E
Sample Wake Encounter Reporting Form

The following is a sample wake turbulence encounter reporting form used by the UK Civil Aviation Authority. This format could provide a model for a U.S. reporting form.



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OCR for page 85
E Sample Wake Encounter Reporting Form The following is a sample wake turbulence encounter reporting form used by the UK Civil Aviation Authority. This format could provide a model for a U.S. reporting form. 

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 APPENDIX E WAKE TURBULENCE ENCOUNTER REPORT FORM - AIR TRAFFI C CONTROL (SRG 1422) Plea se complete all relevant sections in BLOCK CAPITALS using black or da blue ink and put an X in the rk appropriate boxes. If report is CONFIDENTIAL, please mark clearly and subm as per CAP 382 paragraph 7.1.8. it For ATCO use when filing a report on wake turbulence encount ers, including those hazardous cases that qualify as Reportable Occurrences under Article 142 of the Air Navigation Order and EU Directive 2003/42. Pilots of both leading and following aircraft involved in a wake turbulence encounter should be requested to complete form SRG 1423, which is available from the CAA website. 1. IS THIS INCIDENT REPORTABLE UNDER THE MOR SCHEME? Ys e No If YES , this form should be sent to the Safety Investigation and Data Department (SIDD) (Full address is given at the end of this form). 2. GENERAL DETAILS Date of incident: ............................................................................. Time (UTC) : .................... ............................................................... . Controller name: ............................................................................. Watch (if applicable) : ...................................................................... Unit address: ................................................................................................................................................................................................ . ....................................................................................................................................................................................................................... Telephone: ...................................................................................... E-mail: ............................................................................................ 3. DETAILS OF AFFECTED AIRCRAFT report: Operator: ......................................................................................... Callsign: ......................................................................................... ICAO aircraft type: .......................................................................... SSR: ............................................................................................... Geographical position: ............................ Flight phase: ........................................ Altitude: ............................................................. Departure airport: ............................................................................ Destination airport: ........................................................................ 4. DETAILS OF GENERATING AIRCRAFT Operator: ......................................................................................... Callsign: ......................................................................................... SSR: ................................................................................................ ICAO aircraft type: ......................................................................... Estimated separa tion between aircraft: .................... .................................................................................................................................... 5. METEOROLOGY Wind direction: ............................................................................... Wind speed: .................... .............................................................. Visibility: .......................................................................................... Cloud: ............................................................................................ Temperature: ........................................... Dew point: ........................................... QNH: ............ ..................................................... Wind shear known or reported: ................................................................................................. ................................................................... Weather: ..................................................................................................................... ................................................................................. . 6. OTHER INFORMATION Pleas e enter any further information which you may feel is relevant to this ....................................................................................................................................................................................................................... ....................................................................................................................................................................................................................... ....................................................................................................................................................................................................................... ....................................................................................................................................................................................................................... SRG 1422 Issue 1 (November 2007) Figure called: 22 Wake Appen E part