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Attributes | |
ACN | 155776 |
Time | |
Date | 199009 |
Day | Wed |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : oak |
State Reference | CA |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Heavy Transport, Low Wing, 4 Turbojet Eng |
Flight Phase | ground other : taxi landing other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp pilot : cfi pilot : flight engineer pilot : commercial |
Experience | flight time last 90 days : 220 flight time total : 3700 flight time type : 300 |
ASRS Report | 155776 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | non adherence : far other anomaly other |
Independent Detector | other flight crewa |
Resolutory Action | none taken : anomaly accepted |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
It started with a call from the crew desk at xa:45 after 2 1/2 hours of sleep. The F/east had 1 1/2 hours of sleep. I think the captain had about 4 hours of sleep. This call out was for a xo:45 departure from sfo to oak. The captain was late at operations and didn't read the NOTAMS of taxiway 1 being closed from departure end of 29 to taxiway 7. The captain said he had been there last week and know which taxiway it was that was close. (He thought it was 7 that was closed). Now west/O looking it up, which taxiway is closed? Because the captain was late, we were a bit late getting to the aircraft (company bus only runs every 20 min that early). Start was normal, but a very short taxi to runway 10R for departure, rushed checklist, short flight, rushed approach into 29 at oak, and a long fast T/D at oak, approximately T/D was 3000' down 29. Not an unusual landing for a heavy transport but we missed the highspd taxiway 7, the last turn off due to the taxiway closure at the end. I did not know that the captain didn't know that taxiway 1 was closed at the end of the runway. I assumed he was going to the end to make a 180 degree turn in the small pad and back taxi. He started to pull off to the right (I thought for a left 180 degree turn) and then continued right as if to exit on the taxiway. Now it was too late, he realized #1 was the one closed, at the same time I said stop. No lighted barriers, only reflective ones we couldn't see until the lights were on them. Now we are stuck. Not enough room on either side to safely make a turn back on the runway. I was going to suggest calling a tug or possibly reverse, but we sat a moment pondering then the captain started a left turn into the overrun west/O discussing it or saying what he was doing. I told him I couldn't see the taxi lights or runway. He said it was clear. I didn't realize until after the turn that the aircraft had departed the runway and into the overrun. I don't know how we missed the lights. No aircraft damage and as far as I know, no light damage either. The tower did not see the incident. In conclusion factors lack of sleep, rushed flight, poor judgement on the captain, my inaction and poor clear (the F/east did say ooooh XXXX), could not see the closed taxiway. Recommendations. Don't be complacent and never assume anything. Take your time, don't rush even on a short leg, more sleep, lighted barriers for closed txwys especially exiting runways, in addition to referencing numbered txwys for closures describe which one it is in the NOTAM, ie. Parallel taxiway at departure end of 29. Callback conversation with reporter revealed following information. Reporter told of fatigue as contributing to the incident. He added that he had just returned from a 12 day trip to the south pacific with the air force reserve.
Original NASA ASRS Text
Title: HVT GOT TRAPPED ON A CLOSED TXWY WHEN LEAVING THE RWY AFTER LNDG. WHILE ATTEMPTING TO RETURN TO THE RWY, ACFT TAXIED ONTO THE OVERRUN AREA.
Narrative: IT STARTED WITH A CALL FROM THE CREW DESK AT XA:45 AFTER 2 1/2 HOURS OF SLEEP. THE F/E HAD 1 1/2 HOURS OF SLEEP. I THINK THE CAPT HAD ABOUT 4 HOURS OF SLEEP. THIS CALL OUT WAS FOR A XO:45 DEP FROM SFO TO OAK. THE CAPT WAS LATE AT OPS AND DIDN'T READ THE NOTAMS OF TXWY 1 BEING CLOSED FROM DEP END OF 29 TO TXWY 7. THE CAPT SAID HE HAD BEEN THERE LAST WEEK AND KNOW WHICH TXWY IT WAS THAT WAS CLOSE. (HE THOUGHT IT WAS 7 THAT WAS CLOSED). NOW W/O LOOKING IT UP, WHICH TXWY IS CLOSED? BECAUSE THE CAPT WAS LATE, WE WERE A BIT LATE GETTING TO THE ACFT (COMPANY BUS ONLY RUNS EVERY 20 MIN THAT EARLY). START WAS NORMAL, BUT A VERY SHORT TAXI TO RWY 10R FOR DEP, RUSHED CHKLIST, SHORT FLT, RUSHED APCH INTO 29 AT OAK, AND A LONG FAST T/D AT OAK, APPROX T/D WAS 3000' DOWN 29. NOT AN UNUSUAL LNDG FOR A HVT BUT WE MISSED THE HIGHSPD TXWY 7, THE LAST TURN OFF DUE TO THE TXWY CLOSURE AT THE END. I DID NOT KNOW THAT THE CAPT DIDN'T KNOW THAT TXWY 1 WAS CLOSED AT THE END OF THE RWY. I ASSUMED HE WAS GOING TO THE END TO MAKE A 180 DEG TURN IN THE SMALL PAD AND BACK TAXI. HE STARTED TO PULL OFF TO THE RIGHT (I THOUGHT FOR A LEFT 180 DEG TURN) AND THEN CONTINUED RIGHT AS IF TO EXIT ON THE TXWY. NOW IT WAS TOO LATE, HE REALIZED #1 WAS THE ONE CLOSED, AT THE SAME TIME I SAID STOP. NO LIGHTED BARRIERS, ONLY REFLECTIVE ONES WE COULDN'T SEE UNTIL THE LIGHTS WERE ON THEM. NOW WE ARE STUCK. NOT ENOUGH ROOM ON EITHER SIDE TO SAFELY MAKE A TURN BACK ON THE RWY. I WAS GOING TO SUGGEST CALLING A TUG OR POSSIBLY REVERSE, BUT WE SAT A MOMENT PONDERING THEN THE CAPT STARTED A LEFT TURN INTO THE OVERRUN W/O DISCUSSING IT OR SAYING WHAT HE WAS DOING. I TOLD HIM I COULDN'T SEE THE TAXI LIGHTS OR RWY. HE SAID IT WAS CLR. I DIDN'T REALIZE UNTIL AFTER THE TURN THAT THE ACFT HAD DEPARTED THE RWY AND INTO THE OVERRUN. I DON'T KNOW HOW WE MISSED THE LIGHTS. NO ACFT DAMAGE AND AS FAR AS I KNOW, NO LIGHT DAMAGE EITHER. THE TWR DID NOT SEE THE INCIDENT. IN CONCLUSION FACTORS LACK OF SLEEP, RUSHED FLT, POOR JUDGEMENT ON THE CAPT, MY INACTION AND POOR CLR (THE F/E DID SAY OOOOH XXXX), COULD NOT SEE THE CLOSED TXWY. RECOMMENDATIONS. DON'T BE COMPLACENT AND NEVER ASSUME ANYTHING. TAKE YOUR TIME, DON'T RUSH EVEN ON A SHORT LEG, MORE SLEEP, LIGHTED BARRIERS FOR CLOSED TXWYS ESPECIALLY EXITING RWYS, IN ADDITION TO REFERENCING NUMBERED TXWYS FOR CLOSURES DESCRIBE WHICH ONE IT IS IN THE NOTAM, IE. PARALLEL TXWY AT DEP END OF 29. CALLBACK CONVERSATION WITH RPTR REVEALED FOLLOWING INFO. RPTR TOLD OF FATIGUE AS CONTRIBUTING TO THE INCIDENT. HE ADDED THAT HE HAD JUST RETURNED FROM A 12 DAY TRIP TO THE SOUTH PACIFIC WITH THE AIR FORCE RESERVE.
Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.