Narrative:

I work for air carrier. On aug/xb/98 a B737-200 was dispatched for a trip and returned to the field due to a loud air leak on door 1L. On aug/xa/98 myself and another mechanic were assigned to install a snubber on this door. We followed the paperwork and believed the snubber was correctly installed. The paperwork warns that if the snubber is installed incorrectly, you could damage the door lower hinge seal. This is what caused the air leak. We were slightly pressed for time as the aircraft was routed in 2 hours and we had another task to accomplish. During the installation of the new snubber, we had difficulty installing 1 bolt and had to remove it. The snubber retracted and I believe this is when it turned to the wrong position. In the paperwork, a note says that if the snubber is in the wrong position, a cover for filling port on the snubber will contact the seal and damage it. It also says to orient the snubber with a placarded arrow pointing forward with the door closed. This placard is also mentioned in a caution paragraph, but no mention is made of the filler port cover. There are 2 placards on the snubber. When we installed the snubber the arrow was pointing forward. However, it was the wrong arrow. I believe this could have been prevented by not being pressed for time, paying closer attention to the orientation, 1 placard being deleted from the snubber, and better clarification in the caution paragraph of the paperwork. Callback conversation with reporter revealed the following information: the reporter stated the procedure required to check the position of the arrow which had to point forward with the door closed but the part was placarded with 2 arrows 180 degrees apart. The reporter said the manual made no reference to the fill port position after installation which may have caught the error. The reporter stated the door snubber installation procedure has caused a problem over a long period of time and will continue to do so until the procedures and part markings are revised. The reporter said there is no indication that the company is planning a revised document to preclude incorrect installation. The reporter said the other mechanic had 18 months experience and the reporter 12 yrs. The reporter stated the FAA has assigned a letter of reprimand to each mechanic.

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Original NASA ASRS Text

Title: A B737-200 WAS DISPATCHED AND RETURNED TO THE FIELD WITH EXCESSIVE FORWARD ENTRANCE DOOR LEAKAGE CAUSED BY AN INCORRECTLY INSTALLED DOOR SNUBBER.

Narrative: I WORK FOR ACR. ON AUG/XB/98 A B737-200 WAS DISPATCHED FOR A TRIP AND RETURNED TO THE FIELD DUE TO A LOUD AIR LEAK ON DOOR 1L. ON AUG/XA/98 MYSELF AND ANOTHER MECH WERE ASSIGNED TO INSTALL A SNUBBER ON THIS DOOR. WE FOLLOWED THE PAPERWORK AND BELIEVED THE SNUBBER WAS CORRECTLY INSTALLED. THE PAPERWORK WARNS THAT IF THE SNUBBER IS INSTALLED INCORRECTLY, YOU COULD DAMAGE THE DOOR LOWER HINGE SEAL. THIS IS WHAT CAUSED THE AIR LEAK. WE WERE SLIGHTLY PRESSED FOR TIME AS THE ACFT WAS ROUTED IN 2 HRS AND WE HAD ANOTHER TASK TO ACCOMPLISH. DURING THE INSTALLATION OF THE NEW SNUBBER, WE HAD DIFFICULTY INSTALLING 1 BOLT AND HAD TO REMOVE IT. THE SNUBBER RETRACTED AND I BELIEVE THIS IS WHEN IT TURNED TO THE WRONG POS. IN THE PAPERWORK, A NOTE SAYS THAT IF THE SNUBBER IS IN THE WRONG POS, A COVER FOR FILLING PORT ON THE SNUBBER WILL CONTACT THE SEAL AND DAMAGE IT. IT ALSO SAYS TO ORIENT THE SNUBBER WITH A PLACARDED ARROW POINTING FORWARD WITH THE DOOR CLOSED. THIS PLACARD IS ALSO MENTIONED IN A CAUTION PARAGRAPH, BUT NO MENTION IS MADE OF THE FILLER PORT COVER. THERE ARE 2 PLACARDS ON THE SNUBBER. WHEN WE INSTALLED THE SNUBBER THE ARROW WAS POINTING FORWARD. HOWEVER, IT WAS THE WRONG ARROW. I BELIEVE THIS COULD HAVE BEEN PREVENTED BY NOT BEING PRESSED FOR TIME, PAYING CLOSER ATTN TO THE ORIENTATION, 1 PLACARD BEING DELETED FROM THE SNUBBER, AND BETTER CLARIFICATION IN THE CAUTION PARAGRAPH OF THE PAPERWORK. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: THE RPTR STATED THE PROC REQUIRED TO CHK THE POS OF THE ARROW WHICH HAD TO POINT FORWARD WITH THE DOOR CLOSED BUT THE PART WAS PLACARDED WITH 2 ARROWS 180 DEGS APART. THE RPTR SAID THE MANUAL MADE NO REF TO THE FILL PORT POS AFTER INSTALLATION WHICH MAY HAVE CAUGHT THE ERROR. THE RPTR STATED THE DOOR SNUBBER INSTALLATION PROC HAS CAUSED A PROB OVER A LONG PERIOD OF TIME AND WILL CONTINUE TO DO SO UNTIL THE PROCS AND PART MARKINGS ARE REVISED. THE RPTR SAID THERE IS NO INDICATION THAT THE COMPANY IS PLANNING A REVISED DOCUMENT TO PRECLUDE INCORRECT INSTALLATION. THE RPTR SAID THE OTHER MECH HAD 18 MONTHS EXPERIENCE AND THE RPTR 12 YRS. THE RPTR STATED THE FAA HAS ASSIGNED A LETTER OF REPRIMAND TO EACH MECH.

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.