37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 653118 |
Time | |
Date | 200503 |
Local Time Of Day | 1801 To 2400 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Environment | |
Light | Night |
Aircraft 1 | |
Operator | common carrier : air carrier |
Make Model Name | B737-300 |
Operating Under FAR Part | Part 121 |
Flight Phase | ground : maintenance |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
Qualification | technician : airframe technician : powerplant |
Experience | maintenance technician : 20 |
ASRS Report | 653118 |
Person 2 | |
Affiliation | company : air carrier |
Function | maintenance : lead technician |
Events | |
Anomaly | maintenance problem : improper maintenance maintenance problem : improper documentation non adherence : published procedure non adherence : far |
Independent Detector | other other : 1 |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Factors | |
Maintenance | contributing factor : schedule pressure performance deficiency : scheduled maintenance performance deficiency : non compliance with legal requirements performance deficiency : installation performance deficiency : inspection |
Supplementary | |
Problem Areas | Environmental Factor Maintenance Human Performance Company Aircraft |
Primary Problem | Maintenance Human Performance |
Narrative:
I replaced a slide on aircraft X on mar/tue/05. It was a callout to replace the slide. I replaced the slide reference maintenance manual 25-61-35. I also had other work on the aircraft. In addition; it was monday and I commuted from ZZZ1. I was up more than 24 hours. I was very tired. I don't recall calling inspection or removing the safety pin from the slide. I worked on the airplane alone. A work partner would help prevent this occurrence.
Original NASA ASRS Text
Title: A B737-300 TECHNICIAN RPTS INSTALLING AN ESCAPE SLIDE ON 2L DOOR WITHOUT INSPECTION AND REMOVING THE SAFETY PIN.
Narrative: I REPLACED A SLIDE ON ACFT X ON MAR/TUE/05. IT WAS A CALLOUT TO REPLACE THE SLIDE. I REPLACED THE SLIDE REF MAINT MANUAL 25-61-35. I ALSO HAD OTHER WORK ON THE ACFT. IN ADDITION; IT WAS MONDAY AND I COMMUTED FROM ZZZ1. I WAS UP MORE THAN 24 HRS. I WAS VERY TIRED. I DON'T RECALL CALLING INSPECTION OR REMOVING THE SAFETY PIN FROM THE SLIDE. I WORKED ON THE AIRPLANE ALONE. A WORK PARTNER WOULD HELP PREVENT THIS OCCURRENCE.
Data retrieved from NASA's ASRS site as of January 2009 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.