Form FAA Form 7140-1 FAA Form 7140-1 Notice of Proposed Outdoor Laser Operation(s)

C
U.S. Department
of Transportation
Federal Aviation
Administration

FAA Form 7140-1, Notice of Proposed Outdoor Laser Operation(s)

Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor
shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of
information displays a currently valid OMB control number. The OMB control number for this
information collection is 2120-0662. Public reporting for this collection of information is
estimated to be approximately 240 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed,
completing, and reviewing the collection of information.
The Federal Aviation Administration (FAA) requires all responses to this collection of
information if the proponent wishes to obtain or retain benefits available per Title 21 Code of
Federal Regulations Part 1010. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden to:
Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood
Parkway, Fort Worth, TX 76177-1524.

Instructions to Complete
Use FAA Order JO 7400.2, Chapter 29 as a reference for additional background information.
Consult FAA Advisory Circular (AC) 70-1 for detailed instructions to assist with completing,
submitting, and the expected disposition of this form. FAA provides public access to these
documents via https://www.faa.gov/regulations_policies.
Please print or type on this form and complete all sections prior to submission to the
appropriate FAA service center. To enhance clarity, use plain language and numbers, e.g.,
decimal notation (0.7277) instead of scientific notation (72.77 x 10-2 or 72.77E-02). Failure to
provide all requested information may delay processing.
FAA Form 7140-1 approved August 2021 (supersedes previous version)

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Form Approved OMB No 2120-0662

Print form

Expiration Date: 08/31/2024

Please print or type on this form. Failure to provide all requested information may delay processing.

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U.S. Department of Transportation
Federal Aviation Administration

Notice of Proposed Outdoor Laser Operation(s)

1. General information
a. To:
(FAA Service Center)

b. From:
(Proponent)

c. Name of event
or facility

d. Report date

e. Customer

f. Site address

2. Date(s) and time(s) of laser operation
a. Testing and alignment

b. Operation

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3. Brief description of laser operation

4. On-site operation information
a. Operator(s)
b. On-site phone #1
(primary)

c. On-site phone #2
(secondary)

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5. FDA/CDRH information (if applicable)
a. Variance #

c. Accession #

b. Variance
expiration date

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6. Brief description of control measures

7. Attachments
a. Number of laser configurations: State the total number of configurations and complete a copy of page 2 (blocks 10 through 15) for each configuration
b. Attachments: List all attachments, e.g., maps, diagrams, control measure details, calculation details, or software printouts

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8. Designated contact person (if FAA requires further information)
a. Name
c. Phone

b. Position
d. Fax

e. E-mail

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9. Statement of accuracy
To the best of my knowledge, the information provided in this form (all pages) and corresponding attachment(s) is accurate and correct
a. Name
(if different from
contact person)
c. Signature

FAA Form 7140-1 approved August 2021 (supersedes previous version)

b. Position
d. Date

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Form Approved OMB No 2120-0662
Expiration Date: 08/31/2024

Print form
Please print or type on this form. Failure to provide all requested information may delay processing.

Laser Configuration Worksheet
10. Configuration information
a. Configuration number ______ of ______ b. Brief description of configuration
(example: 7 of 9)

11. Geographic location
a. Site elevation (mean sea level), in feet: __________

d. Information determined by: ☐GPS ☐Map (topo) ☐Other __________________

b. Laser height above site elevation (above ground level), in feet:

__________

c. Overall laser elevation (a) + (b), in feet: __________ mean sea level

e. Latitude:

_______degrees, _______minutes, _______seconds

f. Longitude:

_______degrees, _______minutes, _______seconds

12. Beam characteristics and calculations (check only one mode of operation and fill in only that column)
MODE OF OPERATION

☐Single pulse

☐Continuous wave

☐Repetitively pulsed

(maximum power)

(average power )

a. Laser and beam characterists
Laser type
(example: DPSS, sodium-vapor, etc.)
Laser hazard class
(example: Class 3B or Class 4)
Power
Watts (W)

(not applicable)

Pulse energy
Joules (J)
Pulse duration
Seconds (s)
Pulse repetition frequency (PRF)
Hertz (Hz)

(not applicable)
(not applicable)
(not applicable)

Beam diameter at 1/e points
Centimeters (cm)
Beam divergence 1/e at full angle
Milliradians (mrad)
Wavelength(s)
Nanometers (nm)
b. Maximum permissible exposure (MPE) values (use this value to calculate the NOHD)
MPE
(not applicable)
Milliwatts per square cm (mW/cm2)
MPE per pulse
(not applicable)
Joules per square cm (J/cm2)
c. Visual effect calculations
The following items are for lasers with visible wavelengths (400-700 nm). If the laser has no visible wavelengths, enter “N/A (non-visible laser)” in all blocks.
Pre-corrected power (PCP)
Watts (W)

Pulse energy (J) x 4

Maximum power (W)

Pulse energy (J) x PRF (Hz)

Visual correction factor (VCF)
Enter “1.0” or use FAA AC 70-1 Table 3
Visually corrected power
PCP x VCF
13. Beam direction(s)
c. Azimuth
(degrees)
d. Magnetic
variation (degrees)

a. Maximum elevation angle
(degrees)
b. Minimum elevation angle
(degrees, where horizontal = 0 degrees)
14. Protection distances (fill in all three columns below)
Slant range (feet)

Horizontal distance (feet)

☐True or ☐Magnetic north

Vertical distance (feet)

a. NOHD (based on MPE value)
The following items are for lasers with visible wavelengths (400-700 nm). If the laser has no visible wavelengths, enter “N/A (non-visible laser)” in all blocks.
b. SZED (for 100 µW/cm2)
c. CZED (for 5 µW/cm )
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d. LFED (for 50 nW/cm2)
15. Calculation method

☐Commercial software (print product name)

☐Other (describe method such as a spreadsheet or calculator)

FAA Form 7140-1 approved August 2021 (supersedes previous version)

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