mn en ee ee ee ee ee et RELATO DE PREVENCAO - RELPREV AIR SAFETY REPORT - ASR De acordo com as regulamentagées brasileras, este relato (ou parte dele) somente seré usado para a prevencio de acidentes aeronduticos, a fm de aumentar a seguranca operacional. Este relato nao precisa ser ‘dentiicado, Caso o relator se identifque, o mesmo sera informado sobre as medidas adotadas. In accordance with Brazilian regulations, this report (or any part of it) shall only be used for preventing aeronautical accidents, and has the sole purpose of enhancing safety. This report does not need to be identified. ‘Should the reporter, hoviever. chose to identify him/herself, he/she will be informed on the measures adopted, CENIPA DADOS GERAIS DA OCORRENCIA (OCCURRENCE INFORMATION) LOCAL (PLace} DATA (ore): HORA (rimey PESSOAL ENVOLVIDO E/OU AERONAVE (PERSONNEL ANDIOR AIRCRAFT INVOLVED) SITUAGAO (siTUATION) RELATOR (REPORTE! -MAILITELEFONE PARA CONTATO (CONTACT INFORMATION) Ue neENCAMINHAMENTO DO ELO-SIPAER (10 BE FILLED BY BRAZILIAN SAFETY PERSONNEL) / / Do: PARA: DATA: ‘ASSINATURA PARECER DO SETOR RESPONSAVEL: ASSINATURA, AGOES CORRETIVAS RECOMENDADAS PELO ELO-SIPAER: AVALIAGAO DO RISCO: ASSINATURA,