Aviation Accident Summaries

Aviation Accident Summary MIA97LA087

CALHOUN, GA, USA

Aircraft #1

N72GL

Cessna 310R

Analysis

The copilot stated the PIC had requested a lower altitude and switched the fuel tanks from the main fuel tank to the auxiliary fuel tank position. The engines sputtered, and they switched back to the main fuel position. The PIC informed ATC, 'sir we are running out of fuel now.' A witness heard the engines sputter and saw the airplane approaching his position at tree top level. The airplane made a left turn followed by a steep bank to the right and disappeared from view below the tree line. Examination of the crash site revealed the left fuel selector was in the main fuel position. The right fuel selector was found loosely in-between the auxiliary and main fuel position. Disassembly of both engines revealed no evidence of a precrash mechanical failure or malfunction. Examination of the left propeller revealed it was operating under low power at impact, and was probably windmilling. The right propeller was operating under conditions of higher power at impact. Neither propeller was in the feather position or were in the vicinity of the low pitch stop at impact.

Factual Information

On February 27, 1997, about 0250 eastern standard time (EST), a Cessna 310R, N72GL, Skibble 840 (SBQ840), registered to SmithKline Beechman Clinical Laboratories, operating as a 14 CFR Part 91 corporate flight, crashed in the vicinity of Calhoun, Georgia, during a forced landing. Instrument meteorological conditions prevailed and an IFR flight plan was filed. The airplane was destroyed by a post crash fire. The airline transport pilot-in-command (PIC), and airline transport copilot (CP) sustained serious injuries. The flight originated from New Orleans, Louisiana (NEW), about 2 hours 49 minutes before the accident. The PIC stated he was scheduled to depart Lawrenceville, Georgia (LZU), at 1930 EST en route to Jackson, Mississippi (JAN). The flight time was scheduled for 2 hours en route. No fuel was purchased at JAN. He was scheduled to depart JAN at 2115 central standard time (CST) en route to NEW with 50 minutes en route. He was scheduled to take on 70 gallons of fuel, and depart NEW at 2215 CST en route to LZU. The flight time was scheduled for 2 hours 5 minutes. He could not recall who flew the 1st or 2nd leg. The CP stated the PIC flew the 1st and 2nd leg, and he started off flying the 3rd leg. The PIC stated he conducted the preflight inspection before departing LZU, and determined that the auxiliary fuel tanks and main fuel tanks were full of fuel. (See the pilot statement for fuel computations pertaining to the flight). They departed LZU on the main fuel tanks near their scheduled departure time and climbed to 6, 000 feet. He switched the main fuel tanks to the auxiliary fuel tanks after they had been airborne for 1 hour 30 minutes. Ten minutes before their arrival time at JAN, he switched the auxiliary fuel tanks back to the main fuel tanks. He estimated his average fuel burn rate at 36.8 gallons per hour. They departed JAN at 2100 CST and climbed to 6,000 feet which took 15 minutes. He switched the fuel tanks to the auxiliary tanks for 25 minutes, and switched back to the main fuel tanks 10 minutes before arriving at NEW. Upon landing, he requested that 70 gallons of fuel be added to the airplane. The refueler could only put 33 gallons of fuel in each main fuel tank., and 2 gallons were put in each auxiliary fuel tank. The PIC stated he did not up date his weather before departing NEW, and an alternate airport was required at LZU. He did not know what the alternate airport was because he did not have a copy of the canned company flight plan. In addition, he did not recall any conversations with the CP regarding the weather conditions at LZU. The CP stated he was in the left front seat flying the airplane when they departed NEW at about 2310 CST. Review of recorded transcripts revealed they were airborne at 2226 CST (0426 UTC). The PIC stated they switched to the auxiliary fuel tanks 1 hour 30 minutes after takeoff, remained on the auxiliary fuel tanks for 14 minutes, and switched back to the main fuel tanks 10 minutes before starting the instrument approach at LZU. He called company operations inquiring about the weather conditions at LZU. The chief pilot stated he informed the PIC that other airplanes had been getting in, and he should have no problem. The PIC stated they were cleared for the ILS runway 25 approach at 0110 EST (0610 UTC). Review of transcripts revealed SBQ840 was cleared for the approach at 0619:24. The 0556 UTC Atlanta (ATL) surface weather observation was: 100 broken, 600 overcast, visibility 4 miles, fog, temperature 56 degrees Fahrenheit, dewpoint 56 degrees Fahrenheit, wind from 110 degrees at 4 knots, and altimeter29.98 in Hg. Review of transcripts revealed that SBQ840 made a missed approach at 0625:52 and requested another ILS at LZU. In addition, the PIC informed company operations that he had made a missed approach, and that he would try again. According to the Assistant Manager, Gwinnet County Briscoe Field Tower, there were no NOTAMS in effect at LZU concerning airport lighting. SBQ840 was provided radar vectors to the final approach course, and was cleared for the second ILS approach at 0632:31. SBQ840 stated at 0639:01, "yes sir skibble eight forty back with you and three thousand." SBQ840 stated at 0639:40, "sir eh let's go ahead and eh eh hold over the ndb we're receiving it now if that's okay with you and eh we'll eh wait and see if this other guy gets in and then we'll work it out from there." The controller informed SBQ840 that he would vector him around a little to keep him clear of the area, while they waited for the other airplane to try the approach. The chief pilot stated that SBQ840 called him and stated, "it was too low, he had gone missed again, and was going to ATL." He asked him to hold to see if the weather would improve. About 3 minutes later the chief pilot informed SBQ840 to proceed to ATL and to call him when he arrived. The PIC stated about 3 minutes after the second missed approach that they switched back to the auxiliary fuel tanks. He calculated with a calculator that he had the following fuel on board: Left Main: 2.8 Right Main: 2.8 Left Aux: 12.42 Right Aux: 12.42 At 0645:22, SBQ840 informed Atlanta approach that they would like to proceed to Atlanta International Airport. SBQ840 was provided radar vectors for the ILS runway 8 left. The PIC stated he switched back to the main fuel tanks before starting the ILS approach. Review of transcripts revealed that SBQ940 was cleared for the approach at 0709:06 (0209:06 EST), and made a missed approach at 0714:23. The 0656 UTC, ATL surface weather observation was: 100 overcast, visibility 4 miles, temperature 56 degrees Fahrenheit, dewpoint 56 degrees Fahrenheit, wind from 110 degrees at 5 knots, and altimeter 29.99 inHg. The PIC requested the Fulton County (FTY) weather, another ILS approach at ATL. The FTY weather at 0646 UTC was: wind calm, visibility 3/4 of a mile, mist, ceiling 300 overcast, temperature and dewpoint missing, and altimeter 30.00 inHg. While they were being vectored for the approach the CP stated he put the airplane on autopilot, and he and the PIC changed seats so the PIC could fly the airplane. When asked how much fuel they had used for third approach, the PIC calculated with a calculator that they had used 5.7 gallons in the left and right main fuel tank. When the PIC started to subtract his calculations from the previous calculated fuel quantities, he realized that he had not been calculating the fuel that was being returned from the auxiliary fuel tanks to the main fuel tanks. Review of transcripts revealed that SBQ840 was cleared for the approach at 0722:05, made a missed approach at 0727:33, and informed approach at 0727:41, "yes sir er we are running into a situation here we have about ah probably about forty minutes of fuel we need to find another place to go." SBQ840 was asked if he wanted to try FTY or if he had something else in mind. SBQ840 requested the weather at FTY which was provided by ATL approach. SBQ840 informed approach at 0728:58, "okay we'll go ahead and try fulton county." As SBQ840 was being vectored for the ILS approach at FTY, the controller informed him that the glideslope was unusable. SBQ840 requested to divert to Chattanooga, Tennessee (CHA), and to remain at 4,100 feet. A short time later, SBQ840 was instructed to climb to 6,000 feet. The chief pilot stated SBQ840 called on the radio and informed him that they were not able to get in at ATL and that he was going to CHA. He was informed that another company airplane had landed at LZU and asked if he would like to try LZU again. SBQ840 told him no, "he was low on fuel and would prefer CHA where weather conditions were reported as marginal," and indicated his auxiliary fuel tanks were empty. While in cruise flight SBQ840 requested the CHA weather at 0739:42. The controller informed SBQ840 that the CHA weather at 0653 was: winds 200 at nine, visibility 5 miles, mist, ceiling 800 variable to1,300. SBQ840 requested a lower altitude and was cleared to descend to 4,100 feet. The controller asked SBQ840 if he wanted to go all the way to CHA, and stated, he wasn't sure what the weather was at Rome, Georgia. SBQ840 elected to continue to CHA. At 0744:15, SBQ840 was cleared to descend to 3,400 feet. The controller asked SBQ840 if he was going to be able to do the complete ILS approach at CHA. SBQ840 stated he would do the full approach, and was cleared direct to daisy, and was informed by that they would have the approach clearance in a few moments. The CP stated they switched to the auxiliary fuel tanks, the engines sputtered, and they switched back to the main fuel tanks. SBQ840 stated at 0745:10, "emergency here eh we are running out of fuel." The controller asked SBQ840 how much fuel do you have. SBQ840 stated at 0745:20, "sir we are running out of fuel now." The controller informed SBQ840 the Calhoun airport was at his 10 o'clock and two miles. SBQ840 asked, "does it have an approach?" The controller informed SBQ840 that it had an localizer approach. SBQ840 requested and received the localizer frequency, followed by, "where's the airport Atlanta" at 0746:15. The controller stated it should be just off your left wing there about a mile. The last recorded communication of SBQ840 was at 0746:23, when he stated, "and approach where's the airport for Skibble eight forty." Radar contact was lost with SBQ840 at 0746:35. A witness located in the vicinity of the Tom B. David Field, Calhoun, Georgia, stated he was outside filling a propane tank when he observed an airplane approaching his location at treetop level with the engines sputtering. He turned off the propane to listen to the engine noise. The engines continued to sputter and quit. The airplane was observed to start a turn to the left, then made a steep bank to the right, disappearing from view below the tree line. A short time later, the witness observed an orange glow which lasted an instant, and went out immediately. He called 911 to report a possible airplane accident. The wreckage of N72GL was located about 1 nautical mile southwest of the Tom B. David Airport, Calhoun, Georgia. Examination of the crash site revealed the airplane collided with trees in a descending left wing low attitude on a heading of about 268 degrees magnetic. The left wing tip (main) fuel tank had separated, and was located on the right side of the crash debris line. The fuel tank was ruptured, and there was no browning of vegetation or noticeable odor of fuel. The left auxiliary fuel tank was ruptured. The fuselage, right wing, and inboard portion of the left wing remained intact and came to rest inverted. The right main fuel tank and auxiliary fuel tank sustained extensive fire damage. The left main fuel selector valve was found in the main position. The right main selector valve was found loose in the housing between the auxiliary and main fuel position. The left and right engines were separated from the wing and displaced to the right. The left and right propeller assembly separated the propeller flange. Two propeller blades on the left propeller were bent aft with no signs of torsional twisting or chordwise scarring. Two of the right propeller blades had extensive bending and twisting damage. The remaining propeller blade tip was broken off and not recovered. Examination of the airframe, and flight control assembly revealed no evidence of a precrash mechanical failure or malfunction. All components necessary for flight were present at the crash site. Continuity of the flight control system was confirmed for pitch, roll, and yaw. For additional information see, FAA RECORD OF ON-SITE INVESTIGATION, Date: 02-27-97 and Cessna REPORT OF ON-SITE INVESTIGATION, 20 March, 1997. The left and right engine assembly were transported to the manufacturer and disassembled in the presence of the FAA and parties to the investigation. It was concluded that both engines sustained fire and impact damage. Both engines exhibited normal operational signatures throughout, and appeared to be operational prior to the accident For additional information see, TELEDYNE CONTINENTAL MOTORS ANALYTICAL INSPECTION REPORT, DATE: 03-31-97. The left and right propeller assembly were transported to the manufacturer and examined in the presence of the FAA. It was concluded that there was no indication of any type of propeller failure prior to impact. All propeller damage was a result of impact. Both propellers were rotating at impact, and were in the vicinity of the low pitch stop. Neither propeller was at or near the feather position at impact. The left propeller was operating under low power at impact, and was probably windmilling. The right propeller was operating under conditions of higher power and energy at impact. For additional information see, McCAULEY Teardown Inspection of Propellers From Cessna 310R, N72GL, date: April 16, 1997. The wreckage of N72GL was released to Mr. Max Allen, Allen Aero Services, Jefferson, Georgia, on March 4, 1997. The aircraft logbooks were released to Mr. John Reiner, SmithKline Beechman Clinical Laboratories, Lawrenceville, Georgia, on March 7, 1997. The left and right engine assemblies were released to Mr. Joseph B. Smith, Teledyne Continental Motors, Mobile, Alabama, on March 31, 1997. The left and right propeller assemblies were released to Mr. Thomas M. Knopp, McCauley Propellers, Vandalia, Ohio, on April 1, 1997.

Probable Cause and Findings

The pilot-in-command's improper fuel management and improper positioning of the fuel selector valve to the empty fuel tank. Factors in the accident were: the PIC's improper in-flight planning and decision, his failure to list an alternate airport, and his decision to allow the newly hired copilot to perform instrument approaches in marginal weather which led to numerous instrument approaches and missed approaches.

 

Source: NTSB Aviation Accident Database

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