LOCAL STATION DE/ANTI-ICING PLAN

MBL

Winter 2016/2017

This page intentionally left blank

10/28/2016

2016/2017 DE/ANTI-ICING PLAN

TABLE OF CONTENTS

SECTION – 1 LOCAL STATION DE/ANTI-ICING PLAN

SECTION – 2 QUALIFIED DE/ANTI-ICING AGENTS

SECTION -- 3 SYSTEM DE/ANTI-ICING WORKSHEET

SECTION – 4 REFRACTOMETER-HARNESS – LANYARD INSPECTION

DOCUMENTATION

SECTION – 5 DE/ANTI-ICING FLUID ACCEPTANCE WORKSHEET

SECTION – 6 PRE-OPERATIONAL EQUIPMENT CHECKLIST (if applicable)

SECTION – 7 PRESEASON TYPE II AND TYPE IV FLUID TEST RESULTS

SECTION – 8 OTHER

This page intentionally left blank

10/28/2016

2016/2017 DE/ANTI-ICING PLAN

IMPORTANT: De/Anti-Icing will be carried out in accordance with Corporate Flight Management Ground De/Anti-icing Manual

Ground handlers may use their own Local Deicing/Anti-Icing Plans provided they are included in a FAA Approved Ground Deice Program with approval from the Corporate Flight Management (CFM) Airport Operations. Ground handlers may adhere to their own retention policy. Local Station De/Anti-Icing plans not included in an FAA approved Ground Deice Program may be used, if the plan contains similar information as the CFM plan.

Station Information / Deicing Provider
Station Type: N/ACold WeatherCold Season
Target Readiness Date: 11/1/2016 / Primary: MBL
Contact Name: NORTH COUNTRY SK7
Contact Number: 231 38-9272
Secondary:
Contact Name:
Contact Number:

I.  RESPONSIBILITY:

The following qualified positions will be responsible for implementing and terminating the de/anti-icing plan:

1.  Station Manager

2.  Station Supervisor

3.  Lead Agent on duty

4.  Any de/anti-ice trained individual delegated by one of the above positions

II.  QUALIFIED DEICING/ANTI-ICING PERSONNEL:

Other Information: J Payne/ M. Jalosynski/C Sedelmaier/R Payne/F. Tabaczka/ J Superczynski

III.  PROCEDURE

When the need for de/anti-icing is determined, the person implementing the plan will contact:

1.  The Deicing desk located in the local ATC tower at no tower

2.  The deicing personnel on duty and the flight crew

3.  Backup deicing contractor if necessary at na

4.  If de/anti-icing creates a delay, Corporate Flight Management dispatch (615-220-1765) will be advised and the flight schedule will be updated.

IV.  DE/ANTI-ICE LOCATIONS:

·  Primary Deicing:

·  Secondary Deicing:

V.  TYPES OF FLUID AVAILABLE AT THE STATION:

Type I Fluid:

Type II Fluid:

Type III Fluid:

Type IV Fluid:

VI.  DE/ANTI-ICING FLUID

1.  PRIMARY - De/Anti-icing fluids used by the primary deicer (enter manufacturer and fluid trade name in the space provided or N/A if Not Available):

Deicing (Type I): Manufacturer: Dow co

Fluid Name: UCAR

Anti-Icing (Type II): Manufacturer: na

Fluid Name:

Anti-Icing (Type III): Manufacturer: na

Fluid Name:

Anti-Icing (Type IV): Manufacturer: na

Fluid Name:

2.  SECONDARY: - Contractor, Back-up deicer or Other Airline De/Anti-Icing Fluids Available (enter manufacturer and fluid trade name in the space provided or N/A if Not Available):

Deicing (Type I): Manufacturer: na

Fluid Name:

Anti-Icing (Type II): Manufacturer: na

Fluid Name:

Anti-Icing (Type III): Manufacturer: na

Fluid Name:

Anti-Icing (Type IV): Manufacturer: na

Fluid Name:

Additional fluids may be listed on a Local De/Anti-Icing Plan (Addendum) form and should include the fluid manufacturer and trade name. If used, this document should be attached to the Local Station De/Anti-Icing Plan.

VII. DE/ANTI-ICING COMMUNICATION PROCEDURES:

Radio: Frequencies:

Interphone: Other: hand signals

VIII.  OTHER DE/ANTI-ICING ITEMS SPECIFIC TO THE LOCAL AIRPORT:

IX.  PRE-SEASON FLUID TEST RESULTS:

Type II –: Type IV – :

Type II –: Type IV – :

Type IV – :

Type IV – :

Type IV – :

Type IV – :

Type IV – :

Additional preseason fluid storage test results should be listed on a separate sheet and attached to the Local Station De/Anti-Icing Plan.

TRUCK/ DEICING UNIT # na

Type II Fluid – Truck Nozzle: Type II Fluid – Truck Tank:

Type IV Fluid – Truck Nozzle: Type IV Fluid – Truck Tank:

TRUCK/DEICING UNIT # na (if applicable)

Type II Fluid – Truck Nozzle: Type II Fluid – Truck Tank:

Type IV Fluid – Truck Nozzle: Type IV Fluid – Truck Tank:

TRUCK/DEICING UNIT # na (if applicable)

Type II Fluid – Truck Nozzle: Type II Fluid – Truck Tank:

Type IV Fluid – Truck Nozzle: Type IV Fluid – Truck Tank:

TRUCK/DEICING UNIT # na (if applicable)

Type II Fluid – Truck Nozzle: Type II Fluid – Truck Tank:

Type IV Fluid – Truck Nozzle: Type IV Fluid – Truck Tank:

Additional preseason Truck Nozzle and/or Truck Tank test results should be listed on a Local De/Anti-Icing Plan (Addendum) form and attached to the Local Station De/Anti-Icing Plan.

NOTE: All fluid test results must be maintained in the Station De/Anti-Icing Plan or its equivalent until the beginning of the next de/icing season (October 15th) and then purged.

This page intentionally left blank

10/28/2016