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|
Attributes | |
ACN | 558731 |
Time | |
Date | 200209 |
Day | Sun |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : jfk.airport |
State Reference | NY |
Altitude | agl single value : 0 |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B767 Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : parked |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
ASRS Report | 558731 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
ASRS Report | 558731 |
Events | |
Anomaly | aircraft equipment problem : critical non adherence : published procedure non adherence : far non adherence : company policies other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : fuel indicators, eicas other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact none taken : anomaly accepted other |
Consequence | other other |
Factors | |
Maintenance | contributing factor : schedule pressure performance deficiency : repair |
Supplementary | |
Problem Areas | Flight Crew Human Performance FAA Aircraft Company |
Primary Problem | Flight Crew Human Performance |
Narrative:
Fuel imbal discovered after takeoff. From jfk, we discovered a fuel imbal between the left and right fuel tanks that was out of limits (left 29.5 pounds, right 35.9 pounds, center 2.0 pounds, and total 67.5 pounds -- in 1000's of pounds). We leveled off at an intermediate altitude, balanced the fuel, and contacted air carrier X dispatch who verified with maintenance controller at our request that no structural limits were exceeded. Maintenance controller also indicated that they would contact air carrier X maintenance at our destination (lax) to perform the appropriate checks. Fuel quantity and balance were monitored closely throughout the flight. A logbook entry was made stating the imbal, describing the actions taken, and requesting the appropriate inspections. During tai prior to takeoff, the 'fuel confign' EICAS message illuminated. 2000 pounds of fuel was in the center tank and the takeoff performance settings departure plan was checked to verify 1000 pounds of ballast fuel. Believing that center tank fuel in excess of 1200 pounds was the only reason for the illumination of the fuel confign message. We canceled the message. As an additional note, approximately 2 hours into the flight, an EICAS 'fuel quantity indication' EICAS message illuminated. The right fuel quantity and total fuel quantity gauge indications on the overhead panel blanked for a short time. This discrepancy was also entered into the logbook. The aircraft was dispatched with 3 placarded MEL items, one of which was an inoperative fuel stick. At the gate prior to departure, we consulted with an air carrier X mechanic to ensure compliance with air carrier X fueling procedures in accordance with MEL requirements. The additional 2 placarded items were also addressed and verified at that time. This incident emphasizes the need for vigilance in verifying all elements of each checklist item and when canceling any EICAS messages -- with extra care required during periods of high workload and while managing distrs. This is particularly important with reference to checking the fuel system prior to departure. The imbal was apparently missed at the gate due to misreading the gauges, with a total fuel load of approximately 71000 thousand pounds and approximately 2000 pounds in the center tank, both left and right gauges would have been reading 3X.X -- with possibly similar digits. Additionally, each of the 3 reasons for illumination of the fuel confign message should be addressed before canceling the message to prevent future occurrences of this nature.
Original NASA ASRS Text
Title: B767 CREW THEIR FUEL WAS OUT OF BAL AFTER DEPARTING JFK.
Narrative: FUEL IMBAL DISCOVERED AFTER TKOF. FROM JFK, WE DISCOVERED A FUEL IMBAL BTWN THE L AND R FUEL TANKS THAT WAS OUT OF LIMITS (L 29.5 LBS, R 35.9 LBS, CTR 2.0 LBS, AND TOTAL 67.5 LBS -- IN 1000'S OF LBS). WE LEVELED OFF AT AN INTERMEDIATE ALT, BALANCED THE FUEL, AND CONTACTED ACR X DISPATCH WHO VERIFIED WITH MAINT CTLR AT OUR REQUEST THAT NO STRUCTURAL LIMITS WERE EXCEEDED. MAINT CTLR ALSO INDICATED THAT THEY WOULD CONTACT ACR X MAINT AT OUR DEST (LAX) TO PERFORM THE APPROPRIATE CHKS. FUEL QUANTITY AND BAL WERE MONITORED CLOSELY THROUGHOUT THE FLT. A LOGBOOK ENTRY WAS MADE STATING THE IMBAL, DESCRIBING THE ACTIONS TAKEN, AND REQUESTING THE APPROPRIATE INSPECTIONS. DURING TAI PRIOR TO TKOF, THE 'FUEL CONFIGN' EICAS MESSAGE ILLUMINATED. 2000 LBS OF FUEL WAS IN THE CTR TANK AND THE TKOF PERFORMANCE SETTINGS DEP PLAN WAS CHKED TO VERIFY 1000 LBS OF BALLAST FUEL. BELIEVING THAT CTR TANK FUEL IN EXCESS OF 1200 LBS WAS THE ONLY REASON FOR THE ILLUMINATION OF THE FUEL CONFIGN MESSAGE. WE CANCELED THE MESSAGE. AS AN ADDITIONAL NOTE, APPROX 2 HRS INTO THE FLT, AN EICAS 'FUEL QUANTITY INDICATION' EICAS MESSAGE ILLUMINATED. THE R FUEL QUANTITY AND TOTAL FUEL QUANTITY GAUGE INDICATIONS ON THE OVERHEAD PANEL BLANKED FOR A SHORT TIME. THIS DISCREPANCY WAS ALSO ENTERED INTO THE LOGBOOK. THE ACFT WAS DISPATCHED WITH 3 PLACARDED MEL ITEMS, ONE OF WHICH WAS AN INOP FUEL STICK. AT THE GATE PRIOR TO DEP, WE CONSULTED WITH AN ACR X MECH TO ENSURE COMPLIANCE WITH ACR X FUELING PROCS IN ACCORDANCE WITH MEL REQUIREMENTS. THE ADDITIONAL 2 PLACARDED ITEMS WERE ALSO ADDRESSED AND VERIFIED AT THAT TIME. THIS INCIDENT EMPHASIZES THE NEED FOR VIGILANCE IN VERIFYING ALL ELEMENTS OF EACH CHKLIST ITEM AND WHEN CANCELING ANY EICAS MESSAGES -- WITH EXTRA CARE REQUIRED DURING PERIODS OF HIGH WORKLOAD AND WHILE MANAGING DISTRS. THIS IS PARTICULARLY IMPORTANT WITH REF TO CHKING THE FUEL SYS PRIOR TO DEP. THE IMBAL WAS APPARENTLY MISSED AT THE GATE DUE TO MISREADING THE GAUGES, WITH A TOTAL FUEL LOAD OF APPROX 71000 THOUSAND LBS AND APPROX 2000 LBS IN THE CTR TANK, BOTH L AND R GAUGES WOULD HAVE BEEN READING 3X.X -- WITH POSSIBLY SIMILAR DIGITS. ADDITIONALLY, EACH OF THE 3 REASONS FOR ILLUMINATION OF THE FUEL CONFIGN MESSAGE SHOULD BE ADDRESSED BEFORE CANCELING THE MESSAGE TO PREVENT FUTURE OCCURRENCES OF THIS NATURE.
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.