- DEPPrinted: January 28, 2019

Aeronautical Information Services

Instrument Procedure Design Unit –Departure / SIDSubmission Form

1.DGN Filename / 2.CRC Number / 3.Reference Number(s)
4.Catalogue / 5.Design Process / 6.New or Revised / 7.Requested Effective Date
- Canada Air PilotRestricted CAP / - Manual DesignAutomated Design / - NewRevised
8.Aerodrome Name / 9.ICAO Identifier
10.Community Name / 11.Field Elevation
’
12.Aerodrome Geometric Centre Coordinate (press F1 for resolution requirement)
DD:MM:SS.SSSS►NAD 83
13. Procedure Type and Identification
SID (VECTOR)
SID (PILOT NAV)
SID (RNAV)
DEPARTURE PROCEDURE (RNAV) / If this submission form applies to a SID or Departure Procedure (RNAV), complete the following / Procedure Type:
- SID (VECTOR)SID (PILOT NAV)SID (RNAV)DEPARTURE PROCEDURE (RNAV)
Plain Language Designator:
- ONETWOTHREEFOURFIVESIXSEVENEIGHTNINEDEP
Coded Designator:
( - 123456789.) - (TRUE)(DND)(TRUE) (DND)
Departure Procedure / If this submission form applies to a conventional departure procedure, indicate the runways for which this form applies
14.Communications Block
Automated Wx System / Ground System / Tower System / Departure System
- ATISAUTOLWISMETAR AUTO / - CLNC DELAPRONGNDPAD CTLICEMAN / - TWRRADIOUNICOMAPRT RADIOTFC / - CTRDEPTMLRADIO
DRCO
/ DRCO
- ATISAUTOLWISMETAR AUTO / - CLNC DELAPRONGNDPAD CTLICEMAN / - TWRRADIOUNICOMAPRT RADIOTFC / - CTRDEPTMLRADIO
DRCO
/ DRCO
- CLNC DELAPRONGNDPAD CTLICEMAN / / MF / *
/ ATF / *
- CLNC DELAPRONGNDPAD CTLICEMAN
Notes:
15.Variation / Declination
AGCC
Variationº - EW
Year
NDA / VOR
Declinationº - EW
NDA / VOR
Declinationº - EW
NDA
Notes:
16.En Route Transition Identification
Plain Language Designator / Coded Designator
En Route Transition # 1 / TRANSITION / (- .)
En Route Transition # 2 / TRANSITION / (- .)
En Route Transition # 3 / TRANSITION / (- .)
En Route Transition # 4 / TRANSITION / (- .)
En Route Transition # 5 / TRANSITION / (- .)
En Route Transition # 6 / TRANSITION / (- .)
17.Departure Climb Rate Table
Ground Speed / 90 / 120 / 140 / 160 / 180 / 200 / 250 / 300
Notes:
18. Departure Procedure (RNAV) / SID Departure Route Description or Departure Procedure Text (F)
Notes:
19.Operational Notes
a / Radar Requirement
(applicable to all pages of charted SID) / Radar Required
b / Quiet Hours Procedure
(applicable to all pages of charted SID) / Quiet Hours Procedure
Quiet Hours Procedure – to local time
Quiet Hours Procedure – to local time or when assigned by ATC
(F)
c / Effective Runways
(runway numbers may end up charted on relevant page only) / Rwy
Rwys
d / Type of Aircraft
(applicable to all pages of charted SID) / Jet acft only
Turbo prop acft only
Non jet acft only
e / Navigation Specification Requirements
(applicable to all pages of charted SID) / RNAV 1
RNAV 2
For use by GNSS equipped acft. GNSS acft with selectable CDI must be set to 1 NM sensitivity. Acft without selectable CDI must use flight director.
For use by GNSS or D/D/I equipped acft. Acft with selectable CDI must be set to 1 NM sensitivity. Acft without selectable CDI must use flight director.
D/D/I or GNSS Required
(F)
f / Critical DMEs
(chart note on relevant page(s) only) / For non GNSS equipped acft: DMEs must be operational.
For non GNSS equipped acft: Departures from rwys , DMEs must be operational.
(F)
g / Speed Restriction
(applicable to all pages of charted SID) / Do not exceed kt until above ASL
Do not exceed kt in climb until in contact with departure control and passing ASL
(F)
19.Operational Notes Cont’
h / Holding
(applicable to page(s) of charted SID where hold depiction exists) / * Holding @ NM legs
* Holding @ or below
* Holding @ or above
(F) / *
i / Parallel Operations
(chart note on relevant page(s) only) / Caution: Simultaneous parallel departures in use.
Caution: Rwy departures: Simultaneous parallel departures in use.
(F)
j / Restrictions / (F)
k / Other Required Operational Notes / (F)
Comments:
20. Departure End of Runway Information (Enter coordinates here using a space to separate degree, minutes and seconds)
DER / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.SS) / Elevation
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
DER Rwy / ‘
Notes:
21.NAVAID, Fix and Waypoint Information
NAVAID /
Fix / WPT / Type / Ident / Frequency
(if required) / Latitude
(NAD 83) / Longitude
(NAD 83) / Chart
Symbol
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
- NAVAIDFIXWPT / - VORTACTACANVOR/DMEVORNDBDMELOCINTXNFBFOLR-RLR-LLB-RLB-L / - N - FON - FBI - FOI - FBW - FOW - FB
Notes:
List the names of any fixes to be defined by a crossing radial, bearing or distance
Fix Name / Name of Facility Providing Radial / Bearing / Dist. / Value of Radial / Bearing / Dist. to be Charted / Fix Name / Name of Facility Providing Radial / Bearing / Dist. / Value of Radial / Bearing / Dist. to be Charted
List the requirements for the charting of lead radial or bearing on conventional arcs
LR / LB / Name of Facility Providing Radial / Bearing / Value of Radial / Bearing to be Charted / LR / LB / Name of Facility Providing Radial / Bearing / Value of Radial / Bearing to be Charted
22.Holding / Shuttle (For DME holds / shuttles, specify DME distances in the “Notes” section below)
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Ident / Temp # / Direction / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev. (MSL) / ROC / Max Hold Alt. / Min Hold
Alt.
- LR / ’ / ( - PrimarySecondary) / ’ / ’
Bearing or Radial of Inbound / Assessed A/S / Charted A/S
Notes:
23.Exemption From Criteria 1
Exemption Required / Reason: / (Attach Memorandum)
1 Transport Canada exemption must accompany the design file and must be renewed for every cyclic / regulatory review.
24.Controlling Obstacles
Segment / Obst. # / Latitude / Longitude (NAD 83)
(minimum resolution – DD:MM:SS.S) / Elev.
(MSL) / ROC / MOCA
(to be charted) / MEA
(if applicable)
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘ / ‘ ( - PrimarySecondary) / ‘ / ‘
‘R’ = Terrain
‘T’ = Tower or other Man Made Structure (Database)
‘C’ = Tower or other Man Made Structure (Topo Culture)
‘A’ = Area
Notes:
25.Flight Check Information
Notes to the Flight Check Pilot:
Design Constraints
(deviations, airspace, noise, etc.)
Customer Requirements
Obstacle Issues
Special Instructions for FIO Pilot
26.Depiction Information
Depiction notes to the Assembly Specialist:
CYA, CYR, Blasting Areas
27.Remarks
Criteria Used: / Tree Height Used:
28.Draft Depiction
Draft
Depiction
Included / Graphic
Not
Required / A draft depiction of the instrument procedure is required when the departure procedure or SID will be published with a graphic component. This depiction need only communicate the basic layout of the instrument procedure. Special attention should be given to depicting features of the instrument procedure that may not be suitably communicated by a completed submission form. Avoid duplicating information already communicated by this submission form (i.e. en route transition identification, operational notes, etc). A French draft depiction is not required for sites published in CAP 5.
29.Database Coding
Database
Coding
Included / Database
Coding Not
Required / Database coding information must be submitted for all RNAV Departure Procedures and SIDs. This information can be provided as a separate Excel file. (NAV CANADA use only)
30.Coordination
(S) Sponsor 2 / Name / Company / Telephone / Address
Signature / Date / E-mail
(D) Designer / Name / Company / Telephone / Address
Signature / Date / E-mail
(V) Independent
Reviewer / Name / Company / Telephone / Address
Signature / Date / E-mail
(A) Air Traffic
Services / Name / Company / Telephone / Address
Signature / Date / E-mail
(Q) Quality
Assurance 3 / Name / Company / Telephone / Address
Signature / Date / E-mail
2Sponsor signature required if the procedure is sponsored by a party other than NAV CANADA. A ‘Sponsor’s Responsibility Form’ must accompany the design file.
3Quality Assurance is performed based on a random sampling in accordance with the NAV CANADAIPDUProcedures Manual.

______

F-IPD-130 Version 15.2Page 1 of 132 February 2015

- DEPPrinted: January 28, 2019

Summary of Coordinates

The following table is intended to provide a starting point for a coordinate table in copy / paste format. It does not necessarily represent the complete content of the final AIRAC table. This table may need to be adjusted to satisfy the AIRAC coordinate table requirements.

NUMNAMEIDENTTYPELATITUDELONITUDE

======

1 - -

2- -

3 - -

4 - -

5 - -

6 - -

7 - -

8 - -

9 - -

10 - -

11 - -

12 - -

13 - -

14 - -

15 - -

16 - -

17 - -

18 - -

19 - -

20 - -

Instructions for Completing the Departure/SID Submission Form

This departure/SID submission form is available in Microsoft Word for use in a ‘form-fill’ format. The following instructions are intended to provide the Procedure Designer with guidance on completing the form.Items identified with an ‘(F)’ following the title are to be provided by the Procedure Designer in both English and French when the site for which the submission form pertains exists (or will exist) within volume 5 of the Canada Air Pilot. In these cases, both the English and French text is to be inserted in the available text field; English first followed by the French. Other items not specifically identified with the ‘(F)’ will be translated into French during assembly of the chart using standard French translations. The Procedure Designer is not required to make these translations nor is he/she required to provide a French draft depiction.

Item 1: DGN Filename

  • NAV CANADA use only.
  • Enter the filename of the associated DGN.

Item 2: CRC Number

  • NAV CANADA use only.
  • Enter the CRC number for the associated DGN file.

Item 3: Reference Number(s)

  • NAV CANADA use only.
  • Enter applicable reference numbers (tracking number, ADC number, etc.) if not referenced elsewhere.

Item 4: Catalogue

Select the catalogue in which the procedure is to be published: Canada Air Pilot or Restricted CAP.

Item 5: Design Process

Select the design process used in the development of the procedure: Manual Design or Automated Design.

Item 6: New or Revised

Select the revision status of the procedure: New or Revised.

Item 7: Requested Effective Date

Enter the effective date as requested.

Item 8: Aerodrome Name

Provide the official name of the aerodrome as indicated on the operating certificate.

Item 9: ICAO Identifier

Enter the ICAO identifier for the aerodrome.

Item 10: Community Name

Provide the name of the community and the province where the aerodrome is located.

Item 11: Field Elevation

  • Enter the aerodrome’s field elevation.
  • The aerodrome field elevation is the highest point on the usable landing surface expressed in feet above sea level (ASL).

Item 12: Aerodrome Geometric Centre Coordinate

  • Provide the latitude and longitude of the aerodrome geometric centre based on the NAD 83/WGS 84 reference data.
  • The aerodrome geometric centre is the centre of the runway pattern; see TP308 Annex C for a method of determining this coordinate.
  • Provide the aerodrome geometric centre coordinate in seconds (max resolution 1/10,000 of a second, min resolution 1/100 of a second).

Item 13: Procedure Type and Identification

  • Select whether the procedure is a SID, DEPARTURE PROCEDURE (RNAV) or conventional departureprocedure.
  • If the procedure is a SID or DEPARTURE PROCEDURE (RNAV), enter the procedure identification in accordance with the Design Unit manuals. This will include the procedure type, plain language designator and coded designator of the primary procedure identification.
  • If the procedure is a conventional departure procedure, enter the runway for which the procedure applies.

Item 14: Communications Block

  • Enter the communication agencies and frequencies as required.
  • For each communication agency required for the procedure, select the limited hours symbol if necessary and the type of communication agency. Then enter the appropriate frequencies and any other associated text in accordance with the Design Unit manuals.
  • For frequencies in the Tower System and Departure System blocks, select if the frequency is accessed by a dial-up remote communication outlet.
  • For the Tower System block, select MF or ATF if the site has one of these areas established around it.
  • Select the if the MF / ATF area applies for only a portion of the day.
  • Select * if the MF or ATF is of non-standard radius and / or height.
  • Enter the ICAO identifier of the site to which the MF or ATF area is centred if it is not centred on the site associated with this procedure.

Item 15: Variation/Declination

  • Enter the variation/declination for the applicable AGCC or VOR.
  • Each entry should include the identification of the aerodrome or VOR, the value of the variation / declination in degrees and the direction of the variation / declination. For aerodrome variation, also include the date on which the variation was determined.
  • If the procedure is located within Northern Domestic Airspace and does not use variation / declination, select 'NDA' and leave everything else blank.

Item 16: En Route Transition Identification

  • Enter the identification of each of the en route transitions in accordance with the Design Unit manuals.
  • This will include both the plain language designator and coded designator of the en route transition identification.

Item 17: Departure Climb Rate Table

  • If a climb gradient is required for the departure or SID, enter the climb gradient in ft/NM followed by its corresponding ft/min values.
  • Consult the Design Unit manuals for appropriate values.

Item 18:Departure Procedure (RNAV) / SID Departure Route Description or Departure Procedure Text (F)

Enter the required departure route description or departure procedure text.

Item 19:Operational Notes

  • Select the operational notes that apply to the procedure.
  • Enter information in the fields of the operational notes that apply to the procedure.
  • Non-standard operational notes (as indicated on the departure / SID submission form) require French translation.

Item 20:Departure End of Runway Information

  • Enter the runway identification for each runway at the aerodrome.
  • Provide the latitude and longitude for the departure end of the runway. These coordinates are to be provided in NAD 83 to a maximum resolution of 1/10,000 of a second and a minimum resolution of 1/100 of a second. Refrain from adding zeros to meet this requirement.
  • Enter the departure end of runway elevation in feet.

Item 21:NAVAID, Fix and Waypoint Information

  • Select the entry as either ‘NAVAID’, ‘Fix’ or waypoint.
  • Select the type of NAVAID, fix or waypoint.
  • Enter the identification of the NAVAID, fix or waypoint.
  • For each NAVAID, enter its assigned frequency.
  • Provide the latitude and longitude for each entry. These coordinates are to be provided in NAD 83 to a maximum resolution of 1/10,000 of a second and a minimum resolution of 1/100 of a second. Refrain from adding zeros to meet this requirement.
  • To assist with the correct charting of significant points based on the hierarchy of symbol guidance, the Procedure Designer selects the type of symbol to be charted (N = NAVAID, I = intersection, W = waypoint, FO = fly over, FB = fly by).
  • List the names of any fix identified by a crossing radial, bearing or distance. For each fix, specify the name of the facility providing the crossing radial, bearing or distance and the value of the crossing radial, bearing or distance.
  • Select ‘LR’ or ‘LB’ if a lead radial or bearing is to be charted for a conventional arc. If one is required, specify the name of the facility providing the radial or bearing and the value of the radial or bearing.
  • If additional lines are required, attach a separate sheet.

Item 22:Holding / Shuttle

  • For each hold or shuttle, provide the identification of the NAVAID, fix or waypoint on which the hold or shuttle is based.
  • Enter the hold template number and select the direction of the hold or shuttle.
  • For the controlling obstacle, enter the obstacle number, latitude and longitude, obstacle elevation (MSL) and applicable ROC and the segment area in which the obstacle resides (primary / secondary).
  • The obstacle number should commence with either an ‘R’ for terrain, ‘T’ for tower or other man-made structure (database), ‘C’ for tower or other man-made structure (topo culture) or ‘A’ for blasting areas that do not have a Class F designation assigned to them. For Class F airspace, the controlling obstacle number shall be the airspace designation assigned to the area.
  • The coordinate is to be provided in NAD 83 to a maximum resolution of 1/10,000 of a second and a minimum resolution of 1/10 of a second. Refrain from adding zeros to meet this requirement.
  • Enter the maximum hold altitude on which the selected template number is based.
  • Enter the minimum hold altitude.
  • Enter the inbound bearing or radial applicable for the hold or shuttle.
  • Enter the maximum airspeed in KIAS on which the selected template number is based.
  • Enter the airspeed to be charted on the procedure chart.
  • Enter any applicable design notes (including shuttle procedures) that may exist. If an altitude has been raised from the standard ‘obstacle plus ROC’ value, indicate the reason under ‘Notes’.
  • If additional lines are required, attach a separate sheet.

Item 23:Exemption From Criteria