Download:
pdf |
pdfC
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 7140-1, Notice of Proposed Outdoor Laser Operation(s)
Who Should Complete and Submit This Form
Any person, entity, or proponent planning to conduct outdoor laser operations with a
visible laser beam exceeding 50 nanowatts per square centimeter or with a
(visible or non-visible) laser beam that exceeds the maximum permissible exposure in
navigable airspace. FAA encourages proponents to contact the applicable FAA service
center for guidance.
Instructions to Complete
Consult FAA Advisory Circular (AC) 70-1 for detailed instructions to assist with
completing and submitting this form. Reference FAA Order JO 7400.2, Chapter 29 for
additional background information. 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 (72.77x10-2 or
72.77E-02). Failure to provide all requested information may delay processing.
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
if projecting into navigable airspace. 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.
FAA Form 7140-1 approved August 2021 (supersedes previous version)
Page i
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.
0
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
I
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)
I
5. FDA/CDRH information (if applicable)
a. Variance #
c. Accession #
b. Variance
expiration date
I
I
6. Brief description of control measures
7. Attachments
a. Number of laser configurations: State the total number of configurations and complete a Laser Configuration Worksheet (page 2) for each configuration
b. Attachments: List all attachments, e.g., maps, diagrams, control measure details, calculation details, or software printouts
l
8. Designated contact person (if FAA requires further information)
a. Name
c. Phone
b. Position
d. Fax
e. E-mail
I
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
b. Position
c. Signature
d. Date
FAA Form 7140-1 approved August 2021 (supersedes previous version)
Page 1 of 2
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, in feet: __________ mean sea level
d. Information determined by: ☐GPS ☐Map (topo) ☐Other __________________
b. Laser height above site elevation, in feet: __________ above ground level
e. Latitude:
_______degrees, _______minutes, _______seconds
c. Overall laser elevation (a) + (b), in feet: __________ mean sea level
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 characteristics
Laser type
(example: CO2, diode, or Nd-YAG)
Laser hazard class
(example: Class 2, 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
See FAA AC 70-1
13. Beam direction(s)
a. Minimum elevation angle
(degrees, where horizontal = 0 degrees)
b. Maximum elevation angle
(degrees)
c. Azimuth
(degrees)
d. Magnetic declination
(degrees)
☐True north or ☐Magnetic north
14. Protection and visual interference distances (fill in the entire NOHD row and the entire column for the applicable mode of operation)
Slant range (feet)
Horizontal distance (feet)
Vertical distance (feet)
a. NOHD (based on MPE value)
The following items are for lasers with visible wavelengths (400 nm to 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 )
2
d. LFED (for 50 nW/cm2)
15. Calculation method
☐Commercial software (product name and version) ☐Other (describe method such as a spreadsheet or calculator)
FAA Form 7140-1 approved August 2021 (supersedes previous version)
Page 2 of 2
File Type | application/pdf |
File Title | Notice of Propsed Outdoor Laser Operation(s) |
Author | Brian Konie |
File Modified | 2021:07:13 15:40:30-04:00 |
File Created | 2014:09:29 07:36:53-04:00 |