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|
Attributes | |
ACN | 608716 |
Time | |
Date | 200403 |
Day | Wed |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | A320 |
Operating Under FAR Part | Part 121 |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
Qualification | technician : powerplant technician : airframe |
Experience | flight time total : 18 |
ASRS Report | 608716 |
Person 2 | |
Affiliation | company : air carrier |
Qualification | technician : airframe technician : powerplant |
Experience | maintenance lead technician : 15 maintenance technician : 15 |
ASRS Report | 608715 |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : improper documentation maintenance problem : improper maintenance non adherence : company policies non adherence : far non adherence : published procedure |
Independent Detector | aircraft equipment other aircraft equipment : warning flag other flight crewa other flight crewb |
Resolutory Action | none taken : detected after the fact |
Consequence | other other |
Factors | |
Maintenance | contributing factor : briefing contributing factor : schedule pressure contributing factor : work cards performance deficiency : logbook entry performance deficiency : non compliance with legal requirements performance deficiency : testing performance deficiency : inspection |
Supplementary | |
Problem Areas | Aircraft Environmental Factor Maintenance Human Performance |
Primary Problem | Maintenance Human Performance |
Narrative:
Shift replaced the idg on the #2 engine of aircraft. They left the leak and operational check for day shift. Aircraft trip was not until XA00. As the lead I had a crew of 6 a&P's and 2 right&east's. For our crew we were working 3 other aircraft so at the time of the leak check I assigned 2 crew members to perform the check with me helping. After leak check and servicing idg, cowls were closed and aircraft taxi from hangar to terminal for departure, whereupon landing #2 engine reverser did not deploy, due to the reverser lockout pin not being removed. No indication was visible when closing cowls that reverser was locked closed. While I took care of the paperwork the rest of the crew moved over to work another aircraft. While signing off paperwork when I signed off the card for reversers, I just assumed that the pin had been removed because the flag was not visible and the reverser cowls were not open on our shift just the fan cowls for the operational check. The lockout pins have 6 ft of flag material. If it was hanging down, it would have been very visible. Either weighted flags or another type of indication should be used. It was obvious. The flag was not obvious whether the wind blew it up out of the way or if someone placed it out of view while working in the area. I was helping and standing right in view of where the flag should have been and I did not see it. I would not close the cowls if it would have been visible.
Original NASA ASRS Text
Title: AN AIRBUS 320 WAS DISPATCHED IN NON COMPLIANCE WITH #2 ENG THRUST REVERSER LOCKOUT PIN INSTALLED. UNABLE TO REVERSE #2 ENG ON LNDG.
Narrative: SHIFT REPLACED THE IDG ON THE #2 ENG OF ACFT. THEY LEFT THE LEAK AND OPERATIONAL CHK FOR DAY SHIFT. ACFT TRIP WAS NOT UNTIL XA00. AS THE LEAD I HAD A CREW OF 6 A&P'S AND 2 R&E'S. FOR OUR CREW WE WERE WORKING 3 OTHER ACFT SO AT THE TIME OF THE LEAK CHK I ASSIGNED 2 CREW MEMBERS TO PERFORM THE CHK WITH ME HELPING. AFTER LEAK CHK AND SVCING IDG, COWLS WERE CLOSED AND ACFT TAXI FROM HANGAR TO TERMINAL FOR DEP, WHEREUPON LNDG #2 ENG REVERSER DID NOT DEPLOY, DUE TO THE REVERSER LOCKOUT PIN NOT BEING REMOVED. NO INDICATION WAS VISIBLE WHEN CLOSING COWLS THAT REVERSER WAS LOCKED CLOSED. WHILE I TOOK CARE OF THE PAPERWORK THE REST OF THE CREW MOVED OVER TO WORK ANOTHER ACFT. WHILE SIGNING OFF PAPERWORK WHEN I SIGNED OFF THE CARD FOR REVERSERS, I JUST ASSUMED THAT THE PIN HAD BEEN REMOVED BECAUSE THE FLAG WAS NOT VISIBLE AND THE REVERSER COWLS WERE NOT OPEN ON OUR SHIFT JUST THE FAN COWLS FOR THE OPERATIONAL CHK. THE LOCKOUT PINS HAVE 6 FT OF FLAG MATERIAL. IF IT WAS HANGING DOWN, IT WOULD HAVE BEEN VERY VISIBLE. EITHER WEIGHTED FLAGS OR ANOTHER TYPE OF INDICATION SHOULD BE USED. IT WAS OBVIOUS. THE FLAG WAS NOT OBVIOUS WHETHER THE WIND BLEW IT UP OUT OF THE WAY OR IF SOMEONE PLACED IT OUT OF VIEW WHILE WORKING IN THE AREA. I WAS HELPING AND STANDING RIGHT IN VIEW OF WHERE THE FLAG SHOULD HAVE BEEN AND I DID NOT SEE IT. I WOULD NOT CLOSE THE COWLS IF IT WOULD HAVE BEEN VISIBLE.
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.