`Reaping the whirlwind` `Passengers behaving badly`

`Reaping the whirlwind` `Passengers behaving badly`
‘Reaping the whirlwind’
Aerial agriculture and mustering
Jul-Aug 2011
Issue 81
iFar away … so close
Remote tower technology
i Volcanic fallout
Australian flights cancelled
‘Passengers behaving badly’
Bad manners and dangerous acts
AUSTRALIAN
AIR PILOTS
MUTUAL
BENEFIT
FUND
YOUR LOSS OF LICENCE FUND PROVIDING SUPPORT AND PEACE OF MIND
TO AUSTRALIA’’” S
’ COMMERCIAL PILOTS
The Australian Air Pilots Mutual Benefit Fund is the loss
of licence fund that exists solely to assist its members.
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pilots with the peace of mind that they will be financially
supported in the event their Australian Class One Medical
Certificate is suspended or cancelled.
We’re different to other loss of licence providers:
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available is $550,000.
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This information is of a general nature only. It does not take into account your personal circumstances and is not intended to be relied upon as specific financial advice.
You should read the Product Disclosure Statement (available at www.aapmbf.com.au) before deciding whether to become a member of the Fund. No responsibility for loss
by any person acting, or not acting, as a result of this advertisement will be accepted.
Trustee: Austair Pilots Pty Ltd AFSL 344259
AAPMBF CELEBRATING 50 YEARS OF SERVING OUR MEMBERS
ISSUE NO. 81, Jul-Aug 2011
DIRECTOR OF AVIATION SAFETY, CASA
John McCormick
MANAGER, SAFETY PROMOTION
Gail Sambidge-Mitchell
EDITOR, FLIGHT SAFETY AUSTRALIA
Margo Marchbank
WRITER, FLIGHT SAFETY AUSTRALIA
Robert Wilson
SUB-EDITOR, FLIGHT SAFETY AUSTRALIA
Joanna Pagan
DESIGNER, FLIGHT SAFETY AUSTRALIA
Fiona Scheidel
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CONTENTS
Features
8
'Reaping the whirlwind'
The risks of agricultural and mustering flying, and how operators
manage them
14 'Stockhorse of the sky: the Robinson R22'
A study of the cattle-chasing ‘copter found some reassuring results
20 'Passengers behaving badly'
Boorish at best, an aviation hazard at worst
24 'Far away, so close'
The air traffic controllers of the future may not even be at the airport
28 'Volcanic fallout extends its reach'
Suddenly it’s Australia’s problem
31 'Birthday blues'
Take a closer look at your ageing aircraft
44 'Sea Change: the offshore evolution'
Offshore helicopter aviation is influencing rotary-wing operations on land
58 'War and remembrance, fog and death'
The needless tragedy of last year’s Polish presidential plane crash
62 'By the numbers'
Is your transponder set correctly?
Warning: This educational publication does not
replace ERSA, AIP, airworthiness regulatory
documents, manufacturers’ advice, or NOTAMs.
Operational information in Flight Safety Australia
should only be used in conjunction with
current operational documents.
Regulars
Information contained herein is subject to change.
The views expressed in this publication are those
of the authors, and do not necessarily represent the
views of the Civil Aviation Safety Authority.
2 Flight Bytes–aviation safety news
16 ATC Notes–news from
Airservices Australia
18 Accident reports–International
19 Accident reports–Australian
31 Airworthiness pull-out section
© Copyright 2011, Civil Aviation Safety
Authority Australia.
Copyright for the ATSB and ATC supplements
rests with the Australian Transport Safety Bureau
and Airservices Australia respectively – these
supplements are written, edited and designed
independently of CASA. All requests for permission
to reproduce any articles should be directed to FSA
editorial (see correspondence details above).
34 SDRs
39 Directives
Registered–Print Post: 381667-00644.
ISSN 1325-5002.
46 Close Calls
Main cover photo: myloupe.com
Cover design: Fiona Scheidel
˜‡”ƒ‰‡‡–‹•–”‹„—–‹‘
…–‘„‡”ʹͲͳͲǦƒ”…ŠʹͲͳͳ
ͺ͹ǡͷͷͺ
46 Down and dirty
48 Shear luck
50 A weighty problem
This magazine is printed
on paper from sustainably
managed forests and
controlled sources
Recognised in Australia
through the Australian
Forestry Standard
52
66
70
71
ATSB supplement
Av Quiz
Calendar
Quiz answers
Flight Safety Australia: winner of the international
Flight Safety Foundation’s 2010 Cecil A. Brownlow
Award for aviation safety journalism.
Upcoming conferences
July
26 - 28
Australian Aircraft Airworthiness & Sustainment Conference
Brisbane Convention and Exhibition Centre
October
26 - 27
Safeskies biennial International Aviation Safety Conference, Hyatt Hotel Canberra
October
26 - 27
National Chief Flying Instructor Conference, Hyatt Hotel Canberra
AERIAL APPLICATION PILOTS
MANUAL UPDATE
CASA JOINS THE
TWITTERVERSE
SUSTAIN YOUR OLD PLANE
Owners and operators of ageing
CASA is now tweeting. Access all our aircraft – and that’s most of them
latest information quickly and easily – should make a diary note of the
on Twitter by going to @CASABriefing.
Australian Aircraft Airworthiness and
Follow CASA on Twitter and stay in Sustainment Conference.
touch with all things aviation. This
includes news, updates to our website, It’s at the Brisbane Convention and
the release of new documents and Exhibition Centre from 26-28 July. The
The new edition will be launched publications, new safety promotion conference brings together engineers,
at the 4As Conference in Adelaide products, seminars and workshops operators, maintainers, managers and
in mid-June, and printed copies of and other activities.
scientists to discuss all aspects of
the manual will be sent out to 4As
aircraft sustainment. Among the topics
members as soon as possible in the CASA does not release news and are fleet management, avionics and
new financial year. Extra copies information solely on Twitter. However,
wiring, mechanical systems, structures
can be purchased via the AAAA it is a quick and easy way to keep
website www.aerialag.com.au and up-to-date with new information from and corrosion, ageing materials,
spares, logistics and crashworthiness.
a downloadable .pdf version will be CASA.
available on the members’ section of
For more information visit:
the site.
www.ageingaircraft.com.au/aasc
As this issue of Flight Safety Australia
goes to print CASA is collaborating with
the Aerial Agricultural Association
of Australia (AAAA) to produce a
revised and updated third edition of
this essential resource for all aerial
application and agricultural pilots.
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Informing and entertaining pilots for over 20 years.
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34961_5
FSA JUL-AUG 2011
2
SAFESKIES 2011
The award-winning Safeskies biennial International
Aviation Safety Conference is recognised globally as a
highly informative event at which aviation professionals
gather to exchange ideas on current and developing
air safety issues. This year’s conference, with the
theme Future growth: Future challenges, will be held
on Wednesday 26 and Thursday 27 October at the
Hyatt Hotel in Canberra. Speakers and attendees will
include national and international representatives from
airlines, the military, general aviation and airports,
industry associations, safety and professional bodies,
government regulators and safety investigators, air
traffic management and other service providers and the
aerospace industry.
A highlight promises to be the Sir Reginald Ansett
Memorial Lecture and Safeskies conference dinner on
Tuesday, 25 October, at Parliament House in Canberra,
which will feature a joint presentation by Australian
astronauts, husband and wife, Dr Andy Thomas and
Dr Shannon Walker.
3
For bookings and more information visit:
www.safeskiesaustralia.org
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FLIGHT BYTES
$73/7+(25<
ATLANTIC YIELDS AIR FRANCE
DETAILS
CALLING ALL CFIs
CLARIFICATION ON
CASA is holding the second National CARBY ICING
Chief Flying Instructor Conference in
conjunction with Safeskies in Canberra
on 26 - 27 October 2011. This is a
‘must-attend’ for leading CFIs. It’s a
perfect opportunity to gain an insight
into latest trends, network with other
aviation professionals and contribute
to the development of aviation safety
material.
FSA JUL-AUG 2011
4
The main theme for this year’s
conference is ‘Threat and Error
Management’ (TEM). Flying schools
have given CASA feedback that they
would welcome additional guidance
material and tools for integrating TEM
into their flying training curriculum and
guidance on assessing it effectively at
flight test stage.
The conference will include a workshop
at which attendees will develop
material for CASA to incorporate in
safety education resources for the
flying training sector.
The second theme is an exploration
of generational learning styles. An
interactive session will include a case
study on how flying schools can engage
more effectively with new generations
of students: the Gen Ys and Gen Zs.
There will also be updates from CASA
on flying training and testing, and the
new flight crew licensing and flying
training regulations.
As several readers have pointed out,
the article in Flight Safety Australia
May/June 2011 should have been
more accurate about latent heat and
the instrumentation of Robinson
helicopters. Latent heat is not lost
but added in the transformation
from a liquid to a gas. In the case
of a carburettor, this extra heat is
taken from the air flowing through it.
This is why the air flowing through a
carburettor cools, often to the point of
ice formation.
Details of what happened in the final
few minutes of Air France Flight 447
are emerging after its flight data
and cockpit voice recorders were
raised from 4000m beneath the sea.
The Airbus A330 flying from Rio de
Janeiro to Paris crashed on 1 June
2009, killing all 228 on board. But
the mystery surrounding the flight
has, if anything, deepened with the
revelation that the pilot flying pulled
back on the side-stick, despite the stall
warning sounding. The French Bureau
of Investigation and Analysis (BEA)
Robinson helicopter pilots familiar
released an update to the investigation
with their panels would have realised
in late May. Among its findings were
that carburettor heat is added to keep
that:
the carburettor air temperature gauge
There was an inconsistency
needle out of the yellow arc, rather
between the speeds displayed on
than in it, and that manifold pressure
the left side and the integrated
on a helicopter or constant-speed prop
standby instrument system. This
is not a reliable indication of icing. It’s
lasted for less than one minute.
also worth adding that in its Safety
Notice 25 Robinson recommends full
carburettor heat on the R22 whenever
manifold pressure is at 18 inches or
less and on the R44 whenever there is
visible moisture.
Thanks to those who pointed
this out and for their generous
comments that these mistakes did
not negate the important message
of the story – it doesn’t need to
be a freezing cold day for there to be a
danger of carburettor ice.
After the autopilot disengagement
the airplane climbed to 38,000ft,
the stall warning was triggered
and the aeroplane stalled,
The inputs made by the pilot
flying were mainly nose-up,
The descent lasted 3 min and
30 seconds, during which the
aeroplane remained stalled.
The angle of attack increased
and remained above 35 degrees,
The engines were operating
and always responded to crew
commands,
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The last recorded values were
a pitch attitude of 16.2 degrees
nose-up, a roll angle of 5.3
degrees left and a vertical speed
of -10,912 ft/min.
The BSc degree in aeronautics with
a major in UAS operations includes
courses in the systems of unmanned
aircraft, UAS ground systems, UAS
communications
and
telemetry,
and UAS remote sensing. The major
The BEA is continuing to analyse
curriculum also includes aviation
the accident in preparation for its
safety, human factors, and crew
final report.
resource management relating to UA
operations.
UNMANNED SECTOR GROWS
BY DEGREES
The Commission is committed
to supporting better compliance
with international safety standards
whenever possible and has therefore
mandated the European Aviation Safety
Agency (EASA) to carry out technical
assistance missions to support the
competent authorities of various states
in their efforts to enhance safety and
address any safety concerns.
In Australia, the Civil Aviation Safety
Authority (CASA) is charged with
the effective safety regulation of air
operations. Australia does not have
a black list, but CASA's International
Operations branch has developed a
risk matrix, in accordance with ICAO
standards.
5
FLIGHT BYTES
Students use a ScanEagle simulator,
The University of North Dakota recently progressing from basic flight operations
celebrated the graduation of the first to advanced sensor techniques and
unmanned aircraft systems operations emergency procedures, and finally to
degree students in America.
mission-related UAS employment and
operational techniques.
All the UAS graduates are enjoying great
interest from potential employers, and EU BLACK LIST UPDATED
some are already working in the field,
The European Commission has
which is expected to explode when the
updated the list of carriers banned
Federal Aviation Administration (FAA)
from operating in the European Union
opens airspace to civilian applications.
(EU). Newly-added are all airlines from
‘We may see it open up in the next few
Mozambique, and two Boeing 767s
months for law enforcement agencies,’
belonging to Air Madagascar – the only
said UAS chief pilot Mark Hastings, ‘but
long-haul aircraft the airline operates.
it probably won’t be until 2015 that we
Four all-cargo carriers from Indonesia
see it open to commercial applications,
and one from Ukraine have been
such as patrolling oil pipelines.’
removed from the list, but 269 carriers
are still banned from operating in the
EU. Twenty-one countries are subject
to blanket bans of all their registered
aircraft. In other cases, specific airlines
are blacklisted but the country is not,
and some airlines can only operate
into the EU with restrictions such as
using specifically approved aircraft, or
undergoing special inspections.
organised, and that the process
The matrix:
(a) applies entry control standards to complies with regulations for paperless
an applicant for a foreign aircraft operation.
AOC, and
Fleet managers, jet librarians and
(b) determines the level of surveillance flight dispatchers are provided with a
required for an operator of foreign console that allows them to drag and
aircraft conducting commercial air drop electronic copies of their manuals,
documents, and notices into online
operations in Australia.
routing folders that transfer the correct
The risk matrix is one of many tools
documents to the correct aircraft.
used to assist the International
Operations branch with their regulatory Documents and emails can be sent to
oversight of foreign operators. Some one plane, all planes of the same type,
foreign operators require enhanced the entire fleet, or to special libraries
surveillance based on a risk assessment customised for the fleet. Pilots are
automatically notified that documents
and historical data.
are waiting for them. By pressing one
For more information:
button, all the documents are retrieved
http://ec.europa.eu/transport/
and organised in the appropriate
air-ban/list_en.htm
folders, and an audit trail is generated.
NO PAPER IN NEW FLIGHT BAG
Canadian company On-Board Data
Systems recently announced the
release of Aviation Docs, a paperless
flight deck solution for business
jet fleet operators to securely and
selectively route all documents, emails
and flight plans to their pilots’ Apple
iPads and some Windows-based
devices anywhere in the world. Pilots
can now use electronic features, such
as search, hyperlink and annotation
support, to create an economical and
reliable electronic flight bag.
For a number of years CASA has
offered a document library, updated
several times a year, on CD-ROM to the
aviation industry. The CD contained
aviation
legislation
and
other
information such as airworthiness
bulletins, manuals and forms.
Recently CASA surveyed subscribers
to the CD document library to find
out how they used the service and
to evaluate its continuing value for
subscribers. Feedback from these
users shows that the CD version of
the document library has outlived its
usefulness, so it will be discontinued.
The CD-ROM subscribers received
in April 2011 is the last to be offered
An ‘instant aircraft switch’ feature by CASA.
allows the pilot to select which aircraft
they are flying from a list, and the All the aviation legislation and
document library switches instantly to supporting material is freely available
that aircraft, allowing one iPad to be on the internet, and can be accessed
used on a number of aircraft. Ground through CASA’s web site. The aviation
Console also makes sure that flight bags legislation itself resides on the official
always have the latest information by Commonwealth legislation web site,
allowing flight plans to be automatically Comlaw, but can be accessed using
emailed to the document library.
links on the CASA website under the
OBDS provides training material ‘regulations and policy’ button on
and customer support to help ease the front page. All CASA’s manuals
the transition to paperless cockpits. and forms are available in electronic
Aviation Docs apps are available free format, online, free-of-charge, on
of charge to subscribers to the OBDS CASA’s website.
The system simplifies the task of
Aviation document service.
ensuring that all electronic documents,
flight manuals, training manuals, For more information: www.obds.com
revisions and flight plans are in the or www.aviationdocs.aero
pilots' hands, up-to-date, and well
05
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FSA JUL-AUG 2011
6
CD DOCUMENT SERVICE NO
LONGER NEEDED
-69:(3,-09:;9;<9)05,
>0;/(09*6505(<:;9(30(
Those
requiring
paper
copies
of the aviation legislation can
purchase some of it from the
Airservices Australia online store at
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;(2,(+=(5;(.,6-/,30-30;,»:,(93@:36;:
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7O! ‹^^^OLSPÅP[LJVTH\
9VIPUZVU:HSLZ (N\Z[H>LZ[SHUK:HSLZ
in January 2011). Ms Borschmann was
a passionate and dedicated educator
and aviator and the program is a
testament to her commitment to the
future of aviation. The program has
produced 53 GFPT holders and 35
PPLs and is an exciting example of the
diverse curriculum choices available
at the College.
http://web.stkevins.vic.edu.au/
The Hamilton and Alexandra
College, Hamilton, Vic
About 20 students have gained
their junior pilot’s licences since
the
Hamilton
and
Alexandra
College aviation program began in
1998. In 2000, the school signed a
memorandum of understanding with
RMIT University’s Aviation Aerospace
Engineering Faculty, with students
receiving preferred entry to RMIT
aviation courses and unit accreditation
to various aviation courses worldwide.
The course involves 20 hours of flying,
with at least five hours of solo flight.
www.hamiltoncollege.vic.edu.au/
Check out our website at
www.bobtait.com.au
BAK & PPL
Coming soon!
Bob Tait’s Aviation Theory School’s Online CPL
Performance Course.
*
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Virtual classroom presentation.
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Email bobtait@bobtait.com.au
7
FLIGHT BYTES
w w w.a i r s er v ic e s au s t r a l i a .c om / MORE AVIATION HIGH
store, or you can contact them on SCHOOLS
1300 306 630.
The following aviation high schools
Eligible subscribers who have already did not make it into the article in the
paid for the CASA CD document May-June issue but we are happy to
library service will receive an rectify their omission.
appropriate refund. Pro-rata refunds The Essington School, Darwin, NT
will be provided to subscribers who The Essington School, in Darwin, is
made payments receipted by CASA entering its eleventh year of using
after July 2010, as these existing its Year 10 ‘Learn to Fly’ program
subscribers
received
a
partial to encourage students to develop
subscription service. Full refunds will confidence and a belief that with the
also be provided to those subscribers right training and experiences there
who made payments receipted after is nothing they cannot do. Nationally
October 2010, when CASA ceased accredited gliding instructors, Gavin
accepting new subscriptions to the Wrigley and Reg Moore, provide a
service. Refunds will be processed program of theory lessons on the
against the credit card nominated ground and hands-on flying lessons
by the subscriber in their original in a European-built, single-engine
application. Subscribers who paid powered glider.
via EFT, cheque or money order will www.essington.nt.edu.au/
be contacted to obtain the correct
client banking details. The pro-rata St Kevin’s College, Toorak, Vic
refund rates will be provided on The Aviation program at St Kevin’s
College was founded in 2005 by Julie
www.casa.gov.au
Borschmann (who unfortunately died
2EAP).'THE
WHIRLWIND
FSA JUL-AUG 2011
8
Can flying for agriculture
be made safer, or will lowlevel spraying and mustering
always take their human toll?
Flight Safety Australia talks
with experts and old hands
who say encouraging
trends are emerging.
It’s a tough life, and sometimes a short life,
on the farm. Statistically, agriculture is a
dangerous game, even when a farmer’s feet
are on the ground. Tractors, quad bikes,
drowning and ute accidents are the most
common causes of death for agricultural
workers, according to research group
Farmsafe. Together with miscellaneous
causes they kill about 90 people in farm
accidents in an average year, costing the
Australian economy about $651 million,
Farmsafe found.
Agricultural flying follows a similar trend.
Flying on the farm, whether for aerial
application or mustering, is one of the more
dangerous things you can do in an aircraft.
In the ten years between 1999 and 2008,
aerial agriculture averaged 174.4 accidents per
million hours flown, according to Australian
Transport Safety Bureau figures. Over those
ten years, aerial mustering averaged 72.8
accidents for every million hours flown.
For fatal accidents, the rates were 7.06 per
million ‘agricultural’ hours flown and 4.85 for
aerial mustering.
Over these same ten years - 1999 to 2008 there were 13 deaths and 18 serious injuries
from crashes in aerial agriculture, which
doesn’t sound like much until you consider
there are only about 300 active agricultural
pilots in Australia. Likewise, the five
mustering deaths over the period came from
an even smaller pool of active pilots.
It’s not a route to building hours, as some pilots perceive
instructing to be. The combination of stability and experience in
the core group of agricultural pilots means that safety programs
can be effective. We don’t accept that aerial agriculture has to
have inherently poor safety. That’s why we continue to develop
and refine safety systems. Since our first ag pilot safety course in
1998 there’s been a long-term decline in accident rates.’
Chief executive of the Aerial Agricultural
Association of Australia, Phil Hurst, says
agricultural pilots fly in a different environment
to private pilots. All agricultural flying is low
level, which under most circumstances is
prohibited in private aviation. Hurst winces
when he hears the mainstream media
describe an aerial application pilot as a ‘crop
duster’. Few outside the agricultural aviation
industry realise how tightly regulated and
professionally stringent it is, he says.
Although the small number of agricultural pilots makes the
figures volatile, the trend is unmistakable, and correlates to the
introduction of the safety course, Hurst says.
‘The two issues that drive the Association are
chemicals and safety. Aerial application pilots
have to be trained in the safe handling and
application of agricultural chemicals, and
safe flying goes hand-in-hand with that. The
two issues reinforce each other. All our pilots
have to complete 15 education units over
three years as part of the professional pilots
program that provides ongoing currency for
the Spraysafe qualification,’ says Hurst.
This continual career development is the
hallmark of a profession, he adds, noting that
the AAAA dates from 1958, only about ten
years after the first agricultural aviation in
Australia. ‘The thing about agricultural flying
is that people who go into it tend to stay.
‘In the 80s and 90s there were about seven or eight fatal accidents
a year; this century the rate has been down to two, although it’s
been higher recently as the volume of work has increased. But the
rates per hours flown tell a similar story: a downward trend with
occasional blips up because the total numbers involved are small.
Meanwhile, the Association is continuing its strong emphasis
on safety education and training. ‘We’re rewriting the Aerial
Application Pilots Manual to be launched at our annual convention,
and we’ve also begun a take-offs, turns and wires education
program to address the three main causes of crashes.’
It’s a role the AAAA has to take on, Hurst says, because safety
regulation, by its very nature, is a minimum standard. No matter
how stringent, it is a floor rather than a ceiling. ‘The point is; no
agricultural pilot should ever be complacent enough to say “I meet
the regulations so all’s right with my world.”’
He acknowledges that newer, larger and more crashworthy
aircraft take some credit for fewer deaths in agricultural flying.
And helmets. ‘If you hit the same wire in an old Pawnee or in a
modern turbine aircraft there’s no doubt you’d be better off in
the newer one, particularly if you’re wearing a helmet, Wearing
a helmet is one of the few measures a pilot can take to reduce
the consequences of a crash rather than its likelihood,’ Hurst
reminds us.
9
REAPING THE WHIRLWIND
The crash and death rates for aerial
agriculture and mustering are close to those
of a class of pilot some professional aviators
look down upon: PPL-licensed private and
business flyers. Their crash and death rates
are 60 accidents per million hours and about
20 fatal accidents per million hours.
FSA JUL-AUG 2011
10
Wire strike has been a hazard for as long as pilots have been
flying in agriculture (See Flight Safety Australia March/April
2011 for an in-depth look at this subject). The AAAA runs a wire
risk management training course for aerial application pilots,
highlighting the hazards, and promoting safety techniques, the
foremost of which is thorough flight planning after a pre-treatment
survey, says Hurst. ‘These days a lot of guys are using Google
Earth to spot wires that haven’t been mentioned. They also use it
to look for hazards over a wider radius.’
As techniques for dealing with existing hazards are refined, new
hazards emerge. Wind farms are the latest concern for the AAAA.
‘The big turbines aren’t the problem: anyone can see them, but
there are monitoring towers built before construction that can be
just under 85m high – we think they should be reportable and
marked at that level,’ Hurst says.
0ASSINGMUSTER
Aerial mustering is the locating, rounding up and movement
of animals using an aircraft. Fixed- or rotary-wing aircraft are
used to locate and round up stock such as cattle, sheep, buffalo
and camels.
However, helicopter mustering has become an
essential feature of cattle stations in northern
Australia, reducing the time needed to muster
stock from two weeks on horseback to
one day.
‘Helicopters are part of the trend of capital
replacing labour that has characterised the
Territory’s beef industry since the 1960s,’ says
Northern Territory Cattlemen’s Association
executive director, Luke Bowen.
With stocking rates on NT cattle stations
that can be as low as one animal per square
kilometre, there’s no other economic way of
large-scale mustering,’ Bowen says. ‘While
fixed-wing aircraft have the advantage
of lower operating costs, helicopters are
invaluable in wooded country where stock
have more natural cover and are difficult to
spot from the ground.’
Mustering, by definition, is low-level flying. Its hazards include
vulnerability to wind shear, bank-angle illusions in crosswinds
near the ground, and the inherent danger of being only a few
seconds away from impact in the case of an emergency or pilot
distraction.
Helicopters have many advantages for
mustering, including the ability to move
stock at their own pace. ‘With fixed-wing
you’re making a series of passes but with a
helicopter you can stay with the mob,’ says
Pastoralists and Graziers’ Association of
Western Australia policy director, Zac Zaklan.
Mustering can be done (and under CAO 29.10 is allowed to be
done) by helicopter, aeroplane or gyroplane, but helicopters are
the most commonly used mustering aircraft. When helicopters
are used, there are the added issues of managing power reserve
and avoiding rotor blade overpitching, both of which are more
critical in the high ambient temperatures of northern Australia.
Dust from rotor downwash reducing visibility is another distinct
hazard of helicopter mustering.
But slowing down to a scrub bull’s walking
pace exposes helicopter musterers to a
dangerous phase of flight - the shaded part
of the height/velocity curve, the set of speed
and altitude combinations from which a
helicopter cannot auto-rotate safely. An ATSB
study that examined how Robinson R22
helicopters were used in mustering found
Katherine-based helicopter company owner,
Clinton Brisk, says well-trained mustering
pilots operate away from the shaded curve
as much as possible, but brief excursions into
it are unavoidable in mustering. ‘You try to
maintain airspeed, or use a low hover where
you can, and make a practice of regularly
scanning your engine gauges. Sometimes
you’ve got wind, which can help, but you’ve
also got to consider the terrain. In many
areas you are likely to damage the helicopter
in an auto, even if you’re on the good side of
the curve, because it’s based on flat ground.’
CASA, which generally forbids low flying, has
a series of requirements for pilots seeking a
licence approval for aerial stock mustering.
They are less stringent than the requirements
for aerial application, requiring only 100
hours of command time, and allow for
private pilot licence holders to do their own
mustering.
Brisk says this informal, do-it-yourself,
mustering sector brings safety challenges
with it. While he started his mustering career
under the mentorship of experienced pilots,
others don’t have that advantage.
‘These days we see stockmen coming into aviation. They’re very
good stockmen, but they haven’t had the depth of experience
in aviation that the first generation of musterers had. They’re
basically let loose on their own property under their own direction.
They don’t have the benefit of other people’s experience, as I had.’
There is a clear trend towards training jackaroos as pilots in both
the paid and informal mustering sectors.‘It’s an easier transition
because you have to have stock knowledge,’ says Zaklan.
Brisk says mustering has been isolated from the rest of aviation.
‘There were a few basic airmanship rules applied and that was
about it. You were out in the middle of nowhere doing a stockman’s
job.’ The isolation of the bush can also be isolation from legal
safety requirements and best practice, he says. ‘When you’ve got
a guy mustering on his own property in an R22 he’s not going to
sit up at night reading the civil aviation regulations.’
He came to this insight after his helicopter business grew to
include tourism, agricultural and offshore operations, and says
mustering could benefit from the polish and professionalism seen
in those areas. ‘For example: When I do a mustering approval
these days, I tell the pilots to set themselves an altitude they’re
going to fly at. I never did this until I got into this other world.’
However, he feels that former mustering pilots can be among the
best of any who take hold of cyclic and collective. ‘From what I
hear, they are able to pick up IFR quite easily. I was talking with
an offshore pilot who told me pilots who hadn’t been mustering
wouldn’t have a clue where the wind is coming from half the time,
whereas the ex-mustering pilots always know. It definitely gives
you a higher level of stick and rudder skills.’
Brisk wants to see support and ongoing training and education for
mustering pilots. ‘Don’t get me wrong, I think they get a buzz out
of being an aviator, I think they value it and want to fly skilfully
and safely. But I think they need assistance in achieving the goal
of ALARP - [risk] as low as reasonably practicable,’ he says.
11
REAPING THE WHIRLWIND
airspeeds below 50kt accounted for 45.9
per cent of aerial mustering flights. If those
speeds were flown at altitudes below 225ft,
an R22 at full weight on a standard day (two
big assumptions, admittedly) would be on
the deadly side of the ‘dead man’s curve’.
A loss of engine power would, inevitably, be
followed by a hard impact with the ground,
regardless of what the pilot did.
FSA JUL-AUG 2011
12
Apart from CASA’s regulatory requirements and the wisdom
passed down in the few flight training schools specialising in
mustering, there is little to guide mustering pilots towards that
goal of ALARP. The mustering industry lacks a central store of
knowledge and a lobby group. It has no equivalent to the Aerial
Agricultural Association of Australia. Of the pastoral associations
in states with significant aerial mustering only the Pastoralists and
Graziers Association of Western Australia (PGAWA) has a code
of conduct for the activity. The Northern Territory Cattlemen’s
Association and Agforce Queensland only mention the topic
in occupational health and safety guides concerning safety
near aircraft.
‘It’s not about flying. We can’t regulate how people do things.
It's about the interface between ground and air,’ says PGAWA
executive officer, Ian Randles.
The code, which will be published soon in a revised version, with
new advice on helicopter mustering, has two themes, Randles
explains. ‘It’s pitched at the pilot who’s in command of the aerial
decisions. On the other side it’s for how people on the ground can
best help pilots do their job.’ Sections include a guide to mustering
techniques for the private fixed-wing pilot; the responsibilities of
the mustering pilot to ground staff and the station owner; air law
regarding flight time, maintenance and carrying passengers; and
human factors, including fatigue, nutrition, hydration and the
side-effects of medication.
Randles emphasises that the code contains much which may
be considered common sense but that it is important for this to
be written down and stored. ‘People make a lot of assumptions
about prior knowledge,’ he says. ‘The code of practice is to put
some simple guidance down on paper – for the day the station
manager is sick or away.’
The lack of professional association and control in the mustering
industry means there is little opportunity for even the most safetyconscious pastoralist to assess the safety and professionalism of
a mustering contractor.
The decision often comes down to two factors:
word-of-mouth reputation, or impact on the
hip pocket. There have been acknowledged
instances where pastoralists have instructed
their mustering contractors to improve
their safety practices, but more often the
pressure runs in the other direction, industry
observers say.
Established contractors say the bill for a
Robinson R22 in mustering work is about
$440 an hour wet. A mustering contract
that is significantly lower than this figure
should attract some hard questions about
operational practices and standards. ‘It could
be a loss-leading quote to attract business,
but over the long term you’ve got to cover
your costs. R22s have lifed components that
have to be replaced, and you’ve got to wonder
about a really cheap contract – is that where
it’s saving the money?’ one operator said.
Meanwhile cultural changes on the ground are
starting to have a subtle effect on mustering’s
safety culture. A little-appreciated fact,
Randles says, is that some mining companies
now have significant pastoral holdings.
While miners often buy up properties near
their mine works as a means of avoiding
neighbourhood disputes, they often continue
to work these properties, he says, but do
so under the stringent safety culture of the
minerals industry. ‘On those properties you’ll
see jackeroos wearing helmets on quad bikes,
motorbikes and horses, and wearing seat
belts in vehicles. Not doing so is grounds for
dismissal.’
Heytesbury Cattle Company runs beef cattle
on northern Australian stations, including
Victoria River Downs in the Northern
Territory. Its chief executive, Paul Holmes à
Court, says:
Holmes à Court says it’s inconceivable that
mustering will be able to go against the grain
of this increased emphasis on safety. ‘We use
a contractor, Helimuster, and we hold them
to the same standards of safety as the rest of
our operation.’
The issue of whether to take mustering
operations in-house raises fundamental
safety questions about mixing aviation with
other pastoral activities. Holmes à Court
firmly believes aviation should be left to the
specialists. ‘There are pastoralists who have
the experience and resources to use their
aircraft in mustering. It makes sense for
them, but it’s not for us. I know just enough
of aviation to know that unless you’re serious
about it you shouldn’t do it.
However, cattlemen and pilots agree that mustering can, and
should, be a relatively sedate activity. ‘Most mustering is passive
except when there’s a camera around,’ says helicopter instructor,
Ray Cronin, who is one of a minority of instructors teaching
mustering techniques.
Bowen says a low-stress stock handling mentality now pervades
the industry. ‘It teaches people to use different tools, helicopters,
motorbikes. horses and dogs to maximise the wellbeing of the
animals.’ ‘One result, Bowen says is that helicopters are used
more strategically than they originally were. ‘You don’t often get
cattle being yarded by helicopter.’
Low-stress mustering by helicopter sees the machines flying
slowly some distance from the mob, moving them on while
staying out of the animals’ flight zone. Holmes à Court says:
‘A helicopter at 400ft doesn’t make much of a picture, but that’s
how it is most of the time.’
‘In the old days when we were doing portable yard work, it was a
different game,’ explains Clinton Brisk. ‘The biggest problem we
have now is glazing cylinders, because we’re off the power all day.
When I go for fuel or on the ferry flight I’ll fly at max continuous
power to try and heat the engine.’
Bowen says low-stress handling has been practised by enlightened
and profitable pastoralists for many years, but has come to
the fore as a stated philosophy in recent times. Its advantages
include cattle arriving at markets in better condition, and fewer
workplace injuries on horses, motorcycles, vehicles and aircraft.
‘It’s a process that began with the brucellosis and tuberculosis
eradication program which required fencing of properties,’ he
says. ‘With more fencing and improved practices, there are fewer
untamed cattle and the handling has become easier.’
13
REAPING THE WHIRLWIND
‘We take the safety of our employees
very seriously and that extends to
everything we do with vehicles, horses
and machines.’ After initial resistance,
safety is now an accepted part of
Heytesbury’s operations.
‘I see a generational change. The young
jackaroos come from a world where
safety is taken very seriously and for
them it's natural to wear a helmet or
a seat belt.’
That’s our position on mustering – it’s an activity that requires
high levels of experience and airmanship that only come from
doing it full-time.’
!%2)!,34/#+
-534%2).'/0%2!4)/.3
From Civil Aviation Order 29.10
‘For a pilot to conduct aerial stock mustering activities,
he or she must have the following qualifications:
If conducting private operations, a private pilot’s licence.
14
If conducting commercial aerial work operations, a
commercial pilot’s licence.
FSA JUL-AUG 2011
A minimum of 100 hours as pilot in command, including at
least 50 hours of command in the aircraft type for which
the approval is sought.
A minimum of five hours dual instruction, covering aircraft
handling and low flying.
A minimum of 10 hours operational training in aerial stock
mustering operations in the preceding 90 days.
Five hours experience in the type of aircraft to be used
for aerial mustering operations.’
Further information
www.farmsafe.org.au
T.H. McCosker and A.R. Eggington, Cattle mustering
efficiency using helicopters in a monsoonal savanna
woodland. The Rangeland Journal, Volume 8
number 2, August 1986, pp91-96 CSIRO Publishing,
www.publish.csiro.au
(http://www.rcs.au.com/data/Reference%20
Material/Muster%20with%20Helicopter.pdf )
Australian Transport Safety Bureau:
— Aviation occurrence statistics 1999-2009
— Wirestrikes involving known wires:
A manageable aerial agriculture hazard
www.atsb.gov.au
34/#+(/23%/&4(%3+9
Helicopter mustering dates back to 1968, when exmilitary pilots pioneered the activity in Bell 47 and
Hiller UH-12 helicopters. These were superseded
in the 1980s by the Robinson R22, which offered
unbeatable advantages in fuel consumption and
purchase price. There are now 489 R22s on the
Australian register.
A survey by the Bureau of Transport and Regional
Economics found that 62 per cent of R22 hours
flown were in mustering. The next largest category
was flying training, with 13 per cent.
While the small size of the R22 and its light lowinertia rotor suggest fragility to some eyes its
safety record has, on the whole, been impressive.
Its accident rate is the lowest of the four most
common light utility helicopters in Australia, the
ATSB found in its 2003 mustering study.
The R22’s accident rate for aerial work operations
was 14 per 100,000 hours, which was considerably
better than the accident rate for private flying (76
accidents per 100,000 hours) or aerial agriculture
operations (55 accidents per 100,000 hours)
The R22 also has a good reputation for crashworthiness, despite its small size.
‘I’ve seen R22 pilots walk away from crashes that I
thought would have seriously hurt them, or worse’,
says Katherine-based helicopter company owner
Clinton Brisk.
‘There’s crashworthiness in the structure, in the
skids and in the seats – if you remember never to
stow anything hard underneath them.’
4(%2/").3/.2
In 2007, the Australian Transport Safety Bureau
published a study of R22s in mustering operations
to find out what sort of forces were acting on the
helicopter’s airframe.
The report found that five stresses were higher than
those measured by Robinson in its certification
flights. Tail rotor drive shaft torque was 2.38 times the
certification figure but Robinson replied that:
Our present calculated service life (including all
safety factors) is approximately 44,000 hours.
The results ‘highlight the importance of handling technique,
and especially good engine management,’ the study said.
The study also found some more good news for musterers:
‘the abrupt manoeuvring associated with aerial mustering
produced relatively small stresses, whereas the peak stresses
found during certification occurred during high-speed flight,
which is uncommon in mustering operations.’
15
REAPING THE WHIRLWIND
The study found, ‘mustering operations can involve
large and sudden power changes that apply very high
loads on the helicopter’s drive system, and these may
exceed the limits set during the certification process.’
Adding the mustering data reduces this life to
approximately 34,000 hours. Calculated service
lives of more than 25,000 hours are considered
unlimited. Therefore, although the manoeuvre in
question imposes some additional fatigue damage,
it does not affect part life.
$7& Notes
What’s your designation?
I
ncluding the correct ICAO aircraft type designator for the
aircraft you’re flying in flight plans is vital to ensure that
the Eurocat air traffic services system is using accurate
information, can process your flight plan and display
information to ATC.
FSA
S JU
JJUL-AUG
L AUG 2011
L-
16
Airservices records show that some pilots are routinely
flight planning using incorrect designators. For example,
one turboprop operator flight planned using an incorrect
designator 170 times over a month and a half, while two
operators of light singles flight planned incorrectly 125 times
each over the same p
period.
A very common error is planning the Piper PA-28 family
(Cherokee, Warrior, Archer, Arrow etc) as ‘PA28’. This is
incorrect. The correct ICAO designators should be either
‘P28A’, ‘P28B’, ‘P28R’ or ‘P28T’.
Some military types are also frequently planned incorrectly.
For example, the correct designator for the AP-3C Orion is
‘P3’; the Pilatus PC-9A is ‘PC9’; and the C-17A Globemaster
is ‘C17’.
When NAIPS detects the use of an incorrect aircraft type
designator or a registration/aircraft type mismatch, it will
generate an error message to pilots. Pilots need to address the
error by checking and confirming aircraft registration and
confirming that the correct ICAO aircraft type designator
has been used. If you are certain that the designator used is
correct, or are unable to identifyy the cause of the error, yyou
can click the ‘submit’ button (or in the case of NAIPS for
Windows select ‘To ignore the errors, please resubmit’).
Other common designator errors include:
Importantly, you should also contact the Briefing Office to
advise the circumstances of the error. More information
about this is contained in AIC H03/10 Aircraft Type
Designator Issues: Flight Notification.
t Beech King Air 200s being planned as ‘B200’ rather than
t
the correct ICAO designator ‘BE20’ (other variants of the
ve different designators)
King Air family have
The list of correct ICAO aircraft type
p designators is available
on the Airservices website link gi
ggiven
ven in
i ERSA GEN FPRR 1 or
FPR-1
at h
ttp://ww
www.icao.int/anb/ais/8
/8643/
3 in
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cm
http://www.icao.int/anb/ais/8643/index.cfm
JetRangerrs planned
pllanned as ‘B206’ when the correct
p
t Bell 206 JetRangers
designator is ‘B06’
designator
Pl
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se cche
heck
ck that you’re using
ng tthe
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orrrect des
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esig
igna
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our
Please
check
correct
designator
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nco
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lann
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ng sy
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s em
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stored
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planning
systems.
‘LR
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oh
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Future directions –
Pre-Flight Briefing, Flightwatch High Frequency
(HF) Services and Sartime Service
A
irservices provides a pre-flight briefing service,
domestic and international NOTAM services and
a Flightwatch High Frequency (HF) in-flight
briefing and ATC relay service. Pre-flight briefing
is largely automated by the National Aeronautical
Information Processing System (NAIPS), which is also
the system that manages the NOTAM database.
17
ATC NOTES
These services, and the management of the Centralised
Sartime Database (CENSAR), have for the past 10 years
been delivered by Flight Information Officers of
the Australian Flight Information Centre (AusFIC)
in Brisbane.
As a component of Airservices Air Traffic Management
(ATM) 5 Year Services Plan, services currently
provided by AusFIC will be integrated with like-type
work areas in respective air traffic control service
delivery environments.
Integration will be largely seamless for industry with
principally the same people, interfaces, and systems
delivering the service.
The Briefing Office, NOTAM Office, and the ATS
Message Handling System will physically relocate to
the National Operations Centre (NOC) in Canberra.
Flightwatch High Frequency (HF) services and CENSAR
will be integrated with like-type services in the Brisbane
Air Traffic Services Centre (ATSC).
followed by CENSAR. The Briefing Office and NOTAM
Office will be moved to the NOC by mid to late 2012,
with no interruption or changes to services.
Planning is currently underway to relocate Flightwatch
HF services into the Brisbane ATSC by last quarter 2011,
Above: Airservices National Operations Centre Canberra.
International Accidents/Incidents 10 April 2011 - 13 June 2011
Date
Aircraft
Location
10 Apr
Cessna 310R
near McComb-Pike 3
County Airport
Missouri, USA
Destroyed
Aircraft crashed four miles from runway on approach at 4.30am local time.
11 Apr
Airbus A380
John F. Kennedy
International
Airport, New York
City, USA
Minor
Ground collision: Airbus's wing collided with tail of CRJ701ER regional jet,
spinning the smaller aircraft through 90 degrees.
14 Apr
Piper PA-32-260 near Haifa Airport, 4
Cherokee Six
Israel
Destroyed
Training aircraft reported engine problems soon after take-off, then hit trees
and crashed while attempting to land.
24 Apr
Yakovlev Yak52TD
near Fontenay2
Tresigny
Aerodrome, France
Destroyed
Russian training warbird crashed on approach.
27 Apr
Robinson R22
Beta II
Arawata Saddle,
about 50 km
NW of Wanaka,
South Island, New
Zealand
2
Destroyed
Helicopter did not return from training flight. Search found both occupants
dead at scene of wreckage.
30 Apr
Eurocopter AS
350B3 Ecureuil
Luguthang, near
5
India-China border,
India
Destroyed
Helicopter was carrying chief minister of north-eastern Indian state of
Arunachal Pradesh. Wreckage and bodies found at altitude of 4900m.
7 May
Xian MA6
near KaimanaUtarom Airport,
Indonesia
25
Destroyed
Chinese-made regional airliner crashed into the sea on approach, about
800m south-west of the runway threshold. Conditions were rainy, with
2km visibility.
13 May
Hal Chetak
Sirohi district,
Rajasthan, India
4
Written off
Indian Border Security Force helicopter crashed in hilly area.
15 May
DH-82A Tiger
Moth
near Moor Crichel,
Dorset, Uniited
Kingdom
1
Written off
Privately-owned vintage biplane was performing aerobatics.
Witnesses described the engine stopping and the aircraft 'spiralling' to
the ground. Both people on board were seriously injured; passenger died
overnight in hospital.
16 May
Piper PA-34-200 near Sao Paulo,
Seneca I
Brazil
4
Destroyed
Aero club aircraft used for training lost contact with ATC about 11pm local
time and collided with Morro do Cristo, a mountain near Sao Paulo.
18 May
Saab 340A
22
Destroyed
Aircraft thought to have departed from en route phase of flight. People living
near crash site saw aircraft flying low, then heard sound of crash. All on board
were killed. Aircraft first flew in 1985.
18 May
Boeing 707-321 Port HuenemePoint Mugu
Naval Air Station,
California, USA
0
Destroyed
Tanker on contract to US military ran off runway on take-off and caught fire.
22 May
Cessna 210M
Centurion
Hosea Kutako
International
Airport, Namibia
1
None
Pilot, aged 21, killed by propeller, which apparently hit his head when he
swung it during pre-flight inspection.
6 Jun
Antonov 26
near Libreville
Airport, Gabon
0
Written off
During approach, the pilot reported problems with the hydraulic system and
announced that the flight would perform a go-around. Soon after, the aircraft
crashed into the sea. The aeroplane came to rest submerged, with the top of
the tail sticking out of the water. Crew of three and one passenger escaped.
12 Jun
American Blimp near Reichelsheim
Corporation
Airfield, Germany
A-60+
1
Destroyed
Airship was flying to display advertisement at a music festival. Three
reporters were on board to take aerial shots of the event. When the airship
returned to the airfield, it was damaged during landing and caught fire. Pilot
advised passengers to jump to safety from low altitude. All three passengers
survived. Loss of weight then caused the airship to ascend quickly before
the pilot could escape. The airship crashed and burnt completely, killing the
Australian pilot.
13 Jun
Boeing B-17G
0
Written off
WWII-vintage bomber Liberty Belle force-landed, wheels down, in cornfield
after pilot reported engine fire. All seven on board escaped but fire
destroyed aircraft.
FSA JUL-AUG 2011
18
near Prahuaniyeu,
Argentina
Near Aurora
Municipal Airport,
Illinois, USA
Fatalities Damage
0
Description
Notes: compiled from information supplied by the Aviation Safety Network (see www.aviation-safety.net/database/) and reproduced with permission. While every effort is made to ensure accuracy,
neither the Aviation Safety Network nor Flight Safety Australia make any representations about its accuracy, as information is based on preliminary reports only. For further information refer to final
reports of the relevant official aircraft accident investigation organisation. Information on injuries is not always available.
Australian Accidents/Incidents 17 March 2011 - 27 May 2011
Date
17 Mar
22 Mar
25 Mar
Aircraft
American
Champion
8GCBC
Beech 76
Duchess
Location
Kojonup (ALA),
321°M 34km, WA
Injuries
Nil
Damage
Serious
Lismore
Aerodrome, NSW
Nil
Serious
Geraldton
Minor
Aerodrome, WNW
M 90km (East
Wallabi Island), WA
Piper PA-32Rnear Moree
Fatal
301T
Aerodrome, NSW
Cessna A188B/A1 Ingham (ALA), Qld Nil
Serious
Northam (ALA),
WA
near Maitland
(ALA), NSW
Serious
Minor
2 Apr
Kavanagh
Balloon E-210
Robinson R44
Serious
Minor
18 Apr
Cessna 152
Nil
Serious
18 Apr
Eagle DW-1
Cessnock (ALA),
NSW
Ingham (ALA), Qld
Serious
Unknown
22 Apr
Cessna U206G
30 Mar
31 Mar
2 Apr
Gove Aerodrome,
NT
Piper PA-28R-200 near Bunbury
(ALA), WA
Serious
Serious
Serious
Nil
Serious
near Moruya
Aerodrome
(Lilli Pilli), NSW
Grumman
near Middlemount
American G-164B Aerodrome, Qld
Fatal
Serious
Nil
Serious
26 Apr
Beech A36
Bonanza
Nil
Serious
30 Apr
Robinson R44
Nil
Serious
30 Apr
Aerospatiale
AS.350BA
Robinson R22
Beta
Robinson R22
Beta
Eurocopter
AS.350B3
Amateur-built
Cavalier SA102.5
Nil
Serious
Nil
Serious
Fatal
Serious
Bankstown
Aerodrome, NSW
Caboolture (ALA),
290°M 33km
(Archer Falls), Qld
near Tully (ALA),
Qld
Minor
Serious
Nil
Unknown
Nil
Serious
Springsure (ALA),
Qld
Serious
Serious
24 Apr
25 Apr
7 May
9 May
13 May
15 May
Robinson R44
23 May
Cessna U206G
27 May
PZL M-18B
Geraldton
Aerodrome, WNW
M 90km (East
Wallabi Island), WA
Kilmore (VFR),
120°M 4km, Vic
Ballera Aerodrome,
E M 11km, Qld
Fitzroy Crossing,
WA
Julia Creek, Qld
The aircraft collided with terrain. Four people suffered fatal injuries and two
were seriously injured. The investigation is continuing.
During agricultural spraying operations, the aircraft struck a power line and
hit terrain.
The balloon landed heavily near power lines. The investigation is continuing.
During take-off, the helicopter struck and severed a power line, resulting
in third degree electrical burns to a three-year-old child. The investigation
is continuing.
The aircraft landed heavily, resulting in the nose landing gear collapsing.
The aircraft was seriously damaged.
It was reported that the agricultural aircraft collided with terrain.
The investigation is continuing.
The aircraft landed heavily, resulting in serious damage.
During the approach, the engine failed. During the subsequent forced
landing, the aircraft sustained serious damage. The pilot had forgotten
to change fuel tanks.
The helicopter crashed into the sea. The investigation is continuing.
During agricultural operations, the aircraft performance degraded.
The pilot applied maximum continuous power and dumped the load, but
the aircraft struck trees and came to rest on a creek bank.
The aircraft landed short of the runway and struck raised terrain.
The investigation is continuing.
The helicopter was engaged on aerial survey operations when it impacted
a farm dam at low speed. The investigation is continuing.
While conducting aerial work the helicopter sustained a tail rotor strike and
landed heavily. The investigation is continuing.
During mustering operations, the helicopter landed hard, resulting in
serious damage.
During mustering operations, the helicopter impacted terrain.
The investigation is continuing.
During air transit, the helicopter impacted terrain and was destroyed by fire.
The investigation is continuing.
The aircraft encountered wind shear during approach, stalled at 20ft AGL
and landed heavily.
During the cruise, the engine began to lose power. As the aircraft would
not maintain height, the pilot conducted a forced landing in a paddock.
The operator reported that the power loss was due to fuel starvation.
It was reported that during spraying operations, the aircraft collided
with terrain.
Text courtesy of the Australian Transport Safety Bureau (ATSB). Disclaimer – information on accidents is the result of a cooperative effort between the ATSB and the Australian aviation industry.
Data quality and consistency depend on the efforts of industry where no follow-up action is undertaken by the ATSB. The ATSB accepts no liability for any loss or damage suffered by any person or
corporation resulting from the use of these data. Please note that descriptions are based on preliminary reports, and should not be interpreted as findings by the ATSB. The data do not include sports
aviation accidents.
19
ACCIDENTS/INCIDENTS
22 Apr
Cessna 172N/A1
Description
During the landing roll, the aircraft encountered a tailwind. The pilot
attempted to conduct a go-around, but there was insufficient lift and the
aircraft collided with a fence.
During a touch-and-go landing, the pilot inadvertently retracted the landing
gear, resulting in the nose sliding along the ground and both propellers
striking the ground.
During a go-around, the aircraft clipped a sand dune and landed in two feet
of water. The investigation is continuing.
Passengers behaving badly
FSA JUL-AUG 2011
20
Back when jets were noisy, passengers were quiet, or so the old
hands in the cabin say. In the era when turbojets on Boeing 707s
screamed and spewed black smoke people used to dress up to fly
and the notion of unseemly behaviour on such a special occasion
was unthinkable (although admittedly, many passengers were also
spewing clouds of smoke)
Contrast this far-off era with the tube-train reality of catching a flight
in 2011. A passenger waiting in the Qantas Club lounge in Perth for a
flight to Karratha is obviously somewhat ‘tired and emotional.’ Staff
ask whether he has had anything to drink and he denies it. ‘Maybe we
could organise a flight for you tomorrow sir?’ ‘No, I want to get on this
flight!’ The ground crew and their manager are keen to continue with a
conciliatory approach, but security has been called and once they turn
up the situation escalates, ending with the Australian Federal Police
arriving and the passenger having to be muscled away by ‘two huge
officers’. If this passenger had made it on to the flight and continued to
be aggressive how would the cabin crew have handled him?
The customer often feels that anything goes
once the ticket is paid for, and the holiday
begins in the bar as soon as check-in is
completed. It is a sad but irrefutable fact that,
nowadays, many customers believe that the
customer is always right!’
As the cost of air travel has fallen, so too has the standard of passenger
behaviour, says the conventional wisdom, but does the evidence
support it?
The Australian Office of Transport Security
says there were 7.2 ‘disruptive person’
incidents per million passengers carried
in Australia in 2010. This definition
of
‘disruptive person’ incidents covers
inappropriate
comments,
intoxication,
smoking, altercations and other unruly
behaviour by passengers.
In their 1999 paper on disruptive passengers, Roy Humphreyson and
Nick Kotsapas argued, ‘In the past, travel by air was the privilege of
the well-off and often the better educated. The introduction of cheap
mass air travel has opened up the market to many people who would
otherwise have travelled by train or coach. This, combined with the
stresses associated with airports and flying, pushes some individuals
over the top.
American passengers are almost saintly by
comparison, with the number of serious air
rage incidents reported to the US Federal
Aviation Authority falling steadily since 2004,
when there were 304. In 2010, there were just
92 incidents reported on board aircraft, or
about one per six million passengers carried.
‘When they smoke in the bathroom, abuse crew, call crew names and
say they are going to get their families. That's pretty much what I
mean,’ said Dave, cabin crew trainer.
By that measure Australians are about twelve
times as likely to disgrace themselves on a
plane as Americans.
‘Passengers expect instant gratification and
there are just not enough consequences
for abusive behaviour’, says Jo Justo of the
Australian Services Union. ‘The advent of
check-in machines has meant that many
ground crew are now wearing duress
alarms under their collars because they no
longer have a counter to protect them from
frustrated and abusive passengers.’
According to Humphreyson and Kotsapas,
‘The crew needs a clear understanding of
company policy and a firm belief that the
company will back them in implementing
that policy. The increasing tendency for cabin
crew to operate under marketing rather than
operations can lead to divided loyalties.’
However, cabin staff told Flight Safety
Australia that lack of support from airline
management makes the problem worse.
‘The simple fact is people don’t care any
more,’ a domestic cabin crew member with
a major Australian airline said. ‘They don’t
want to do as they are told. They don’t
want to consider us as safety professionals.
The company puts an emphasis on service,
allowing passengers to make themselves
comfortable and enjoy the flight, but at the
cost of safety, as our directions are rarely
adhered to upon first request.’
21
Cabin crew can’t escape from violence and if physical violence does
occur, it may be difficult for the victim/s to take legal action because
of inconsistencies in international law.
The International Transport Workers’ Federation knows of instances
where passengers who have been restrained following assaults on crew
have sued the carriers concerned, but the airline and crew members
have been unable to take legal action because of jurisdictional issues.
A partial explanation for the lower air rage rate in the US might
be how seriously it is taken in law. After 9/11, the US Congress not
only introduced increased security measures, but also a federal law
prohibiting ‘airport rage’:
An individual who assaults an air carrier employee who
has security duties within the airport, or interferes with
the performance of the duties of the employee or lessens
the ability of the employee to perform those duties, shall
be fined, imprisoned for not more than 10 years, or both. If
the individual used a dangerous weapon in committing the
assault or interference, the individual may be imprisoned for
any term of years or life imprisonment.
There is no similar single law in Australia, although it is (technically)
an offence to board an aircraft while drunk.
Linda White, the Federal Secretary of the Australian Services Union,
says governments and the industry must adopt a zero tolerance
attitude to disruptive behaviour and adopt all possible measures to
minimise the risk.
CABIN CREW
Cabin crew members and trainers
contacted for this story were not surprised
by these statistics. The numbers bear out
their experiences of increasing rudeness,
aggression and assault in the sky.
Another cabin attendant agreed. ‘I can honestly say most cabin crew
feel they do not have the full support of management. They are very
keen to keep the customer satisfaction and business, but less willing to
support the cabin crew who are attempting to adhere to policies and
procedures. We are put in a difficult position, where most crew want
to do what's right, and safe, and follow procedure, but face retribution
and disciplinary action if passengers make complaints. I wish more
CASA representatives flew more often, almost like air marshals, to
be able to give warnings and maybe even fines to those who refuse
to comply.’
‘We have to ask our governments and politicians how they would like
it if there was violence in their workplace. The parliament is a public
place, like an airport. Members of the public who threaten or assault
our politicians in parliament have police swarming everywhere, but
air rage bullies can often walk free, and can sometimes even be
uplifted or upgraded, instead of being banned!
‘It is also ironic that if someone jokingly, although wrongly, says, “I
should blow this place up”, or “I’ve got a bomb in my bag”, the reaction
is immediate; people start appearing from everywhere, and rightfully
so. However, if someone pushes you, abuses you, punches you,
threatens you or stalks you, the response is often much more muted.’
Identifying potential offenders is far from easy, however. Ground and
cabin crew need well-developed judgement skills when faced with
a passenger whose speech is slurred, who seems unsteady on their
feet, or is exhibiting unusual behaviour: Are they disabled, terrified of
flying, or under the influence of alcohol or drugs?
FSA JUL-AUG 2011
22
Many airlines now provide verbal and physical self-defence training,
but conciliation and negotiation skills are emphasised because crew
members would obviously much rather defuse a situation than have
to put a passenger in handcuffs, make a diversionary landing, or call
the police to meet the plane.
If the industry and regulators want to curb
bad behaviour they cannot put their head
in the sand when it comes to causal factors,
such as alcohol and drugs; smoking policies
and prohibitions, cabin baggage disputes,
poor communication about delays and other
service issues, the aircraft environment,
unrealistic expectations of the flying
experience, or fear of flying.
Whatever its cause, disruptive behaviour
can jeopardise the safety of the flight and
risk the lives of everyone on board. There
has not yet been an air disaster caused by
disruptive passenger behaviour, but many
in the aviation industry believe that it may
only be a matter of time. There should be no
part of the industry in any country in which
seriously disruptive passenger behaviour is
allowed to go unchallenged.
Office of Transport Safety ‘disruptive person on aircraft events’ 2008-2010
Events per million departing passengers
8
7
6
5
4
3
2
1
0
2008
2009
2010
Dirty deeds
‘Our plane landed during a severe storm and the air bridge
could not be rolled over because of the risk of lightning
strike. A passenger next to me was punching the ceiling
because he was not allowed off the plane!’
Business traveller
‘A woman attacked cabin crew and threatened fellow
passengers because she and her companions were
refused any more alcohol. It turned out that she and her
companions were US forces personnel on their way to
drug and alcohol rehabilitation.’ Flight attendant
In Australia, captains have the legal power of arrest, but
as they are unable to leave the flight deck, the cabin crew
act as their deputies to physically restrain disruptive
passengers. Obviously, the captain must be informed, and
appropriate documentation submitted.
On a flight with only one cabin attendant, the crew
member stopped to attend to a passenger who had
collapsed (and unfortunately died) and was thoroughly
abused by a female passenger for not attending to her.
Flight attendant
As far as following instructions are concerned, most
people have adopted a ‘me first’ attitude and refuse to
stay seated once the plane has landed. On one flight,
the pilot cruised up to the gate and then put on the
brakes really hard. Anyone standing—and that should
have been no one—was thrown forward and hit the
carpet. An excellent strategy which should be used
more often! Frequent flyer
Relevant regulations:
CAR 309 Arrest of passengers
CAR 256AA Disorderly behaviour/alcohol
23
CAR 138, CAR 215(9) Compliance with instructions
Civil Aviation Act Section 24 Interference with
aircraft or equipment.
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FSA JUL-AUG 2011
24
)DUDZD\VRFORVH
Photo: Saab Systems
25
The day’s last flight touched down as the blazing outback
sun was hovering over the horizon like a welding torch.
Heat rippled over the runway as the whine of the idling
jet interrupted the desert stillness as it taxied towards
the demountable building that served as a terminal. The
controller who had guided the plane through the last phase of
its journey contacted the pilots a final time to sign off with the
traditional pleasantries of aviation. Then she turned off the
screens, walked down the stairs and emerged into a bustling
street in a part of the city renowned for its vibrant nightlife.
This could be a picture of air traffic control in remote and
regional Australia ten years from now, if a joint project
between Saab Systems and Airservices Australia lives up to
its early promise.
Remote tower technology, originally developed in
Sweden, is under consideration for directing air traffic at
Australia’s far-flung aerodromes.
Saab developed the system with Sweden’s airways
provider, Luftfartsverket, (LFV), as partner. After live
testing it was launched in Sweden in 2009. Remote tower
technology allows for air traffic at several small and
medium-sized airports to be managed and controlled
from a single air traffic control centre, reducing costs
and at the same time increasing efficiency and safety, its
developers say.
Saab says the technology can introduce new features, such
as object tracking and alerting, infrared vision and image
enhancement, to improve the controller’s situational
awareness. An on-site controller looking through a
window would see an aircraft with the aid of binoculars,
but a controller viewing the same scene remotely could
see the image magnified on the screen with the aircraft’s
type, registration, altitude and airspeed displayed and
could be alerted by predictive software if it was in danger
of collision with other aircraft in the vicinity. The videos
shown on the screen could be recorded for use in safety
investigations, or training, further enhancing safety,
Saab says.
In
March
2010,
Airservices
Australia
signed
memorandums of understanding with LFV and Saab to
explore using remote towers in Australia. New Zealand’s
Airways Corporation joined the partnership in December
2010. Airservices and Saab signed a contract in June for a
trial of the system.
The Airservices trial will take place in Alice Springs,
Airservices general manager of air traffic control, Jason
Harfield, told the March 2011 ATC Global conference in
the Netherlands. ‘The drivers for the adoption of remote
tower technology are slightly different in Australia to
those in Europe,’ Harfield told the conference. ‘We
are not required to provide control tower services for
all RPT aircraft, as are some European air navigation
service providers,’ he said, going on to explain that many
Australian regional airports dealt with a roughly equal
mix of IFR and VFR traffic and that Alice Springs handled,
on average, only 65 aircraft movements a day.
FAR AWAY, SO CLOSE
New camera, computer and communication
technologies mean the controller in the
tower of the future may no longer be at
the airport.
Another significant issue was that the price of a data
connection between the aerodrome and the control site
would be different in Australia, Harfield said. ‘Fortunately,
data communications costs have been reducing over time
and we expect them to continue to do so.’
He quoted OECD data from 2009, which found that
Australian broadband communications costs were
amongst the highest in the world; nearly double those of
the United Kingdom and Sweden, although not as high as
in Norway.
FSA JUL-AUG 2011
26
Harfield said the driver for remote tower technology in
Australia was the ability to provide services to several
aerodromes from a single location. This would become
important as the minerals boom brought larger aircraft
and more traffic to formerly sleepy outback aerodromes.
He gave the example of Karratha, in Western Australia,
where the control tower reopened last year to cope with
increased fly-in-fly-out traffic associated with mining.
Describing Karratha’s isolation, hot weather and high
rents to his European audience he concluded: ‘Attracting
controllers to work in such arduous conditions over a long
period will become more challenging as time goes on …
we can locate the remote tower centre in much more
lifestyle-beneficial areas.’
However Harfield acknowledged that distinctive Australian
conditions meant the system would need development to
work as well here as it had in the Swedish trials.
The mix of VFR and IFR traffic meant Australian
controllers often relied on visual separation in the circuit
area. ‘Our remote tower technology solution must provide
enough fidelity to ensure our controllers are comfortable
to use visual separation, as well as meet any regulatory
requirements.’
Another contrast with Europe was that large areas of
Australia did not have radar surveillance coverage. ‘This
issue, along with the use of visual separation I mentioned
before, requires Airservices to carefully evaluate the
visual component of the available technology above all
others,’ he said.
Australia also has distinctive climatic conditions to
consider. ‘In comparison with the snow, fog and lowtemperature issues that LFV will face with their remote
tower at Sundsvall, we will have to deal with heat, dust
and very occasionally, heavy rain at our site in Alice
Springs. We may not have to melt the snow off the camera
housing but we probably will have to blow the dust off the
camera windows,’ he told the conference.
Photos: Jan Goosen
Airservices stresses that during the Australian trials
there will be no change to existing air traffic control
arrangements. Any decision to introduce the technology
to non-controlled aerodromes would involve industry
consultation, safety assessments and regulatory
approval from the Civil Aviation Safety Authority (CASA),
Airservices says.
‘We intend to work closely with CASA to ensure that they
understand the technology and Airservices’ approach to
its use in Australia,’ Harfield said.
‘Such a leading-edge technology will take a considerable
amount of thought and discussion before gaining
regulatory approval for its use.’
CASA air traffic services specialist, Jan Goosen visited
Sweden last year to inspect the Saab/LFVsystem. He was
impressed by the clear view of the aerodrome surroundings
from the remote tower which were unobstructed by
building support columns, as they are in most control
towers. The augmented reality display that projected
radar position information onto the visual displays also
impressed him.
‘Aircraft beyond normal view can be projected on the
display as a labelled radar track, and aircraft within view
can be tagged with a label including call sign and other
relevant information,’ he says. ‘This means controllers
gain a earlier awareness of aircraft in the vicinity of the
aerodrome than is possible by optical means alone. This is
a significant situational awareness benefit.’
Goosen noted some challenges and teething problems.
Ambient lighting had to be kept low for the projectors to
display well, which made for a less-than-ideal working
environment, he found. Later versions will use LCD
display screens that should overcome this. Controllers
who participated in the trial told him it could be difficult
to judge relative distance and/or position between aircraft
when they had to provide visual separation instructions.
The use of a 270-degree display of a 360-degree view
was an unknown factor. The trial suite had a 360-degree
display but Goosen says the proposed 270-degree display
‘will obviously have distortion issues that will need to
be overcome.’
Goosen also spoke with the LFV about their view of remote
tower technology. ‘LFV does not consider a remote tower
to be the direct equivalent of a conventional control
tower. Rather, remote tower technology is a type of
aerodrome control that fits between AFIS and a manned
control tower.
‘This is a fair assessment of the potential of the system.
Remote technology could provide an extra tool in
the kit for aerodrome operations risk management,’
he concluded.
',67$17&286,16
Remote tower concepts are also being developed in
at least two other locations.
Germany’s air traffic management provider, the
Deutsche Flugsicherung (DFS), plans to install a
‘distant aerodrome control service’, or virtual control
tower visual in its Munich tower to enable controllers
to manage traffic using a new third runway if it
goes ahead.
Munich’s proposed new runway, 26R/08L, would
be north of the two existing parallel runways, and
would not be visible from the existing control tower.
Instead of building a supplementary tower the DFS
proposes using high- resolution video cameras linked
to the existing tower to watch the activity on the
new runway.
In 2009, London Heathrow Airport commissioned an
emergency remote control tower that was specified
to be able to handle 75 per cent of a normal day’s
traffic. The system, which is at an undisclosed location
away from the airport, is ready to be deployed if fire,
failure, damage, disaster or attack disables the main
control tower, Flight International reported.
FAR AWAY, SO CLOSE
‘This issue may be overcome by the availability of radar
information on a plan position indicator (the controller
has a bird’s eye view of aircraft relative positions) and
by technique (more reliance on the pilot to see and then
follow/avoid),’ Goosen says.
27
Volcanic fallout continues
Volcanoes remind us that this was a small planet even before the
invention of the jet airliner. As this issue of Flight Safety Australia went
to press, airline flights in Australia had been cancelled because of
a volcanic eruption in Chile. Ash from the Puehuye-Córdon Caulle
massif blew westwards around the globe to disrupt air travel half a
world away. Flights were cancelled in locations as far apart as Hobart,
Perth and Darwin. At the time of writing Qantas, Jetstar and Tiger
Airways remained grounded but Virgin Australia had resumed flying.
Across the Tasman Sea, Air New Zealand services continued without
interruption, although at changed flight levels to avoid the ash cloud.
A Qantas spokeswoman said that airline’s reason for stopping flying
was that there was insufficient data on the density of the ash cloud.
At the time of writing, 283 flights had been cancelled and the
eruption was continuing.
FSA JUL-AUG 2011
28
Volcanic ash had been back in the air, and in the minds
of aviation professionals, since May, after Iceland’s
most active volcano, Grimsvötn, erupted. The eruption
produced an ash cloud raising renewed concerns that
there would be a return of the flight chaos experienced
in April 2010.
The eruption caused the cancellation of 1600 flights in Europe (of the
90,000 scheduled from 23–25 May).
Some transatlantic flights were also delayed, and US President,
Barack Obama, had to cut his state visit to Ireland a day short as a
precaution against Air Force One being grounded by the ash.
Grimsvötn’s ash plume billowed to 56,000ft (17,000m), almost twice
as high as that of Eyjafjallajökull the previous year, which reached
29,500ft (9000m). But geologists say Grímsvötn was not the towering
threat to aviation it appeared, because its ash had a lower silica
content—about 50 per cent—than the 63 per cent silica ash that had
spewed from Eyjafjallajökull in 2010. Silica is glass and silica ash is,
in effect, broken glass.
The basalt-based ash emitted from Grimsvötn was also coarser than
the smaller, more abrasive particles emitted from Eyjafjallajökull. As
heavier particles, they were less likely to drift a long way in a cloud.
However, particles of ash from Grímsvötn were found as far away as
Aberdeen in Scotland.
European authorities took a slightly different approach to Grímsvötn
than they had for Eyjafjallajökull the previous year. Flights were
cancelled in Britain, Sweden, Denmark and northern Germany,
but several European countries adopted a different basis for
airspace closure.
All European countries recognised three levels
of ash concentration: low, from zero to 0.002
grams per cubic metre; medium: 0.002 to
0.004 g/m3; and high, more than 0.004 g/m3.
Belgium, Denmark, Germany, Portugal and
Switzerland retained blanket bans on flying in
areas of high ash concentration.
France, Ireland, the Netherlands, Norway,
Spain and the United Kingdom allowed
flight in ‘temporary danger areas’ of high
ash concentration by operators who had
submitted a strategic risk assessment and had
it approved. The assessment was to include
information from tests, as well as information
from consultations between the operators and
aircraft manufacturers.
British Airways, and low-cost airline, Ryanair,
both conducted test flights into the highconcentration areas and said, after engineering
inspection of the aircraft, that they had found
no evidence of ash.
Ryanair’s outspoken chief executive, Tony
O’Leary, described the Grimsvötn ash cloud
as mythical.
He told the British Daily Telegraph: ‘For 50
years the airlines have been telling the public
that flying is some super-sexual experience
and is more complicated than brain surgery.
We've been blowing up that bull for 20 years.
It's no different from a bus or a train.’
However, the UK Civil Aviation Authority said
the Ryanair test flight had not entered the
high-concentration ‘red zone’.
Others were even more forthright.
‘Unfortunately, the speed of the scientific
process is nothing in comparison to that of a
certain Irishman’s tongue, but the evidence
is beginning to come together that the plume
crossed the northern part of the UK yesterday
as predicted,’ geologist and post-doctoral
student in volcanology at the University of
Edinburgh, John A. Stevenson, blogged.
According to the Bureau of Meteorology’s
Northern Territory regional director, Andrew
Tupper, ‘My impression was that the
Europeans did a better job this time than
last year.’
‘I think the warning system worked well.
The first motivation is to save lives and now
there‘s the refinement of making aviation run
as smoothly as it can.’
‘We’re still learning from the Eyjafjallajökull
eruption,’ he says. ‘There was a very large
database collected by aircraft that flew in
the plume, and matching that against the
concentrations of ash we think they flew
through is quite a large job.’
A volcanic eruption in Bali in January this
year saw Jetstar and Virgin Blue cancel flights
to and from the island.
‘There are in the order of 150 active volcanoes
in the countries immediately to our north, and
airlines routinely fly around areas of potential
activity. All routes to Japan, for example, pass
over areas where there are active volcanoes.
Our experience is that most airlines treat the
threat seriously and plan accordingly using
our advice.’
The Asia-Pacific has different volcanic and
weather conditions to the north Atlantic,
Tupper says.
‘One difference in the tropics is that volcanic
clouds don’t tend to linger. You don’t see that
situation as at Heathrow last year with a cloud
that just won’t go away.’
‘Our focus has been much more on making sure we know about
eruptions that are going to happen, rather than in Europe where they
have air traffic management issues.’
The nightmare volcanic ash scenario in this part of the world would
not be an ash cloud hanging for days over Asia or northern Australia,
but the more acute problem of an aircraft encountering ash from an
unmonitored and unreported eruption, Tupper says.
ICAO’s volcanic ash task force will hold its second meeting in Montreal
in July this year. A July conference of the International Union of
Geodesy and Geophysics in Melbourne is also affiliated with the ICAO
task force.
The four groups set up in the task force’s first meeting will report
their findings on four areas: air traffic management; airworthiness;
warning systems and scientific issues, including development of
remote sensing technology; and modelling of ash drift.
29
Tupper says this region’s distinctive volcanic, technological and
climate conditions will require a tailored volcanic ash policy.
‘If you’re modelling ash concentration and you tune it too heavily to
a particular eruption you might get a nasty surprise in a subsequent
eruption. If you’re assuming a system’s going to work because it’s
worked in Europe, in the most technologically advanced parts of the
world, you may find that it’s inappropriate in the developing world.’
‘The European system was brought in very quickly. Now we have to
work out whether it’s the best system for the rest of the world, or
whether we can do even better.’
Civil Aviation Safety Authority office of airspace regulation operations
manager, Graeme Rogers, says: ‘Although there are only two active
volcanoes within Australian territory - on the sub-Antarctic islands,
Heard and McDonald - CASA takes a very close interest in volcanic
ash issues because of the potential of so many active areas to our near
north to impact upon Australian aviation.
‘CASA is also anxious that there is a standard approach to airspace
regulation in relation to volcanic ash issues. Through the office of
airspace regulation, CASA is endeavouring to provide assistance in
developing appropriate procedures for the region.’
‘To this end, the authority is actively involved in the ICAO deliberations
on these issues and will be participating in a workshop associated with
the July meeting of the volcanic ash task force.’
Rogers says all parties in aviation have learned many lessons from
the recent volcanic events. ‘The July conference will be an important
chance to review the recent situation and build on what we can learn
from it.’
VOLCANIC FALLOUT
Volcanic ash is a major potential concern
in the region north of Australia, and there
have been major incidents in this region, he
says. ‘The most recent case of an aircraft
engine failure caused by ash in an aircraft
engine was over Papua New Guinea in 2006,
and the eruption of Mount Pinatubo in the
Philippines in 1991 produced more aircraft
ash encounters than any other eruption,’
Tupper says.
But while every active volcano in Europe is monitored, many of the
volcanoes in the Asia-Pacific are unmonitored.
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‘There is still no cure for the common birthday,’
lamented John Glenn. But as an astronaut who
first orbited the Earth in 1962 aged 30, and
then again in 1998, at 77, he is a case in point.
There is more to ageing than having had lots
of birthdays.
What the team has discovered, and emphasised in meetings with
aircraft operators, is that ageing affects every part of an aircraft.
When Glenn returned to space after 36 years
he engaged a personal trainer to prepare him
for the trip, results of which revealed that
his bone and muscle loss was no worse than
astronauts half his age, and his heart rate was
slightly lower.
Then there are the variables that affect the ageing process: van
Dijk runs through a list that includes hours, cycles, pressurisation
cycles (in applicable aircraft), operating environment, storage
environment, loading, accident damage, pilot handling style and
maintenance standards.
The difference between age and birthday
count has become very clear to CASA’s ageing
aircraft management team as they investigate
Australia’s aircraft fleet.
With little discernable change in the low rate
of new aircraft acquisitions over the last three
decades, ageing aircraft are here to stay. The
Australian Transport Safety Bureau has found
the average fixed-wing aircraft (single- or multiengined under 5700kg) is now approaching
40 years old.
‘The sad fact is every aircraft on the Australian register is ageing –
it’s just that the newer ones haven’t been exposed to the processes
of ageing for as long,’ CASA’s ageing aircraft management plan
project manager, Pieter van Dijk, says.
‘Ageing is more than just an airframe issue. It affects systems and
parts including avionics, electrical systems, fuel systems, hydraulic
systems, pneumatic systems, flight controls, seats, windows, doors,
and even locks.’
Consultant and presenter at CASA’s series of ageing aircraft seminars,
Dr Bob Holdsworth, elaborates. He says cumulative stress is a major
– and poorly understood – issue in the ageing aircraft debate. He
pithily sums up the relationship between stress and metal fatigue:
‘Metal has a memory. Metal never forgets,’ Holdsworth says. ‘It
always remembers what‘s been done to it. ’Metal fatigue imposed
early in an aircraft’s life is cumulative and will catch up with it many
years later, Holdsworth adds.
According to van Dijk, ‘there’s no simple definition of an ageing
aircraft, and no one-size-fits-all solution. But there are some general
conditions. If an aircraft is: more than several years old; has flown a
significant number of hours and cycles (take-offs and landings); has
31
AIRWORTHINESS
Since late last year, CASA’s ageing aircraft management project
team has been emphasising, on our website and in meetings around
Australia, that working out an aircraft’s effective age is a subtle
calculation. Those which are young in years may be old in health
and vice versa. Among the factors which must be considered are
usage, maintenance and climate.
PULL-OUT SECTION
A survey
completed as part
of CASA’s Ageing
Aircraft Management
Plan (AAMP) reveals a
simple message for pilots and
aircraft: ‘Take a closer look’.
PULL-OUT SECTION
FSA JUL-AUG 2011
32
been operated in a corrosive environment
such as in the dust, over the sea, or along the
coast, and is not supported by a continuing
airworthiness program that takes account of
ageing aircraft issues, it is more than likely
that it has ageing-related problems that will
need to be addressed.’
Under this broader, multifaceted definition of
ageing, a newer aircraft that has led a hard life
in a harsh environment can be ‘older’ than
one made many years earlier that has had
fewer flight hours, avoided heavy loads and
abrupt manoeuvres, and been stored under
cover in a dry environment. This expanded
definition also catches some relatively young
medium- and high-capacity aircraft in its net,
some of which had worrying combinations of
ageing aircraft symptoms, van Dijk says.
‘We’ve seen pressurised aircraft which
weren’t that chronologically old, but had
many thousands of hours, vague histories in
far-flung parts of the world and in a couple of
cases had been written-off and subsequently
rebuilt, with repairs on their repairs. The
consequences of ageing-related failure in
pressurised aircraft are of great concern
because structural failure can literally be
explosive.’
An important message not all aircraft
owners appreciate is that they, and not their
LAME/s, are responsible for their aircraft’s
airworthiness. ‘At some meetings owners
would say, “But doesn’t the LAME take care of
that?’ The answer is no. The aircraft owner/
registered operator has the responsibility to
keep the aircraft airworthy. The buck stops
with them.’
The practical implication of this is that owners/
registered operators of older aircraft should
think carefully about what maintenance
regime and commitment is appropriate to
keep their aircraft flying safely, van Dijk says.
The CASA maintenance schedule, which is in Schedule 5 of the CARs,
is widely misunderstood. Many think it replaces and relaxes the
manufacturer’s maintenance schedule.
In fact, CASA recommends owners and operators study
manufacturer’s maintenance schedules, ‘as it is considered that these
are generally more appropriate for the maintenance of the aeroplane.’
[CAAP 42B-1 (0)]
In other words, CASA regards Schedule 5 as a minimum maintenance
standard, which should be supplemented with relevant information,
checks and techniques for each individual aircraft type. ‘Schedule 5
is aircraft maintenance 101,’ van Dijk says. ‘It says to check for engine
oil level, missing rivets and inspect the internal structures and spars;
basic stuff. It doesn’t give advice on how to inspect the hidden parts
of an aircraft for corrosion and fatigue damage, which can only be
subtly apparent to the eye.’
But as some general aviation aircraft enter their fifth decade in
service, even following the manufacturer’s guidelines may not be
enough to keep them flying safely. ‘Some manufacturers’ systems of
maintenance are good, and meet or exceed what we would consider
as the necessary maintenance standard for an ageing aircraft, but in
many cases they do not,’ van Dijk says.
‘A manufacturer’s system of maintenance, written perhaps in the
1950s or the 60s is based on what was known about airframes,
fatigue and systems back then,’ he says.
‘In the 1960s the manufacturer would have expected their aircraft to
be in use for 20 years, at most, and those assumptions are built into
what they say in guidance.’
Disturbingly, in many cases, such documentation has not been
updated since this time to reflect the growing understanding of how
best to manage the issue of ageing.
Some of the most important aspects are the principal structural
elements. You need to look at as many of the key structural elements
in toto as possible, such as the main spar and longerons. Then there
are the control cables and avionics wiring, so that you’re not going to
get an in-flight failure or fire.
At the moment maintenance Schedule 5 may not necessarily provide
anywhere near that level of thoroughness. This stuff can kill you.
None of this is to say that older aircraft cannot be safely maintained,
van Dijk stresses. But it has quickly become apparent to the project
‘There’s nothing unsafe about having an ageing aircraft as long as you
give it the additional attention it needs,’ van Dijk says ‘Providing it is
looked after properly – and it will need more maintenance as time
goes by – it is likely to then be as safe as on the day it was made.’
That doesn’t mean an older aircraft is as good as a new one, however.
‘You should be aware that it will never have the same level of safety
features and safety performance as a newer, certificated aircraft
does,’ van Dijk says.
‘We’re talking about features such as fuel tank flammability reduction,
use of shoulder harnesses, a higher degree of crashworthiness in
seating, ballistic recovery parachutes and, in a few cases, airbagequipped seat belts. Even in long-running types such as the Cessna
172, you’d be better off in any survivable crash in the latest version
than in an older one, even if both aircraft had identical time.’
At the other extreme, one of the worst things the team has seen is
evidence of a new structural component, required by a manufacturer’s
supplemental inspection document (SID) program, fitted to a corroded
surrounding structure in a wing, totally negating the intent of the
SID. What’s probably happened is that an owner has said to a LAME
‘I am paying for the SID program installation and nothing else. But
implementing that SID program is pointless if the owner chooses to
ignore the existing surrounding structural integrity of aircraft. It was
penny-wise and pound-foolish in the worst possible way.’
Another very useful resource, particularly for smaller GA aircraft is the
network of type clubs and associations. ‘The depth of knowledge those
guys have is very impressive indeed,’ van Dijk says, citing examples
where type clubs have commissioned manufacturing runs of spare
parts no longer available from the manufacturer.
‘CASA fully supports the continued operation
of ageing aircraft, as long as it can be done
safely,’ van Dijk says.
‘What it comes down to is the importance of
taking a closer look at your aircraft’.
Safe keeping: aircraft
storage in the desert
Few things affect the condition of an
aircraft more than environment.
As if to emphasise the point, Alice
Springs Airport, in the dry air of central
Australia announced in May that it
would partner with Asia Pacific Aircraft
Storage to build Australia’s first aircraft
storage and recycling facility.
The press release was too polite to use
the word ‘bone yard’, but the intention
is to construct a similar facility to
American storage parks in Tucson,
Arizona, and Victorville, California.
Asia Pacific Aircraft Storage managing
director, Tom Vincent, said, ‘Alice
Springs Airport offers the ideal
conditions for such an operation to
be effective.’ The APAS website adds:
‘The facility benefits from an arid
desert environment characterised by
an average year-round humidity of
approximately 25 per cent, outside
Australia’s cyclone zone, low rainfall,
and low-lying, in situ vegetation that
provides additional dust suppression.’
33
AIRWORTHINESS
‘There are some people out there in industry who really understand
this well,’ van Dijk says. ‘There are engineers who are rebuilding
ageing aircraft and making them better than they were when new.
Often they remove significant weight by upgrading to modern avionics
and taking the opportunity to replace the ageing wiring at the same
time. They and their customers clearly understand that if you’re
going to operate an ageing aircraft it should be a new ageing aircraft.
Customers tend to flock to these revitalised aircraft.
‘It could be that that this store of knowledge
deserves a place in the formal airworthiness
system. Meanwhile, the type club would
be the first place for an owner to go to for
information or expertise on how to maintain
an aircraft.’
PULL-OUT SECTION
team that maintenance needs to become more comprehensive and
more targeted as an aircraft ages, and may even need to exceed
current regulatory and manufacturers’ standards.
SELECTED SERVICE DIFFICULTY REPORTS
1 April 2011 – 31 May 2011
Note: Similar occurrence figures not included
in this edition
AIRCRAFT ABOVE 5700KG
Airbus A320212 Rear cabin oxygen bottle
incorrect part. SDR 510012692
LH and RH rear cabin oxygen bottles and masks
incompatible. Mask could not be fitted to
bottles. Investigation found oxygen bottles PNo
9700C1ABF23A. Mask PNo 289-601-248.
P/No: 9700C1ABF23A.
PULL-OUT SECTION
Airbus A320232 Flaps locked at zero degrees
and would not deploy. SDR 510012599
Flaps would not deploy and were locked at zero
degrees configuration. Investigation continuing.
FSA JUL-AUG 2011
34
Airbus A321231 Pitot probe quick disconnect
blocked. SDR 510012717
No. 1 pitot probe quick disconnect blocked by a
piece of insulation blanket. Investigation continuing.
P/No: 1QF23S64A.
Airbus A330303 APU generator failed.
SDR 510012842
APU generator failed. Two large holes approximately
25.4mm (1in) square were found in the generator
case with cracking between the holes. Heavy
contamination of generator scavenge filter. Loss of
APU oil. Investigation continuing.
P/No: BA4104.
Airbus A380842 Air conditioning pack
hose burst. SDR 510012673
No. 2 air conditioning pack hose burst. Damage to
pneumatic crossover duct heat shield, leak detectors
and wiring insulation in air conditioning bay.
Investigation continuing.
P/No: L0003040100000.
Airbus A380842 GPS system failed.
SDR 510012844
Auto-land failed during flare/touchdown.
Investigation continuing.
Airbus A380842 Hydraulic ‘green’ system
leaking. SDR 510012667
Loss of all ‘green’ hydraulic system fluid.
Investigation continuing.
BAC 146300 Lower cargo door leaking from
upper release catches. SDR 510012407
Loss of pressurisation. Investigation found leaking
from lower cargo door upper release catches.
No sealant was found at attachment to door inner
face skin. Inner catch o-ring seals deteriorated.
Several small leaks also found at main upper cargo
door and entrance doors.
Beech 1900C Vertical stabiliser rear spar
angle corroded. SDR 510012460
Vertical stabiliser rear spar LH and RH boom
angles PNo 101-640010-9 and PNo 101-640010-10
corroded.
P/No: 10164001010.
Beech 1900C Wing bonded panel partially
delaminated. SDR 510012505
RH wing bonded panel partially disbonded in flight.
P/No: 1141200601.
TSN: 30,170 hours/38,428 cycles.
Boeing 717200 Hydraulic pump ‘V’ band
clamp failed. SDR 510012421
LH engine driven hydraulic pump ‘V’ band clamp
failed allowing pump to separate from accessory
gearbox. Pump splines damaged.
Gearbox drive splines showed signs of fretting.
Investigation continuing.
P/No: 24974.
Boeing 737476 Elevator control rod bearing
seized. SDR 510012558
RH elevator control rod aft bearings seized.
Found during inspection iaw EI 737-27-108 R1.
P/No: 654518614.
Boeing 737476 Elevator hinge plate bushing
missing. SDR 510012596
RH elevator No. 3 hinge outboard attachment
plate bushing missing. Bearing worn beyond limits.
Investigation continuing.
Boeing 737838 Wing flap track attachment
bolts missing. SDR 510012729
No. 3 flap track aft attachment bolts (2off) missing.
Track loose. Investigation continuing.
P/No: 113A92182.
Boeing 737476 Engine bleed air tripped off.
SDR 510012449
RH bleed air tripped off in cruise. Investigation
found No. 2 engine fan air valve failed.
Boeing 7378BK Wing fuel tank access panel
leaking. SDR 510012542 (photo below)
LH wing fuel tank access panels No. 5 and No. 6
leaking due to dome nut cracking.
Panels P/No 112N6101-2 and PNo 65033095-2
(532CB and 532DB).
P/No: 112N61012.
Boeing 737476 Main landing gear tyre
punctured by FOD. SDR 510012595
Main landing gear No. 4 tyre punctured by Foreign
Object Damage causing an approximately 50.8mm
(2in) cut through the tread. Investigation found
the FOD was a thrust reverser bumper which
had separated from another aircraft. See SDR
510012593. P/No: 6558256262.
TSN: 29,496 hours. TSO: 172 hours.
Boeing 737476 PCU reaction link bearing
corroded. SDR 510012801
RH aileron power control unit (PCU) reaction link
lower bearing rusted. Aileron spring cartridge
bearing also rusted and ‘notchy’.
Boeing 73776Q Autopilot TAT sensor failed.
SDR 510012606
Autopilot system total air temperature (TAT)
sensor failed.
P/No: 102AH2AG. TSN: 14,414 hours/7,805 cycles.
Boeing 7377BK Flap system locked.
SDR 510012572
Flaps locked at position 1 during approach.
Investigation could find nil faults.
Boeing 7377Q8 Angle of attack sensor
unserviceable. SDR 510012656
LH angle of attack sensor faulty.
P/No: 0861FL1. TSN: 20,902 hours/14,749 cycles.
Boeing 7377Q8 Wing fuel tank access
panel anchor nut dome cracked/leaking.
SDR 510012782
RH wing fuel tank access panel 632FB leaking due
to a cracked anchor nut dome.
Boeing 737838 APU bleed air system fumes.
SDR 510012800
Burnt rubber smell in cabin. Initial investigation
found slight APU oil leak into bleed air system.
Investigation continuing.
Boeing 737838 Engine failed to go to idle when
thrust levers moved. SDR 510012762
No. 2 engine failed to go to idle when thrust levers
moved to idle position. No. 2 fluctuating up to 0.7
per cent. Investigation continuing.
Boeing 737838 First officer’s pitot/static
probe suspect faulty. SDR 510012458
First officer's pitot/static probe suspect faulty due
to nil pitot heat. Investigation found open circuit
on pins 41 - 15.
Boeing 737838 Horizontal stabiliser trailing
edge panel delaminated. SDR 510012454
Upper horizontal stabiliser inboard trailing
edge panel delaminated. Area of delamination
approximately 228.6mm by 330.2mm (9in by 13in).
During repair, the area of disbond was found to be
more than initially thought. Investigation continuing.
P/No: 185A17011.
Boeing 737838 Integrated standby flight
display failed. SDR 510012859
Integrated Standby Flight Display (ISFD) failed.
Investigation continuing.
P/No: C16221KA02. TSN: 12,970 hours.
TSO: 12,970 hours.
Boeing 737838 Standby rudder PCU leaking.
SDR 510012834
Standby rudder power control unit (PCU) leaking.
Investigation continuing.
P/No: 3812001001. TSN: 26,490 hours.
TSO: 26,490 hours.
Boeing 7378FE Engine IDG unserviceable.
SDR 510012498
No. 1 engine integrated drive generator (IDG) failed.
P/No: 761574B. TSN: 29,532 hours/15,195 cycles.
TSO: 17,129 hours/7,237 cycles.
Boeing 7378FE Rudder Main power control
unit leaking. SDR 510012846
Rudder main power control unit (MPCU)
leaking beyond limits from rod dynamic seal.
Investigation continuing.
P/No: 4193001003.
TSN: 28,924 hours/16,620 cycles.
Boeing 7378FE Wheel well fire detector
unserviceable. SDR 510012403
RH wheel well fire warning loop kinked in one radius
and had low resistance giving false fire indication.
P/No: 0490010110D.
Boeing 737BBJ Display electronic unit
unserviceable. SDR 510012545
No. 1 display electronic unit (DEU) failed.
P/No: 4081600930.
Boeing 737BBJ Flight management computer
failed. SDR 510012576
Dual flight management computer (FMC) failure.
Investigation continuing.
Boeing 747438 Control display unit failed.
SDR 510012679
RH control display unit (CDU) screen blank with
strong electrical burning smell.
P/No: 4058650904.
Boeing 747438 Wing inboard trailing edge flap
damaged - bird strike. SDR 510012442
RH wing inboard trailing edge mid flap damaged
by bird strike in area of leading edge. Hole
approximately 127mm by 127mm (5in by 5in) at WBL
300. Investigation could find no further damage.
Boeing 747438 Wing landing gear trunnion
bearing nut loose. SDR 510012843
RH wing landing gear trunnion forward spherical
bearing retaining nut loose and lock bolts sheared.
Investigation continuing.
Boeing 767336 Galley drain line heater
ribbon burnt. SDR 510012794
Galley drain line heater ribbon burnt in half.
Investigation continuing.
P/No: 11552977.
Boeing 767336 Wingtip navigation light
smoking. SDR 510012592
LH wingtip navigation light smoking. Light was a
newly fitted item. Investigation found earth
bonding lead burnt in half and light reflector short
circuiting to live lamp post. Investigation continuing.
P/No: 3015885.
SELECTED SERVICE DIFFICULTY REPORTS ... CONT
Boeing 767338ER Hydraulic LCCA filter
housing o-ring split/leaking. SDR 510012682
Lateral central control Actuator (LCCA) filter
housing o-ring seal split and leaking. Investigation
continuing.
P/No: NAS1611029.
83260310-103. The skin pin was found to be rusted
and it is suspected that it had been lying in the
housing since the aircraft was manufactured before
eventually jamming the linkage. Foreign object
damage (FOD).
Boeing 767338ER Over-wing escape slide
bottle incorrectly assembled. SDR 510012693
LH over-wing escape slide bottle inflation trigger
cable incorrectly assembled. Cable ball was
installed behind the retainer spring of the pull force
increase mechanism.
P/No: 130104237.
Embraer ERJ170100 Forward passenger
door escape slide incorrect operation.
SDR 510012786
Forward passenger door escape slide failed to
deploy correctly during test.
P/No: 4A40305.
Bombardier DHC8402 Pilot’s outboard brake
cable incorrectly routed. SDR 510012481
Pilot's outboard brake cable incorrectly routed under
the cable keeper on the stick pusher quadrant.
Bombardier DHC8402 Rear emergency door
lock sensor failed. SDR 510012631
LH rear emergency door lock sensor failed.
P/No: 41020101.
Bombardier DHC8315 Engine torque signal
conditioner failed. SDR 510012610
No. 1 engine torque signal conditioner failed.
P/No: MM0316. TSN: 21,092 hours/20,084 cycles.
Bombardier DHC8402 Starter-generator
cooling fan separated. SDR 510012797
No. 2 starter-generator cooling fan failed and
separated from unit.
Bombardier DHC8315 GPS wiring removal incorrect procedure. SDR 510012675
When old GPS system removed from the aircraft,
removal of the associated wiring not carried out
in accordance with Australian Avionics EO 1288
Part 2. Some wiring was cut, but not capped, while
some wires were still connected to other operating
systems and remained live.
CASA C212EE Horizontal stabiliser flange
bracket cracked. SDR 510012581
LH horizontal stabiliser flange bracket cracked.
P/No: 21223100081. TSN: 1,798 hours/1,144 cycles.
Bombardier DHC8315 Nose landing gear door
sequence valve bolts sheared. SDR 510012550
Nose landing gear door sequence valve bolts
sheared. Loss of No. 2 system hydraulic fluid.
TSN: 22,657 hours/22,198 cycles.
Bombardier DHC8315 Stall warning computer
faulty. SDR 510012474
No. 2 stall warning system dual computer failed.
TSN: 12,763 hours/13,331 cycles.
Bombardier DHC8402 Elevator PCU centring
spring broken. SDR 510012766
Elevator power control unit (PCU) centring
spring broken.
TSN: 10,613 hours/12,179 cycles.
Bombardier DHC8402 Fuel tank probe FOD.
SDR 510012630
RH fuel tank No. 3 probe suspected damaged by
FOD. Part was a Hilock fastener and was found in
the fuel tank adjacent to the probe. Investigation
found signs that the part had been lodged in the
probe assembly.
Bombardier DHC8402 Galley urn terminal
loose/burnt. SDR 510012472
No. 2 galley urn connector loose/burnt.
Bombardier DHC8402 Generator failed.
SDR 510012755
No. 2 AC generator failed.
TSN: 8,922 hours/10,386 cycles.
Bombardier DHC8402 Nose landing gear
alternate release linkage jammed - FOD.
SDR 510012388 (photo following)
Nose landing gear alternate release linkage
jammed. Investigation found an aircraft skin pin
(Cleco pin) jamming the release tripping arm P/No
Embraer EMB120 Aileron trim system seized.
SDR 510012677
Aileron trim system solidly locked preventing
movement of trim wheel. Investigation continuing.
Embraer EMB120 Engine starter-generator
incorrectly fitted. SDR 510012712
No. 2 engine starter-generator separated from
engine during start. Investigation found startergenerator had been incorrectly reinstalled
following maintenance on previous day.
P/No: 2308013B.
TSO: 995 hours/547cycles/10 months.
Embraer EMB120 Main wheel inner hub
cracked. SDR 510012395
RH inboard main wheel inner hub cracked along
flange. Crack length approximately 254mm (10in).
Tyre bead was still seated and tyre was still inflated.
P/No: 314461.
Embraer EMB120 Nose landing gear steering
bearing incorrect part. SDR 510012711
Nose landing gear lower steering member
fitted with incorrect bearing. Aircraft was last
overhauled in USA.
P/No: 19829. TSN: 32,015 cycles.
TSO: 2,414 cycles/65 months.
Embraer EMB120 Rear pressure bulkhead
outflow valve faulty. SDR 510012685
Rear pressure bulkhead outflow valve prevented
from correct operation due to insulation blanket
separation.
Embraer EMB120 Rudder actuator
unserviceable. SDR 510012875
Rudder actuator unserviceable. Suspect
internal leak.
P/No: 3081401003.
Embraer ERJ170100 APU fuel line leaking.
SDR 510012489
APU fuel feed line leaking from swaged fitting
located at forward bulkhead/firewall at Frame 100.
P/No: A95481.
Embraer ERJ190100 Hydraulic pump pressure
line worn. SDR 510012425
No. 2 engine driven hydraulic pump pressure line
chafed by ‘P’ clip in upper aft area of RH pylon.
Wear depth approximately 0.2286mm (0.009in)
which is beyond limits.
P/No: 19005170401.
Embraer ERJ190100 Multi function display
unserviceable. SDR 510012776
No. 1 multi-function display (MFD) unit
unserviceable.
P/No: 7037620813. TSN: 7,075 hours/4,740 cycles.
Embraer ERJ190100 Pitot/static/AOA sensor
suspect faulty. SDR 510012720
Integrated pitot/static/AOA sensor suspect faulty.
P/No: 2015G2H2H8A.
TSN: 2,943 hours/1,735 cycles.
Embraer ERJ190100 Primary actuator control
electronic unserviceable. SDR 510012598
No. 2 primary actuator control electronic (PACE)
unserviceable.
P/No: 7028273822. TSN: 8,188 hours/5,670 cycles.
Fokker F27MK50 Wing skin corroded.
SDR 510012828
LH centre wing lower skin contained exfoliation
corrosion located in area forward of panel 923AB
and adjacent to anchor plate screw. Area of
corrosion approximately 15mm (0.59in) to 25mm
(0.98in), with a maximum depth of 1.8mm (0.071in).
Fokker F28MK0100 APU unit seized.
SDR 510012674
While investigating defect SDR 510012647
(damage to rear of aircraft and failure of duct
seal), it was found that the APU had seized.
Investigation continuing.
P/No: 38005142. TSO: 119 hours/116 cycles.
Fokker F28MK0100 Cargo bay fire extinguisher
cartridge discharged. SDR 510012698
Cargo bay No. 2 forward fire extinguisher cartridge
fired. Suspect cartridge had been fitted in a fired
condition. Investigation also found cartridge had
incorrect serial number. Found during inspection
iaw MCN 2620-2110B.
35
AIRWORTHINESS
Bombardier DHC8315 Master caution light
triggered intermittently. SDR 510012518
Master caution light illuminating intermittently
with no accompanying caution light. Investigation
found master caution triggered intermittently by
a blank module filter.
TSN: 23,653 hours.
Dornier DO328100 Fuselage inboard overwing panel separated. SDR 510012529
RH top fuselage inboard over-wing panel separated
in flight. Investigation continuing.
P/No: 001A538A0120101.
Embraer ERJ190100 Brake assembly hose
quick coupling failed. SDR 510012559
(photo below)
No. 2 brake assembly outboard hose quick
disconnect coupling failed and sprayed fluid on
to hot brakes.
P/No: 2000A0529K01.
PULL-OUT SECTION
Bombardier BD7001A10 Microwave oven fire.
SDR 510012570
Smoke from microwave oven when operated.
Door opened and then closed again automatically
restarting the oven. Flames could then be observed
in the oven. Investigation found the source of
the smoke and flames was a plastic packet of
wet towels in the oven for heating. Halon fire
extinguisher discharged to extinguish the fire.
TSN: 350 hours/112 cycles.
Embraer ERJ170100 Emergency door escape
slide internal shaft sheared. SDR 510012583
R2 door emergency escape slide deployed when
door opened. Door assist cylinder did not fire.
Investigation found flex-ball assembly internal shaft
had sheared.
P/No: 17084631401.
SELECTED SERVICE DIFFICULTY REPORTS ... CONT
Fokker F28MK0100 Engine fuel shut-off valve
incorrectly routed. SDR 510012696
RH engine fuel shut-off valve cable incorrectly
routed. Cable was rubbing on No. 1 hydraulic system
flexible line. Cable outer sheath worn through.
P/No: 189770004.
Fokker F28MK0100 Nose landing gear
downlock plunger contaminated.
SDR 510012641
Nose landing gear downlock plunger contaminated
with excessive grease causing the plunger to seize.
TSN: 27,510 hours/20,889 cycles.
PULL-OUT SECTION
Fokker F28MK0100 Passenger door escape
slide bottle empty. SDR 510012831
Passenger door escape slide nitrogen bottle empty.
Investigation continuing.
TSN: 52 hours/30 cycles. TSO: 52 hours/30 cycles.
FSA JUL-AUG 2011
36
Beech B200C Aircraft fuel system relief
valve incorrectly fitted. SDR 510012620
RH nacelle tank pressure relief valve fitted in
reverse with the flow arrow pointing in the
wrong direction.
P/No: 10138901131. TSN: 1,254 hours/1,545
landings/27 months.
Cessna 441 Wing upper spar cap inner angle
corroded. SDR 510012526
RH wing upper spar cap inner angle contained
exfoliation corrosion in area between CWS34
and CWS45. LH wing inspected with exfoliation
corrosion also found.
P/No: 572216525. TSN: 11,079 hours/10,570 cycles.
Cessna 150E Main landing gear stub axle
failed. SDR 510012571 (photo below)
LH main landing gear stub axle failed in area
located beneath brake caliper attachment plate.
Investigation found axle had been cracked for
some time.
P/No: 0541124. TSN: 8,448 hours.
Cessna 550 Main landing gear brake disc
cracked. SDR 510012855 (photo below)
RH main landing gear brake disc cracked causing
brakes to lock.
Fokker F28MK0100 Rudder flutter damper
shafts sheared. SDR 510012515
LH and RH rudder flutter damper rotating shafts
sheared. Investigation continuing.
Fokker F28MK1000 Stall warning computer
unserviceable. SDR 510012787
Stall warning computer unserviceable.
P/No: EASPC8503403.
Lear 45 Cabin inverter failed. SDR 510012633
Cabin sidewall power outlet inverter failed.
Investigation found unit had burnt out with soot
evident in the area of the cooling fan.
P/No: 100201021029. TSN: 62 months.
TSO: 1 month.
Lear 60 Aircraft fuel tank contaminated/
corroded. SDR 510012821 (photo below)
Inspection of wing fuel tanks found microbiological
contamination. Following removal of the
contamination, corrosion was found between tank
stringers and ribs.
Cessna 208B Engine emergency power lever
rubber cover poor design. SDR 510012429
Emergency power lever quadrant rubber cover
obscures emergency power lever gates. Improved
power lever quadrant is described in CAB06-3.
Cessna 208 Float water rudder cable pulley
corroded. SDR 510012525
Float water rudder cable pulley assembly corroded.
Cable ball had pulled through bracket. Suspected to
be caused by a combination of dissimilar metals and
saltwater environment.
P/No: 8A08000043. TSN: 1,946 hours.
Cessna 402C Elevator control cable
separated. SDR 510012394
Elevator control cable failed. Found during
SIDS inspection.
P/No: 52000841.
Cessna 402C Hydraulic reservoir sight
glass cracked. SDR 510012737
Hydraulic reservoir sight glass cracked.
Two replacement sight tubes also cracked
after two days.
P/No: P610053.
Lear 60 Engine starter-generator clamp bolts
failed. SDR 510012431
LH and RH engine starter generator clamp bolts both
snapped in smooth shank area of the bolt. LH starter
had moved slightly forward.
TSN: 610 hours/279 cycles.
Saab SF340B Nose landing gear strut to drag
brace pin fractured. SDR 510012619
Nose landing gear strut to drag brace attachment
pin failed. The end of the pin complete with nut and
cotter pin separated.
P/No: AIR129698. TSN: 26,315 cycles/26,315
landings. TSO: 11,652 cycles/11,652 landings.
AIRCRAFT BELOW 5700kg
Beech 200 Wing skin cracked. SDR 510012852
LH wing skin cracked in areas adjacent to three of
the upper forward wing attachment fitting screws.
P/No: 0001101091557200010230.
TSN: 12,187 hours/14,632 cycles.
Beech 58 Nose landing gear wheel bead
failed. SDR 510012803
Nose landing gear wheel bead failed allowing
nose wheel to separate from rim.
P/No: 3680025.
Cessna 404 Aircraft fuel indicator out of
calibration. SDR 510012690
Fuel quantity gauges over-reading. LH tank gauge
reading in excess of 100 pounds when tank was
virtually empty (4-5 litres left). Boost pump
unserviceable due to running dry. RH tank had
approximately 40 litres but gauge still reading
100 pounds.
Cessna 404 Elevator and aileron trim control
stop blocks missing. SDR 510012649
Elevator and aileron trim control system stop
blocks missing.
P/No: 51152141.
Cessna 404 Elevators jammed at full ‘nose up’
– elevator horns transposed. SDR 510012384
Elevators jammed when moved to full ‘nose up’.
Investigation found LH and RH elevator horns
transposed causing horns to foul on the fork end
of the elevator pushrod tube P/No 5815144-16.
Investigation also found aft elevator cables P/No
5815103-5 (LH) and P/No 5815103-6 (RH)
worn beyond limits with several broken strands.
Aileron cables found over-tensioned.
P/No: 581514534.
Cessna 441 Cabin door locks out of
adjustment. SDR 510012716
Cabin door locks out of adjustment. Loss of cabin
pressurisation due to flexing of door.
Cessna R172K Engine foam air filter element
split. SDR 510012566
Engine foam air filter element split. Filter had been
split for some time. Replacement filter element also
split after approximately 40 minutes operation.
P/No: BA24. TSN: 28 hours.
Cirrus SR22 Wing aileron hinge loose.
SDR 510012734
LH outboard aileron hinge loose. Further
investigation found two attachment bolts threadbound. AN-3-10A bolts had been installed.
Correct bolt AN3-6A. Aircraft being reassembled
after delivery from manufacturer.
P/No: 16817003. TSN: 1 hour/3 months
Diamond DA42 Main landing gear actuator
cracked. SDR 510012377 (photo below)
RH main landing gear actuator failed at end
bearing support. Evidence of corrosion cracking.
P/No: D6090290701 (X1100060000001).
TSN: 564 hours.
Gulfstream 500S Main landing gear trunnion
failed. SDR 510012837
LH main landing gear trunnion failed at retraction
cylinder attachment point.
P/No: ED12402. TSO: 505 hours/441 cycles/441
landings/6 months.
Kavanagh B400 Balloon burner load frame
cracked. SDR 510012539
Balloon burner load frame cracked adjacent to inner
join. During weld repair, hairline cracks were found
on other welds at the join.
P/No: LF148. TSN: 1,261 hours.
Partenavia P68B Rudder upper hinge bracket
cracked and corroded. SDR 510012763
(photo following)
Rudder upper hinge fitting failed due to intergranular
corrosion. Hinge spread apart allowing the hinge
bolt to detach. Investigation also found a fatigue
crack beneath the hinge on the rudder spar that had
been previously repaired.
P/No: 68340451.
SELECTED SERVICE DIFFICULTY REPORTS ... CONT
Bell 206B3 Cabin roof beam web cracked.
SDR 510012430 (photo below)
Cabin roof beam web P/No 206-031-200-016
cracked through. Crack length 105mm (4.13in).
Stiffener P/No 206-031-106-131 also cracked.
P/No: 206031200016.
TSN: 13,582 hours/370 months.
PISTON ENGINES
Continental GTSIO520M Engine oil
pressure relief valve faulty. SDR 510012410
RH engine oil pressure relief valve faulty.
Fluctuating pressure affecting governor and
preventing accurate RPM setting.
TSO: 949 hours.
Continental IO240B Engine stalled.
SDR 510012623
Engine stalled when pulled back to idle.
Suspect caused by low inertia in lightweight
propeller. Manufacturer has increased idle speed.
P/No: IO240. TSN: 3,602 hours.
Reims F406 Rudder jammed during taxi.
SDR 510012415
Rudder jammed during taxi. Rudder pedals then
became free again after engine shut down.
Investigation found the rate gyro and yaw damper
unserviceable.
Eurocopter BK117C1 Tail rotor servo hydraulic
line leaking. SDR 510012490
Tail rotor servo input pressure supply line leaking.
Loss of No. 1 hydraulic system hydraulic fluid.
P/No: 112043031.
Eurocopter EC120B Engine input flange
hole worn. SDR 510012688 (photo below)
Engine input flange assembly worn by incorrectly
fitted bearing.
P/No: C632A2181101.
Swearingen SA227AC Rudder control cable
frayed – incorrect routing. SDR 510012427
Rudder control cable badly frayed. Cable had been
incorrectly routed over the cable keeper instead of
the pulley. Cable is located under floor.
P/No: 2770001069. TSN: 50 hours. TSO: 50 hours.
Swearingen SA227DC Brake pedal pushrods
contacting clevis springs. SDR 510012635
RH brake pedal pushrods contacting clevis springs
when brakes operated at full rudder deflection.
Pushrods had been fitted 19 days previously.
P/No: 3272006003.
37
McDonnell Douglas 369D Tail rotor fork
elastomeric bearing worn. SDR 510012700
Tail rotor fork elastomeric bearing worn
beyond limits.
P/No: 369A1724.
Continental IO520C Engine cylinder cracked.
SDR 510012509 (photo below)
RH engine No. 2 cylinder cracked between spark
plug hole and exhaust valve.
P/No: AEC631397. TSN: 576 hours/67 months.
McDonnell Douglas 369E Main rotor
transmission ring gear failed. SDR 510012654
Main rotor transmission output ring gear failed.
Metal contamination of transmission.
P/No: 369D2512711. TSN: 577 hours.
Swearingen SA227DC Pneumatic de-ice
tubing broken. SDR 510012706
LH and RH airframe pneumatic de-ice tubing broken
and leaking. Tubing was deteriorated in area
located forward of aileron where tubing exposed
to direct sunlight.
P/No: 2787000147.
TSN: 13,223 hours/12,875cycles/204 months.
McDonnell Douglas 369F Fuselage skin
cracked. SDR 510012617
Fuselage skin cracked in area of upper engine bay
at FS 145. Crack length 139.7mm (5.5in).
Tecnam P2006 Wing leading edge ribs
damaged. SDR 510012504 (photo below)
LH and RH wing leading edge ribs damaged due to
contact with fuel tube. Nil damage to fuel tube.
P/No: 2611320. TSN: 266 hours.
Robinson R44 Tail rotor pitch control bearing
dry and rough. SDR 510012549
Tail rotor pitch control bearings dry and slightly
‘notchy’. Dust coming from bearing seal.
P/No: C0311. TSN: 982 hours/20 months.
Robinson R44 Main rotor head teeter
bearing worn. SDR 510012574
Main rotor head teeter bearing worn through.
P/No: C6483. TSN: 2,165 hours.
Schweizer 269C Main rotor blade leading
edge tip debonded. SDR 510012426
Main rotor blade tip leading edge abrasion strip
debonding on lower surface. Approximate area of
debonding 1sqcm (0.155sqin). Two blades affected.
Nil corrosion evident.
P/No: 269A11851. TSN: 3,454 hours.
ROTORCRAFT
Schweizer 269C Main rotor blade pitch
bearing brinelled. SDR 510012758
Main rotor blade pitch bearing set brinelled.
Found during inspection iaw 269C-1 HMI 8.26.
P/No: 269A1231. TSN: 579 hours.
Agusta Westland AW139 Tail Rotor rigging
tool incorrect part. SDR 510012396
Tail rotor actuator GAG tool suspect incorrect part.
Tool length 38mm (1.496in) where maintenance
manual quoted 44.5mm (1.75in).
P/No: 3G6705G02731.
Schweizer 269C Tail rotor gearbox shaft
splined adaptor teeth damaged.
SDR 510012760
Tail rotor gearbox input shaft splined adaptor
teeth chipped.
P/No: 269A6030005. TSN: 579 hours.
Continental IO550P Engine cylinder fuel
nozzle broken. SDR 510012796
No. 1 cylinder fuel nozzle cracked and broken.
Suspect manufacturing error. Bore appears to
be drilled offset.
P/No: 6570681234.
Continental TSIO520N Engine connecting
rod cracked. SDR 510012626
No. 3, No. 5 and No. 6 connecting rods cracked
in little end bushings. Found during engine
disassembly.
P/No: 655005. TSO: 415 hours.
Continental TSIO520N Engine crankshaft
oil transfer tube loose unserviceable.
SDR 510012627
Crankshaft oil transfer tube loose and
connecting rod bearings damaged. Found during
engine disassembly.
P/No: 649898. TSO: 1,354 hours.
Jabiru JABIRU2200 Engine cylinder cracked.
SDR 510012863
No. 4 cylinder cracked and leaking oil.
TSN: 679 hours. TSO: 4 hours.
Jabiru JABIRU3300 Engine cylinder exhaust
valve broken. SDR 510012561
No. 6 cylinder exhaust valve failed. Severe internal
damage to engine.
AIRWORTHINESS
Swearingen SA227AT Flap up hydraulic tube
failed. SDR 510012587
Flap up hydraulic tube failed in area adjacent to
hydraulic power pack. Tube is located in LH nacelle.
Loss of hydraulic fluid and pressure.
P/No: 2781032135.
PULL-OUT SECTION
Piper PA44180 Nose landing gear drag brace
cracked. SDR 510012809
Nose landing gear drag brace cracked.
P/No: 86280003. TSN: 5,384 hours.
Continental IO520C Engine connecting
rod failed. SDR 510012715 (photo below)
Two forward connecting rods failed at big end.
Crankshaft holed.
SELECTED SERVICE DIFFICULTY REPORTS ... CONT
Lycoming IGSO480A1E6 Engine cylinder
piston failed. SDR 510012775
LH engine No. 6 cylinder piston badly melted and
holed due to detonation.
Suspect caused by excessively lean mixture.
TSN: 288 hours/119 cycles/119 landings/6 months.
PULL-OUT SECTION
Lycoming IO540E1B5 Engine base studs failed.
SDR 510012742 (photo below)
LH engine No. 2 cylinder base studs failed.
FSA JUL-AUG 2011
38
Garrett TPE3315251K FCU under speed faulty.
SDR 510012428
RH engine fuel control unit under speed
governor failed.
P/No: 89352832. TSO: 890 hours/660 cycles.
GE CF3410E Engine FADEC unserviceable.
SDR 510012400
No. 2 engine Full Authority Digital Engine Control
(FADEC) unserviceable.
P/No: 114E7099G2. TSN: 1,682 hours/1,086 cycles.
GE CF680C2 Engine thrust reverser electromechanical brake failed test. SDR 510012533
No. 4 engine thrust reverser electro-mechanical
brake failed holding torque check due to
uncommanded voltage. Investigation found thrust
reverser central data unit (CDU) switch pack pins
closed circuit and deploy switch not activating with
thrust reverser in stowed position.
Lycoming IO540K1A5 Engine fuel pump drive
shaft failed. SDR 510012503
Engine driven fuel pump drive shaft failed.
Investigation found evidence of a pre-existing crack
in the shaft. Unit had been rebuilt approximately
21.5 hours previously.
P/No: 201F5003R. TSN: 21 hours.
GE CF680E1 Engine accessory drive shaft/
starter gear-shaft worn. SDR 510012669
(photo below)
Accessory drive horizontal driveshaft/starter
gear-shaft splines badly worn.
P/No: 9312M99P03.
TSN: 25,041 hours. TSO: 8,554 hours.
Lycoming O540E4C5 Engine cylinder pushrod
tube retainer spring broken. SDR 510012501
No. 2 cylinder pushrod tube retainer spring broken.
Further investigation found the retainers broken
in the other five cylinders. It was noticed that the
retainers were much less thick than normal.
P/No: LW14995. TSN: 311 hours.
Lycoming TIO540J2BD Engine cylinder
studs cracked. SDR 510012811
LH engine cylinder attachment studs P/No 38-13
and P/No 50-15 cracked and failed allowing cylinder
assembly to become loose and allow oil leakage.
P/No: 3813. TSO: 937 hours.
PWA PW150A Engine failed to start.
SDR 510012471
LH engine failed to start. Initial investigation
found hot section damage which prevented engine
rotation. Investigation continuing.
PWA PW206C Engine exhaust extension
‘V’ band coupling broken. SDR 510012768
LH engine exhaust extension ‘V’ band coupling
fractured through spot weld. Suspect manufacturing
fault. Damage to LH engine starter/generator
cable insulation.
P/No: A117A1052. TSN: 52 hours.
Rolls Royce BR700715A130 Engine HP turbine
blades failed. SDR 510012643
LH engine stage 1 high-pressure turbine blades
failed. Downstream damage also evident.
Fire bottles discharged. Aircraft inspected for
overweight landing. During hard/overweight landing
inspection a fuel leak was found at the LH rear spar
in the area of the main landing gear trunnion caused
by defective.
P/No: FW64379. TSN: 3,481 hours/2,116 cycles.
Rolls Royce RB211524G Engine failed.
SDR 510012826
No. 4 engine failed. Investigation continuing.
Lycoming O320E2D Engine carburettor
float porous. SDR 510012379
Carburettor float faulty. Float filled with fuel and
sank, causing the engine to flood and stop.
P/No: 30804. TSN: 140 hours.
Lycoming O360E1A6 Engine cylinder fuel
primer line broken. SDR 510012750
No. 3 cylinder fuel primer line broken at primer
nozzle. Small fire at start-up, which self
extinguished with minimal damage.
TSO: 2,225 hours.
PWA PW150A Engine FADEC failed.
SDR 510012850
RH engine full authority digital engine control
(FADEC) failed.
P/No: 8193007009.
TSN: 10,985 hours/12,741 cycles.
Rolls Royce RB211524G Engine low power.
SDR 510012765
No. 3 engine low take-off power. Investigation
continuing.
GE CF680E1 Engine low-pressure turbine
case cracked. SDR 510012694
RH engine low pressure turbine (LPT) case
cracked between 1 o'clock and 2 o'clock positions
approximately 139.7mm (5.5in) aft of the case
forward flange.
IAE V2533A5 Engine fuel tube worn.
SDR 510012806 (photo below)
RH engine fuel tube chafed by VSV actuator
to bellcrank link bolt.
P/No: 6A2145.
Rolls Royce RB211524G Engine tailpipe metal
contamination. SDR 510012752
No. 4 engine EGT rose to 850 degrees. N1 vibration
at 3.5. Engine shutdown. Initial investigation found
metal in the tailpipe. Investigation continuing.
Rolls Royce TRENT97284 Engine
uncommanded thrust increase. SDR 510012773
No. 1 engine uncommanded thrust increase.
Investigation continuing.
PROPELLERS
Hamilton Standard 14SF7 Propeller blade
cracked. SDR 510012819
LH propeller No. 1 blade cracked at blade root.
P/No: SFA13M1R0AD.
TSO: 2,911 hours/2,246 cycles/35 months.
McCauley 3FF32C501 Propeller blade latch
pin sheared. SDR 510012582
LH propeller went into full feather during shutdown.
Investigation found latch pins had sheared.
Aircraft had recently complied with AD/Prop/2.
Numerous similar problems shortly after compliance
with AD/Prop/2.
TSO: 1,583 hours.
Unknown make/model Engine tappets surface
pitted. SDR 510012761 (photo below)
Tappets contained surface pitting on face.
Metal contamination of engine.
P/No: 15B26064. TSN: 245 hours.
COMPONENTS
IAE V2527A5 Engine turbine disc corroded
in blade slot fir trees. SDR 510012701
First stage turbine disc corroded in blade slot
fir trees.
P/No: 2A5001. TSN: 19,695 hours/11,717 cycles.
TSO: 19,695 hours/11,717 cycles.
TURBINE ENGINES
Garrett TPE33111U Engine surged/flamed out.
SDR 510012769
RH engine surged and then flamed out. Scavenge
pump gear not rotating. Investigation continuing.
PWA PW119C Engine ECU sense line
contaminated. SDR 510012853
LH engine control unit (ECU) suspect faulty.
Investigation found salt contamination of
the P1.8 sense line. ECU replaced due to
suspect salt contamination of unit.
P/No: 8111804004.
BF Goodrich Co 313571 Main wheel faulty.
SDR 510012637
Wheel removed from aircraft as serviceable for
fitting to another aircraft. During receipt inspection
it was found that the wheel tie bolts and nuts were
the incorrect part number. The installed bolts were
AN bolts instead of MS21250-05022. The nuts
were single hex instead of 42FLW524 (12 point).
Nil evidence also of NDI inspection as required at
tyre change.
P/No: 313571.
Kavanaugh BalloonsKBS34 Burner valve
cracked. SDR 510012817
Balloon burner coil cracked.
TSN: 486 hours.
APPROVED AIRWORTHINESS DIRECTIVES
10 March - 24 March 2011
Rotorcraft
Eurocopter AS 332 (Super Puma)
Series helicopters
2011-0044-E - Doors - Cabin sliding and plugging
Doors - limitation
Eurocopter EC 225 Series helicopters
2011-0044-E - Doors - Cabin sliding and plugging
Doors - limitation
Below 5700kgs
Tecnam P2006T Series aeroplanes
Above 5700kgs
Airbus Industrie A380 Series aeroplanes
2011-0036 (Correction) - fire protection, nacelles/
pylons - wing pylon interface/double-wall fuel pipe
assembly - inspection/modification
2011-0041-E - Flight controls - aileron and elevator
servo controls - electronic centralized aircraft
monitoring (ECAM) and aircraft flight manual (AFM)
changes/installation prohibition
AMD Falcon 50 and 900 Series aeroplanes
2011-0049 - Fuel - fuel quantity sensor identification/replacement
2011-06-05 - Main Slat track downstop assembly
Boeing 747 Series aeroplanes
2011-05-11 - Hangar Fitting and Bulkhead of Forward
Engine Mount
2011-06-03 - Fuel System Motor Operated Valve
Actuator
Boeing 777 Series aeroplanes
2011-05-12 - Horizontal Stabilizer Jackscrew Fitting Karon Lined Bushing Inspection and Replacement
Bombardier (Boeing Canada/De Havilland)
DHC-8 Series aeroplanes
CF-2011-04 - Cracking of the outer wing fuel access
panel
British Aerospace BAe 146 Series
aeroplanes
2011-0048 (Correction) - Time limits/Maintenance
checks - airworthiness limitations - amendment/
implementation
British Aerospace BAe 3100 (Jetstream)
Series aeroplanes
2011-0016 (Correction) - Landing gear - main landing
gear to wing fitting - inspection/repair/replacement
Dornier 328 Series aeroplanes
Rolls-Royce Turbine Engines - RB211 Series
2011-0050 - Engine - right-hand (RH) fuel manifold
assembly - cleaning/replacement equipment
Radio Communication and Navigation
Equipment
2011-0043 - Mode-S Transponder Control Panels –
Modification
25 March - 7 April 2011
Rotorcraft
Bell Helicopter Textron and Agusta 212
Series helicopters
2011-08-01 - Main rotor - hub inboard strap fitting
Below 5700kgs
Aerospatiale (Socata) TBM 700 Series
aeroplanes
Cessna 180, 182 and Wren 460 Series
aeroplanes
AD/CESSNA 180/71 - Fuel system water drainage
placard - CANCELLED
Cessna 185 Series aeroplanes
AD/CESSNA 185/41 - Fuel system water drainage
placard - CANCELLED
Cessna 188 (Agwagon) Series aeroplanes
AD/CESSNA 188/41 - Fuel system water drainage
placard - CANCELLED
2011-0051 - Hydraulic power - hydraulic quantity
abnormal procedure - airplane flight manual change
2011-0046 - Time limits/maintenance checks maintenance requirements - implementation
2011-0062 - Engine - engine air intake cowl assembly
- piccolo tube - inspection
Avions de Transport Regional ATR 42 Series
aeroplanes
AD/ATR 42/22 - Vertical stabilizer - fin tip upper
closure rib - CANCELLED
Boeing 737 Series aeroplanes
AD/B737/307 Amdt 3 - main slat track downstop
assembly - CANCELLED
2011-08-51 - Cracking in the lower skin between body
stations (BS) 664 and 727
Gulfstream (Grumman) G1159 and G-IV Series
aeroplanes
AD/G1159/52 - avionics standard communication bus
8 April - 21 April 2011
Eurocopter AS 350 (Ecureuil) Series
helicopters
Cessna 206 Series aeroplanes
2011-0072 - Equipment and furnishings - emergency
flotation gear attachment brackets - inspection/
replacement
AD/CESSNA 206/42 - Fuel system water drainage
placard - CANCELLED
Cessna 207 Series aeroplanes
AD/CESSNA 207/30 - Fuel system water drainage
placard - CANCELLED
Cessna 210 Series aeroplanes
AD/CESSNA 210/59 - Installation of fuel system
water drainage placard - CANCELLED
Eurocopter AS 355 (Twin Ecureuil) Series
helicopters
2011-0072 - Equipment and furnishings - emergency
flotation gear attachment brackets - inspection/
replacement
Embraer EMB-500 (Phenom 100) Series
aeroplanes
Above 5700kgs
Airbus Industrie A319, A320 and A321 Series
aeroplanes
2009-10-01R3 - ADS sensors
2011-0069 - Landing gear - Main landing gear (MLG)
Gulfstream (Rockwell) 112 Series aeroplanes door actuator - monitoring/inspection
Airbus Industrie A330 Series aeroplanes
2011-07-13 - Elevator spar cracking
Gulfstream (Rockwell) 114 Series aeroplanes 2011-0073 - Fire Protection - Fire Detection Unit (FDU)
2011-07-13 - Elevator spar cracking
Pacific Aerospace 750XL Series aeroplanes
DCA/750XL/14 - Rudder pedal assembly - inspection
and repair
2011-06-10 - Turbine inlet temperature system
2011-0061-E - Landing gear - emergency accumulator
for landing gear extension - inspection/replacement
Tecnam P2006T Series aeroplanes
2011-0063-E - Landing gear - emergency accumulator
for landing gear extension - inspection/replacement
Above 5700kgs
Airbus Industrie A319, A320 and A321 Series
aeroplanes
2007-0065R2 (Correction) - Landing gear - extension
and retraction selector valves - inspection/
replacement
39
Rotorcraft
Bell Helicopter Textron and Agusta 212
Series helicopters
AD/CESSNA 205/19 - Fuel system water drainage
placard - CANCELLED
Tecnam P92, P96, and P2002 Series
aeroplanes
Fokker F100 (F28 Mk 100) Series aeroplanes
Airbus Industrie A330 Series aeroplanes
2011-0068-E - Rotors - Main rotor hub inboard strap
fitting - identification/inspection/replacement
Fokker F27 Series aeroplanes
2011-0047 - Standard practices - Electrical wiring
interconnection system - Instructions of continued
airworthiness
2011-0055 - Navigation - nose landing gear glide
slope antenna harnesses - replacement
2011-0056 - Electrical and electronic common
installation - pressure seal screws - replacement
2011-0058 - Pneumatic - pylon bleed duct inspection/replacement
Cessna 205 (210-5) Series aeroplanes
Piper PA-46 (Malibu) Series aeroplanes
Fokker F28 Series aeroplanes
Airbus Industrie A380 Series aeroplanes
2011-0060 (Correction) - Flight controls - elevator trim Fokker F100 (F28 Mk 100) Series aeroplanes
AD/F100/54 - time limits/maintenance checks tab elevator - identification/replacement
maintenance requirements - CANCELLED
2009-0194R1 (Correction) - wings - lower inner panel
- inspection/repair/modification
2011-0045 - Standard practices - Electrical wiring
interconnection system - Instructions of continued
airworthiness
replacement
-inspection/replacement
British Aerospace BAe 146 Series
aeroplanes
2011-0065 - Fire protection - baggage bay fire bottles
wiring looms
Embraer ERJ-170 Series aeroplanes
2011-04-01 - Airworthiness limitation section (ALS)
- changes
Fokker F50 (F27 Mk 50) Series aeroplanes
2011-0064 - rear fuselage lap joint
Piston Engines
Rotax piston engines
2011-0067-E - Ignition - magneto flywheel hub washer
- replacement
Turbine Engines
AlliedSignal (Lycoming) Turbine Engines LTS 101 Series
2011-08-06 - power turbine rotors
AIRWORTHINESS
Boeing 737 Series aeroplanes
AD/CF6/72 - Long fixed core exhaust nozzles CANCELLED
2011-07-01 - Long fixed core exhaust nozzles
PULL-OUT SECTION
2010-0022 - Oil - oil vent line - modification
2010-0121-E - Stabilizers - stabilator trim mechanical
actuator Seeger ring - replacement
2010-0129 - Landing Gear - nose landing gear (NLG)
hydraulic actuator - modification
2010-0143 - Landing Gear - nose landing gear (NLG)
steering assembly - inspection
2011-0042 - Landing gear - landing gear hydraulic
actuators - modification
2011-0054 - Electric and electronic common
Turbine Engines
installation - terminal modules - identification/
General Electric Turbine Engines - CF6 Series
APPROVED AIRWORTHINESS DIRECTIVES ... CONT
22 April - 5 May 2011
Below 5700kgs
Cessna 170, 172, F172, FR172 and 175 Series
aeroplanes
2011-06-02 - Prevention of interruption of electrical
power to the FADEC
PULL-OUT SECTION
2011-0058R1 - Pneumatic - pylon bleed duct inspection/replacement
Cessna 180, 182 and Wren 460 Series
aeroplanes
AD/PA-28/35 Amdt 2 - Main landing gear torque links
Piper PA-32 (Cherokee Six) Series aeroplanes
Cessna 185 Series aeroplanes
AD/PA-32/24 Amdt 2 - Main landing gear torque links
AD/CESSNA 185/43 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Above 5700kgs
Airbus Industrie A319, A320 and A321 Series
aeroplanes
AD/A320/202 Amdt 1 - Main landing gear door
actuator - CANCELLED
Airbus Industrie A330 Series aeroplanes
2010-0103R1 - Electric and electronic common
installation - cable loom installation - modification
Boeing 747 Series aeroplanes
2011-09-14 - Left and right access doors of the spring
beam mid-pivot bolt assembly for no.1 strut
Boeing 777 Series aeroplanes
FSA JUL-AUG 2011
Airbus Industrie A380 Series aeroplanes
AD/CESSNA 177/29 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
AD/CESSNA 180/72 Amdt 2 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Piper PA-28 Series aeroplanes
40
Cessna 177 Series aeroplanes
2011-09-05 - Prevention of potential ignition sources
inside fuel tanks
2011-09-11 - Strut disconnect assembly - inspection
2011-09-15 - To prevent potential ignition sources
inside fuel tanks
Bombardier (Canadair) CL-600 (Challenger)
Series aeroplanes
CF-2011-07 - Roll control system - aileron stiffness
Bombardier (Boeing Canada/De Havilland)
DHC-8 Series aeroplanes
CF-2011-06 - Airstair door - blocked water
drainage path
Embraer ERJ-170 Series aeroplanes
2011-05-01 - Air management system (ams) controller
processor modules
2005-09-03R3 - Low pressure check valves
Embraer ERJ-190 Series aeroplanes
2006-11-01R6 - Low pressure check valves
2011-05-02 - Air management system (AMS) controller
processor modules
6 May - 19 May 2011
Rotorcraft
Agusta AB139 and AW139 Series helicopters
2011-0081 - Tail rotor - tail rotor blades - inspection
Eurocopter BO 105 Series helicopters
2011-0091 - Main rotor drive - main gearbox inspection
Below 5700kgs
Cessna 150, F150, 152 & F152 Series
aeroplanes
AD/CESSNA 150/40 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 170, 172, F172, FR172 and 175 Series
aeroplanes
AD/CESSNA 170/53 Amdt 2 - Seat adjustment
mechanism - CANCELLED
2011-06-02 (Correction) - Prevention of interruption of
electrical power to the FADEC
2011-10-09 - Seat adjustment mechanism
Cessna 188 (Agwagon) Series aeroplanes
AD/CESSNA 188/42 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 190 and 195 Series aeroplanes
Avions de Transport Regional ATR 42 Series
aeroplanes
AD/ATR 42/28 - Barrel - swinging lever hinge
Boeing 747 Series aeroplanes
AD/B747/392 Amdt 1 - Fuselage Upper Lobe Doubler
2011-10-02 - Thrust reverser control system
modification
Bombardier BD-700 Series aeroplanes
CF-2011-10 - Oxygen supply system - deformation of
the pressure regulator on the oxygen cylinder and
regulator assembly
Bombardier (Canadair) CL-600 (Challenger)
Series aeroplanes
CF-2011-08 - Air-driven generator electrical power
feeder cable - potential failure due to corrosion
AD/CESSNA 190/5 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Embraer ERJ-170 Series aeroplanes
Cessna 205 (210-5) Series aeroplanes
Embraer ERJ-190 Series aeroplanes
AD/CESSNA 205/20 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 206 Series aeroplanes
AD/CESSNA 206/46 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 207 Series aeroplanes
AD/CESSNA 207/31 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
AD/ERJ-170/9 Amdt 1 - Low stage engine bleed check
valve - CANCELLED
2006-11-01R6 (Correction) - Low pressure check valves
Fokker F27 Series aeroplanes
2011-0083 - Electrical power - Electrical power center
(EPC) and battery relay panel - inspection/adjustment
Fokker F28 Series aeroplanes
2011-0083 - Electrical power - Electrical power center
(EPC) and battery relay panel - inspection/adjustment
Fokker F50 (F27 Mk 50) Series aeroplanes
2011-0083 - Electrical power - Electrical power center
(EPC) and battery relay panel - inspection/adjustment
Cessna 210 Series aeroplanes
Fokker F100 (F28 Mk 100) Series aeroplanes
AD/CESSNA 210/60 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
2011-0083 - Electrical power - Electrical power center
(EPC) and battery relay panel - inspection/adjustment
Saab SF340 Series aeroplanes
Cessna T303 Series aeroplanes
2011-0078 - Flight controls - Elevator pushrod assembly
- Identification /inspection/replacement
AD/CESSNA 303/6 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 336 Series aeroplanes
AD/CESSNA 336/13 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Cessna 337 Series aeroplanes
AD/CESSNA 337/27 Amdt 1 - Seat adjustment
mechanism - CANCELLED
2011-10-09 - Seat adjustment mechanism
Embraer EMB-500 (Phenom 100) Series
aeroplanes
2011-05-03 - Replacement of Angle of Attack Sensors
Above 5700kgs
Airbus Industrie A319, A320 and A321 Series
aeroplanes
AD/A320/201 - Cargo loading system fixed YZ latches
- CANCELLED
2011-0077 - Equipment/furnishings - Cargo loading
system fixed YZ latches attachment points modification
Piston Engines
Rotax Piston Engines
2011-0082 - Engine fuel & control - Fuel pressure
regulator - identification/replacement
Thielert Piston Engines
2011-0087-E - Engine - Friction disk - replacement
Turbine Engines
Rolls-Royce Turbine Engines - RB211 Series
AD/RB211/42 - Front combustion liner head section CANCELLED
2009-0187R2 - Engine - Front combustion liner head
section -inspection/replacement
2011-0080 - Engine - Front combustion liner head
section - Inspection/replacement
Equipment
Oxygen Systems
2011-0090 - Oxygen - Oxygen Mask Regulator
Inflatable Harness - Identification/Replacement
Propellers - Variable Pitch - Hamilton
Standard
2011-04-02 (Correction) - Propeller model 247F - blade
removal from service
Australian Aircraft Airworthiness
& Sustainment Conference
26 - 28 July 2011
With sponsorship from both CASA and the RAAF, a major focus
of the conference is maximising the interaction between the
civilian and military aerospace communities for the ultimate
benefit of all fleets.
As usual there will be guest representatives from our sister
AA&S conference in the US.
PULL-OUT SECTION
The AA&S Conference will cover all aspects of sustainment,
including fleet management, avionics & wiring systems,
mechanical systems, structures & corrosion, propulsion,
publications, supportability of software, workforce capability,
ageing materials, spares, logistics, supply chain design, support
equipment, knowledge retention, crashworthiness, condition
monitoring, obsolescence, and unmanned aerial systems.
41
Please see website for key dates and registration details.
Brisbane Convention and Exhibition Centre 26 - 28 July
> Your aircraft is ageing – find out why and how
> You alone as the owner, are responsible for its
maintenance and airworthiness
> Find out how to operate it safely, to protect you
and your passengers
Take a closer look:
How:
Attend a CASA airworthiness and ageing
aircraft seminar
When: A Saturday between June and November 2011
Where: You tell us
Time:
9am to 12pm, followed by a sausage sizzle
Register your club or group’s interest now!
Bookings limited (minimum numbers apply).
Contact Wendy McIntosh
P: 131 757
E: wendy.mcintosh@casa.gov.au
AIRWORTHINESS
www.ageingaircraft.com.au/aasc
Tool control at a glance
Organisation
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Visibility
FSA JUL-AUG 2011
42
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Security
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Trackability
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ZPVSJEFOUJåDBUJPOTZTUFN
t4QFDJBMJTFELJUToCPYFTUPCBHTUP
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Accountability
t#BSDPEFSFBEFSToCFUUFSBDDFTTDPOUSPM
t5VSOLFZMJTUTUPMBZPVUToDPNQVUFS
BTTJTUFEGPSTQFFEBOEBDDVSBDZ
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Tool Control System
Phone: 1800 811 480
Web: www.snapontools.com.au/industrial
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43
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FSA JUL-AUG 2011
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SEA
CHANGE
Offshore aviation’s evolution
The high standards required for helicopter flying
to oil and gas rigs are starting to permeate the
rest of the industry as the minerals boom extends
the safety culture of offshore drilling into aviation.
FSA JUL-AUG 2011
44
For civilian fixed-wing pilots, high-capacity RPT is the top of the
tree. Flying the Boeing or Airbus heavy metal for a major airline
is aviation par excellence, with training, management and safety
systems an order of magnitude above those of general aviation, as
safety statistics clearly show.
For rotary-wing pilots the pinnacle is a helipad, far from shore.
There are no helicopter airlines, but offshore flying occupies the
same exalted niche in the rotary wing world. One reason for its
strong reputation is the dangerous business of its customers.
Offshore helicopter flying to supply oil and gas fields, is no stranger
to the high safety standards of the resources industry.
The result, says Bristow Helicopters managing pilot, Marc
Newmann, is a sector that has evolved into the rotary wing world’s
equivalent of regular public transport (RPT) operations.
Oil companies have high reliability
expectations that translate into high safety
standards, Newmann says, and the offshore
helicopter industry has been shaped by this
unique combination of stringent standards
and educated customers.
‘In the helicopter industry you have to look at offshore as
being the top, as RPT is for fixed wing. That implies very
much higher standards,’ he says.
‘Some offshore oil and gas aviation standards are
considerably higher than regulatory requirements,’ he
says. ‘Because helicopter transport is so central to their
operations, oil and gas companies take intense interest
in operational matters, wanting to know the precise
reasons for any delays and breaches and what is being
done to prevent them recurring.’
The flip side, he says is a willingness to spend on keeping
operations running smoothly. ‘For example, if we have
a flight crew that’s coming up to their duty hours limit
because things have been busy, we can let the client
know and they’ll often agree to bringing up a standby
crew,’ he says.
There’s also a unique operational environment.
‘We fly a lot of IFR with night helideck approaches,
which we must train for every 90 days. That’s our own
requirement and that of the oil companies. We also fly
day rig radar approaches in IMC.
‘A lot of rigs are floaters, not even fixed to the
seabed; or we could be landing on the back of an
LNG tanker doing 18 knots at night in a heaving swell.
It’s not pleasurable, I can tell you.’
There is also a strong emphasis on
recurrent simulator training. Crews
flying the EC225 or AS332 Super
Pumas go to Aberdeen, in Scotland,
once a year to fly the type simulator.
The downside is the difficulty in producing sufficiently
skilled and qualified pilots and engineers, whom Bristow
also trains to well beyond regulatory requirements.
‘We have a stringent training regime and the guys we
employ we can’t just get off the street. It can take up
to eight months before a pilot can come online,’
Newmann says.
As Bristow and other offshore operators tend to retain their
highly trained pilots the effect on the industry as a whole
is more one of leading by example than a pilot production
line, he says.
Not everyone agrees that the offshore environment is
uniquely tough. Heliwest’s David Grimes, who was an
offshore pilot for nine years, says, ‘Flying onshore is far
more difficult than flying offshore; there’s no doubt. The
logistics of going to a platform and back are easier than
flying to outback locations, finding them, having to move
fuel, and pick up from unknown landing sites in heat,
and dust.’
But Grimes and Newman both say the high standards of
the oil and gas industries set the tone for offshore flying.
‘It’s a different mindset going from onshore to offshore
in that you’re dealing with the oil and gas companies and
they have different set of rules that you have to play by,’
Grimes says.
They also agree that the two sectors are becoming closer.
‘BHP’s aviation standards don’t delineate between offshore
and offshore - they must be met,’ Newmann says.
And Grimes agrees. ‘We fly two pilots onshore in
the Squirrel, as they do offshore. The rules are all
aligning now.’
As a 23-year-veteran of offshore flying, Newmann has
seen several booms and busts, which he says are a
normal part of the oil and gas business cycle.
The current peak has been more of an
incremental increase than a boom, and growth
has been manageable for Bristow, he says. His
prediction is that the company will ride out any
future slowdown in the industry by diversifying into other
operations. If and when it does so, it will bring to those
areas the high operational standards it has developed in oil
and gas operations.
But he doesn’t see a swift end to the current busy times.
Developments such as the Browse Basin gas field north of
Broome promise plenty of offshore aviation demand.
45
SEA CHANGE
Constant training is the key to safe operations in these
conditions. ‘At some of our bases there’s more training
done than revenue flying,’ Newmann says.
If they’re on the Sikorsky S76, they go to Florida, and those
flying the Agusta Westland AW139 go to Italy.
FSA JUL-AUG 2011
46
It was the mid 80s, and I was working as a mustering pilot on a group of
Barkly Tableland cattle stations. I had about 2500 hours at that point, all
station flying with lots of mustering, so half my life was spent below 200ft.
One of the planes was a 1963 Cessna 172. It had about 6000 hours on the
clock and had obviously had a fairly hard life, but it was fairly reliable,
if a bit underpowered, and we got along OK. We were mustering cattle
from a huge area onto a large plain and the ground crew were moving
them along in the direction of the next yard. It was a good day: the cattle
were working well; the thermals weren’t shaking the proverbial out of me;
everything was going fine as I worked a mob out of the timbered area.
¸]ac
`c¸
¸
I did a quick check of the engine gauges, something I had trained myself
to do very regularly, because if I have an engine problem, I want to know
about it sooner rather than later. Fuel, fuel, temperature, pressure, it takes
1-2 seconds every 5-10 minutes. On this occasion it was fuel, fuel, temp,
‘Holy @#$%, no oil pressure!’. Not low, none!
Craig Commens
on a mustering incident
What followed was the longest five minutes of my life. I lost all interest
in the cattle, pointed the old girl towards the open country and cut the
throttle to 1900 rpm. I figured that if I didn’t flog it, it might last a bit longer,
and then I started looking for the thinnest patch of trees to crash into.
I was under no illusions here, I knew that the engine was going to seize,
I was going down in the trees and it was going to be ugly. I was about
50ft above the trees, but decided to get to the open country as quick as
possible, without trying to climb, as I figured that would need more power
and kill the engine more quickly.
47
The pressure gauge was still below zero and my
crash site was constantly changing. I knew I
would only have 20-30 seconds from the engine
seizing to impact. This eventuality had never
been mentioned in any of my training, so I was
making it up as I went along. I really didn’t want
to be on the news that night.
After what seemed like an eternity, I got to the
point where if the engine seized, I’d be able to
clear the trees and land on the open country.
Even though it was very rough and I knew that
the nose wheel would be torn out on touchdown
and I’d probably nose over, I was happy with
that because it was survivable. I did wonder
how much unrestrained gear I had behind the
back seat though.
After another eternity, which was all of about
two minutes, I got to within gliding distance of
the track behind the cattle. So I shut the engine
down and had an uneventful landing. I figured I
might even be able to salvage the engine.
After I rolled to a stop I just sat there for a minute sucking in a few deep
breaths. It was about then that I realised why the Pope kisses the ground
when he gets out of a plane. While I was kissing the ground I noticed that
the whole underside of the fuselage was covered in oil. I pulled out the
dipstick revealing a half-litre of oil in the sump. I felt sick in the guts.
How close had I come to ending up in the trees? One of the ground crew
turned up with the usual question, ‘What do you need?’, but he didn’t
have a cold beer on him.
I removed the top cowl and quickly found the problem. The oil line that
ran from the engine to the oil pressure gauge had fractured and it was
pumping all the oil out. Even though this oil line is in the top of the engine
bay, there wasn’t one speck of oil on the windscreen. The line was
repaired, the oil was replaced, and we lived to fight another day.
The wash-up: The oil line failure was fatigue resulting from the hard life
the plane had led. I saved my own skin because of the way I had trained
myself to check the gauges regularly. It had been drummed into me as
a student pilot, but I had fortunately added to it. Losing an engine at
10,000ft and at 50ft are worlds apart. The way I saw it, I was my own
keeper. How many revs would have been left in the engine if I’d been
another couple of minutes checking the gauges is something I don’t
want to think about.
CLOSE CALLS
On this occasion it was fuel, fuel, temp, ‘Holy @#$%,
no oil pressure!’. Not low, none!
6KHDUOXFN
48
FSAJUL-AUG 2011
E\*DU\%URZQ
The day was clear, as crystal clear as if it had been swept
clean. ‘Swept’ was a word that would have much greater
meaning by the time we hit the parking bay. The sector
was Sydney to Maroochydore (now Sunshine Coast), with
perfect weather on a beautiful winter’s day. It doesn't
come much better, and with a TAF and ATIS to match, with
wind calm, CAVOK and no reported NOTAMs what could
go wrong?
Clearing with Brisbane approach via the steps we passed
to Maroochy tower and inside the zone, with no reported
traffic and the runway across the windshield, we
requested and received tracking to a left base for runway
18. The landing brief was pretty standard with regards to
manoeuvring and in the event of a go-round etc., so with
speed set for Vref, margin of 5kt for a calm surface wind,
we were through to gear and final flap.
With gear down we rolled onto final and with the
satisfaction that I had nailed the VASI, I took final flap,
set the thrust and the aircraft started slowing to Vref with
about 4nm to touchdown. With a ‘cleared to land’, the
checklist was complete.
The sight picture was perfect on the VASI, with no drift
and runway aligned, literally as though we were on the
proverbial rails with not the slightest ripple of turbulence,
but something wasn’t quite right.
I was increasing the thrust (manual) but the setting
seemed higher than usual and I was became aware there
was a perceptible slowing in the sight picture, I recall
looking at the weight data and mentally rechecking my
bug speed but, looking ahead at a limp windsock, no
alarm bell rang and I never thought of, or even had time
to voice, the ‘W’ word.
Without as much as a flicker, the airspeed plummeted,
instantly losing 20-plus knots. Gone was our measly
margin of five knots and a good percentage of the stall
margin as well. The bottom fell out from underneath us.
I don’t recall at what height this happened, 4ft or 500ft;
all the procedural words - take off, go-around - were gone,
replaced by something much more pithy.
The thrust levers had been instantly slammed against the
stops, and probably thanks to the higher approach spool,
the engines responded rapidly and gave all they had.
,WZDVWKHSHUIHFW
ZLQGVKHDUVXFNHUWUDS
DQG,KDGIDOOHQLQWRLW
As luck would have it, it was nothing more. The wheels
touched smoothly on the runway just inside the threshold
with full flap, pitched for a go-round with max thrust and
a strange ‘what's wrong with this picture?’ moment, as it
wasn't something I'd seen in the simulator.
With the nose-wheel high in the air and the column in my
stomach, any brake application or relaxation would have
dropped the nose-wheel heavily to the tarmac, so I had to
overcome an overwhelming desire to apply the brakes to
bring this nightmare to an end.
There was no need, as there was enough runway ahead to
finesse the nose-wheel down and slow for taxiing to the
parking bay.
Stunned? We were gobsmacked; there is no other word
for it. It had all happened in an instant. Clues? The
forecast, NOTAMs and ATIS gave a nil report, there
had been no recent traffic to give a heads-up, and the
windsock was limp. The thrust setting wasn't necessarily
unusual for the heavy weight and the perceived slowing
wasn't immediately apparent to me, probably because I
was pilot flying. The low-level airstream sweeping across
the airport was aligned to the runway, so there was no
indication there either.
Complacent? I don't think so. A perfect day and a good
approach do not make for a slack attitude, and when the
blade dropped the levers had been instantly fire-walled,
but from that point on there was little to do but ride it out
and touch down on or off the runway. It was the perfect
wind-shear sucker trap and I had fallen into it.
There were some strange looks from some of the
passengers on disembarkation, and a raised eyebrow,
from a crew member flying as a passenger, over a shared
experience.
Sometimes you can be lucky.
CLOSE CALLS
But the aircraft was heavy (every seat was full), and
sluggish, and with the nose being raised further to keep
on-slope (failing) and flying (just) we were seriously on the
back side of the power curve. There was nothing to trade,
and what remained of the approach became a prolonged
flare with max power.
49
YLRD
"XFJHIUZQSPCMFN
YSDU
Name witheld by request
YMTG
FSA JUL-AUG 2011
50
A number of years ago, I had occasion to fly a
Cessna 210 from Mt Gambier in the lower southeast of South Australia, to Lightning Ridge in
northern New South Wales. As it happened I
had a friend, who, along with three other friends,
needed to get to Dubbo for a two-day Apex
convention. It was therefore ideal for me to fly
them there and continue to Lightning Ridge,
returning on Sunday afternoon to pick them up
and fly home.
Although I was very familiar with the Cessna
210 and quite current at the time, I still carefully
checked the pilot’s operating handbook to
confirm we would meet weight and balance
limitations. We were able to take full fuel,
provided everybody limited themselves to a
small bag. This wasn’t a problem, as there
were just two nights away for us all, and we
met before dawn on the Friday morning for an
unhurried and on-time departure. Everybody had
cooperated with my request and the aircraft was
quite happy as we climbed into the cool early
morning air, bound for sunny Dubbo. As I had
topped the tanks, we had sufficient fuel to get us
there without an intermediate stop. As I helped
my passengers unload their bags and get into
the taxi at Dubbo, I arranged to meet them again
on Sunday afternoon for the return journey.
I then refuelled and departed for my weekend in
Lightning Ridge.
At the appointed time on Sunday, I pulled up to the apron and had just
finished refuelling for the next leg when my passengers arrived and walked
out to the aircraft. As they had been involved in the loading process just
a couple of days earlier, I left them to pack their gear while I went to the
briefing office to lodge a flight plan. By the time I returned to the aircraft,
they were all sitting comfortably in a jovial mood after a big lunch and a
few drinks. I noted, without really thinking much of it at the time that the tail
of the aircraft seemed to be quite close to the ground – much lower than I
would have expected.
As I prepared for departure, I had checked the windsock and planned which
runway I would use. After I completed the start checks without incident,
and with everything functioning as it should, I taxied for departure, making
contact with flight service to open my flight plan. It soon became evident
that the wind had changed: I was now taxiing for the wrong runway.
I contemplated changing to the reciprocal runway, but as there was no
traffic, and the tailwind would only be around three to five knots, I decided
to save the fuel and depart downwind. It would also allow for a simple left
turn of 100 degrees or so to set course, rather than an overhead departure,
saving further time and fuel.
Checks completed, I lined up and applied take-off power. To say that the
aircraft performance was surprising would be an understatement – the
engine was clearly performing normally, but the Cessna seemed reluctant
to move.
By the time we had covered half the available runway, the airspeed indicator
was barely registering 50 knots, and as I pulled tentatively on the control
column, the stall warning immediately began sounding. We continued for
another several hundred feet along the runway before the airspeed was
sufficient to become airborne, but the aeroplane clearly was not happy to
fly yet. By now I had passed my point of decision (or indecision) and was
committed to take-off, but as we passed over the airport boundary fence,
the aircraft was barely 20 feet high, and gaining at an alarmingly slow rate.
We were three miles from the airport before I felt able to turn left and set
course, and it was another 25 minutes before we levelled off at 8,500 feet.
Clearly, there was something amiss, and once I felt under some semblance
of control, I turned to my passengers and asked them if they had packed
anything else in the aircraft today, that hadn’t been with us when we
arrived two days ago.
Of course, I couldn’t be too hard on them, as it was my responsibility to
ensure the aircraft was loaded in accordance with the POH, and I had
essentially abdicated that responsibility when I left them to it.
The remainder of the trip to Mt Gambier was uneventful, but not without
concern and much soul-searching and contemplation of ‘what-ifs?’
We landed with the aircraft still in balance, but it had been a full hour in
cruise before I felt the aircraft was finally under its maximum take-off
weight and performing as it should be.
1. Whenever planning a trip that is approaching the
limit of the aircraft’s range, you need to consider
weight and balance limitations very carefully.
Although I did it for the outbound trip, I failed
to ensure that all remained the same for the
return leg.
2. When I noticed the tail-low stance of the aircraft
at Dubbo, I should have asked and found out just
what was where, and whether anything extra had
been added. I shouldn’t have expected non-fliers
to understand the requirements for safe flight.
Although they can help you load the aircraft, they
should never be left to do that task unsupervised.
Also, do not forget that they can (and will) put
one or two additional things on board if they find
room. The untrained normally use volume as a
measure for whether or not an aircraft is able to
take the item/s. We know otherwise.
3. I should not have accepted the tailwind, even
though it was only a few knots. The extra
fuel burned for taxi would have been far less
of a problem than the extended take-off run,
and I threw away the added safety factors by
committing to a longer take-off run. There was
no traffic or operational reason to conduct a
downwind take-off.
4. Having noticed the sluggish performance of the
aircraft in the first part of the take-off, I should
have aborted then and returned to the apron for a
closer look.
5. I should have held firm to a point of go/no go.
Instead, I continued past that point, hoping
that the aircraft would accelerate sufficiently.
Thank goodness it did – I had no backup plan!
51
CLOSE CALLS
Rather sheepishly, my front-seat passenger admitted that they had
purchased some souvenirs and a few cans of beer, and bottles of wine.
As I was clearly not satisfied with that answer, he elaborated and listed the
additional load as being two full slabs of beer and a dozen bottles of wine.
They had all also purchased a jacket as the Friday had been unusually cool
and nobody had packed one, because I told them to limit their baggage.
Of course they had all had a big lunch too, so that added more weight.
Now I knew why the aircraft was so reluctant to climb, but I was concerned
that we might well have a problem with centre of gravity, as the 210 tended
to become tail heavy as the fuel was used. As a precaution, I had my (now)
very apologetic passengers move as much of their booze forward and
under their seats as they could. I also promised that it would be thrown
overboard if it looked as if I was going to have any further problems with
the aircraft (or them).
As with most incidents and accidents, there was
a chain of events that led up to the situation, and
any one of them could have been changed to break
that chain.
The Australian
Turning safety
issues into
action
The ATSB recently
released a research report
that examines the safety
issues—and the resulting
actions—we identified
across the aviation sector during 2009–10.
FSA JUL-AUG 2011
52
From our investigations, we uncovered 46 safety
issues in the aviation industry (a safety issue is
a factor that could adversely affect the safety of
future operations).
The report also shows that operators,
manufacturers and the regulator undertook 60
safety actions to deal with these issues. The ATSB
was satisfied with these actions, only making one
recommendation for further safety action.
This is a positive sign. It shows that industry
is taking safety seriously and is committed
to improving safety when becoming aware of
unacceptable risks.
It also means that by working together, the ATSB
along with other transport safety bodies and
industry are making a real difference to transport
safety.
While these actions represent a positive safety
outcome, we continue to see pilots—particularly
general aviation pilots—dying in recurring types
of aviation accidents. Tragically, many of these
accidents could have been avoided through basic
risk management strategies.
In this edition of Flight Safety Australia, we feature
two articles that offer techniques on avoiding
accidents involving wirestrikes and partial power
loss.
I encourage all general aviation pilots to read these
articles and seriously review the strategies that can
help make flying safer.
Martin Dolan
Chief Commissioner
Kokoda crash prompts major safety
improvements
ATSB investigation report AO-2011-016
E
xtensive safety
improvements have taken
place in PNG aviation as
a result of the PNG Accident
Investigation Commission’s
(AIC) investigation into the fatal
aircraft accident near Kokoda.
The ATSB provided investigator
support, information and
technical advice and facilities
support to the investigation, following a request for assistance
from the AIC.
On 11 August 2009, a de Havilland Canada DHC-6 Twin Otter
aircraft, registered P2 MCB, with two pilots and 11 passengers on
board, was en route to Kokoda airstrip after taking off from Port
Moresby. Prior to the accident the crew were manoeuvring the aircraft
within the Kokoda Gap, probably in an attempt to maintain visual
flight in reported cloudy conditions. Witnesses at Misima village stated
that they heard an aircraft fly near their village, but that they could not
see the aircraft as the area was covered by cloud. They reported that,
shortly after, there was a loud bang above their village and the sound of
the aircraft stopped.
The aircraft crashed on the eastern slope of the Kokoda Gap at about
5,780 ft above mean sea level in heavily-timbered jungle about 11 km
south-east of Kokoda airstrip. It was destroyed on impact, and there
were no survivors.
The investigation concluded that the accident was probably the result
of an otherwise airworthy aircraft being unintentionally flown into
terrain, with little or no awareness by the crew of the impending
collision.
As a result of the investigation, the AIC issued a safety
recommendation in respect of the installation of cockpit voice
recorders (CVR) in PNG aircraft with a seating capacity of 18
or more passengers.
The Civil Aviation Safety Authority of PNG (CASA PNG) intends
legislating to require the installation of CVRs in turbine-powered
aircraft with seating for more than nine passengers. CASA PNG has
also established a principal medical officer position and has advised
of action to move responsibility for the administration of the PNG
mandatory occurrence notification system to the AIC PNG.
The aircraft operator has taken extensive proactive safety action in
response to the risk of inadvertent flight into cloud while employing
visual flight procedures. Q
Aviation Safety Investigator
Managing Partial Power-Loss
F
From 1 January 2000 to
31 December 2010, there were
242 occurrences (nine of which were fatal)
reported to the ATSB involving singleengine aircraft sustaining a partial engine
power loss after takeoff1 and
75 occurrences (none of which were fatal)
reported as sustaining an engine failure
after takeoff.
Partial engine power loss occurs when
the engine is providing less power than
commanded by the pilot, but more power
1 Partial power loss occurrences include those
where a total engine failure was preceded by a
partial power loss.
than idle thrust. This kind of power loss
is actually more complex than a complete
failure, and it can be much harder to stay
ahead of the aircraft. The pilot is thrust
into a situation where the engine is still
providing some power, but it may be
unreliable, and the power level might be
difficult to access. As a result, pilots are
uncertain about the capabilities of their
vehicle, and what their options are – a
situation that has led to loss of aircraft
control.
And because it’s not a substantial part of
flight training, pilots don’t tend to think
about it beforehand. Compared to the
spectre of total loss of power, they don’t
muse about how they would react in such
a scenario. And, as a result, when it does
happen, it can turn into disaster very
easily.
The first way to combat a partial powerloss is simply to think about it before
it happens. Just by acknowledging the
possibility, and establishing different
strategies that you might employ, you’re
giving yourself an advantage. Establishing
procedures, however, offers a far greater
advantage. By planning for this ahead of
time, you reduce your mental workload,
and you have greater confidence.
Many of the causes of partial power
loss after takeoff events could have been
identified, thereby preventing the partial
power loss during pre-flight checks.
Aircraft physical inspection, engine run
ups and on takeoff engine checks are vital
barriers that can serve to prevent the
possibility of partial power-loss. Many
instances of partial power-loss
have been found to be fuel-related
and spark plug related.
If, however, despite these
precautions, you still experience
a partial power-loss, then you
need to respond immediately.
And taking no action is not an
option in these circumstances.
Most fatal and serious injury
accidents resulting from partial
power loss after takeoff are
avoidable. The first priority is to
maintain control. You might be
turning back to the aerodrome or
conducting a forced landing, but
as long as you are maintaining
glidespeed and no more than a moderate
bank angle, you retain some modicum of
control, and arriving at the ground in a
controlled flight rather than after a stall
and or spin could make all the difference.
Partial Power-loss is a complicated issue,
and the ATSB’s publication, Managing
Partial Power-Loss After Takeoff in
Single-Engine Aircraft examines it indepth, breaking it down into the same
sequence of events as if conducting a flight.
The information booklet is available for
free on the ATSB website at
www.atsb.gov.au Q
53
ATSB
or a pilot, losing engine power after
takeoff ranks with the worst things
that can happen in a single engine
aircraft. Understandably. You can easily
imagine a situation – say, on mid upwind
over a factory or approaching powerlines
and trees – where you’d give anything for
even a bit of power. And yet a new ATSB
research report shows that partial-engine
power-loss actually causes more fatalities
than a complete engine failure.
Managing Partial Power-Loss After Takeoff
in Single-Engine Aircraft is the
newest information booklet
in the ATSB’s ‘Avoidable
Accidents’ series. It came about
after a spate of fatal accidents
where witnesses reported that
the engine had not failed fully.
Such power-losses are a largely
unexplored topic, and not just
in research, but in training
scenarios as well. This is despite
the fact that partial power
loss events occur three times
more frequently than complete
engine failures during takeoff
and initial climb.
Pre-flight: Check your electrical power supply
A
pilot who took off without power
to the aircraft’s primary flight
instruments likely became
disoriented and lost control of the aircraft,
according to an ATSB report.
On 9 April 2008, a Fairchild Industries
Inc. SA227-AC (Metro III) aircraft,
registered VH-OZA took off from Sydney
on a late night freight charter flight to
Brisbane. Shortly after, the aircraft turned
right despite being instructed by air traffic
control to turn left. The pilot reported
that he had a ‘slight technical fault’ but no
other transmissions were received.
FSA JUL-AUG 2011
54
Radar data showed the aircraft turning
right and then left, followed by a descent
and climb, a second right turn and a
second descent at over 10,000 feet per
minute before the aircraft disappeared
from the radar.
A search operation found a small amount
of aircraft wreckage floating in the ocean.
The pilot likely died in the accident. The
aircraft was destroyed.
Cockpit voice recorder on the ocean floor
There was no evidence of a midair
breakup of the aircraft. Both of the
aircraft’s on-board flight recorders were
recovered from the ocean floor, but they
only contained data from a previous
flight—not the accident flight.
The ATSB investigation found that the
pilot took off without any alternating
current electrical power to the aircraft’s
primary flight instruments. This included
the pilot’s artificial horizon and both
flight recorders. Without a primary
attitude reference during night takeoff, it
is likely that the pilot became disoriented
and lost control of the aircraft.
The investigation identified that the pilot’s
Metro III endorsement training
As a result of the accident and
audits by the Civil Aviation Safety
Authority, the operator has taken action
to improve its safety and training
operations. This includes:
t rewriting their operations manual
t retraining pilots to meet the operator’s
endorsement training requirements
t establishing a new safety committee.
The ATSB’s investigation report Loss of
control – Fairchild Metro III, VH-OZA,
19 km SE Sydney, NSW, 9 April 2008 is
available at www.atsb.gov.au Q
Pilots urged: ‘stay focused around powerlines’
A
gricultural pilots are being
reminded of the dangers
associated with flying near
wires following the SFDFOUrelease of
an ATSB booklet.
The booklet, released in association
with the Aerial Agriculture Association
of Australia, highlights recent
wirestrike accidents that occurred
while pilots were conducting spraying
activities.
Importantly, the report provides
ways for pilots to minimise the risk of
striking a powerline while conducting
aerial operations.
Flight data recorder, popularly referred to
as the ‘black box’
had not been conducted in accordance
with the operator’s approved training and
checking manual.
The booklet provides methods for pilots
to minimise the risk of striking wires
while conducting aerial operations.
These are:
t setting client expectations so that
they are clear that safety comes first
t conducting an aerial reconnaissance
before spraying and extra aerial
reconnaissance before the cleanup
run
t reassessing the risks when plans
change
t avoiding unnecessary distractions
and refocussing when distracted
ATSB General Manager of Strategic
Capability, Mr Julian Walsh, said that
in the majority of wirestrike accidents
the pilots had known of the powerlines
before they struck them.
t keeping vigilance limitations in mind
‘Typically, pilots have been working
around the same wires in the hours
before a wirestrike accident,’ Mr Walsh
says.
t having a systematic approach to
safely managing wires.
‘Due to a change of spraying plans
or a clean-up run once a paddock
has been sprayed, the pilot’s focus is
temporarily shifted away from the task
of identifying the location of wires.’
t actively looking for wires
t managing operational pressures
including not accepting tasks that are
beyond your personal minimums
The report also highlights the role
of landholders and utility owners
in contributing to safety. This
includes installing markers on wires,
particularly where regular low-level
flying takes place. Q
Report confirms Qantas A380 engine failure event
sequence
A
n interim ATSB investigation
report has confirmed the
sequence of events that led to the
4 November 2010 uncontained engine
failure on board a Qantas A380 aircraft
over Batam Island, Indonesia.
The report also sets out how, as a result
of the investigation to date, Rolls-Royce,
affected airlines and safety regulators
have taken action to ensure the continued
safe operation of A380 aircraft.
The report highlights how the
intermediate pressure turbine disc in
the aircraft’s No. 2 engine had been
weakened by an oil fire. As a result, the
disc separated from its shaft, increased
its rotation speed and broke into several
parts. Sections of the fractured disc and
other engine components penetrated
the aircraft’s left wing and a number
of other areas on the aircraft, resulting
in significant structural and systems
damage.
The report also shows how some of the
extensive flight data recovered in the first
stage of the investigation has been used
to program a simulation of how the
aircraft handled following the accident.
This has helped investigators to
understand better the aircraft’s handling
and performance.
The simulation was part of a broader
exercise to understand the extent and
consequences of the airframe and
systems damage to the aircraft and the
consequences for flight crew workload.
The findings from this continuing work
will provide valuable safety lessons for
future operations.
The ATSB will continue to work with
international safety agencies and other
organisations to gather and compile
the large amount of complex factual
information required to complete the
t testing and
analysing the
black-coloured soot
residue found in the
left wing fuel tank
t analysing the flight
simulation test data
t continuing to
review the quality
control and quality
assurance system
affecting the engine
design and manufacturing process
t reviewing the aircraft’s maintenance,
including engine workshop visits.
The aircraft is currently in Singapore
awaiting repair.
Given the highly complex nature of this
investigation, the final ATSB report is
expected to be released in May 2012.
A copy of the interim factual report is
available on the ATSB website at
www.atsb.gov.au. Q
55
Fact sheet for General Aviation Pilots
T
he Australian Transport Safety
Bureau (ATSB) has issued a fact
sheet reminding pilots of the
risks associated with operations in
uncontrolled airspace. This warning
comes as the result of a significant
increase in reports of situations
involving near miss incidents. The
ATSB has received many notifications
from pilots reporting how they have
suddenly realised that another aircraft
is flying dangerously close to them in
uncontrolled airspace.
The fact sheet notes that, surprisingly,
just as many near miss incidents are
reported for en route aircraft as those
in airspace close to airports. ‘Near
airports, planes are operating in closer
quarters,’ explains Martin Dolan, Chief
Commissioner of the ATSB, ‘so you
might expect to hear about aircraft
getting too close to each other, but it’s
surprising that there are just as many
reports from aircraft that are up there
cruising along, going from one place to
another.’
In response, the fact sheet describes
the factors that increase the chance of
these dangerous situations. The core
recommendation on how to avoid other
aircraft when outside controlled airspace
is to ensure that pilots are aware of each
other in plenty of time, using whatever
systems are available.
‘This may sound like an obvious
message,’ says Dolan, ‘but our figures
are indicating that it’s not always
happening – that pilots aren’t always
advertising their presence, when in fact
they could be.’ In fact, there were twice
as many near-miss notifications where
pilots had no prior warning of other
aircraft in their vicinity, compared with
situations when a pilot received an alert
by radio, or from a traffic avoidance
system like TCAS.
There are a number of specific strategies
in the fact sheet to help pilots announce
their presence in uncontrolled airspace
more effectively. Hopefully, this may
help cut down the number of situations
where pilots suddenly find that another
aircraft has come too close. Q
ATSB
The oil fire that weakened the disc was
due to a manufacturing defect in an oil
feed pipe. That defect resulted in fatigue
cracking in the pipe, so that oil sprayed
into an engine cavity where it ignited
because of the high air temperature.
investigation. Included
in this work will be:
Close flying highlighted in ATSB
bulletin
ATSB investigation AB-2010-040
The ATSB has released its latest bulletin of
short investigations, covering a variety of
occurrences. Among them, it highlights
five instances of aircraft coming too close
to each other.
‘Two of those occurrences were
‘breakdowns of separation,’ taking place
in airspace that was under the control of
Air Traffic Control officers, which has
carefully defined separation standards to
keep aircraft a set distance apart.
Several safety actions have come out
of these occurrences, including the
establishment of an awareness program
for Air Traffic Controllers, and a systemic
review by Airservices Australia.
FSA JUL-AUG 2011
56
Mr Joe Hattley, the ATSB’s Assistant
General Manager of Aviation Safety
Investigations says the investigations
bulletin provides a useful resource for the
aviation industry to help improve safety.
‘The bulletin covers a range of the ATSB’s
shorter investigations and highlights
valuable safety lessons for pilots, operators
and safety managers,’ Mr Hattley says.
Other investigations covered in the
bulletin included a depressurisation event,
two instances of total power loss and
a situation in which fumes and smoke
appeared in an aircraft’s cockpit. As a
result of a wirestrike, an aircraft operator
will annotate powerline information onto
their topographic survey plans.
Released quarterly, the bulletin provides
a summary of the less-complex factual
investigations conducted by the ATSB. The
results, which are based on information
supplied by organisations or individuals
involved in the occurrence, detail the
facts behind the event, as well as any
safety actions undertaken or identified.
The bulletin also highlights important
safety messages for the broader aviation
community, drawing on earlier ATSB
investigations and research.
Aviation Short Investigation Bulletin: First
Quarter 2011 is available on the ATSB
website at www.atsb.gov.au Q
Bushfire fighting now safer
ATSB investigation AO-2009-077
NSW’s bush fire operating procedures
have been improved following the ATSB’s
investigation into a fatal helicopter
accident.
On 9 December 2009, the pilot of a Bell
Helicopter 206L-1 LongRanger, registered
VH-MJO, was flying a fire-fighting
support flight under visual flight rules
(VFR) in the Dorrigo area, NSW.
Shortly after takeoff, low cloud came in
and the pilot lost all visual reference with
the horizon and the ground. The pilot
became disoriented and the helicopter
crashed into the ground. The passenger
died and the pilot was seriously injured.
The accident showed how quickly a pilot
can lose situational awareness and aircraft
control when all visual reference with
their surroundings is lost. Pilots should err
on the side of caution when considering
visual operations in marginal weather
conditions, especially when conditions can
change rapidly.
The ATSB’s investigation found that the
helicopter landing area was occasionally
subjected to rapidly moving fog or low
cloud that increased the safety risk of
flights under VFR. The National Parks
and Wildlife Service closed the helicopter
landing site at the Dorrigo Rainforest
Centre shortly after the accident.
Following the accident, the National Parks
and Wildlife Service, the NSW Rural
Fire Service and other NSW fire-fighting
authorities conducted a full review of the
Fire Agencies Bush Fire Aviation Standard
Operating Procedures. A number of safety
actions have been initiated as a result of
the review, including:
t developing guidelines for helicopter
landing areas that are regularly used
during bush fire operations
t identifying potential hazards for each
helicopter landing area
t compiling a Bush Fire Helicopter
Landing Area directory
t conducting a full audit of the helicopter
operator before awarding them any
further contract work.
The investigation report is available at
www.atsb.gov.au Q
Turbulences catches pilot
off-guard
ATSB investigation AO-2010-008
An incident at Canberra Airport in which
an aircraft experienced severe turbulence
has reinforced the potential safety benefits
of the formation of a national airport
safety group.
On 31 January, 2010 a Grumman Traveller
AA-5 aircraft was flown on a private
flight from Temora to Canberra. The pilot
reported that, during the final approach
to the runway at about 150 ft above the
ground, the aircraft experienced severe
turbulence. This resulted in a loss of
control, causing an uncommanded roll
to the right. The pilot rapidly regained
control, and landed.
The ATSB determined that the wind
conditions on the day and the position of
two buildings about 220 m and
290 m upwind from runway 12 at
Canberra probably combined to produce
the turbulence. There were no standard
criteria for assessing the potential local
wind effect of aerodrome building
developments on aviation operations, and
no national building codes for aerodrome
developments that address the phenomena
of building-induced turbulence.
The airport operator had commissioned
pre-construction assessments of the
two buildings that concluded that the
buildings would not result in adverse
wind effects. This conclusion was based
partially on the assessment that use of
runway 12 was unlikely in northerly
wind conditions. However, operations to
that runway remained possible in those
conditions, and there was no alert to
affected pilots about possible risk.
Subsequent to this occurrence, the
National Airports Safety Advisory Group
was established. Its role is to examine
airport planning issues, including the
potential for building-induced local
wind effects on aircraft operations. The
group will also develop a set of universal
guidelines and policy material.
Airservices Australia is also progressing
the installation of wind shear detection
technologies at several airports, which
may include Canberra Airport.
The investigation report is available at
www.atsb.gov.au Q
REPCON briefs
Australia’s voluntary confidential aviation reporting scheme
REPCON allows any person who has an aviation safety concern to report it to the ATSB
confidentially. All personal information regarding any individual (either the reporter or any
person referred to in the report) remains strictly confidential, unless permission is given by
the subject of the information.
The goals of the scheme are to increase awareness of safety issues and to encourage
safety action by those best placed to respond to safety concerns.
REPCON would like to hear from you if you have experienced a ‘close call’ and think others
may benefit from the lessons you have learnt. These reports can serve as a powerful
reminder that, despite the best of intentions, well-trained people are still capable of making
mistakes. The stories arising from these reports may serve to reinforce the message that we
must remain vigilant to ensure the ongoing safety of ourselves and others.
Testing of instruments in IFR
aircraft
The reporter believes that CASA is aware
of the problem with this airworthiness
directive and some CASA staff agree that
the airworthiness directive needs to be
changed to remove option 1.
Action taken by REPCON:
REPCON supplied CASA with the
de-identified report. The following is
a version of the response that CASA
provided:
CASA published Airworthiness Bulletin
(AWB) 31-004 in February 2008. This
t 8IFOBOPQFSBUPSFMFDUTUPVTFPQUJPO
1 in AD/INST/9 for the testing of
pressure altimeters to Federal Aviation
Regulation Part 43 Appendix E they
must also ensure that the requirements
of CAR 41 are met.
t $"3
TUBUFTUIBUABQFSTPO
must not use a class B aircraft in an
operation if there is not a maintenance
schedule for the aircraft that includes
the provision for the maintenance of all
aircraft components from time to time
included in, or fitted to, the aircraft’.
t &MFDUJOHUPVTFPQUJPOJOUIF"%
instead of option 2 does not remove the
requirement to ensure the serviceability
of all other aircraft instruments and
instrument systems as per CAR 41.
Operation without a flight
attendant
Report narrative:
The reporter expressed safety concerns
that a company aircraft operated two
sectors without a flight attendant
onboard; there were approximately 10
passengers on board.
Action taken by REPCON:
REPCON supplied the operator with the
de-identified report. The following is a
This subject has already been addressed
with CASA. All actions have been accepted
by CASA and this issue has been closed out
accordingly.
REPCON supplied CASA with the
de-identified report and a version of
the operator’s response. The following
is a version of the response that CASA
provided:
CASA has reviewed the report and
contacted the operator concerned. CASA is
aware of the issue and is satisfied that the
matter has been addressed.
57
What is not a reportable
safety concern?
To avoid doubt, the following matters are
not reportable safety concerns and are
not guaranteed confidentiality:
a) matters showing a serious and
imminent threat to a person’s health
or life;
b) aircraft;
c) industrial relations matters;
d) conduct that may constitute a serious
crime.
Note: REPCON is not an alternative to
complying with reporting obligations
under the Transport Safety Investigation
Regulations 2003 (see www.atsb.gov.au).
Submission of a report known by the
reporter to be false or misleading is an
offence under section 137.1 of the Criminal
Code.
How can I report to REPCON?
Online: www.atsb.gov.au/voluntary.aspx
Telephone: 1800 020 505
Email: repcon@atsb.gov.au
Facsimile: 02 6274 6461
Mail: Freepost 600
PO Box 600, Civic Square ACT 2608
ATSB
Report narrative:
The reporter expressed safety concerns
that CASA Airworthiness Directive
(AD/INST/9), testing requirements
for instruments in IFR aircraft allows
operator’s to elect to carry out one of two
options for the periodic testing of flight
instruments on IFR aircraft. The reporter
believes that most operators would
elect the first option as it is less labour
intensive, despite needing to be carried
out every 2 years, as opposed to
3 years with option 2, but only checks
the pressure altimeters and not the whole
system. Option 1 does not confirm that
the whole system is operational and
airworthy. Latent defects may remain
undetected until that part of the system is
needed (in an emergency) or the system
fails.
AWB addresses the concerns raised in
this REPCON report concerning the two
options presented in AD/INST/9 for the
testing of flight instruments. The AWB
also explains the relationship between the
AD and Civil Aviation Regulations (CAR)
1988 i.e.:
version of the response provided by the
operator:
War and remembrance, fog and death
FSA JUL-AUG 2011
58
On 10 April 2010, a Polish Air Force Tupolev
Tu-154M struck trees short of the runway
and crashed to destruction while
attempting to land at Smolensk, Russia,
in fog. All 96 occupants were killed.
By Macarthur Job
It was always going to be a sombre occasion. The
flight, from Warsaw to the former military airbase of
Smolensk North Airport, was taking Polish dignitaries
to attend the 70th anniversary commemoration
of the massacre of Polish army officers at Katyn, a
short distance west of Smolensk, during World War II.
The delegation included the Polish president and his
wife, the deputy foreign minister, 12 members of
parliament, the chief of the Polish General Staff and
senior military officers, the president of the national
bank, senior clergy, and relatives of victims of
the massacre.
The three-engined Russian-built Tu-154M (‘the Russian
727’) was one of two aircraft of its type operated by
the Polish Air Force as VIP transports. The flight crew
comprised the captain, co-pilot, navigator and flight
engineer. Also on board were a security officer and
three flight attendants to attend to the 88 passengers.
All were Polish. Russian authorities had offered to
provide a navigator, but this was declined.
The Tu-154M was manufactured in June 1990 and
had flown 5150 hours, 140 since its last overhaul in
December 2009. The investigation found no failure of
the aircraft’s systems and engines, and the accident
was unrelated to any technical problem.
Even so, the aircraft’s airworthiness certificate had
expired nearly three weeks before the accident.
A different captain was originally to command the
flight but was replaced five days before because of
a ‘service necessity’. The investigation found serious
shortcomings both in the training and the makeup of the crew. Responsible for their own training
on Tu-154M aircraft, as well as for maintaining and
upgrading their skills, they did not undergo regular
simulator training.
The captain lacked command experience, having
logged only 530 hours as a captain. After being
promoted to this status, instead of undergoing formal
command training under supervision, he alternated
as co-pilot and captain as circumstances required.
Three days before the accident he had flown to the
same Smolensk airport as a co-pilot.
The co-pilot, navigator and flight engineer had even
less experience. Apart from the captain, none of the
crew had flown to Smolensk before.
There were other shortcomings in the organisation
of the VIP flight. Crew members had conducted their
own pre-flight briefing the day before, with senior staff
playing no part. No records were kept of the briefing,
or of crew readiness. Furthermore, the crew did not
have to complete navigation data for their destination
airport. Their approach charts were out of date, and
a NOTAM listing information on the unserviceability
of some navigation aids was not provided to them.
No technical flight was conducted beforehand to
check the facilities at the destination for receiving the
VIP Tu-154M and its high level passengers. Officers
responsible for the flight’s management, as well as
the captain, thus violated Polish aviation regulations
requiring crews to have pertinent data.
A smaller Polish Air Force three-engined jet, a
Yak-40, carrying support staff and journalists to
cover the anniversary, left for Smolensk two hours
before the VIP flight, but requests for clearances and
information on the readiness of the airport in respect
of either flight were not sent. Consequently, when the
YAK-40 first contacted Smolensk ATC at 08.50am,
they had no information on the aircraft.
The forecast provided to the Yak-40 contained no
information about deterioration in the weather. But
by the time the Yak was approaching to land at 0915,
conditions were rapidly worsening, with visibility
decreasing from 4km at 0900 to only 1500m when
the Yak touched down.
The Tupolev took off at 0927. About this time visibility
at Smolensk had reduced to 1000m in mist and
smoke, and the sky was overcast by stratus cloud with
a base of 100m (330ft). Thus, by the time the Tupolev
departed, the destination weather was already below
the minimums for a twin locator approach under
guidance from ground radar. Fifteen minutes later,
another observation showed the beginning of fog.
Analysis of the cockpit voice recording revealed that
the cockpit door was open during the entire descent
and approach and that from time to time there were
unauthorised people in the cockpit. The investigation
also found the aircraft’s weight at the time of its
approach exceeded the maximum landing weight for
the conditions.
At 1014, when the Tupolev was descending through
7500m, (24,600ft) Minsk Control informed the crew
of fog, with only 400m visibility at their destination.
After contacting Moscow Control at 1022 the aircraft
was cleared for further descent to 3600m (11,800ft)
and instructed to contact Smolensk Airport ATC.
The captain was now speaking in Russian, his second
language.
After clarifying the aircraft’s remaining fuel, the
Smolensk controller twice informed the crew that
the weather was foggy, and unsuitable for landing.
The crew also contacted the Yak-40 on the ground
at Smolensk. After colourfully describing the bad
weather, the Yak crew said they had been lucky to
land ‘at the last moment’. They added, ‘you could try,
of course.’
The Tupolev crew decided on a ‘trial’ approach, the
captain informing the controller, ‘If it’s possible we'll
try an approach. But if there’s no weather we'll go
around.’ A senior officer in the ATC operations building
asked the crew, ‘After the trial approach, will you have
enough fuel for your alternate?’
The crew replied: ‘We have enough – request further
descent please’, and the controller cleared the aircraft
accordingly. The crew did not advise their selected
approach system and did not request radar vectoring.
The controllers interpreted this as meaning the crew
would be using on-board equipment.
59
WAR & REMEMBRANCE
During the pre-flight briefing, the navigator signed
for weather information including TAFs and actual
weather at Warsaw, Vitebsk and Minsk. The forecast
and actual weather for the destination were not
provided, and the forecast for Vitebsk had expired.
At 1009 the navigator reported they were ready for
descent. Minsk Control then cleared them to descend
to 3900m (12,800ft).
War and remembrance, fog and death
60
This was the beginning of the chain of events that led
to the disaster. Analysing the crew’s motivation, the
investigation noted that in August 2008, one of the
Polish VIP aircraft was flying the President and the
Deputy Commander-in-Chief of the Polish Air Force
to Tbilisi in Georgia. The weather was deteriorating
and the captain judged it was not possible to continue
safely. Despite the orders of both the President and the
Deputy Commander-in-Chief to continue, the aircraft
landed at Gyandj in Azerbaijan. The President and his
entourage were obliged to continue to Tbilisi by road.
FSA JUL-AUG 2011
That captain was never again included in crews for
presidential flights.
The captain and the co-pilot of the Tupolev on
10 April had been co-pilot and navigator respectively
on the aborted Tbilisi flight. He and the crew discussed
the worsening weather with each other and with the
President’s director of protocol, who had entered
the cockpit. The discussion ended with the captain
remarking, ‘... if we don't land, he'll give me trouble’.
But the captain had not made any approaches in
complex weather for over five months and in Tu-l54
aircraft he had made only six NDB approaches, all of
them in straightforward meteorological conditions.
He was thus under considerable stress.
Meanwhile, the ATC personnel and their senior officers
were sure the aircraft would divert. The weather was
not expected to improve and the Tu-154M’s remaining
fuel did not allow a prolonged stay in the holding
pattern.
At 1027 the crew contacted the pilots of the Yak-40
again and were informed that a Russian IL-76 aircraft
had left for an alternate after two unsuccessful
approaches. The Tu-154M crew then set the airfield
pressure (QFE) on their altimeters, the navigator
expressing regret there was no ILS system available.
The crew reported they were maintaining 1500m
(4900ft), and the controller cleared them for further
descent to 500m (1640ft). At this stage the director
of protocol, still in the cockpit said, ‘So far there's no
President's decision on what to do next.’ The crew
replied that they had been cleared down to circling
height, and as they approached the base turn, the
captain said: ‘We'll make an approach – in case of
failure we'll go around.’
As the aircraft reached the base turn, the controller
warned them to be ready to go around from a height
of 100m (330ft). The captain replied: ‘yes sir!’
Despite two more weather warnings from the
Yak-40, the Tu-154M continued the approach. As the
crew configured the aircraft for landing, another voice
on the CVR revealed a second visitor to the cockpit.
He was later identified as the Commander-in-Chief
of the Polish Air Force. He made no comment on
the handling of the aircraft, and though fully aware
of the conditions, took no measures to terminate the
approach. A word from him that a successful approach
was not possible could have made all the difference to
the captain’s attitude. As it was, his presence could
only have added to the captain’s stress.
The crew did not achieve a stable descent, the rate
increasing excessively after the aircraft diverged
above the glide path. Passing the outer marker, the
aircraft was 120m (400ft) above the glide path, and
the crew’s efforts to correct the profile resulted in a
rate of descent almost double the desired rate. This
high rate of descent was maintained throughout the
rest of the approach.
Seconds after 1040, the first ‘terrain ahead’ warning
sounded in stentorian English for six seconds, but
there was no reaction by the crew. A few seconds later
the navigator reported their height as 300m (980ft).
But he was now monitoring the aircraft’s height on the
radio altimeters and the terrain along the flight path
is as much as 80m (260ft) lower than the Runway 26
threshold.
The second ‘terrain ahead’ warning sounded with
the aircraft about 180m (600ft) above the runway
threshold. Half a minute later, when the aircraft
reached the decision height of 100m, (330ft) there
was no reaction by the captain.
The Commander-in-Chief’s indifference to the
extremely hazardous situation that was developing
probably influenced the captain to risk descending
below decision height, in the hope of making visual
contact. Although crew members called out ‘descent
height’ three times, the captain made no response.
But a few seconds before 1041, at 30m (100ft) on
the radio altimeter, the control column was abruptly
pulled back, overpowering the autopilot, and the
throttles were simultaneously pushed fully open.
Evidently at that moment the captain had caught
sight of the trees in front of the aircraft and reacted
instinctively.
It was too late. The aircraft passed through the upper
branches of a tree 10m above the ground, but more
than 10m below the elevation of the runway. Seconds
later, and 245m further along the up-sloping ground,
the port wing hit a more substantial tree, tearing
off the outer wing. The aircraft rolled and ploughed
violently into the ground upside down, breaking
apart as its wreckage slid to a stop 130m further
on. There was no substantial fire, but all on board
died instantly from high-impact forces estimated
at 100G.
Cause
The investigation concluded that the
immediate cause of the accident was
the failure of the crew to divert to
an alternate aerodrome when cloud
and fog were substantially lower than
the minimum descent height, as well
as their lack of response to ‘terrain
ahead’ warnings.
Comment
Photo: Russian Interstate Aviation Bureau (MAK)
One can only marvel at the utter lack of rigour in the planning, preparation and conduct of this VIP
flight, carrying not only the Polish president but also numerous other leading figures of the country’s
political, military and commercial life. Also difficult to comprehend is the lack of responsibility
manifested by senior personnel aboard the aircraft, who could have terminated the well-nigh
impossible approach.
61
WAR & REMEMBRANCE
Just before passing the middle marker, and
simultaneously with the warning that the aircraft had
reached the target height of 60m (200ft) the crew
had set on the radio altimeter, the co-pilot called, ‘go
around’. At that moment the aircraft’s actual height
was only 10-15m (30-50ft) above the runway. The
investigation believed that the co-pilot tried to initiate
a go around but did not complete it.
The control column had been pulled back, but not
enough to overpower the autopilot.
0
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FSA JUL-AUG 2011
62
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10
By the numbers: is your
transponder set correctly?
1
1
1
10
01
0
1
11
10
1
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1
Airservices Australia is continuing its rollout of Mode S secondary
0 surveillance radars (SSR) to replace the older Mode A/C-based SSR
0 systems, currently at capital city locations, and in the future at the
enroute radar stations. With this rollout, it is critical that pilots and
0 operators whose aircraft are installed with Mode S and automatic
1 dependent surveillance–broadcast (ADS-B) transponders enter
their aircraft’s flight identification (FLTID) and aircraft address
0 (ICAO 24 bit binary code) in their aircraft’s transponder/s correctly.
0
0 What to enter into the aircraft’s Mode S
1 transponder/s?
0 The AIP uses the term ‘aircraft identification’ rather than ‘flight ID’
specifying transponder requirements. ‘Aircraft identification’
1 when
is the approved ICAO terminology for this feature of Mode S;
0 however, ‘flight ID’ is the term avionics manufacturers and pilots
1 typically use.
Airline aircraft will have cockpit controls, which will need to be
set for each flight to enter the FLTID. That may also be the case for
some general aviation aircraft, whilst others may have the FLTID
set at installation of the transponder, so that it does not need to be
changed for each flight. Pilots should determine whether the ATC
transponder in their aircraft has been set up to ask for ‘flight ID’
at each power up, or whether it always uses a pre-programmed
Flight ID1.
It is important to enter the FLTID and the ICAO aircraft address
correctly. If you enter either of these incorrectly, ATC may not be
able to see your aircraft, or the ATC computers may confuse it with
another aircraft. You could also affect the detection of your aircraft
by the traffic collision avoidance system (TCAS) of other aircraft.
The codes are flight-critical information, so enter them carefully.
1
1
1
1
1
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1
Correct entry of FLTID
and aircraft address in an
aircraft’s Mode S/ADS-B
transponder
Flight Identification (FLTID)
The flight identification (FLTID) is the
equivalent of the aircraft callsign and is
included in both mode S SSR and ADS-B
transmissions. The FLTID is up to seven
characters long, and may be set by the flight
crew via a cockpit interface, or in the case
of general aviation aircraft, at the time of
installation or power on of the transponder.
When transmitted by the aircraft transponder following either a Mode-S radar
interrogation or by ADS-B squitter, FLTID
enables ATC to identify each individual
aircraft on a controller’s display screen, and
to correlate a radar or ADS-B track with the
submitted flight plan information filed by
the pilot or operator. Correlation between
an aircraft’s FLTID and the radiotelephony
callsign improves situational awareness and
communication between pilots and ATC. For
the Airservices ATC system to positively
correlate an aircraft FLTID to a flight plan,
the FLTID must exactly match the aircraft
identification (ACID) entered in Item 7 of the
flight notification.
1
The Garmin GTX33/330 transponders should never be set
to ‘SAME AS TAIL’ in Australian registered aircraft because
the product does not convert the 24-bit code to an Australian
registration-based flight ID, as it does for US-registered
aircraft.
1
0
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1
The aircraft identification you enter in
the flight notification and the transponder
should be no more than seven characters.
Airline aircraft providing scheduled flight
services must use the three-letter ICAO
airline code used in flight plans, not the
two-letter IATA codes. The ICAO threeletter designator for the aircraft operator is
followed by the flight number (i.e. QFA511
for Qantas flight 511). Do not add any zeros,
dashes or spaces if the aircraft identification
is fewer than seven characters.
General aviation aircraft, or other aircraft
not operating under an ICAO flight designator
must transmit the aircraft registration mark.
For VH-registered aircraft operating wholly
in Australian territorial airspace, enter only
the three letters of the registration mark;
for example, ABC; and do not include the
VH nationality mark. However, for those
flights where the aircraft is operating to an
overseas destination, you should include
the VH, followed immediately by the three
letters of the registration mark.
In almost all cases, the ICAO aircraft address is set at installation
and pilots should not change it. For ease of entry, many transponders
use the six-character (hexadecimal) or eight-character (octal)
equivalent form of the ICAO 24-bit code. These shorter, six or eightcharacter, forms of the code are used to reduce the risk of error
when entering the codes into the transponder.
Once it is set correctly, the aircraft address should not need to be
changed, unless the aircraft subsequently changes ownership and
registration. However, new aircraft arriving from overseas to be sold
in Australia often have the original FLTID and aircraft address in the
transponder from the country of origin; for example, a USA-issued
code, and not the correct Australian code. Owners should check for
that on delivery of an aircraft from overseas.
Conversion charts for entry of ICAO
aircraft address
There are conversion charts available on the internet which can be
used to convert the ICAO 24-bit aircraft addresses to the equivalent
hexadecimal or octal formats. For example, initial entry to a
transponder such as the widely used Garmin GTX330 requires entry
in hexadecimal, while some other types of transponders may use the
octal format.
For RA-Aus registered aircraft, enter the
allocated registration in full (e.g. 551875).
For non-airline foreign registered aircraft,
enter the full nationality and registration
marks without any zeros, dashes or spaces
(e.g. ZKABC).
ICAO aircraft address
The ICAO aircraft address for each aircraft is
issued by CASA, or the Recreational Aircraft
Association of Australia (RA-Aus), when it
is registered. The ICAO aircraft address is a
unique code that identifies each individual
airframe worldwide.
0
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63
BY THE NUMBERS
0
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Aircraft address conversion table –
binary to hexadecimal
In using the binary to hexadecimal chart below, the 24 binary bits
of the ICAO aircraft address are split into three groups of 8 bits.
Then each 8-bit binary group is looked up in the table and converted.
The three converted groups are then reassembled in the same
sequence into the corresponding hexadecimal format.
For example:
Bin
Hex
01010000
50
01010001
51
01010010
52
01010011
53
01010100
54
Bin
Hex
01010101
55
01110000
70
01010110
56
01110001
71
01010111
57
01110010
72
ICAO aircraft 24-bit address
011111001000000101100101
Split into three groups of 8 bits
01111100 10000001 01100101
01011000
58
01110011
73
Look up the table
7C
01011001
59
01110100
74
Aircraft hexadecimal address
7C8165
01011010
5A
01110101
75
01011011
5B
01110110
76
Hex
01011100
5C
01110111
77
00100000
20
01011101
5D
01111000
78
00100001
21
01011110
5E
01111001
79
01011111
5F
01111010
7A
01111011
7B
Bin
Hex
01111100
7C
01100000
60
01111101
7D
01100001
61
01111110
7E
01100010
62
01111111
7F
01100011
63
01100100
64
Bin
Hex
01100101
65
10000000
80
01100110
66
10000001
81
82
Bin
FSA JUL-AUG 2011
64
Bin
Hex
00010000
10
00010001
11
00010010
12
00010011
13
00010100
14
00010101
15
00010110
16
00010111
17
00011000
18
00011001
19
00011010
1A
00011011
1B
00011100
1C
00011101
1D
Hex
00011110
1E
00000000
00
00011111
1F
00000001
01
Bin
00000010
02
00000011
03
00000100
04
00000101
05
00000110
06
00000111
07
00001000
08
00001001
09
00001010
0A
00001011
0B
00001100
0C
00001101
0D
00001110
0E
00001111
0F
81
00100010
22
00100011
23
00100100
24
00100101
25
00100110
26
00100111
27
00101000
28
00101001
29
00101010
2A
00101011
2B
00101100
2C
00101101
2D
00101110
2E
00101111
65
2F
Bin
Hex
00110000
30
00110001
31
00110010
32
00110011
33
00110100
34
00110101
35
00110110
36
00110111
37
00111000
38
00111001
39
00111010
3A
00111011
3B
00111100
3C
00111101
3D
00111110
3E
00111111
3F
01100111
67
10000010
Hex
01101000
68
10000011
83
01000000
40
01101001
69
10000100
84
01000001
41
01101010
6A
10000101
85
01000010
42
01101011
6B
10000110
86
01000011
43
01101100
6C
10000111
87
01000100
44
01101101
6D
10001000
88
89
Bin
01000101
45
01101110
6E
10001001
01000110
46
01101111
6F
10001010
8A
8B
01000111
47
10001011
01001000
48
10001100
8C
01001001
49
10001101
8D
01001010
4A
10001110
8E
01001011
4B
10001111
8F
01001100
4C
01001101
4D
01001110
4E
01001111
4F
0
1
0
1
01
0
1
1
0
1
00
10
10
01
10
00
00
01
10
01
00
01
10
01
10
01
Hex
10110000
B0
10110001
B1
10110010
B2
10110011
B3
10110100
B4
10110101
B5
10110110
B6
10110111
B7
1
0
1
0
Bin
Hex
10111000
B8
10010000
90
10111001
B9
Bin
Hex
10010001
91
10111010
BA
11100000
E0
10010010
92
10111011
BB
11100001
E1
10010011
93
10111100
BC
11100010
E2
10010100
94
10111101
BD
11100011
E3
10010101
95
10111110
BE
11100100
E4
10010110
96
10111111
BF
11100101
E5
10010111
97
11100110
E6
10011000
98
Bin
11100111
E7
10011001
99
11000000
C0
11101000
E8
10011010
9A
11000001
C1
11101001
E9
EA
Hex
10011011
9B
11000010
C2
11101010
10011100
9C
11000011
C3
11101011
EB
10011101
9D
11000100
C4
11101100
EC
10011110
9E
11000101
C5
11101101
ED
10011111
9F
11000110
C6
11101110
EE
11000111
C7
11101111
EF
11001000
C8
11001001
C9
01
10
11
1
1
1
0
1
0
1
0
1
0
0
0
1
0
0
0
1
1
0
1
1
1
1
1
0
1
0
1
1
1
1
1
1
0
1
0
0
1
0
1
0
1
1
1
1
1
0
1
0
0
1
0
1
0
1
0
1
0
1
0
1
0
1
1
1
1
1
0
1
Bin
Hex
11110000
F0
11110001
F1
11110010
F2
11110011
F3
11110100
F4
11110101
F5
11110110
F6
11110111
F7
11111000
F8
11111001
F9
11111010
FA
11111011
FB
11111100
FC
11111101
FD
11111110
FE
11111111
FF
65
BY THE NUMBERS
0
1
01
10
11
00
11
00
11
01
11
11
11
10
11
00
11
0
1
Bin
11001010
CA
CB
11001100
CC
11001101
CD
11001110
CE
11001111
CF
Bin
Hex
11010000
D0
11010001
D1
For example:
11010010
D2
ICAO aircraft 24-bit address
011111001000000101100101
11010011
D3
Split into 8 groups of 3 bits
011 111 001 000 000 101 100 101
11010100
D4
Look up the table
3
11010101
D5
11010110
D6
Aircraft octal address
37100545
11010111
D7
11011000
D8
11011001
D9
11011010
DA
11011011
DB
11011100
DC
10101101
0
1
1
0
Hex
1
A0
0
A1
A21
A30
A4
1
A5
A61
A7
1
A8
A91
AA
1
AB
0
AC
1
AD
11001011
11011101
DD
10101110
AE
11011110
DE
10101111
AF
11011111
DF
Bin
10100000
10100001
10100010
10100011
10100100
10100101
10100110
10100111
10101000
10101001
10101010
10101011
10101100
Aircraft address conversion table –
binary to octal groups
In using the binary to octal chart below, the 24 binary bits of the ICAO
aircraft address are split left to right into eight groups of three bits
each. Then each three-bit binary group is looked up and converted.
The eight converted groups are then reassembled in the same
sequence into the corresponding octal format.
0
1
1
0
1
0
1
7
1
0
Binary group
000
0
5
4
5
Octal group
0
001
1
010
2
011
3
100
4
101
5
110
6
111
7
1.
An aerodrome frequency response unit (AFRU) will broadcast
an announcement after the end of an aircraft transmission (of
more than two seconds duration):
6.
(a) lift from the aft part of the rotor disc compared to the
forward part.
(a) after every fifth transmission.
(b) lift from the forward part of the rotor disc compared to
the aft part.
(b) after every tenth transmission.
(c) when there has been no transmission for more than
90 seconds.
(c) phase lag at the aft part of the rotor disc compared to
the forward part.
(d) when there has been no transmission for more than
five minutes.
FSA JUL-AUG 2011
66
2.
3.
If an aircraft is on a heading of 330(m) and the ADF bearing is
050 relative, the (m) track to the NDB is:
(d) phase lag at the forward part of the rotor disc compared
to the aft part.
7.
(a) diminishes with increasing airspeed.
(b) 080
(b) increases with increasing airspeed.
(c) 280
(c) does not vary with forward speed.
(d) 020
(d) only results from a crosswind.
At a towered aerodrome, runway guard lights (RGLs) on
standard taxiways, refer to flashing:
8.
If an aircraft has a stall speed in straight and level flight of 41
KIAS, the stall speed at the same weight during a turn at a 60º
angle of bank will be approximately:
(a) 58 KIAS.
(b) red lights at either side of the holding point mark which
are extinguished with a clearance to enter the runway.
(b) 51 KIAS.
(c) yellow lights at either side of the holding point mark which
remain on regardless of a clearance to enter the runway.
(d) 44 KIAS.
(d) yellow lights at either side of the holding point mark which
are extinguished with a clearance to enter the runway.
At a towered aerodrome, stop bar lights are:
(a) always red and do not flash, whereas runway guard lights
(RGLs) are always flashing yellow.
(b) always red and flashing, whereas runway guard lights
(RGLs) are always steady yellow.
(c) always flashing red.
(d) the only lights which are distributed across the taxiway.
5.
On a helicopter moving forward, transverse flow effect:
(a) 050
(a) red lights at either side of the holding point mark which
remain on regardless of a clearance to enter the runway.
4.
On a helicopter moving forward, transverse flow lift refers to
the effect of greater:
For flight notification via the NAIPS system, if a common
name is entered for a significant point, the system will:
(a) assume that this means the aerodrome of that name.
(b) assume that this means the navigational waypoint
associated with that name.
(c) ignore the location.
(d) request clarification.
(c) 47 KIAS.
9.
In order to provide power for anti-icing, an electrically
heated propeller requires
(a) DC power.
(b) AC power.
(c) brushes and slip rings.
(d) brushes and a commutator.
10. A magneto impulse coupling produces:
(a) a retarded spark and requires battery power only
for starting.
(b) a retarded spark and does not require battery power.
(c) an advanced spark and requires battery power
for starting.
(d) an advanced spark and does not require battery power.
1.
The tripping of a differential pressure indicator (DPI)
associated with an oil filter occurs when the:
8.
(a) downstream pressure reduces below a pre-set amount.
(b) the flow rate through the filter reduces below a
pre-set amount.
(a) slowly reduces, because the terminal voltage of the
battery approaches the charger output voltage.
(c) the upstream pressure exceeds a pre-set amount.
(b) slowly reduces, because the terminal voltage of the
battery reduces.
(d) the pressure drop across the filter element exceeds a
pre-set amount.
2.
(b) DC at twice the frequency of the applied voltage.
(c) AC at the same frequency as the applied voltage.
(d) AC at twice the frequency of the applied voltage.
For silver soldering, an oxyacetylene flame should be:
(a) oxidising.
(b) strongly oxidising.
(c) neutral.
(d) reducing.
4.
(c) slowly increases, because the battery internal
resistance increases.
If an AC voltage is applied across a resistor, the resulting
current through the resistor will be:
(a) DC at the same frequency as the applied voltage.
3.
As a general principle, as the charge state of a battery
increases the charging current from a constant voltage
battery charger:
Acetylene is normally:
(a) stable, but will tend to become unstable at pressures
above about 15psi.
(d) slowly reduces, because the battery internal
resistance reduces.
9.
A twin-spool turbo prop engine is easier to start because,
during start mode, the starter-generator only has to drive the:
(a) power turbine.
(b) high-pressure turbine and compressor.
(c) compressor turbine.
(d) low-pressure turbine and compressor.
10. The purpose of a localiser is to:
67
(a) indicate a fixed distance from the runway threshold.
(b) align the aircraft with the runway extended centre line.
(c) indicate the distance from the runway touch-down
markers.
(d) define a pre-determined approach angle to the runway.
(b) stable up to a pressure of 30psi.
(d) unstable unless the pressure exceeds 40psi.
5.
A squib in an aircraft fire protection system is:
(a) a heat detector employing eutectic solder.
(b) a device for releasing stored extinguishant.
(c) an extinguisher bottle that fails to fire.
(d) a heat detector using a bimetallic disc.
6.
A possible source of windscreen cracking in a dual element,
electrically-heated windscreen is the strong temperature
gradient across the screen during operation due to:
(a) an open circuit in one element during parallel operation.
(b) an open circuit in one element during series operation.
(c) a short circuit in one element during parallel operation.
(d) a short circuit in one element during series operation.
7.
The purpose of an eductor in a pneumatic de-icer system is
to provide a:
(a) high pressure to deflate the boots.
(b) high pressure to inflate the boots.
(c) low pressure only until the boots are deflated.
(d) low pressure to deflate the boots and hold them as
close as possible to the aerofoil profile.
QUIZ
(c) unstable, but will tend to become stable if stored
under pressure.
Albury NDB or VOR RWY 07 approach
You are tracking along W696 between Eildon Weir (ELW) and
Wangaratta (WGT) (Refer ERC L2) at A070, then flight planned to
Albury (YMAY) along W465.
Now passing 17 GPS AY with no RAIM warnings active, you
consider further descent, noting also with a further check on
the AY VOR that there is only the Morse identifier.
3.
(a) The route LSALT of 4200
The date is 20 August, and your estimate overhead WGT is 1030Z.
(b) The MSA of 5400
You are in a BE55 Baron (Category B) equipped with TSO'd GPS,
VOR, 1 R.M.I. (ADF) and one fixed card ADF. You are endorsed and
current on all these nav aids for approaches.
You copy the AY ATIS, noting the time when AY TWR closes, to
gain the surface conditions. The ATIS indicates a wind of 060/15
with a cloud base of broken at 1900 and with a visibility of 8km in
rain showers.
(c) The MSA of 3400
(d) The sector C DME or GPS arrival step of 4500
4.
FSA JUL-AUG 2011
(b) ‘Albury traffic (aircraft registration), altitude,
inbound, Albury.’
(c) ‘Albury Tower (aircraft registration), 17 GPS AY on the
225 radial (altitude) received (ATIS) request clearance.’
The following questions relate to the descent and this approach
(plate dated 10 March 2011):
1.
At what distance can you expect to copy the ATIS and on
what frequency?
Now approaching 14 GPS you consider a lead in to join the arc.
(a) 60nm on AY NDB 236
5.
What would be an approximate initial heading to turn onto to
join this arc?
(b) 60nm on AY VOR 115.6
(a) 315°M
(c) 90nm on 120.6
(b) 135°M
(d) 90nm on AY VOR 115.6
(c) 245°M, the lead radial
(d) 065°M, the reciprocal of the lead radial since you
are inbound
You pass overhead WGT at 1030 having planned top of descent.
2.
Which of the following would be the content of your
inbound call?
(a) ‘Albury traffic (aircraft registration) an IFR Baron,
17 miles southwest passing (altitude) inbound for the
(approach description) estimating AY at (time) Albury.’
Based on this information, you elect to conduct the RWY 07 VOR/
DME via the 12 arc.
68
What height may you now descend to?
What height may you initially descend to along this track?
(a) The sector C DME or GPS arrival altitude of 5000.
(b) The route LSALT of 4200
(c) The MSA of 3400
Established on the arc at 3400, and with a current heading of
355°M you consider the lead radial.
6.
(d) The MSA of 5400
If you have already pre-set the VOR final track of 075 for the
intercept, what would you expect the ADF (RMI) and ADF
(fixed card) to read respectively at this lead radial/bearing?
(a) RMI 265, fixed card 090R
(b) RMI 085, fixed card 270R
(c) RMI 065, fixed card 090R
(d) RMI 065, fixed card 070R
7.
What altitude can you now descend to passing this
lead radial?
(a) You must remain at 3400 until past 12 GPS on the final
approach track of 075.
(b) 3000 but only when within half scale of the 075 track.
(c) 3000
(d) 2240
8.
Your single navigation display is an H.S.I that can be selected
to ‘VLOC’ or ‘GPS’. It must be selected to ‘VLOC’ for the final
approach. True or false?
(a) True
(b) False
Passing the final approach fix, you descend to the MDA. Note that
no telephone coverage is available.
9.
What is this MDA for landing on RWY 07?
(a) 2050ft on AWIS QNH, visibility 2.4km
(b) 1800 since no ATIS or AWIS QNH, visibility 5.0km
(c) 1700 on AWIS QNH, visibility 5.0km
(d) 1950 on ATIS QNH, visibility 2.4km
You land and vacate RWY 07. Post-landing checks are completed.
10. Whom will you contact to cancel the SARWATCH?
(a) AY TWR 124.2, since there is no SMC
(b) It is cancelled automatically at a controlled aerodrome
(c) ML Centre on 125.2 in the circuit, since VHF contact is
unavailable on the ground.
(d) ML Centre on 125.2, since VHF contact is available on
the ground.
69
QUIZ
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FSA JUL-AUG 2011
70
2
3
3
4
10
10
10
11
13
15
16
17
17
17
17
17
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71
QUIZ ANSWERS
IFR OPERATIONS
1. (d) GEN-3.4 – 8.
2. (d) 330 + 050 = 020.
3. (c) Airservices 16/05/2011
Safety Bulletin. AD 1.1-26.
4. (a)
5. (b) ERSA GEN –PF- 4 para. 6.2.
6. (b)
7. (a)
8. (a)
9. (c) and can use either AC
or DC.
10. (b) only the ‘shower of sparks’
system requires bus power.
1. (d) AIP GEN 1.5-7 Para 2.2b Approach plate
2. (b) ERC 2
AIP ENR 1.5-2 Para 1.4
3. (c) AIP ENR 1.5-14 Para 2.2.1 Note that your inbound track is along
the dividing line (225 radial) for the sector MSA.
4. (a) After 1030Z AY TWR closes (ERSA FAC A-14). The absence of
the ATIS confirms this. So AY is now a CTAF.
AIP ENR 1.1-75 Para 46.1 and 1.1-43 Para 20.1-12
5. (a) A 90° turn to your inbound track is suggested using a rule of
thumb for anticipating the turn of 1 per cent of your groundspeed
e.g. 130kt. Thus 1.3nm prior to the 12DME arc, start the turn.
This works quite well at rate one.
6. (d) RMI shows magnetic track to the station, hence the L.R. of
245-180 = 065. Fixed card based on HDG thus 355 to 065 = 070R.
7. (c) Approach plate
8. (a) AIP GEN 1.5-15 Para 8.5.5.1b
AIP ENR 1.5-13 Para 2.1.1
The GPS is used to replace DME i.e. distance information only,
not track guidance.
9. (b) Approach plate.
Note that outside TWR hours there is no AWIS so the 100'
reduction cannot be applied.
AIP ENR 1.5-30 Para 5.3.1.c and 5.3.2 refer
10. (d) Outside TWR hours thus: ML CEN 125.2
ERSA FAC A-14
Note: Answer (b) is correct during TWR hours.
MAINTENANCE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
(d)
(c)
(c)
(a)
(b)
(a)
(d)
(a)
(b)
(b)
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flightsafety
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INSIDE SEPT - OCT 2011
Here comes the judge: The trend towards
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Cabin series continues
Hotting up: Aerial firefighters prepare for
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And … more close calls
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;OLYLOHZUL]LYILLUHIL[[LY[PTL
[VIL^P[ONVVKWLVWSL
*RRGSHRSOHWREHZLWK
8),0UZ\YHUJL(\Z[YHSPH3PTP[LK()5! (-:3PJLUJL5V *VU[HJ[KL[HPSZMVY`V\HUK`V\YIYVRLY!
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