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|
Attributes | |
ACN | 256565 |
Time | |
Date | 199311 |
Day | Sun |
Place | |
Locale Reference | atc facility : amg airport : ord |
State Reference | GA |
Altitude | msl bound lower : 29000 msl bound upper : 29000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | artcc : zjx tower : sfo |
Operator | common carrier : air carrier |
Make Model Name | Widebody, Low Wing, 3 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | cruise other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : flight engineer pilot : atp |
Experience | flight time last 90 days : 125 flight time total : 12500 flight time type : 600 |
ASRS Report | 256565 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 180 flight time total : 14000 flight time type : 5000 |
ASRS Report | 256662 |
Events | |
Anomaly | aircraft equipment problem : critical non adherence : far non adherence : published procedure |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : overcame equipment problem |
Consequence | faa : investigated |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
En route from chicago to orlando, #2 fuel quantity dropped twice. Approximately 6000 pounds and then a few mins later, approximately an additional 10000 pounds. The crew assumed it was a gauge problem until #2 engine gauges fluctuated. Fuel was immediately xfed from #1 and #3 tanks. After analyzing the problem, it was concluded that the aircraft was fueled at the hangar for another flight but the fuel supplement was not given to our crew. Also the #2 fuel gauge operated intermittently and the flight crew neglected to follow the fuel check procedure completely. Callback conversation with reporter revealed the following: reporter advised that the so had not followed the fuel service procedures. He did not check the pre-service fuel. Normally, the incoming crew figures how much fuel is remaining in the aircraft and enters that figure in the logbook. Then the outbound crew adds the fuel added as indicated on the 'fuel slip' to the pre-service fuel to arrive at the supposed fuel on board. Had this been done, the error in the #2 fuel gauge would have been noted. A plane change caused a fuel slip mixup and the so never got around to following prescribed procedures. They expected about 22000 pounds per tank and the fuel gauges showed that. Luckily, they had ordered 9000 pounds of extra fuel and therefore had no trouble reaching their destination.
Original NASA ASRS Text
Title: #2 ENG FLAMED OUT DUE TO FUEL STARVATION.
Narrative: ENRTE FROM CHICAGO TO ORLANDO, #2 FUEL QUANTITY DROPPED TWICE. APPROX 6000 LBS AND THEN A FEW MINS LATER, APPROX AN ADDITIONAL 10000 LBS. THE CREW ASSUMED IT WAS A GAUGE PROB UNTIL #2 ENG GAUGES FLUCTUATED. FUEL WAS IMMEDIATELY XFED FROM #1 AND #3 TANKS. AFTER ANALYZING THE PROB, IT WAS CONCLUDED THAT THE ACFT WAS FUELED AT THE HANGAR FOR ANOTHER FLT BUT THE FUEL SUPPLEMENT WAS NOT GIVEN TO OUR CREW. ALSO THE #2 FUEL GAUGE OPERATED INTERMITTENTLY AND THE FLC NEGLECTED TO FOLLOW THE FUEL CHK PROC COMPLETELY. CALLBACK CONVERSATION WITH REPORTER REVEALED THE FOLLOWING: RPTR ADVISED THAT THE SO HAD NOT FOLLOWED THE FUEL SVC PROCS. HE DID NOT CHK THE PRE-SVC FUEL. NORMALLY, THE INCOMING CREW FIGURES HOW MUCH FUEL IS REMAINING IN THE ACFT AND ENTERS THAT FIGURE IN THE LOGBOOK. THEN THE OUTBOUND CREW ADDS THE FUEL ADDED AS INDICATED ON THE 'FUEL SLIP' TO THE PRE-SVC FUEL TO ARRIVE AT THE SUPPOSED FUEL ON BOARD. HAD THIS BEEN DONE, THE ERROR IN THE #2 FUEL GAUGE WOULD HAVE BEEN NOTED. A PLANE CHANGE CAUSED A FUEL SLIP MIXUP AND THE SO NEVER GOT AROUND TO FOLLOWING PRESCRIBED PROCS. THEY EXPECTED ABOUT 22000 LBS PER TANK AND THE FUEL GAUGES SHOWED THAT. LUCKILY, THEY HAD ORDERED 9000 LBS OF EXTRA FUEL AND THEREFORE HAD NO TROUBLE REACHING THEIR DEST.
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.