLC	(hereafter	referred	to	as

“CloudD8ta”),	for	use	in	conjunction	with	CloudD8ta’s	grant	of	exemption	and/or

applicable	Certificate	of	Waiver	or	Authorization	(COA).		CloudD8ta	pilots,	sensor

operators,	visual observers,	and	other	personnel	when	applicable,	will	comply	with

the	policies,	procedures	and	conditions	of	this	manual,	as	required	by	CloudD8ta’s

grant	of	exemption	and/or	applicable	COA.



### Owner/Operator	&	Organization

CloudD8ta	LLC

PO	Box	1185

Tahoe City,	CA	96145

530	386	6677



### Persons	Authorized

FAR	91.119(c)	is	waived	only	with	respect	to	those	persons,	vehicles	and	structures

essential	to,	or	directly	participating	in	the	intended	purposes	of,	the	operation.

CloudD8ta	shall	ensure	that	no	pers ons	are	allowed	within	500	feet	of	the	area

except	CloudD8ta	employees,	contractors	and	sub

- contractors	consenting	to	and

directly	participating	in	the	intended	purpose	of	this	operation.



### Distribution	and	Revision	Procedures

CloudD8ta	shall document	and	record	all	revisions	made	to	this	manual	to	ensure

that	records	are	kept	current.	CloudD8ta	shall	forward	all	revisions	to	the	Flight

Standards	District	Office	(FSDO)	at	least	15	days	before	the	proposed	effective	date.

All	revisions	shall	be documented	using	the	Revision	Letter	( Appendix	C )	and

recorded	using	the	Revision	Control	Page	( Appendix	D ).



### Area	of	Operations

CloudD8ta’s	approved	area	of	operations	will	be	the	United	States,	including	its

territories	and	possessions.UAS	Operations	Manual

Rev:1.0

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This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 

### Plan	of Activities

At	least	24	hours	prior	to	any	operation	conducted	closer	than	500	feet	to	people

directly	participating	in	the	intended	purpose	of	the	operations,	not	protected	by

barriers,	CloudD8ta	shall	submit	a	written	Plan	of	Activities	to	the	local	FSDO having

jurisdiction	over	that	area.

The	Plan	of	Activities	will	include	the	following:

1. Dates	and	times	for	all	flights.	For	seasonal	or	long

- term	operations,	this	can

include	the	beginning	and	end	dates	of	the	timeframe,	the	approximate

frequency	(e.g. daily,	every	weekend,	etc.),	and	what	times	of	the	day

operations	will	occur.	A	new	plan	of	activities	must	be	submitted	prior	to

each	season	or	period	of	operations.

2. Name	and	phone	number	of	the	on

- site	person	responsible	for	the	operation.

3. Make, model,	and	serial	or	N

- Number	of	each	UAS	to	be	used.

4. Name	and	certificate	number	of	each	UAS	Pilot

- in

- Command	(PIC)	involved

in	the	operations.

5. A	statement	that	the	operator	has	obtained	permission	from	property

owners.	Upon	request,	the	operator	will	m ake	available	a	list	of	those	who

gave	permission.

6. Signature	of	exemption	holder	or	representative	stating	the	plan	is	accurate.

7. A	description	of	the	flight	activity,	including	maps	or	diagrams	of	the	area

over	which	operations	will	be	conducted	and	the altitudes	essential	to

accomplish	the	operation

In	accordance	with	this	exemption,	the	Plan	of	Activities	and	all	other	operating

documents	must	be	accessible	to	the	PIC	during	UAS	operations.	A	new	Plan	of

Activities	must	be	submitted	should	there	be	any changes	to	items	(1)	through	(7).



### Permission	to	Operate

Before	any	flight	operations	is	conducted	under	the	provisions	of	this	manual,	the

operator	will	obtain	permission	to	conduct	these	operations	from	property	owners

and	local	officials	as	necessary	or	appropriate.	Persons	from	whom	permission	mayUAS	Operations	Manual

Rev:1.0

Page 5 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) be	require d	are	listed	below:

1. Property	owners

2. Law	enforcement	officials

3. Fire	department	officials

4. Local,	State	and	Federal	government

5. Air	traffic	control

CloudD8ta	personnel	obtaining	such	permission	will	do	so	in	writing	whenever

practical;	however,	verbal	permission	is	otherwise	acceptable.			If	only	verbal

permission	is	received,	document	the	time,	date,	and	the	name	/	title	of	the	person

providing	permi ssion.	A	standard	Permission	Form	is	provided	in Appendix	E and

may	be	used	when	obtaining	written	permission	and	may	also	be	used	to	document

verbal	permission.		CloudD8ta	personnel	will	assure	a	sufficient	number	of

Permission	Forms	are	available	at	the operations	site.	Written	permission	forms	will

be	maintained	at	the	operations	site	until	flight	operations	are	completed,	and	then

turned	into	the	Operations	Manager	to	be	kept	on	file	for	a	minimum	of	six	(6)

months.	These	forms	will	be	made	available	fo r	inspection	by	the	Federal	Aviation

Administration	(FAA)	or	other	official	personnel	upon	request.



### Security

Prior	to	any	flight	operation	CloudD8ta	will	coordinate	with	appropriate	site

personnel	to	devise	a	plan	of	securing	the	area(s)	of	operation	f rom	all	unauthorized

persons	and	vehicles	to	a	minimum	of	a	500

- foot	perimeter.	Provisions	will	be	made

to	immediately	discontinue	operations	should	the	area(s)	become	unsecured	or	for

any	other	reason	in	the	interest	of	safety.



### Briefing	of	Flight	Perso nnel/Participating	Persons

Prior	to	the	start	of	any	operation	under	the	provisions	of	this	manual,	the	PIC	will

conduct	a	briefing	of	all	procedures	to	the	Visual	Observer,	camera/gimbal	operator,

and	any	participating	persons	of	the	risks	involved,	emer gency	procedures,	and

safeguards	to	be	followed	during	the	event.	Flight	personnel	and	participating

persons	will	also	be	briefed	on	additional	provisions	that	may	be	issued	by	the	FSDO

that	has	geographic	responsibility	for	the	operational	area,	including the	location	of

boundaries	or	time	limits.	The	briefing	shall	cover:UAS	Operations	Manual

Rev:1.0

Page 6 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 1. Pertinent	sections	of	this	manual	and	any	other	manual	necessary	for	the

safe	operation	of	the	UAS

2. Plan	of	Activities

3. UAS	takeoff	and	landing	procedures

4. Role	of	PIC,	Visual	Observer, camera/gimbal	operator,	and	any

participating	persons

5. Overview	of	flight	activities	to	be	conducted	during	the	intended	operation

6. Recall	procedures

7. Emergency	procedures

8. Risks	to	participating	personnel

9. How	to	control	nonparticipating	persons



### Pilot &	Visual	Observer	Minimum	Requirements

CloudD8ta	shall	establish	and	specify	the	minimum	pilot	requirements.	Minimum

requirements	shall	meet	or	exceed	the	following:

Prior	to	conducting	operations,	the	PIC	must	have	logged,	consistent	with	14	CFR

61.51( b)	a	minimum	of:

• 25	hours	of	total	time	as	a	UAS	pilot

• 5	hours	as	a	UAS	pilot	operating	the	same	make	and	model	UAS	to	be

operated

• 3	takeoffs	and	landings	in	the	preceding	90	days	(for	currency	purposes)

Prior	documented	flight	experience	t hat	was	obtained	in	compliance	with	applicable

regulations	could	satisfy	this	requirement.

Training,	proficiency,	and	experience

- building	flights	can	also	be	conducted	to

accomplish	the	required	flight	time.	During	training,	proficiency,	and experience

building	flights	the	PIC	is	required	to	operate	the	UAS	with	appropriate	distances	in

accordance	with	14	CFR	91.119.UAS	Operations	Manual

Rev:1.0

Page 7 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) CloudD8ta	may	determine	that	additional	hours	are	necessary	to	address	all

potential	flight	hazards	and	requisite	airmanship	sk ills.	CloudD8ta	will	not	permit

any	PIC	to	operate	unless	that	PIC	is	able	to	safely	operate	the	UAS	in	a	manner

consistent	with	how	the	UAS	will	be	operated	under	this	exemption,	including

evasive	and	emergency	maneuvers	and	maintaining	appropriate	distan ces	from

persons,	vessels,	vehicles	and	structures.

Prior	to	operations	the	PIC	must	hold	either	an	airline	transport,	commercial,

private,	recreational,	or	sport	pilot	certificate.	The	PIC	must	also	hold	a	current	FAA

airman	medical	certificate	or	a	vali d	U.S.	driver’s	license	issued	by	a	state,	the

District	of	Columbia,	Puerto	Rico,	a	territory,	a	possession,	or	the	Federal

government,	and	have	completed	the	minimum	flight	hour	and	currency

requirements	as	stated	in	the	conditions	and	limitations	above.

Visual	Observers	should	have	a	minimum	of	1	hour	of	observation	time	with	the

UAS	that	they	are	observing,	affording	them	direct	experience	with	the	performance

and	operating	capabilities	of	the	UAS	they	will	be	observing.



### Communications

Prior	to	the start	of	any	operation	covered	by	this	manual,	the	PIC	will	formulate	a

plan	to	provide	communications	capability	to	all	participants	during	the	actual

operation.	Oral,	visual	or	radio	communications	may	be	used	as	long	as	it	is	effective

and	is	capable	of keeping	the	participants	continuously	appraised	of	the	current

status	of	the	operation.



### Accident	Notification

Should	an	accident	or	incident	requiring	notification	of	the	NTSB	occur,	the

notification	requirements	of	FAR	Part	830	would	apply.		CloudD8t a	shall	also

comply	with	the	notification	requirements	of	the	grant	of	exemption	and/or

applicable	COA.



### Recall/Stop	Procedures

Specific	procedures	will	vary	based	on	the	UAS	being	used,	the	physical	location,	and

other	unique	configurations	in	the field.	Details	will	be	part	of	the	required	pre

flight	briefing.UAS	Operations	Manual

Rev:1.0

Page 8 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 

### Special	Provisions

The	controls,	procedures,	and	conditions	set	forth	in	this	manual	are	the	primary

assurance	that	persons	on	the	surface	will	not	be	jeopardized.

The	UAS	and	pilots	use d	under	this	exemption	and/or	waiver	will	only	be	those

specified	in	manual, Appendices A and B ,	or	associated	Plan	of	Activities.	Each

pilot’s	name	and	certificate	number	shall	appear	on	each	daily	plan	of	activity.	All

UAS	and	pilot(s)	participating	in the	activity	shall	be	available	for	FAA	inspection

before	the	scheduled	event.

Each	PIC	conducting	operations	authorized	under	this	exemption	and/or	waiver

understands	the	conditions	of	issuance,	and	that	it	constitutes	a	waiver	of	Section

91.119	and	(c). ( Appendix	G )	UAS	takeoff	and	landing	areas	will	be	protected

in	a	manner	that	will	prevent	unauthorized	persons	from	entering	the	takeoff	and

landing area.	CloudD8ta	will	ensure	that	the	participating	persons	involved	in	the

operations are	thoroughly	brie fed	on	special	procedures,	communication,

emergency	procedures, and	on	the	provisions	of	the	authorization	and/or	waiver

before	commencing	the activities.	No	person	may	participate	in	any	event	unless

that	person	has	received	a briefing	on	the	provisions	o f	the	exemption	and/or

waiver.



### CloudD8ta	Organization

OPERATIONS	MANAGER

Duties	and	Responsibilities:

1. Has	final	word	in	the	formulation	of	policy	and	procedures	concerning	this

manual.

2. Act	as	liaison	between	CloudD8ta	and	the	FAA	on	matter	concerning this

manual.

3. Assure	that	each	approved	pilot	is	issued	a	copy	of	this	manual	and	obtain

a	signed	statement	from	each	that	they	have	read	and	understand	its

contents.

4. Maintain	a	current	copy	of	this	manual	at	the	main	base	of	operations	for

CloudD8ta.

5. Responsible	for	assuring	that	all	revisions	to	this	manual	are	distributed

and	processed	properly.UAS	Operations	Manual

Rev:1.0

Page 9 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) 6. Must	approve	or	disapprove	each	proposed	operation	performed	by

CloudD8ta under	the	provisions	of	this	manual.

7. Assume	the	responsibilities	of	PIC	when	acti ng	as	such.

8. The	Operations	Manager	may	delegate	functions	to	other	personnel	but

retains	responsibility.

PILOT	IN	COMMAND	(PIC)

Duties	and	Responsibilities:

1. Assure	the	UAS	to	be	flown	is	in	airworthy	condition	and	required

maintenance	have	been performed	as	appropriate.

2. Acquire	permission	from	the	Operations	Manager	before	any	operation

under	the	provisions	of	this	manual.

3. Be	very	knowledgeable	of	the	contents	of	this	manual	and	abide	by	the

procedures,	policies	and	conditions	contained	herein.

4. Coordinate	with	location	personnel	to	formulate	plans,	routes,	locations,

etc.	with	safety	of	all	persons	involved	is	the	primary	concern.

5. Maintain	and	keep	current	their	copy	of	this	manual	and	have	it	on	site	at

any	operation	requiring	the	waiver.

6. Th e	PIC	may	delegate	functions	to	other	personnel,	but	retains

responsibility.

VISUAL	OBSERVER

Duties	and	Responsibilities:

1. Maintain	visual	line	of	sight	with	the	UAS	at	all	times.

2. Maintain	direct	communication	with	the	PIC.

3. Maintain	a	broader “situational”	awareness	of	the	secure	area	and	stay

alert	for	unauthorized	persons	or	vehicles	that	could	compromise	the	area.

4. Assist	the	PIC	in	with	collision	avoidance.	Including,	but	not	limited	to,

avoidance	of	other	traffic,	clouds,	obstructions,	and terrain.UAS	Operations	Manual

Rev:1.0

Page 10 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	A

- List	of	Approved	Pilots

Pilot	Name Tom	Jennings

Certificate	Number	/	Type Light Sport Aircraft Pilot Certificate Number

3827138

Grade

Medical	Class	(if	applicable)	/	Date

Contact	Number 530	386	6677UAS	Operations	Manual

Rev:1.0

Page 11 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	B

- List	of	Approved	UAS

1. DJI Inspire

2. 3D	Robotics	Aero

- M	or	Aero

- M

3. 3D	Robotics	Iris+

4. 3D	Robotics	X8

5. 3D	Robotics Solo 6. DJI	Flame	Wheel	F550

7. DJI	Flame	Wheel	F 4 50

8. DJI	Matrice	100

9. DJI	Spreading	Wings	S1000UAS	Operations	Manual

Rev:1.0

Page 12 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	C

- Revision	Letter

R	=	Remove	and	Replace

D	=	Delete	and	Destroy

N	=	Insert New	Page

Manual	Serial	#	_______________________			Issued	To	________________________

Revised	By	__________________________________		Date	_____________________

This	form	must	be	returned	to	the	Operations	Manager	no	later	than:	_______________ Revision	# Section Page Action Remarks InitialsUAS	Operations	Manual

Rev:1.0

Page 13 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	D

- Revision	Control	Page

Revision	Number

______________________________________________________________________________

Revised	By

______________________________________________________________________________

Date	Effective

_________________________

Date	Forwarded	to	FSDO

_________________________

Proposed	Revision

______________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_____________________________________________ ____________________________________________________________

Revision	Number

_________________________

Revised	By

_________________________

Date	Effective

_________________________

Date	Forwarded	to	FSDO

_________________________

Proposed	Rev ision

______________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________UAS	Operations	Manual

Rev:1.0

Page 14 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	E

- Location	Permission	Form

In	s igning	this	form,	I	hereby	grant	permission	to	CloudD8ta	to	operate	its	UAS	at	less

than	 500	 feet	 from	 the	 property	 described	 below,	 of	 which	 I	 am	 the	 owner	 and/or

authorized	representative,	for	the	purpose	of	aerial	data	collection	/	filming.

Please indicate	the	basis	of	authority	to	grant	permission:	_______________________________________

_________________________________________________________________________________________________________

Name:

___________________________________

Title	(if applicable):

___________________________________

Location:

___________________________________

Date	of	Operation:

___________________________________

Signature:

___________________________________

Date:

___________________________________

CloudD8ta	Representative	Receiving	Permission:

Name:

___________________________________

Date:

___________________________________UAS	Operations	Manual

Rev:1.0

Page 15 of 15

This	manual	contains	proprietary	and	commercial	information	exempt	from	disclosure	under	the	Freedom	of

Information	Act,	5	U.S.C.	§	552 et	seq. ,	and	should	be	held	in	a separate	file	pursuant	to	14	C.F.R.	§	11.35(b) Appendix	F

- UAS	Operations	Manual	Pilot	Acknowledgment	and	Receipt

By	 signing	 below,	 I	 hereby	 acknowledge	 that I	 have	 received	 a	 copy	 of	 CloudD8ta’s

UAS	Operations	Manual.	 I	hereby	acknowledge	 that	 I	have	read	and	understand	 the

policies	and	procedures	as	outlined	herein	and	accept	to	be	subject	to	compliance.

___________________________________________ Signature

___________________________________________ Date

___________________________________________ Print	Name

___________________________________________ Pilot	Certificate	Number	/	Type