FOR QCAA USE ONLY NOTICE OF PROPOSED CONSTRUCTION OR ALTERATION Aeronautical Study Number (Failure to provide all requested information may delay processing of your notice) الهيئة العامة للطيران المدني CIVIL AVIATION AUTHORITY 1. Company or person proposing this action Company/Owner Name: Contact Person: Company Address: E-Mail Address: Telephone Number: Facsimile Number: 2. Notice of: ☐New Construction ☐Alteration 3. Duration: ☐ Permanent ☐Temporary ( 4. Work Schedule: 5. Type of Structure: 6. months, Beginning days) End ☐Antenna Tower ☐Building ☐Crane ☐Landfill ☐Powerline ☐Water Tank ☐High Voltage Equipment ☐Arc Welding ☐Radar Emission ☐VHF Radio ☐High Powered Transmissions ☐Other Marking/Painting and/or Lighting Preferred: ☐Red lights and Paint ☐WGS84 7. Datum: 8. Geographic Coordinates of Site: (for multiple points , attached a separate sheet) 9. ☐Existing ☐Dual – Red and Medium Intensity ☐White – Medium Intensity ☐Dual – Red and High Intensity ☐White – High Intensity ☐ Other ☐ QNG/QND95 Latitude degrees minutes seconds Northing Longitude degrees minutes seconds Easting Ground Elevation (Above Mean Sea Level): ☐m 10. Total Structure Height (Above Ground Level): ☐m 11. Overall Height (#9 + #10) (Above Mean Sea Level): ☐m 12. Previous QCAA Aeronautical Study Number (if applicable): 13. Description of Location (Attach a map with the precise site marked): 14. Complete Description of Proposal: I hereby certify that all of the above statements made by me are true, complete and correct to the best of my knowledge. In addition, I agree to mark and/or light the structure in accordance with established marking & lighting standards as necessary Date Type or Printed Name and Title of Person Filing Notice OF-018 Rev. 0 dated 7th July 2014 Signature Page 1 of 2 INSTRUCTIONS FOR COMPLETING QCAA FORM ITEM #1. Please include the company/owner name, address, and phone number of a personal contact point as well as the electronic mail address. ITEM #2. New Construction would be a structure that has not yet been built. Alteration is a change to an existing structure such as the addition of a side mounted antenna, a change to the marking and lighting, a change to power and/or frequency, or a change to the height. The nature of the alteration shall be included in ITEM #14 “Complete Description of Proposal”. Existing would be a correction to the latitude and/or longitude, a correction to the height, or if filing on an existing structure which has never been studied by the QCAA. The reason for the notice shall be included in ITEM #14 “Complete Description of Proposal”. ITEM #3. If Permanent, so indicate. If Temporary, such as a crane or drilling derrick, enters the estimated length of time the temporary structure will be up. ITEM #4. Enter the date that construction is expected to start and the date that construction should be completed. ITEM #5. Please indicate the type of structure, details shall be included in ITEM #14. DO NOT LEAVE BLANK. ITEM #6. In the event that obstruction marking and lighting is required, please indicate type desired. If no preference, check “other” and indicate “no preference” DO NOT LEAVE BLANK. (NOTE: High Intensity lighting shall be used only for structures over 150m AGL. In the absence of high intensity lighting for structures over 150m AGL, marking is also required). For marking and lighting requirements refer to http://www.caa.gov.qa/en/safety_regulations , Aerodrome Regulations, QCAR-ADR-V5, Chapter 6. All obstacle above 45m must be lighted. ITEM #7. WGS84 is preferred. However, if WGS84 is not available QNG/QND95 may be used. It is important to know which datum is used. DO NOT LEAVE BLANK. ITEM #8. Geographic coordinates shall be up to four (4) decimal places. For multiple points, please provide a separate sheet or a digital file (preferably in Microsoft Excel file). The separate sheet or the digital file should be provided on the following format: Column 1 Building # / Point # Column 2 N (Northing) / X / Lat Column 3 E (Easting) / Y / Long Column 4 Elevation (AMSL) / m Column 5 Height (AGL) / m Column 6 Remark Latitude and longitude derived solely from a hand-held GPS instrument is NOT acceptable. A hand-held GPS is only accurate to within 100 meters (328 feet) 95 percent of the time. ITEM #9. Enter the site elevation above mean sea level, provide up to four (4) decimal places of a meter. ITEM #10. Enter the total structure height above ground level, provide up to four (4) decimal places of a meter. The total structure height shall include anything mounted on top of the structure, such as antennas, obstruction lights, lightning rods, etc. ITEM #11. Enter the overall height above mean sea level and provide up to four (4) decimal places of a meter. This will be the total of ITEM #9 + ITEM #10. ITEM #12. If a QCAA aeronautical study was previously conducted, enter the previous study number. ITEM #13. Attach a map (digital file preferably in AutoCad file format) depicting the relationship of the structure to roads, airports, prominent terrain, existing structures, etc. If available, attach also a copy of a documented site survey with the surveyor’s certification stating the amount of vertical and horizontal accuracy in meter. ITEM #14. • For alterations, explain the alteration thoroughly. • For existing structures, thoroughly explain the reason for notifying the QCAA (e.g. corrections, no record or previous study, etc.). Filing this information with the QCAA does not relieve the sponsor of this construction or alteration from complying with any other state or local rules or regulations. • For transmitting stations, include type of transmission, maximum effective radiated power (ERP) and all frequencies. • For antennas, include the type of antenna and center of radiation (Attach the antenna pattern, if available). • For buildings, include site orientation, coordinates of each corner, dimensions, and construction materials. • For crane(s), (temporary and mobile) used in the construction/assembly of a new building, placement of roof top structures, flare stack, etc., where the maximum operating height will be higher than the overall height of the proposed structure must be assessed for potential impacts at least 40 working days in advance. We ask that crane application(s) be cross reference to the associated construction project and to provide detailed crane specifications such as maximum height, boom length and swing radius. A drawing detailing the crane specifications and type would be beneficial. • For overhead wires or transmission lines, include size and configuration of wires and their supporting structures (Attach depiction). • For each pole/support, include coordinates, site elevation, and structure height above ground level or water. • For microwave, include azimuth relative to true north. NOTE: This form should be submitted to the Air Safety Department, Qatar Civil Aviation Authority. Details are as follows: Director of Air Safety Department Qatar Civil Aviation Authority New Salata - C Ring Road P.O Box 3000, Doha State of Qatar OF-018 Rev. 0 dated 7th July 2014 Page 2 of 2