OPERATOR:

A/C IDENTIFICATION: (as indicated on flight plan)

PILOT-IN-COMMAND:

DEP FROM:

DATE:

TIME; UTC:

ARR AT:

DATE:

TIME; UTC:

ADDRESSEE

AIREP SPECIAL

Items 1–8 are to be reported immediately to the ATS unit that you are in contact with.

1) AIRCRAFT IDENTIFICATION

2) POSITION

3) TIME

4) FLIGHT LEVEL OR ALTITUDE

5) VOLCANIC ACTIVITY OBSERVED AT

(position or bearing, estimated level of ash cloud and distance from aircraft)

6) AIR TEMPERATURE

7) SPOT WIND

8) SUPPLEMENTARY INFORMATION SO2 detected Yes ☐

Ash encountered Yes ☐

No ☐ No ☐

Other

(Brief description of activity especially vertical and lateral extent of ash cloud and, where possible, horizontal movement, rate of growth, etc.)

After landing complete items 9–16 then fax form to: (Fax number to be provided by the meteorological authority based on local arrangements between the meteorological authority and the operator concerned.)

9) DENSITY OF ASH CLOUD

(a) Wispy

☐

(b) Moderate dense

(c) Very dense

10) COLOUR OF ASH CLOUD

☐ (a) White

☐ (d) Black

☐☐

(b) Light grey

(e) Other

(c) Dark grey

11) ERUPTION

(a) Continuous

☐

(b) Intermittent

(c) Not visible

12) POSITION OF ACTIVITY

☐☐

(a) Summit

(d) Multiple

☐☐

(b) Side

(e) Not observed

(c) Single

13) OTHER OBSERVED
FEATURES OF ERUPTION

☐☐

(a) Lightning

(d) Ash fallout

☐☐

(b) Glow

(e) Mushroom cloud

☐☐

(c) Large rocks

(f) All

14) EFFECT ON AIRCRAFT

☐☐

(a) Communication

(d) Pitot static

☐☐

(b) Navigation systems

(e) Windscreen

☐☐

(c) Engines

(f) Windows

15) OTHER EFFECTS

(a) Turbulence

☐

(b) St. Elmo’s Fire

(c) Other fumes

16) OTHER INFORMATION

(Any information considered useful.)