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|
Attributes | |
ACN | 201088 |
Time | |
Date | 199202 |
Day | Tue |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : ont |
State Reference | CA |
Altitude | msl bound lower : 4000 msl bound upper : 6000 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : ont |
Operator | common carrier : air carrier |
Make Model Name | Widebody, Low Wing, 4 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | descent : approach descent other |
Route In Use | arrival other enroute : on vectors |
Flight Plan | IFR |
Aircraft 2 | |
Operator | common carrier : air carrier |
Make Model Name | Medium Large Transport, Low Wing, 2 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | descent : approach descent other |
Route In Use | arrival other enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | government : faa |
Function | controller : approach |
Qualification | controller : radar |
ASRS Report | 201088 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | conflict : airborne less severe non adherence : published procedure non adherence : required legal separation |
Independent Detector | aircraft equipment other aircraft equipment : unspecified other controllera other flight crewa |
Resolutory Action | none taken : detected after the fact |
Consequence | faa : investigated |
Miss Distance | horizontal : 12000 vertical : 500 |
Supplementary | |
Primary Problem | ATC Human Performance |
Air Traffic Incident | Operational Error |
Narrative:
Air carrier X widebody transport arrival from bands intersection. Heading 270 for sbd. Air carrier Y , medium large transport arriving from bands direct petis NDB. Landing ont. Air carrier X was 12 mi ahead of air carrier Y and roughly 2500 ft below. Aircraft landing sbd must be over petis inbound at 3200. Aircraft landing ont must be over petis at or above 4200. This is referred to as the petis over and under. In this case both aircraft were descending for their respective approachs. Air carrier Y was issued altitudes 1000 ft above those assigned to air carrier X. However, as each aircraft was being vectored in an effort to have them both over petis at the same time and at appropriate altitudes, air carrier X's rate of descent slowed down and air carrier Y rate of descent increased. As a result of this air carrier Y descended below air carrier X. Neither aircraft had each other in sight. A traffic alert was issued to both aircraft. The petis over/under is an everyday operation at ontario. This particular error occurred because I failed to assign altitudes to air carrier Y that were 1000 ft above air carrier X's actual altitude. There are several different types of separation afforded to ATC. In the petis over/under eventually only one type can be used -- vertical. The only way this can be prevented is to ensure vertical separation at all times. As a personal note regarding TCASII, at a critical point while issuing traffic information to air carrier Y, he said my xmissions were blocked. In the backgnd I could hear TCASII loud and clear. Later, the pilot told me the volume of his TCASII was the reason for not hearing me. Although TCASII was not the reason for this error, it is clear that TCASII volumes are way too loud.
Original NASA ASRS Text
Title: ONE ACR FOLLOWING ANOTHER ACR GET TOO CLOSE RESULTING IN LTSS.
Narrative: ACR X WDB ARR FROM BANDS INTXN. HDG 270 FOR SBD. ACR Y , MLG ARRIVING FROM BANDS DIRECT PETIS NDB. LNDG ONT. ACR X WAS 12 MI AHEAD OF ACR Y AND ROUGHLY 2500 FT BELOW. ACFT LNDG SBD MUST BE OVER PETIS INBOUND AT 3200. ACFT LNDG ONT MUST BE OVER PETIS AT OR ABOVE 4200. THIS IS REFERRED TO AS THE PETIS OVER AND UNDER. IN THIS CASE BOTH ACFT WERE DSNDING FOR THEIR RESPECTIVE APCHS. ACR Y WAS ISSUED ALTS 1000 FT ABOVE THOSE ASSIGNED TO ACR X. HOWEVER, AS EACH ACFT WAS BEING VECTORED IN AN EFFORT TO HAVE THEM BOTH OVER PETIS AT THE SAME TIME AND AT APPROPRIATE ALTS, ACR X'S RATE OF DSCNT SLOWED DOWN AND ACR Y RATE OF DSCNT INCREASED. AS A RESULT OF THIS ACR Y DSNDED BELOW ACR X. NEITHER ACFT HAD EACH OTHER IN SIGHT. A TFC ALERT WAS ISSUED TO BOTH ACFT. THE PETIS OVER/UNDER IS AN EVERYDAY OP AT ONTARIO. THIS PARTICULAR ERROR OCCURRED BECAUSE I FAILED TO ASSIGN ALTS TO ACR Y THAT WERE 1000 FT ABOVE ACR X'S ACTUAL ALT. THERE ARE SEVERAL DIFFERENT TYPES OF SEPARATION AFFORDED TO ATC. IN THE PETIS OVER/UNDER EVENTUALLY ONLY ONE TYPE CAN BE USED -- VERT. THE ONLY WAY THIS CAN BE PREVENTED IS TO ENSURE VERT SEPARATION AT ALL TIMES. AS A PERSONAL NOTE REGARDING TCASII, AT A CRITICAL POINT WHILE ISSUING TFC INFO TO ACR Y, HE SAID MY XMISSIONS WERE BLOCKED. IN THE BACKGND I COULD HEAR TCASII LOUD AND CLR. LATER, THE PLT TOLD ME THE VOLUME OF HIS TCASII WAS THE REASON FOR NOT HEARING ME. ALTHOUGH TCASII WAS NOT THE REASON FOR THIS ERROR, IT IS CLR THAT TCASII VOLUMES ARE WAY TOO LOUD.
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.