OMB No.

2120-0663
Exp. 9/30/2024

DESIGNATION
8. Comments (Describe the malfunction or defect and the circumstances under which it

OPERATOR
DISTRICT
OPER. Control No.

OFFICE
DEPARTMENT OF TRANSPORTATION occurred. State probable cause and recommendations to prevent recurrence.)
FEDERAL AVIATION ADMINISTRATION
ATA Code
The main break failed to stop the aircraft. There was a small jam with the
MALFUNCTION OR DEFECT REPORT 1.
A/C Reg. No. N- 3062V right break which cause the break to fail the the usage.

OTHER
Enter pertinent data MANUFACTURER MODEL/SERIES SERIAL NUMBER

0746
2.

COMMUTER
AIRCRAFT Cessna 150M 75076374

3.
POWERPLANT

FAA
4.
PROPELLER

( 832 ) 403
MFG.
5. SPECIFIC PART (of component) CAUSING TROUBLE
Part Name MFG. Model or Part No. Serial No. Part/Defect Location.

AIR TAXI
Break N/A 12345 Main Wheel

Jonathan Knox
6. APPLIANCE/COMPONENT (Assembly that Includes part)

MECH.

✘
Comp/Appl Name Manufacturer Model or Part No. Serial Number

TELEPHONE NUMBER
Break N/A 12345 Main Wheel

OPER.
Optional Information:

SUBMITTED BY:
Part TT Part TSO Part Condition 7. Date Sub. Check a box below, if this report is related to an aircraft

REP.STA.
37054 N/A Failed 10/30/24 Accident; Date ✘ Incident; Date 10/30/24

FAA FORM 8010-4 (10-92) SUPERSEDES PREVIOUS EDITIONS

Use this space for continuation of Block 8 (if required).

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