37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 429308 |
Time | |
Date | 199902 |
Day | Thu |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : sna.airport |
State Reference | CA |
Altitude | msl bound lower : 800 msl bound upper : 3000 |
Environment | |
Flight Conditions | VMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : sct.tracon tower : sna.tower |
Operator | common carrier : air carrier |
Make Model Name | MD-90 Series (DC-9-90) Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Navigation In Use | ils localizer only : sna other |
Flight Phase | climbout : intermediate altitude climbout : takeoff climbout : initial |
Route In Use | departure : noise abatement |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 270 flight time total : 13400 flight time type : 2800 |
ASRS Report | 429308 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : multi engine pilot : instrument pilot : commercial |
Events | |
Anomaly | aircraft equipment problem : less severe non adherence : clearance non adherence : published procedure non adherence other other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : auto throttle other flight crewa |
Resolutory Action | flight crew : overrode automation none taken : insufficient time |
Supplementary | |
Problem Areas | Aircraft Airport Environmental Factor Flight Crew Human Performance Airspace Structure |
Primary Problem | Aircraft |
Air Traffic Incident | Pilot Deviation |
Narrative:
During takeoff from sna, our autothrottles became inoperative. The procedure for an MD90 is to reduce thrust at 800 ft. Our takeoff EPR was 1.51 and our cutback EPR was to be 1.33. With the autothrottles inoperative, I would do this manually at 800 ft. We were doing a pack off 24 degree flap takeoff. The landing gear aural warning goes off if the gear is not down when the flaps are greater than 23 degrees. We have a button to silence the horn. The procedure at sna is to do the cutback EPR at 800 ft, turn to 175 degrees at 1 DME on the sna localizer. (We were using runway 19R) climb to 7000 ft with an altitude restr at 5.6 DME. Also with a pack off takeoff, the procedure is to turn the packs on one at a time at 400 ft. The workload is high and made higher with the packs off and autothrottles inoperative. As soon as we took off and raised the go around, the gear aural warning would not silence. Flaps are not retracted until 2500 ft on this departure procedure. Tower called and said to level now at 3000 ft and to call departure. Resetting the altitude, changing the heading, getting the packs back on, departure telling us about traffic then saying climb to 16000 ft, I missed doing the manual cutback. Departure control then said to climb to 13000 ft and turn immediately to 120 degrees. At this point I was so far behind the aircraft, I wasn't sure that we hadn't made a mistake on the altitude changes. Departure control switched us to ZLA and we continued. I suspect we exceeded the noise abatement level, and although departure never said anything in my mind by the third altitude change I was wondering if we had read back the wrong altitude when we changed to 16000 ft. It was a case of being quickly overloaded on a departure that is highly loaded when all is normal, when items were added to our workload.
Original NASA ASRS Text
Title: A DEPARTING MD90 VIOLATES THE NOISE ABATEMENT SOUND LEVEL AT SNA WHEN THE AUTOTHROTTLE AND GEAR WARNING HORN CUTOFF BUTTON BOTH MALFUNCTION DURING THE INITIAL CLBOUT.
Narrative: DURING TKOF FROM SNA, OUR AUTOTHROTTLES BECAME INOP. THE PROC FOR AN MD90 IS TO REDUCE THRUST AT 800 FT. OUR TKOF EPR WAS 1.51 AND OUR CUTBACK EPR WAS TO BE 1.33. WITH THE AUTOTHROTTLES INOP, I WOULD DO THIS MANUALLY AT 800 FT. WE WERE DOING A PACK OFF 24 DEG FLAP TKOF. THE LNDG GEAR AURAL WARNING GOES OFF IF THE GEAR IS NOT DOWN WHEN THE FLAPS ARE GREATER THAN 23 DEGS. WE HAVE A BUTTON TO SILENCE THE HORN. THE PROC AT SNA IS TO DO THE CUTBACK EPR AT 800 FT, TURN TO 175 DEGS AT 1 DME ON THE SNA LOC. (WE WERE USING RWY 19R) CLB TO 7000 FT WITH AN ALT RESTR AT 5.6 DME. ALSO WITH A PACK OFF TKOF, THE PROC IS TO TURN THE PACKS ON ONE AT A TIME AT 400 FT. THE WORKLOAD IS HIGH AND MADE HIGHER WITH THE PACKS OFF AND AUTOTHROTTLES INOP. AS SOON AS WE TOOK OFF AND RAISED THE GAR, THE GEAR AURAL WARNING WOULD NOT SILENCE. FLAPS ARE NOT RETRACTED UNTIL 2500 FT ON THIS DEP PROC. TWR CALLED AND SAID TO LEVEL NOW AT 3000 FT AND TO CALL DEP. RESETTING THE ALT, CHANGING THE HDG, GETTING THE PACKS BACK ON, DEP TELLING US ABOUT TFC THEN SAYING CLB TO 16000 FT, I MISSED DOING THE MANUAL CUTBACK. DEP CTL THEN SAID TO CLB TO 13000 FT AND TURN IMMEDIATELY TO 120 DEGS. AT THIS POINT I WAS SO FAR BEHIND THE ACFT, I WASN'T SURE THAT WE HADN'T MADE A MISTAKE ON THE ALT CHANGES. DEP CTL SWITCHED US TO ZLA AND WE CONTINUED. I SUSPECT WE EXCEEDED THE NOISE ABATEMENT LEVEL, AND ALTHOUGH DEP NEVER SAID ANYTHING IN MY MIND BY THE THIRD ALT CHANGE I WAS WONDERING IF WE HAD READ BACK THE WRONG ALT WHEN WE CHANGED TO 16000 FT. IT WAS A CASE OF BEING QUICKLY OVERLOADED ON A DEP THAT IS HIGHLY LOADED WHEN ALL IS NORMAL, WHEN ITEMS WERE ADDED TO OUR WORKLOAD.
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.