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|
Attributes | |
ACN | 453719 |
Time | |
Date | 199910 |
Day | Tue |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : lemd.airport |
State Reference | FO |
Altitude | msl single value : 2000 |
Environment | |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B767-300 and 300 ER |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : intermediate altitude |
Route In Use | departure other |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
ASRS Report | 453719 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Events | |
Anomaly | non adherence : published procedure non adherence : clearance other spatial deviation |
Independent Detector | other flight crewa other flight crewb |
Resolutory Action | flight crew : returned to original clearance none taken : detected after the fact |
Supplementary | |
Problem Areas | Chart Or Publication |
Primary Problem | Chart Or Publication |
Air Traffic Incident | Pilot Deviation |
Situations | |
Chart | sid : navas 2w |
Narrative:
Botched departure out of madrid. After departing runway 36L at mad we did not make the right turn to intercept the 008 degree radial as indicated by page 10-3D. We did parallel the outbound course and at 12 DME made the left turn to cnr. We realized our error after the departure when finding the fine print on page 10-3L. Page 10-3L has a note that states for initial climb out procedures refer to charts 10-3 to 10-3D. Page 10-3D had the notes for intercepting the 008 degree radial. I believe this is the only SID that I have flown that has referenced another SID page. Fatigue also played a part in my overlooking of this note. The night before was spent in a substandard hotel. Around XA00 am my room temperature went from around 68 degrees F to 90 degrees F. With the window open my room cooled to 80 degrees F. The trade off was that now street noise kept me up most of the night. My first officer had the same problem with room temperature. Many other cabin crew complained of the same problem. 2 problems were directly related to our error. One is the small print of the note to refer to another chart. Sleeping conditions. Had we all had a good night's sleep and the fine print printed in bold, I believe this error would not have happened. Please reprint this note in bold on the 10-3L page and change hotel in madrid.
Original NASA ASRS Text
Title: B767 CREW HAD TRACK DEV DEPARTING LEMD.
Narrative: BOTCHED DEP OUT OF MADRID. AFTER DEPARTING RWY 36L AT MAD WE DID NOT MAKE THE R TURN TO INTERCEPT THE 008 DEG RADIAL AS INDICATED BY PAGE 10-3D. WE DID PARALLEL THE OUTBOUND COURSE AND AT 12 DME MADE THE L TURN TO CNR. WE REALIZED OUR ERROR AFTER THE DEP WHEN FINDING THE FINE PRINT ON PAGE 10-3L. PAGE 10-3L HAS A NOTE THAT STATES FOR INITIAL CLBOUT PROCS REFER TO CHARTS 10-3 TO 10-3D. PAGE 10-3D HAD THE NOTES FOR INTERCEPTING THE 008 DEG RADIAL. I BELIEVE THIS IS THE ONLY SID THAT I HAVE FLOWN THAT HAS REFED ANOTHER SID PAGE. FATIGUE ALSO PLAYED A PART IN MY OVERLOOKING OF THIS NOTE. THE NIGHT BEFORE WAS SPENT IN A SUBSTANDARD HOTEL. AROUND XA00 AM MY ROOM TEMP WENT FROM AROUND 68 DEGS F TO 90 DEGS F. WITH THE WINDOW OPEN MY ROOM COOLED TO 80 DEGS F. THE TRADE OFF WAS THAT NOW STREET NOISE KEPT ME UP MOST OF THE NIGHT. MY FO HAD THE SAME PROB WITH ROOM TEMP. MANY OTHER CABIN CREW COMPLAINED OF THE SAME PROB. 2 PROBS WERE DIRECTLY RELATED TO OUR ERROR. ONE IS THE SMALL PRINT OF THE NOTE TO REFER TO ANOTHER CHART. SLEEPING CONDITIONS. HAD WE ALL HAD A GOOD NIGHT'S SLEEP AND THE FINE PRINT PRINTED IN BOLD, I BELIEVE THIS ERROR WOULD NOT HAVE HAPPENED. PLEASE REPRINT THIS NOTE IN BOLD ON THE 10-3L PAGE AND CHANGE HOTEL IN MADRID.
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.