Paperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required to
respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.
The OMB Control Number for this information collection is 2120-0020. Public reporting for this collection of information is
estimated to be approximately 30 minutes per response, including the time for reviewing instructions, completing and reviewing
the collection of information. All responses to this collection of information are mandated by 14 CFR Part 43. Comments
concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800
Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ASP-110.
OMB No. 2120-0020 Electronic Tracking Number
Exp: 5/31/2018
US Department
MAJOR REPAIR AND ALTERATION For FAA Use Only
of Transportation (Airframe, Powerplant, Propeller, or Appliance)
Federal Aviation
Administration
INSTRUCTIONS: Print or type all entries. See Title 14 CFR §43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for
instructions and disposition of this form. This report is required by law (49 U.S.C. §44701). Failure to report can result in a civil penalty for each
such violation. (49 U.S.C. §46301(a))
Nationality and Registration Mark Serial No.
N62350 17275255
1. Aircraft Make Model Series
Cessna 172 P
Name (As shown on registration certificate) Address (As shown on registration certificate)
Address 8601 AVIATION BLVD NW
2. Owner FLYCAROLINA LLC
City Concord State NC
Zip 28027 Country USA
3. For FAA Use Only
4. Type 5. Unit Identification
Repair Alteration Unit Make Model Serial No.
Cessna 17275255
X AIRFRAME (As described in Item 1 above)
POWERPLANT
PROPELLER
Type
APPLIANCE
Manufacturer
6. Conformity Statement
A. Agency's Name and Address B. Kind of Agency
Name Micah Bittner X U. S. Certificated Mechanic Manufacturer
Address 1021 Maxwell Mill Rd
Foreign Certificated Mechanic C. Certificate No.
City Fort Mill State SC Certificated Repair Station
Zip 29708 Country USA
Certificated Maintenance Organization A&P3801465IA
D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto
have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information
furnished herein is true and correct to the best of my knowledge.
Extended range fuel Signature/Date of Authorized Individual
per 14 CFR Part 43
App. B
7. Approval for Return to Service
Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the
Administrator of the Federal Aviation Administration and is Approved Rejected
FAA Flt. Standards Maintenance Organization
Persons Approved by Canadian
Manufacturer Department of Transport
Inspector
BY Other (Specify)
FAA Designee Repair Station Inspection Authorization
Certificate or Signature/Date of Authorized Individual
Designation No.
FAA Form 337 (10/06)
Page 1
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be
compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)
N62350 11/06/2024
Nationality and Registration M ark Date
Aircraft Total Time: 5560.3
STC: SA71GL
Work Performed:
Found aircraft to previously be fitted to recieve Brackett air filter. Inspected previous installation for
conformity and condition, no defects noted. Installed filter assembly P/N: BA-5110A Rev. D.
Installed filter element P/N: BA-6108. Work performed IAW Installation Instruction Sheet Part No.
5105. Performed operational check, no defects noted.
INSTRUCTIONS FOR CONTINUED AIRWORTHINESS(Document I-194):
INSPECTION INTERVALS: Pre-flight inspections, engine backfire
inspection, 100 hour inspections, annual inspections, filter element
replacements.
INSPECTION PROCEDURES
A. Pre-flight inspection: Per Pilots Operating Handbook, check filter assembly
for security, damage or 50% contamination of element face. If found report
to maintenance personnel prior to flight.
B. Engine start-up backfire inspection: Prior to flight, check the entire intake
system for security or damage. If a fire was present, the downstream face of
the foam element will show erosion. If any irregularities are found see
Chart I and also refer to the Aircraft Maintenance Manual for the intake
system.
C. At element replacement intervals: With the element removed, inspect the
filter grill, filter frame, filter mountings and entire intake system for
security, wear and any deformation. Note: On filter assemblies with gaskets,
visually inspect inside and outside of frame for any signs of gasket
looseness, movement or deterioration. If found refer to Chart I or the
proper maintenance manual for your aircraft or component.\
No change to Weight and Balance.
Micah Bittner A&P3801465IA _________________ 11/06/2024
------------------------------------------------------------END------------------------------------------------------------------
Additional Sheets Are Attached
FAA Form 337 (10/06)
Page 2
