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|
Attributes | |
ACN | 358260 |
Time | |
Date | 199701 |
Day | Thu |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | airport : zzz |
State Reference | US |
Altitude | agl bound lower : 0 agl bound upper : 0 |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | Commercial Fixed Wing |
Operating Under FAR Part | Part 121 |
Navigation In Use | Other Other |
Flight Phase | ground : preflight |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp pilot : flight engineer |
Experience | flight time last 90 days : 50 flight time total : 9000 flight time type : 250 |
ASRS Report | 358260 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : instrument pilot : commercial |
Events | |
Anomaly | non adherence : far non adherence other other anomaly other |
Independent Detector | other other : unspecified |
Resolutory Action | none taken : detected after the fact |
Consequence | Other |
Supplementary | |
Air Traffic Incident | Pilot Deviation |
Narrative:
This was one of those chain of events that if just 1 link had been broken, would have prevented a violation of our aircraft MEL. As captain, I was the last link in that chain. We received our flight plan release with an MEL listed. MEL was 'lower forward cargo area missing blowout panel, do not load this area.' during the first officer's walk around, he noted the main deck and aft belly being loaded and the forward belly closed. As we were completing our preflight duties, we had 2 major distrs arise. First, was that we had been shorted 7000 pounds on fuel. Second, was a unique maintenance problem. With departure time bearing down on us and with 2 mechanics in the cockpit, I was handed a weight and balance from a ramp person. We had, by this time, gotten the rest of our fuel and this was the first ramp person I had seen or talked to. The ramp people never asked me for verification of fuel or number of jump seaters as is standard procedure. The weight and balance had the wrong fuel load and incorrect number of jump seaters. I requested a new weight and balance. The mechanics finished and a new weight and balance arrived about 10 mins after scheduled departure. I perused it for correctness and signed it. We closed up and went to abq. Upon arrival at abq we were informed that the forward belly had indeed been loaded with freight. Here are the contributing factors in this matter. 1) since we had been informed of the MEL restr we had every reason to believe the ramp people had also been told. This especially after the first officer noted the forward belly door closed. With the busy preflight workload on a 2 crew member aircraft we don't have the time to track down the ramp lead man to discuss something he/she should have already been informed of through proper procedures. Nor are we responsible for overseeing the proper loading of the aircraft. Obviously someone failed to notify the ramp people or they overlooked that notification. 2) with the pressure of departure time looming and the 2 additional problems the first officer and I were dealing with, we were rushed and task saturated. In that situation, things get overlooked and one tends to fall back on old habit patterns. 3) perhaps if I had been asked about fuel and jump seaters, it may have triggered a discussion about the MEL restr. As it was, I looked the weight and balance over for the things I have been trained to look for (which does not include what position are void of freight) and signed it. It was obviously a mistake for me to assume that the ramp people knew of the restr. Somehow with the distrs, time pressure, and failure of the ramp people to follow standard procedures, I just forgot the rather unusual restr. My fix for this is rather a simple one. From now on, when I encounter an unusual situation, I will write a reminder on a fluorescent 'post-it' and stick it in a conspicuous place.
Original NASA ASRS Text
Title: WDB FLC HAS MEL ITEM TO NOT LOAD FORWARD CARGO AREA. SEVERAL DISTRS DELAY THE FLT AND UPON LNDG AT DEST THEY DISCOVER THE FORWARD CARGO AREA WAS LOADED WITH CARGO.
Narrative: THIS WAS ONE OF THOSE CHAIN OF EVENTS THAT IF JUST 1 LINK HAD BEEN BROKEN, WOULD HAVE PREVENTED A VIOLATION OF OUR ACFT MEL. AS CAPT, I WAS THE LAST LINK IN THAT CHAIN. WE RECEIVED OUR FLT PLAN RELEASE WITH AN MEL LISTED. MEL WAS 'LOWER FORWARD CARGO AREA MISSING BLOWOUT PANEL, DO NOT LOAD THIS AREA.' DURING THE FO'S WALK AROUND, HE NOTED THE MAIN DECK AND AFT BELLY BEING LOADED AND THE FORWARD BELLY CLOSED. AS WE WERE COMPLETING OUR PREFLT DUTIES, WE HAD 2 MAJOR DISTRS ARISE. FIRST, WAS THAT WE HAD BEEN SHORTED 7000 LBS ON FUEL. SECOND, WAS A UNIQUE MAINT PROB. WITH DEP TIME BEARING DOWN ON US AND WITH 2 MECHS IN THE COCKPIT, I WAS HANDED A WT AND BAL FROM A RAMP PERSON. WE HAD, BY THIS TIME, GOTTEN THE REST OF OUR FUEL AND THIS WAS THE FIRST RAMP PERSON I HAD SEEN OR TALKED TO. THE RAMP PEOPLE NEVER ASKED ME FOR VERIFICATION OF FUEL OR NUMBER OF JUMP SEATERS AS IS STANDARD PROC. THE WT AND BAL HAD THE WRONG FUEL LOAD AND INCORRECT NUMBER OF JUMP SEATERS. I REQUESTED A NEW WT AND BAL. THE MECHS FINISHED AND A NEW WT AND BAL ARRIVED ABOUT 10 MINS AFTER SCHEDULED DEP. I PERUSED IT FOR CORRECTNESS AND SIGNED IT. WE CLOSED UP AND WENT TO ABQ. UPON ARR AT ABQ WE WERE INFORMED THAT THE FORWARD BELLY HAD INDEED BEEN LOADED WITH FREIGHT. HERE ARE THE CONTRIBUTING FACTORS IN THIS MATTER. 1) SINCE WE HAD BEEN INFORMED OF THE MEL RESTR WE HAD EVERY REASON TO BELIEVE THE RAMP PEOPLE HAD ALSO BEEN TOLD. THIS ESPECIALLY AFTER THE FO NOTED THE FORWARD BELLY DOOR CLOSED. WITH THE BUSY PREFLT WORKLOAD ON A 2 CREW MEMBER ACFT WE DON'T HAVE THE TIME TO TRACK DOWN THE RAMP LEAD MAN TO DISCUSS SOMETHING HE/SHE SHOULD HAVE ALREADY BEEN INFORMED OF THROUGH PROPER PROCS. NOR ARE WE RESPONSIBLE FOR OVERSEEING THE PROPER LOADING OF THE ACFT. OBVIOUSLY SOMEONE FAILED TO NOTIFY THE RAMP PEOPLE OR THEY OVERLOOKED THAT NOTIFICATION. 2) WITH THE PRESSURE OF DEP TIME LOOMING AND THE 2 ADDITIONAL PROBS THE FO AND I WERE DEALING WITH, WE WERE RUSHED AND TASK SATURATED. IN THAT SIT, THINGS GET OVERLOOKED AND ONE TENDS TO FALL BACK ON OLD HABIT PATTERNS. 3) PERHAPS IF I HAD BEEN ASKED ABOUT FUEL AND JUMP SEATERS, IT MAY HAVE TRIGGERED A DISCUSSION ABOUT THE MEL RESTR. AS IT WAS, I LOOKED THE WT AND BAL OVER FOR THE THINGS I HAVE BEEN TRAINED TO LOOK FOR (WHICH DOES NOT INCLUDE WHAT POS ARE VOID OF FREIGHT) AND SIGNED IT. IT WAS OBVIOUSLY A MISTAKE FOR ME TO ASSUME THAT THE RAMP PEOPLE KNEW OF THE RESTR. SOMEHOW WITH THE DISTRS, TIME PRESSURE, AND FAILURE OF THE RAMP PEOPLE TO FOLLOW STANDARD PROCS, I JUST FORGOT THE RATHER UNUSUAL RESTR. MY FIX FOR THIS IS RATHER A SIMPLE ONE. FROM NOW ON, WHEN I ENCOUNTER AN UNUSUAL SIT, I WILL WRITE A REMINDER ON A FLUORESCENT 'POST-IT' AND STICK IT IN A CONSPICUOUS PLACE.
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.