Belgian Civil Aviation Authority Certification of Aerodromes template ref: GDF-14 Annex 04 template version: 27/01/2015 DEVIATION ACCEPTANCE AND ACTION DOCUMENT (DAAD: ANNEX TO THE AERODROME CERTIFICATE) Location indicator: EB Date: dd/mm/yyyy Reference: DAAD_EBxx_##_yyyymmdd Relevant Certification Specification(s): CS ADR-DSN.X.###, … Deviation exists since: dd/mm/yyyy Description of the non-compliance: Reference to supporting documentation: Reference to safety assessment: Publication of the DAAD in: Period of validity of the DAAD: Proposed by: Accountable Manager: name: date: dd/mm/yyyy signature: BCAA approval: Director General: name: date: dd/mm/yyyy signature: DAAD_EBxx_##_yyyymmdd 1/1
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