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60°W
55°W
50°W
45°W
40°W
35°W
30°W
25°W
20°W
15°W
10°W
5°W
0°E/W
Give an estimate of
the duration of the
equipment failure
Time of failure :
Time of exit from MNPS :
Duration of failure in MNPS :
At what time did
you advise ATC of
the failure
Thank you for your co-operation
NORTH ATLANTIC MNPSA OPERATIONS MANUAL ATTACHMENT 2
NAT MNPS 86 Edition 2005
Attachment 2 - Altitude Deviation Report Form
MESSAGE FORMAT FOR A REPORT TO THE CENTRAL MONITORING AGENCY OF AN
ALTITUDE DEVIATION OF 300 FT OR MORE, INCLUDING THOSE DUE TO TCAS,
TURBULENCE AND CONTINGENCY EVENTS
1. REPORT OF AN ALTITUDE DEVIATION OF 300 FT OR MORE
2. REPORTING AGENCY
3. DATE AND TIME
4. LOCATION OF DEVIATION
5. RANDOM / OTS1
6. FLIGHT IDENTIFICATION AND TYPE
7. FLIGHT LEVEL ASSIGNED
8. OBSERVED / REPORTED1 FINAL FLIGHT LEVEL2 MODE “C” / PILOT REPORT1
9. DURATION AT FLIGHT LEVEL
10. CAUSE OF DEVIATION
11. OTHER TRAFFIC
12. CREW COMMENTS WHEN NOTIFIED
13. REMARKS3
1. State one of the two choices.
2. In the case of turbulence, state extent of deviation from cleared flight level.
3. In the event of contingency action, indicate whether prior clearance was given and if contingency procedures
were followed
When complete send this form to:
North Atlantic Central Monitoring Agency
c/o National Air Traffic Services
Room G41
Scottish & Oceanic Area Control Centre,
Sherwood Road,
Prestwick, Ayrshire - KA9 2NR
natcma@nats.co.uk
NORTH ATLANTIC MNPSA OPERATIONS MANUAL ATTACHMENT 3
NAT MNPS 87 Edition 2005
Attachment 3 - Wake Turbulence Report Form
For use by pilots involved in Wake Vortex incidents which have occurred in NAT MNPS Airspace.
This information is requested by the North Atlantic Central Monitoring Agency and will be forwarded for
inclusion in the UK National Air Traffic Services Limited Wake Vortex database.
SECTION A
DATE OF OCCURRENCE TIME (UTC)
*DAY/NIGHT
OPERATOR FLIGHT NUMBER
AIRCRAFT TYPE & SERIES
REGISTRATION AIRCRAFT WEIGHT (KG)
ORIGIN & DESTINATION
POSITION IN
LAT & LONG
CLEARED TRACK CO-ORDINATES
FLIGHT LEVEL SPEED/MACH
NBR.
FLIGHT PHASE:
*CRUISE/CLIMB/DESCENT
WERE YOU
TURNING?
*YES/NO
DID YOU APPLY A
TRACK OFFSET?
*YES/NO
SIZE OF TRACK OFFSET?
Nautical Miles
WAS ATC INFORMED?
*YES/NO
MET CONDITIONS
IMC
VMC
ACTUAL WEATHER
WIND VISIBILITY CLOUD
TEMPERATURE
/ km / °C
DEGREE OF TURBULENCE
*LIGHT/MODERATE/SEVERE
OTHER SIGNIFICANT WEATHER?
(*Circle the appropriate reply only)
SECTION B
1 What made you suspect Wake Vortex as the cause of the disturbance?
2 Did you experience vertical acceleration? *YES/NO
If YES please describe briefly
3 What was the change in attitude? (please estimate angle)
Pitch º Roll º Yaw º
4 What was the change in height if any? *INCREASE/DECREASE
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NORTH ATLANTIC MNPSA OPERATIONS MANUAL ATTACHMENT 3
NAT MNPS 88 Edition 2005
5 Was there buffeting? *YES/NO
6 Was there stick shake? *YES/NO
7 Was the Autopilot engaged? *YES/NO
8 Was the Auto throttle engaged? *YES/NO
9 What control action was taken?
Please describe briefly
10 Could you see the aircraft suspected of causing the wake vortex? *YES/NO
11 Did you contact the aircraft suspected of causing the vortex? *YES/NO
12 Was the aircraft suspected of causing the vortex detected by TCAS? *YES/NO
If YES to any of questions 10 to 12, what type of aircraft was it?
and where was it relative to your position?
(Estimated separation distance)
Were you aware of the preceding aircraft before the incident? *YES/NO
OTHER INFORMATION
13 Have you any other comments that you think may be useful?
Signed
Name (BLOCK CAPITALS) DATE
(*Circle the appropriate reply only)
When complete send this form to: North Atlantic Central Monitoring Agency
c/o National Air Traffic Services
Room G41
Scottish & Oceanic Area Control Centre,
Sherwood Road,
Prestwick, Ayrshire - KA9 2NR
natcma@nats.co.uk
Page 2 of 2
NORTH ATLANTIC MNPSA OPERATIONS MANUAL
NAT MNPS 89 Edition 2005
BIBLIOGRAPHY
Documents referred to in this Manual hyperlink
Annex 2 *(SC & RCF) http://www.paris.icao.int/ or www.icao.int
Annex 6 *(ELTs) http://www.paris.icao.int/ or www.icao.int
Annex 10 *(RCF) http://www.paris.icao.int/ or www.icao.int
　
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