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A B767-300 was dispatched in non compliance with the axle spacer for #5 wheel and tire assembly not installed.
| Attributes | |
| ACN | 570806 |
| Time | |
| Date | 200212 |
| Day | Sun |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| 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 : maintenance |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : lead technician |
| Qualification | technician : powerplant technician : airframe |
| ASRS Report | 570806 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | maintenance : technician |
| Events | |
| Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance maintenance problem : improper documentation non adherence : company policies non adherence : published procedure non adherence : far |
| Resolutory Action | none taken : detected after the fact |
| Consequence | other other other |
| Factors | |
| Maintenance | contributing factor : lighting contributing factor : weather performance deficiency : scheduled maintenance performance deficiency : inspection performance deficiency : installation performance deficiency : logbook entry performance deficiency : training |
| Supplementary | |
| Problem Areas | Maintenance Human Performance Chart Or Publication Aircraft |
| Primary Problem | Maintenance Human Performance |
| Situations | |
| Publication | Maint Manual Proc |
Narrative:
As crew chief, I assigned 3 mechanics to a tire change on aircraft X. They pulled their paperwork and went out aircraft. They informed me they never changed tire before so I went out and made sure they were set up properly, and followed paper. Other duties pulled me away. I returned with grease for axle and quality assurance. I greased the axle and overlooked the spacer, the mechanics installed tire. I watched the completion and signed off item in E-6 logbook.
Original NASA ASRS Text
Title: A B767-300 WAS DISPATCHED IN NON COMPLIANCE WITH THE AXLE SPACER FOR #5 WHEEL AND TIRE ASSEMBLY NOT INSTALLED.
Narrative: AS CREW CHIEF, I ASSIGNED 3 MECHS TO A TIRE CHANGE ON ACFT X. THEY PULLED THEIR PAPERWORK AND WENT OUT ACFT. THEY INFORMED ME THEY NEVER CHANGED TIRE BEFORE SO I WENT OUT AND MADE SURE THEY WERE SET UP PROPERLY, AND FOLLOWED PAPER. OTHER DUTIES PULLED ME AWAY. I RETURNED WITH GREASE FOR AXLE AND QUALITY ASSURANCE. I GREASED THE AXLE AND OVERLOOKED THE SPACER, THE MECHS INSTALLED TIRE. I WATCHED THE COMPLETION AND SIGNED OFF ITEM IN E-6 LOGBOOK.
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.