Air Safety Report Form

NOTE: When using this form for a reportable incident; it is the reporter’s responsibility to ensure this is received by Safety Department within 24 hours for timely ROSI reporting.


(*) Indicates the field is required



Actual Weather


Weather Conditions

(A detailed description of event and its immediate cause)
Other Information and suggestions for preventive action

Aircraft Configuration


Occurence Type

(GCAA Form is also required)
Number of Injuries
(Draw airplane positions on Blank paper and add to the report)
Please specify
Deviation from Clearance
(i.e. Security breach)

APPENDIX A
UAE operators and air navigation service providers
GNSS RADIO FREQUENT INTERFERENCE (RFI)

“SPURIOUS” TAWS/EGPWS ALERT
Note:
─ Separate submission to be made for GNSS Radio Frequency Interference (RFI) events and spurious TAWS/EGPWS events.

Specifics for the table format are given below:
Column Title Description
Date of Occurrence Date on which GNSS interference/failure occurred.
Operator Name of the operator reporting the incidents (Emirates, Flydubai, Etihad Airways, Abu Dhabi Aviation, etc.).
Flight No./Call sign Flight number and/or call sign of the flight encountering GNSS interference/failure (UAE234, FDB173, ETD787, etc.).
Aircraft Type The aircraft make and model reported in the incident. Use ICAO code for aircraft types. For example (B737, B772, B77W, A388, A321, etc).
Aircraft Registration Registration of the aircraft reported in the incident.

Column Title Description
Departure Aerodrome of departure, entered using ICAO 4-letter code (OMDB, EGLL, WSSS, OPIS, etc.).
Destination Aerodrome of destination, entered using ICAO 4-letter code (OMDB, EGLL, WSSS, OPIS, etc.).
Phase of flight The phase of flight at the time of GNSS interference/failure. Enter the appropriate value: Parked, Taxi, Take-off, Climb, Cruise, Descent, Approach, Landing.
Exact Location The exact location of encountering GNSS interference/failure is to be entered in terms of Latitude and Longitude as per GPS coordinates. For example, (35.403847, 44.073636), (43.06267276, 27.87887503), etc.
Area/State of Occurrence The area or state of occurrence where the GNSS interference/failure occurred.
Flight Information Region (FIR) The Flight Information Region within whose airspace the GNSS interference/failure was encountered.

Drop your file here or click here to upload You can upload up to 10 files.
Drop your file here or click here to upload You can upload up to 10 files.