Received 8130 Certificate

This is the received 8130-3 form, included in the component shipment. We must verify the paper document matches what the issuer submitted.

The component

Scanned 8130

SYNTHETIC
NOT AN AIRWORTHINESS RECORD

FAA/United States

AUTHORIZED RELEASE CERTIFICATE

FAA Form 8130-3 · AIRWORTHINESS APPROVAL TAG

Block 3 · Form tracking number SYNTHETIC81309181

Block 5 · Work order / contract / invoice WO20269181

Block 4 · Organization name Clearwater Turbine Works

Block 4 · Organization address 8800 Bayline Parkway, Tampa, FL 33619

Block 6 · Item 1

Block 7 · Description Constant speed drive disconnect assembly

Block 8 · Part number MR708434

Block 9 · Quantity 1

Block 10 · Serial number SN416708

Block 11 · Status / work TESTED

Block 12 · Remarks Functional test per CMM 29-20-15; disconnect and reset cycle times within limits. No further action required.

Block 13/14 · Certifying block RETURN_TO_SERVICE

Block 13a/14a · Approval basis PART_43_RETURN_TO_SERVICE

Block 13c/14c · Approval / certificate no. SYNTHETICCERT22015

Block 13d/14d · Name R. Inspector

Block 13e/14e · Date 2026-10-11T20:39:00Z