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Attributes | |
ACN | 564294 |
Time | |
Date | 200211 |
Day | Sat |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : sea.airport |
State Reference | WA |
Altitude | agl single value : 0 |
Environment | |
Flight Conditions | VMC |
Weather Elements | other |
Light | Daylight |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B737-700 |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : takeoff roll ground : parked |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 200 flight time total : 10000 flight time type : 6500 |
ASRS Report | 564294 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 225 flight time total : 6500 flight time type : 1000 |
ASRS Report | 564296 |
Events | |
Anomaly | maintenance problem : improper documentation non adherence : company policies non adherence : far non adherence : published procedure other anomaly other |
Independent Detector | other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact other |
Consequence | other other |
Factors | |
Maintenance | contributing factor : schedule pressure performance deficiency : inspection performance deficiency : logbook entry performance deficiency : non compliance with legal requirements |
Supplementary | |
Problem Areas | Aircraft FAA Company |
Primary Problem | Company |
Narrative:
Just prior to takeoff roll from sea in a -700 aircraft, my first officer mentioned something about the aircraft being deiced which he had noticed when he did his exterior inspection. I was not aware prior to that, that the aircraft had been deiced. On departure, I realized that I should have made a logbook entry (maintenance note) indicating that the aircraft was restr to 270 KTS. We confirmed with company operations in sea when we called our out/off time back that the aircraft had been deiced, including the tail, and that dispatch had been notified. We adhered to the 270 KT speed restr and continued the flight to mdw. On arrival, we had mdw maintenance meet the aircraft and we contacted maintenance control by phone. We wrote up the aircraft indicating that we had been deiced in sea and maintenance accomplished the tasks to restrict the aircraft until it could be inspected. I believe there are several factors that contributed to this error: 1) I failed to contact dispatch on arrival at the aircraft to confirm the status of the aircraft per the read before fly. 2) due to the clear WX in sea, it did not dawn on me to ask the operations agent, first officer or dispatch if the aircraft had been deiced. 3) the operations agent did not mention that the aircraft had been deiced prior to our arrival. The first officer did not mention anything about being deiced until we were starting our takeoff roll. Even though dispatch was aware that we had been deiced, they did not contact us prior to departure. I am normally a pm flyer and have not been confronted with this situation since the -700 speed restrs have been implemented. Also, it is early in the deicing season and habit patterns have not yet been well established. Recommendations: I believe that it should be unnecessary for the captain to contact dispatch before each originating departure to check on the status of the aircraft. The operations agent could include a note with the paperwork (releases, WX, etc) indicating that the aircraft had been deiced prior to the crew's arrival and to contact dispatch. The operations agent should also inform dispatch and they could include it in the remarks section of the release. If the dispatcher has not heard from the captain shortly before departure time, he/she should contact the crew via the jetway phone to remind the crew to make the logbook entry. I understand that dispatch may not always have time to do this, but if they do, it would be another check-and-balance. I believe that in our business, we all need to work together to prevent mistakes like this from occurring. Callback conversation with reporter revealed the following information: the B737-700 and -800 aircraft are susceptible to having type 2 and type 4 anti-ice fluid get caught in the elevator. This then affects the balance of the flight control surface. The 270 KT limitation is to prevent control flutter at higher speeds. The maintenance inspection consists of cleaning the interior of the elevators to insure no anti-ice fluid is contaminating the area. The company has not published a flight manual bulletin with this information. This is only covered on the daily posted bulletins. Captain indicated there is a fix for having fluid get trapped in the elevator, and wonders why this modification is taking so long.
Original NASA ASRS Text
Title: B737-700 CREW WAS NOT NOTIFIED THE ACFT HAD BEEN DEICED AT THE DEP STATION.
Narrative: JUST PRIOR TO TKOF ROLL FROM SEA IN A -700 ACFT, MY FO MENTIONED SOMETHING ABOUT THE ACFT BEING DEICED WHICH HE HAD NOTICED WHEN HE DID HIS EXTERIOR INSPECTION. I WAS NOT AWARE PRIOR TO THAT, THAT THE ACFT HAD BEEN DEICED. ON DEP, I REALIZED THAT I SHOULD HAVE MADE A LOGBOOK ENTRY (MAINT NOTE) INDICATING THAT THE ACFT WAS RESTR TO 270 KTS. WE CONFIRMED WITH COMPANY OPS IN SEA WHEN WE CALLED OUR OUT/OFF TIME BACK THAT THE ACFT HAD BEEN DEICED, INCLUDING THE TAIL, AND THAT DISPATCH HAD BEEN NOTIFIED. WE ADHERED TO THE 270 KT SPD RESTR AND CONTINUED THE FLT TO MDW. ON ARR, WE HAD MDW MAINT MEET THE ACFT AND WE CONTACTED MAINT CTL BY PHONE. WE WROTE UP THE ACFT INDICATING THAT WE HAD BEEN DEICED IN SEA AND MAINT ACCOMPLISHED THE TASKS TO RESTRICT THE ACFT UNTIL IT COULD BE INSPECTED. I BELIEVE THERE ARE SEVERAL FACTORS THAT CONTRIBUTED TO THIS ERROR: 1) I FAILED TO CONTACT DISPATCH ON ARR AT THE ACFT TO CONFIRM THE STATUS OF THE ACFT PER THE READ BEFORE FLY. 2) DUE TO THE CLR WX IN SEA, IT DID NOT DAWN ON ME TO ASK THE OPS AGENT, FO OR DISPATCH IF THE ACFT HAD BEEN DEICED. 3) THE OPS AGENT DID NOT MENTION THAT THE ACFT HAD BEEN DEICED PRIOR TO OUR ARR. THE FO DID NOT MENTION ANYTHING ABOUT BEING DEICED UNTIL WE WERE STARTING OUR TKOF ROLL. EVEN THOUGH DISPATCH WAS AWARE THAT WE HAD BEEN DEICED, THEY DID NOT CONTACT US PRIOR TO DEP. I AM NORMALLY A PM FLYER AND HAVE NOT BEEN CONFRONTED WITH THIS SIT SINCE THE -700 SPD RESTRS HAVE BEEN IMPLEMENTED. ALSO, IT IS EARLY IN THE DEICING SEASON AND HABIT PATTERNS HAVE NOT YET BEEN WELL ESTABLISHED. RECOMMENDATIONS: I BELIEVE THAT IT SHOULD BE UNNECESSARY FOR THE CAPT TO CONTACT DISPATCH BEFORE EACH ORIGINATING DEP TO CHK ON THE STATUS OF THE ACFT. THE OPS AGENT COULD INCLUDE A NOTE WITH THE PAPERWORK (RELEASES, WX, ETC) INDICATING THAT THE ACFT HAD BEEN DEICED PRIOR TO THE CREW'S ARR AND TO CONTACT DISPATCH. THE OPS AGENT SHOULD ALSO INFORM DISPATCH AND THEY COULD INCLUDE IT IN THE REMARKS SECTION OF THE RELEASE. IF THE DISPATCHER HAS NOT HEARD FROM THE CAPT SHORTLY BEFORE DEP TIME, HE/SHE SHOULD CONTACT THE CREW VIA THE JETWAY PHONE TO REMIND THE CREW TO MAKE THE LOGBOOK ENTRY. I UNDERSTAND THAT DISPATCH MAY NOT ALWAYS HAVE TIME TO DO THIS, BUT IF THEY DO, IT WOULD BE ANOTHER CHK-AND-BAL. I BELIEVE THAT IN OUR BUSINESS, WE ALL NEED TO WORK TOGETHER TO PREVENT MISTAKES LIKE THIS FROM OCCURRING. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: THE B737-700 AND -800 ACFT ARE SUSCEPTIBLE TO HAVING TYPE 2 AND TYPE 4 ANTI-ICE FLUID GET CAUGHT IN THE ELEVATOR. THIS THEN AFFECTS THE BAL OF THE FLT CTL SURFACE. THE 270 KT LIMITATION IS TO PREVENT CTL FLUTTER AT HIGHER SPDS. THE MAINT INSPECTION CONSISTS OF CLEANING THE INTERIOR OF THE ELEVATORS TO INSURE NO ANTI-ICE FLUID IS CONTAMINATING THE AREA. THE COMPANY HAS NOT PUBLISHED A FLT MANUAL BULLETIN WITH THIS INFO. THIS IS ONLY COVERED ON THE DAILY POSTED BULLETINS. CAPT INDICATED THERE IS A FIX FOR HAVING FLUID GET TRAPPED IN THE ELEVATOR, AND WONDERS WHY THIS MODIFICATION IS TAKING SO LONG.
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.