Fernandina Bch, FL, USA
N14A
Piper PA-30
The airplane was fueled on the day of the accident; the fuel from the fuel truck was contaminant free. No rain was reported at a nearby airport from the time the airplane landed the day before, to the time of departure. After takeoff with the landing gear retracted, the flight climbed to approximately 200 feet, banked left, then quickly to the right. One witness briefly heard a sputtering sound. The airplane was observed to bank to the left, and impacted the ground while in a 25-30 degree left wing low and nose-low attitude. No smoke was noted trailing the airplane in-flight. Both main and auxiliary fuel tanks were ruptured. Examination of the flight controls, and each engine core revealed no evidence of preimpact failure or malfunction. The left propeller was not feathered. Corrosion and a small amount of debris were noted inside the left engine-driven fuel pump. Internal contamination, and corrosion was noted for both servo fuel injectors (fuel servo). Drops of water were noted in the regulator area of the left fuel servo. During troubleshooting for rough running engines in June 2002, a slight amount of water was detected in the fuel tanks; no repairs or work was performed to the airplane's fuel tanks or fuel caps between the troubleshooting date, and March 26, 2004. The pilot noted discrepancies with the fuel injectors on 2 separate flights in October 2003; no corrective action for either entry was taken. During the last annual inspection, a broken screw was removed from a nut plate in the left main fuel cell access hole plate assembly, the left main fuel tank fuel cell cover plate upper gasket was replaced, and both fuel quantity senders were removed, cleaned, and reinstalled with "new hardware." During the accident flight in a six-second period, the EGT readings for each cylinder of the left engine decreased on average approximately 659 degrees Fahrenheit, while the right engine EGT readings remained nearly the same. Testing of a six cylinder engine to determine the EGT drop with reduction to idle and sudden combustion cessation revealed the temperature drops were 86 and 177 degrees, respectively. Postaccident weight and balance calculations revealed the airplane gross weight at the time the engines were started was approximately 3,788 pounds, and the center of gravity (CG) was 89.66 inches; the weight and CG calculations did not include the weight of fuel found in the left tip tank. A limitation for the airplane was that any weight in excess of 3,650 pounds must be carried symmetrically as fuel in the tip tanks.
HISTORY OF FLIGHT On April 4, 2004, about 1606 eastern daylight time, a Piper PA-30, N14A, registered to Light Wing, LLC, crashed onto airport property shortly after takeoff from Fernandina Beach Municipal Airport, Fernandina Beach, Florida. Visual meteorological conditions prevailed at the time and an instrument flight rules (IFR) flight plan was filed for the 14 CFR Part 91 personal flight from Fernandina Beach Municipal Airport, to Burlington-Alamance Regional Airport, Burlington, North Carolina. The airplane was substantially damaged and the commercial-rated pilot and one passenger were fatally injured. The flight originated about 5 minutes earlier from Fernandina Beach Municipal Airport. One witness who is an airplane mechanic and was outside a hangar located north of runway 08/26, near the midfield of the runway, reported hearing the accident airplane's engines start, and based on the time from the engine start to the time he saw and heard the airplane during takeoff, he thought the pilot had time to perform an engine run-up before takeoff. The airplane departed from runway 26, and after becoming airborne, the gear retracted. The flight climbed to approximately 200 feet and at that time, the airplane banked to the left then quickly back to the right. After that, the airplane then appeared to be flying stabilized. The airplane then flew past the hangar where he was located and he lost sight of the airplane. Another witness who was located east of the previous witness and who is a private-rated pilot reported he did not see the point where the airplane became airborne. He reported the airplane was airborne with the landing gear retracted before reaching the intersection of runway 04/22 and 08/26. He believed the airplane climbed to approximately 250-300 feet during climb out which initially appeared normal. Just before the airplane flew past the hangar, he heard a brief sputtering sound, and then observed the airplane bank to the left. He lost sight of the airplane for a short time and when he saw it again, the airplane was south of runway 08/26 and was in a 25-30 degree left wing low and nose-low attitude, which continued until the airplane impacted the ground. He described the sputtering sound as being similar to a sound he has heard in the past when power is reduced. He also reported that he did not see any smoke trailing the airplane. NTSB review of recorded radar data from Whitehouse ARSR-4, Naval Air Station (NAS) Jacksonville ASR-8, and NAS Mayport ASR-8 radar facilities revealed all targets in the vicinity of the airport were transmitting "VFR 1200 code." A radar target at 1605:58, was located southeast of the departure end of runway 26, or northwest of the accident site location. The radar target was noted to be at 200 feet, with a speed of 105 knots, and the location was consistent with the witness reported position of the accident airplane. Readout of the on-board, portable global positioning system (GPS) receiver at the manufacturer's facility revealed the unit retained data from the beginning of the taxi, to near the accident site location. The retained data (coordinates), is correlated with time received directly from satellites' signals. A review of the data and a plot of it revealed the airplane started taxiing at approximately 1600:27. The airplane taxied to runway 26, and a gap in data was noted between 1602:45, and 1604:46. At 1605:04, the airplane was plotted to be on the runway heading 266 degrees. The airplane continued on the runway heading from 1605:04, to 1605:21, at which time the ground speed was recorded to be 77 knots. The plotted data indicates the airplane began a left turn, accelerated to 92 knots groundspeed, and was on a heading of 144 degrees magnetic at 1605:50. The last recorded coordinates occurred at 1605:53, in which the groundspeed was 84 knots, and the heading was 122 degrees magnetic. The initial impact site was located approximately 97 feet and 71 degrees magnetic from the last recorded coordinates. PERSONNEL INFORMATION According to FAA records, the pilot was the holder of a commercial pilot certificate with ratings airplane multiengine land, and instrument airplane; he had a DC-3 type rating. He was also the holder of a private pilot certificate with a airplane single engine land rating. The pilot held a second-class medical certificate that was issued on January 15, 2003, with the restriction "must wear corrective lenses." A review of the pilot's pilot logbook that contained entries from November 18, 1995, to November 23, 2003, and a computer flight log which contained entries from September 1, 2003, to December 28, 2003, some of which are duplicate entries from the pilot logbook, revealed his total logged flight time was approximately 643 hours. His first logged flight in the accident airplane occurred on December 21, 2001; since that date he logged a total time of 150.9 hours in the accident airplane. His last flight review in accordance with federal regulations occurred on September 9, 2003; the flight duration was 3.6 hours, and was flown in a Piper PA-39. At the time of the accident, the airplane had been operated approximately 43 hours since the date of the last logged flight in the computer flight log. AIRCRAFT INFORMATION The airplane was manufactured on July 13, 1966, by Piper Aircraft Corporation, as model PA-30, and designated serial number 30-1208. The airplane was certificated in the normal category, and Brittain Industries model TT-5 tip tanks were installed when the airplane was manufactured under Delegation Option Authorization. With the installed tip tanks, the design gross weight was 3,725 pounds. Robertson Aircraft Corporation modified the airplane on March 3, 1973, in accordance with Supplemental Type Certificate (STC) SA2312WE, and SA1113SW. Supplemental Type Certificate SA2312WE, incorporated leading edge cuffs, stall fences, stall strips, drooped ailerons, flap actuated stabilator trim system, and dorsal fin. The STC (SA2312WE), allowed the gross weight to be increased to 3,800 pounds, and lowered the velocity minimum control (Vmc) speed to 80 miles-per-hour. The limitations and conditions section of the STC indicated, "When Brittain Model TT-5 wing tip tanks are installed, all weight in excess of 3,650 lbs. must consist of symmetrically loaded fuel in the tip tanks." Supplemental Type Certificate SA1113SW incorporated a nose extension. Two 200-horsepower, Lycoming IO-360-C1C engines, and two Hartzell HC-C2YR-2CFU constant-speed, manual-feathering propellers were installed on August 15, 1974, in accordance with STC SA 1151SW. The airplane was also equipped with a JPI Instruments EDM 760 engine monitor that was installed on March 24, 2003, in accordance with STC SA00729SE. The engine monitor was programmed to record in part the exhaust gas temperature (EGT) and cylinder head temperature (CHT) readings from both engines every 6 seconds. Light Wing LLC (owner at time of accident), purchased the airplane on December 21, 2001; the pilot and passenger were each listed as a co-owner of the airplane on the "Aircraft Registration Application." Both engines were removed from the airplane and overhauled on March 21, 2002; the overhauled engines were installed in the airplane on April 17, 2002. At the time of each engine overhaul, both servo fuel injectors and manifold valves were overhauled, and new engine-driven fuel pumps were installed on each engine. At the time of the accident, the airplane had accumulated approximately 161 hours since the overhauled engines were installed. A review of the maintenance records revealed on June 26, 2002, or approximately 6 months after the pilot and passenger purchased the airplane, and approximately 2 months after the overhauled engines were installed, an entry in the airframe logbook indicates, "Troubleshot both engines running rough. Cleaned all fuel injectors and spark plugs. Reinstalled cowlings. Removed small amount of water from fuel tanks during sumping." The airplane was approved for return to service. There was no entry in the airframe logbook between June 26, 2002, and March 26, 2004, indicating repairs or work performed to the airplane's fuel tanks, or fuel caps. A review of the pilot's computer flight log revealed two entries describing discrepancies relating to the fuel injector systems of both engines. The first entry was dated October 18, 2003, and the remark was "clogged L3 injector." The next entry was dated October 19, 2003, and the remark was "L4 & R4 injector clogs." Review of the airframe and both engine maintenance records revealed no entry on or immediately following those dates indicating the above referenced fuel injectors were removed and inspected. Further review of the airframe logbook revealed the airplane was last inspected on March 26, 2004, in accordance with an annual inspection. The inspection of the airplane was performed using Piper Aircraft Corporation Inspection Report, and additional inspection items prepared by the facility. During the inspection, the fuel caps were removed, and the fuel cap seals were inspected and lubricated. Airworthiness Directive (AD) 83-10-01, which requires inspection every 50 hours to prevent retention of water and deterioration of fuel system, was complied with. The AD requires in part removal of the fuel strainers, and to inspect the screen. An individual of the facility that performed the inspection later reported that during the inspection, "When we removed the filter bowls we found water and a little rust. We discussed the importance of draining the fuel bowls and for how long. During the demonstration, we found a small amount of water in the fuel. We drained until clean fuel was present." Also during the inspection, standing water was noted on top of the left main and auxiliary fuel quantity senders. They were removed, corrosion on both was removed, the cleaned area on both was "treated", and the units were installed with "new hardware." Additionally, a broken screw was removed from a nutplate in the left main fuel cell access hole plate assembly. The left main fuel tank fuel cell cover plate upper gasket was replaced during the inspection, and the fuel inlet screens of both fuel injector servos were removed, inspected, and reinstalled. All fuel injector nozzles of both engines were ultrasonically cleaned. The ailerons were rigged in accordance with Robertson Aircraft Corporation literature. According to the vice president (V.P.) of the facility that last inspected the airplane, the pilot contacted him prior to bringing the airplane to his facility and advised him that while flying the accident airplane, he previously experienced a loss of engine power during cruise flight in temperatures below freezing. Engine power was restored after the fuel selector was repositioned. An inspection of the airplane by a mechanic after landing revealed ice in one of the fuel strainers. The V.P. of the facility reported advising the pilot to hold the drain open for 1 minute when checking each fuel tank for water. The airplane and pilot were at his facility from March 21 through March 27, 2004, and during that time, the owner assisted with the annual inspection. The pilot came to their facility with items listed by priority that needed to be accomplished during the annual inspection. NTSB review of the list revealed Item 8 that indicates, "Check complete fuel system due to chronic injector clogging (both engines). This problem only manifests itself if the plane sits for a month or more. If flown regularly it doesn't happen." During the annual inspection, the owner was shown how to clean the fuel injector nozzles. Since the date the annual inspection was signed off (March 26, 2004), the installed engine monitor recorded a total of four separate events including an event on the accident date. The first event following the inspection completion date occurred on March 27th; the duration was .37 hour. The second event the same day was 6.32 hours in duration, and the third event the day before the accident lasted 2.25 hours. The fourth and final event occurred on the day of the accident; the duration was .13 hour. The airplane had accumulated approximately 9 hours since the inspection at the time of the accident as determined by the installed hour meter. METEOROLOGICAL INFORMATION An automated weather observing system (AWOS), weather observation taken on the day accident at 1605, or approximately 4 minutes before the accident, indicates clear skies existed, the visibility was 10 statute miles, the temperature was 26 degrees Celsius, the dew point was missing, the wind was from 300 degrees at 16 knots, with gusts to 22 knots, and the altimeter setting was 29.78 inHg. No rain was recorded on any of the METAR reports for April 3rd or April 4th, at the Jacksonville International Airport (KJAX), Jacksonville, Florida. The KJAX airport is located approximately 14 nautical miles west-southwest of the Fernandina Beach Municipal Airport. COMMUNICATIONS The pilot did not advise on the UNICOM frequency that the flight was returning, nor did he advise of a malfunction. WRECKAGE AND IMPACT INFORMATION The airplane crashed onto airport property during daylight conditions. The ground impact was located at 30 degrees 36.470 minutes North latitude and 081 degrees 27.806 minutes West longitude, or approximately 85 feet south of the southern edge of runway 04/22. A pitot tube mast was located approximately 6 feet east of the first ground scar. The left tip tank was separated and was found 43 feet left of a line drawn from the first ground impact point to the main wreckage location (wreckage centerline path), and 104 feet from the first ground impact point. The wreckage was upright on a magnetic heading of 330 degrees, approximately 122 feet from the first ground impact point. Review of photographs taken by personnel from Fernandina Beach Police Department revealed luggage/items from the cabin were removed, placed on the ground, then returned to the airplane before NTSB arrival. The luggage/items were retained for weighing. Examination of the airplane revealed all components necessary to sustain flight were attached to the airplane or in close proximity to the main wreckage. No evidence of in-flight or on-ground fire was noted on any observed components. The left engine with attached propeller came to rest on the right side of the airplane. The right engine with attached propeller was separated but came to rest in close proximity to the right nacelle area. The cabin roof and stabilator trim cables were cut during extraction of the occupants. The empennage, stabilator control cables, and rudder control cables were cut at the start of the dorsal fin to facilitate recovery of the airplane. Examination of the cockpit revealed the left and right alternate engine air controls were in the off position, both magneto switches of both engines were on, and both auxiliary fuel pump switches were on. The left and right throttle controls were positioned to within approximately 1 3/4 inches and 1 inch from idle or closed, respectively. The left and right propeller controls were positioned approximately 3/4 inch from full forward and full forward, respectively, and the left and right mixture controls were positioned within 1 inch and 3/4 inch from full rich, respectively. A placard to the right of the airspeed indicator on the pilot's side of the airplane indicated, "Drain fuel tanks before the first flight each day." Another placard located above the flap indicator indicated, "Do not extend flaps beyond 15 degrees (takeoff position)." Examination of the airplane following recovery revealed the landing gear selector handle was in the "down" position, but the right main landing gear was in the wheel well, and the left main and nose landing gears were near the retracted position. The flaps were retracted, and the stabilator trim was found in the full nose down direction. The rudder trim was found in the neutral position. Flight control cable continuity was confirmed for roll, pitch, and yaw with the exception of where the cables were cut postaccident. The stabilator was in position; no damag
The failure of the pilot to feather the left propeller and his failure to maintain control of the airplane following a loss of engine power from the left engine resulting in the in-flight collision with terrain. A factor in the accident was the loss of power from the left engine for undetermined reasons.
Source: NTSB Aviation Accident Database
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