Form 5010-3 Airport Master Record (Newly established public use airp

U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
>1 ASSOC CITY:
>2 AIRPORT NAME:
3 CBD TO AIRPORT (NM):

4 STATE:

LOC ID:
5 COUNTY:

7 SECT AERO CHT:

6 REGION/ADO:

GENERAL

FAA SITE NR:

SERVICES

10 OWNERSHIP:
>11 OWNER:
>12 ADDRESS:

BASED AIRCRAFT

>70 FUEL:

90 SINGLE ENG:
91 MULTI ENG:
92 JET:
TOTAL

>71 AIRFRAME RPRS:
>72 PWR PLANT RPRS:
>73 BOTTLE OXYGEN:
>74 BULK OXYGEN:
75 TSNT STORAGE:
76 OTHER SERVICES:

>13 PHONE NR:
>14 MANAGER:
>15 ADDRESS:
>16 PHONE NR:
17 ATTENDANCE SCHEDULE:
MONTHS
DAYS

FORM APPROVED OMB 2120-0015
1/31/2012

AIRPORT MASTER RECORD

HOURS

93 HELICOPTERS:
94 GLIDERS:
95 MILITARY:
96 ULTRA-LIGHTS:

OPERATIONS

FACILITIES

100 AIR CARRIER:
101 INTENTIONALLY LEFT BLANK:
102 AIR TAXI:
103 G A LOCAL:
104 G A ITNRNT:
105 MILITARY:
TOTAL

>80 ARPT BCN:
>81 ARPT LGT SKED:
>82 UNICOM:
>83 WIND INDICATOR:
84 SEGMENTED CIRCLE:
85 CONTROL TWR:
86 FSS:
87 FSS ON ARPT:
88 FSS PHONE NR:
89 TOLL FREE NR:

18 AIRPORT USE:
19 ARPT LAT:
20 ARPT LONG:
21 ARPT ELEV:
22 ACREAGE:
>23 RIGHT TRAFFIC:
24 NON-COMM LANDING:
25 NPIAS/FEDERAL AGREEMENTS:
26 PART 139 INDEX:

OPERATIONS FOR 12
MONTHS ENDING

RUNWAY DATA
>30 RUNWAY IDENT:
>31 LENGTH:
>32 WIDTH:
33 SURF TYPE-COND:
34 SURF TREATMENT:
35 GROSS WT: S
36 (IN THSDS) D
37
2D
222
38
2D/2D2
39 PCN:
LIGHTING/APCH AIDS
>40 EDGE INTENSITY:
>42 RWY MARK TYPE-COND:
>43 VGSI:
44 THR CROSSING HGT:
45 VISUAL GLIDE ANGLE:
>46 CNTRLN-TDZ:
>47 RVR-RVV:
>48 REIL:
>49 APCH LIGHTS:

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OBSTRUCTION DATA
50 PART 77 CATEGORY:
>51 DISPLACED THLD
>52 CTLG OBSTN:
>53 OBSTN MARKED/LGTD:
>54 HGT ABOVE RWY END:
>55 DIST FROM RWY END:
56 CNTRLN OFFSET:
57 OBSTN CLNC SLOPE:
58 CLOSE-IN OBSTN:
DECLARED DISTANCES
>60 TAKE OFF RUN AVBL (TORA)
>61 TAKE OFF DIST AVBL (TODA)
>62 ACLT STOP DIST AVBL (ASDA)
>63 LNDG DIST AVBL (LDA)

(>) ARPT MGR PLEASE ADVISE FSS IN ITEM 86 WHEN CHANGES OCCUR TO ITEMS PRECEDED BY>
>110 REMARKS:

111 INSPECTOR ( 5 )
FAA Form 5010-3 (6-03) SUPERSEDES PREVIOUS EDITION

112 LAST INSP:

113 LAST INFO REQ:

Paperwork Reduction Act Statement:
The information collected on this form is necessary because it is the description of the physical and operational
characteristics of the airport that will be on file with the FAA. The information will be maintained in FAA computers for
record keeping purposes and used in airspace studies. Some of the information on this form is critical to aviation
safety and will be published in flight information handbooks and charts for pilot use. The burden associated with
completing this form is estimated to be 2 hours. Providing this information is mandatory if the proponent wishes to
have the airport on file with the FAA and entered into the National Airspace System. No assurances of confidentiality
are given. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. The OMB control number associated with this
collection is 2120-0015. Comments concerning the accuracy of this burden and suggestions for reducing the burden
should be directed to the FAA at: 800 Independence Ave SW, Washington, DC 20591, Attn: Information Collection
Clearance Officer, AES-200