MODESTO, CA, USA
N214BD
Cessna T210N
The pilot departed Modesto with 90 gallons of fuel. He first flew to Fresno to pickup some passengers, and then to Phoenix. In Phoenix, he requested the right tank be filled and that half that amount be added to the left tank. The fuel receipt showed that a total of 45 gallons were added. The pilot said he did not visually check the fuel levels. While passing Bakersfield, he noticed his fuel gauges indicated a higher than expected rate of fuel consumption and reduced the power setting. Nearing his destination, the pilot began switching tanks until both ran dry. The engine quit about 4 to 5 miles from the runway, resulting in a forced landing in an almond orchard. The pilot said that by his calculations, he had sufficient fuel onboard to complete the flight. The engine tachometer showed 6.9 total hours for the entire flight. Performance charts revealed a similar flight would require at least 130 gallons of usable fuel without reserves. Fuel records showed a total of 132 gallons of usable fuel had been available. An AD to prevent loss of engine power caused by inadvertent fuel loss or inadequate fuel servicing was accomplished on 1/19/95. In accordance with the AD, the operator had recalibrated the fuel gauges, placed placards on the fuel filler ports, and revised the pilot operating procedures in the POH.
On December 8, 1995, about 0200 hours Pacific standard time, a Cessna T210N, N214BD, crashed in an almond orchard while on approach to Harry Sham Field, Modesto, California. The aircraft was destroyed; however, the pilot, the sole occupant, was not injured. The aircraft was being operated as a non-revenue business flight by Modesto Executive Air Charter when the accident occurred. The flight originated in Modesto about 1725 with a stop in Fresno, California, and Phoenix, Arizona. The final departure from Phoenix was about 2230 hours mountain standard time (MST). Instrument meteorological conditions prevailed at the time and an IFR approach clearance had been obtained. The pilot reported that he left Modesto with full fuel (90 gallons; 45 gallons per tank). The manufacturer stated that, of that amount, 1.5 gallons per tank or a total of 3.0 gallons of that amount are unusable. He leaned the engine and set the power at 29 inches of manifold pressure and 2,400 rpm. He first flew to Fresno to pick up his passengers, arriving about 1750, and then departed for Phoenix about 1815. During his flight to Phoenix his cruising altitude was 9,500 feet msl. He made an en route climb to clear a mountain range and then descended back down to 9,500 feet until beginning his descent into the Phoenix area. The flight arrived about 2245 MST. He deplaned his passengers and requested fuel. According to the lineman on duty, the pilot requested the right tank be filled and then to add half that amount to the left tank. The lineman said he had dispensed somewhere between 23 and 25 gallons. He was waiting for the right tank to settle so that he could top it off when the pilot told him that was 'OK' and instructed him to go ahead and start filling the left tank. At first the pilot instructed him to stop at 38 gallons, then 40, and finally 45 gallons. The pilot reported that 26 gallons were added to the right tank, which he said topped it off. The remaining 19 gallons were pumped into the left tank which the pilot said brought the left fuel gauge up to between 3/4 and full. The fuel receipt shows that a total of 45 gallons were dispensed. After the refueling was completed, the pilot said he did not visually check the fuel levels, or that both of the fuel caps were properly seated. (The fuel receipt and the fuel log are appended to this report.) Both the lineman and his supervisor observed the pilot after his arrival at Sky Harbor airport's executive terminal. To them, the pilot appeared to act differently than the pilots they were accustomed to meeting. The lineman said he displayed a somewhat belligerent attitude while asking for transportation to the main terminal for his passengers. He also said the pilot seemed agitated and anxious for the refueling process to be completed. After the aircraft departed the executive ramp, the lineman happened to again observe the aircraft from the cab of his fuel truck as it taxied for departure. He described its taxi speed as 'fast', also noting that the aircraft made an intersection departure without an engine run-up. The lineman's supervisor also described the pilot's behavior as 'bizarre' due to the nervousness he displayed. Based on his observations he thought some sort of substance abuse could have been involved. On departure the pilot reported the fuel selector was on set on "both". He climbed to a cruising altitude of 10,500 feet msl, and leveled off with the same power setting as the previous leg. As the flight reached a point abeam and east of Bakersfield, he became concerned because he now noticed the fuel gauges were indicating a higher rate of fuel consumption than he had expected. As a precaution he reduced the power setting to 25 inches of manifold pressure and 2,300 rpm. While nearing Fresno the pilot filed a request for an instrument approach from his current position into Modesto. He was given an instrument clearance and continued towards his destination. He checked weather at his destination by calling Sky Trek UNICOM (VHF 132.00) and asking the operator for a current observation. The current weather was reported as 2 miles visibility with breaks in the clouds. Over Fresno the pilot noticed that the fuel gauges now indicated about 10 gallons in the right tank and 15 gallons in the left tank. Because of his low fuel condition he switched to the right tank and ran it until it indicated empty, and then switched to the left tank and ran it until it also indicated empty. He switched back to the right tank, ran it until it was dry, and then switched to the left tank. After being cleared for the Modesto ILS approach to runway 28R the pilot initiated his decent into the Modesto area, entering a cloud layer at 1,500 feet msl. While on the localizer, and still about 4 to 5 miles from the runway, he lost all engine power. Realizing that he would not be able to complete the planned approach the pilot lowered the landing gear and began his final descent while still about 3 miles from the end of the runway. Through the darkness the pilot maneuvered the aircraft away from a ground light he thought might be a house before striking several trees as the aircraft settled into an almond grove. The aircraft came to rest in a level upright attitude and the pilot was able to exit the aircraft without assistance. A postcrash inspection of the aircraft by FAA inspectors revealed no evidence of fuel in either tank. The left wing tank was ruptured. The engine fuel system contained less than 2 ounces of residual fuel. The engine fuel sump and the flow divider screens were clean. Both fuel caps were seated and aligned and there was no evidence of fuel staining around the filler port, wing surfaces, or trailing edges. The turbocharger rotated freely and the intake air filter was clean and undamaged. There was no evidence of a fuel residue in the immediate area or reports of precipitation since the accident occurred. The pilot maintained that by his calculations he had sufficient fuel onboard to complete the flight. The engine tachometer indicated 6.9 total hours for the flight from Modesto to Phoenix and return, up to the point of the forced landing. Based on the performance charts provided by the aircraft manufacturer for a 1984 model T210N, a flight of 6.9 hours (tachometer) in duration with three takeoffs and climbs, leaned in accordance with the POH, and with a cruise power setting of 29 inches of manifold pressure and 2,400 rpm at 10,000 feet msl (interpolated), would consume about 130 gallons of usable fuel. According to the fuel records the aircraft was refueled with a total of 135 gallons with 3 gallons unusable. (The manufacturer's performance planning tables are appended to this report.) According to the operator's records, an airworthiness directive (AD 94-12-08) to prevent loss of engine power caused by inadvertent fuel loss or inadequate fuel servicing was accomplished on January 19, 1995. The operator chose to recalibrate the fuel gages (c ) (1), to placard each fuel filler opening (d) (2), and revise the pilot operating procedures - preflight fuel system quantity check. (AD 94-12-08 is appended to this report.)
the pilot's inadequate preflight planning and preparation, which resulted in fuel exhaustion, due to an inadequate supply of fuel, followed by a forced landing in an area of trees. Darkness was a related factor.
Source: NTSB Aviation Accident Database
Aviation Accidents App
In-Depth Access to Aviation Accident Reports
