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Annex B Checklist of Requirements for Contract Application

CAAP checklist for contract application

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
Department of Transportation and Communications

CIVIL AVIATION AUTHORITY OF THE PHILIPPINES
Flight Standards Inspectorate Service
APPLICATION: PERMIT ON THE SAFE TRANSPORT OF
DANGEROUS GOODS (DG)
Please read the current DG Advisory Circulars (ACs) before completing this form. Refer to website www.caap.gov.ph.
Instructions:
1. This CAAP DG Form 01 once completed should be returned to the address below by post, fax or in person to:
Civil Aviation Authority of the Philippines (CAAP)
Old MIA Road corner Ninoy Aquino Ave.
Pasay City, Metro Manila, Philippines 1300
Fax: (+632) 8799218
2. The completed CAAP DG Form 01 must be submitted to CAAP at least 10 working days prior to the first flight/
day of operation for which it is required.
3. Failure to complete this CAAP DG Form 01 in full or providing lack of supporting documents may result in a delay
in processing the application.
4. The issuance of this CAAP DG Form 01 does not in itself constitute an authorization to carry dangerous goods.
5. All documentation, as required in the current CAAP Advisory Circular AC-18-001 on the application process for
the permit to carry dangerous goods shall be submitted together with CAAP DG Form 01.

PART A - GENERAL INFORMATION
Please check as appropriate:
Application for:

General permit

Initial Application

Adhoc permit

Renewal of Permit (DG Permit No. __________________)

Full Legal Name of Applicant:

Operating/Trading Name (if different from the above):

Person within the Applicant's organization who has the overall responsibility for the transport of dangerous goods by air:
Name:

Job Title:

Address:
Phone:

Mobile

Fax:

Email:

Type of Operations:
Domestic

International

Ground Handling Services

Scheduled Passenger and Cargo

Cargo Aircraft Only

Training Services

Charter

Helicopter

Cargo Handling/ Freight Forwarder Svc

Non-scheduled

Medical Evacuation

Others _________________________

CAAP DG Form 01 / Issue 1/ January-2014
Old MIA Road corner Ninoy Aquino Avenue, Pasay City, Metro Manila, Philippines 1300
Tel: (+632) 879-9102 / www.caap.gov.ph

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Republic of the Philippines
Department of Transportation and Communications

CIVIL AVIATION AUTHORITY OF THE PHILIPPINES
Flight Standards Inspectorate Service
PART B - TRAINING, PROCEDURES AND INSTRUCTIONS
The Applicant ensures that:
Details of DG training programs established in accordance with Part 1 of the ICAO Technical Instructions for ground
staff and crew members are submitted (Categories 1 to 11).
The Applicant’s staff at
(name of airport or city location )
involved in the functions of handling and
processing of cargo and/or passengers have received the relevant training shown in the details of training programs
submitted.
If Applicant uses another company/agent for above functions, it shall state whether it accepts the staff training
carried out by that company/agent, and intends to carry out additional training on its own behalf.
Name of Applicant: ____________________________________________________________________
For Philippine-based Applicants applying for General Permit, policies, instructions and procedures for the handling
of Dangerous Goods in accordance with the ICAO Technical Instructions are submitted.
One (1) set of the Applicant’s Dangerous Goods transport documents and flight schedule for the transport of
Dangerous Goods are submitted.

PART C – NATIONAL APPROVALS (for non-Philippine AOC holders/foreign carriers only)
The Applicant ensures that:
National regulations and approvals granted by the relevant authorities for the operator to carry dangerous goods by
air are submitted.

PART D – DANGEROUS GOODS LIST (Application for Ad-hoc Permit Only)
Proper Shipping Name
(include technical name
for n.o.s. entries)

UN
Number

Hazard Class/Div
(subsidiary classes in
brackets)

Packing
Group

Packing
Instruction Used
(if applicable)

Quantity per
Package and
Number of
Packages

Emergency Response Information (including response procedures, the name and telephone number of 24-hour contact):

CAAP DG Form 01 / Issue 1/ January-2014
Old MIA Road corner Ninoy Aquino Avenue, Pasay City, Metro Manila, Philippines 1300
Tel: (+632) 879-9102 / www.caap.gov.ph

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Republic of the Philippines
Department of Transportation and Communications

CIVIL AVIATION AUTHORITY OF THE PHILIPPINES
Flight Standards Inspectorate Service

PART E – CONSIGNOR/SHIPPER AND CONSIGNEE (Application for Ad-hoc Permit only)
Shipper/Consignor:
Name:
Address:
Contact Numbers:
Consignee:
Name:
Address:
Contact Numbers:

PART F – FORM OF TRANSPORT (Application for Ad-hoc Permit only)
Date of Transport:

Route:

Aircraft Type(s):

Aircraft Registration(s) and/or Flight No(s).:

Port(s)/Country of Origin:

Port(s)/Country of Destination:

PART G – DECLARATION AND SIGNATURE
I hereby certify that the information provided in this application is correct to the best of my knowledge and understanding.

(a) Name of Applicant's Rep

: ______________________________________________________
(Please Print Name)

(b) Date

: ______________________________________________________

(c) Signature

: ______________________________________________________

CAAP DG Form 01 / Issue 1/ January-2014
Old MIA Road corner Ninoy Aquino Avenue, Pasay City, Metro Manila, Philippines 1300
Tel: (+632) 879-9102 / www.caap.gov.ph

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