37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
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Attributes | |
ACN | 752933 |
Time | |
Date | 200709 |
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 | B737-300 |
Operating Under FAR Part | Part 121 |
Flight Phase | landing : roll |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | maintenance : technician |
Qualification | technician : fcc technician : powerplant technician : airframe |
Experience | maintenance technician : 19 |
ASRS Report | 752933 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Events | |
Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance non adherence : published procedure non adherence : far other anomaly other |
Independent Detector | other flight crewa |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Factors | |
Maintenance | contributing factor : lighting contributing factor : schedule pressure contributing factor : weather contributing factor : briefing performance deficiency : installation performance deficiency : non compliance with legal requirements performance deficiency : testing |
Supplementary | |
Problem Areas | Maintenance Human Performance Aircraft Environmental Factor |
Primary Problem | Maintenance Human Performance |
Situations | |
Publication | AMM Not Followed |
Narrative:
I was assigned 2 aircraft; B737 and A320. Working the B737 window heat problem #2 right window; I pulled circuit breakers and 2 boxes; window heat controller and the engine accessory unit in the electronics bay to gain access to the back side of the whc bench plugs to do resistance checks; reference maintenance manuals and wiring diagrams. Once I found the problem; I gathered the parts and crimpers I needed. At this time I was told by my lead to drop what I was doing and start working write-ups on B747. I was told that a widebody transport has priority over a narrow body. Because I was in the middle of a job on the B737 I finished repairing the broken feed wire to the #2 window; replaced whc and eau; and pushed in all breakers. Check and tested window heat in which the #2 window heat was operating ok. I started working on the B747 until the end of shift. I received a call from the shift supervisor telling me the B737 landing at another airport had the reversers deployed but would not stow on rollout. Pilots shut the engines down and were towed to gate. Maintenance noticed that the eau was missing. A new eau was installed and the original eau was found laying inside east&east compartment on top of the drip curtain above the east&east door opening. Preventive measures: do not rush to finish job no matter what stress is put on you. Not getting enough sleep (fatigue). Pressure from management and leads; poor lighting inside the east&east; and working outside in the early morning. Callback conversation with reporter revealed the following information: reporter stated being pulled off the window heat job for other work did contribute to his distraction when returning to finish the window heat problem. The engine accessory unit (eau) may not have been properly secured in the electronic rack. Also; due to the removal of the eau black box; a test of the eau and reverser operation was required but not accomplished. Reporter added he was informed the aircraft would not have been capable of a go around maneuver because the reversers would not stow after deployment with the eau box not connected.
Original NASA ASRS Text
Title: DUE TO EAU NOT BEING INSTALLED DURING MAINT; B737-300 ENGINE REVERSERS WOULD NOT STOW ON LANDING ROLLOUT. ENGINES WERE SHUT DOWN AND ACFT TOWED TO GATE.
Narrative: I WAS ASSIGNED 2 ACFT; B737 AND A320. WORKING THE B737 WINDOW HEAT PROB #2 R WINDOW; I PULLED CIRCUIT BREAKERS AND 2 BOXES; WINDOW HEAT CTLR AND THE ENG ACCESSORY UNIT IN THE ELECTRONICS BAY TO GAIN ACCESS TO THE BACK SIDE OF THE WHC BENCH PLUGS TO DO RESISTANCE CHKS; REF MAINT MANUALS AND WIRING DIAGRAMS. ONCE I FOUND THE PROB; I GATHERED THE PARTS AND CRIMPERS I NEEDED. AT THIS TIME I WAS TOLD BY MY LEAD TO DROP WHAT I WAS DOING AND START WORKING WRITE-UPS ON B747. I WAS TOLD THAT A WDB HAS PRIORITY OVER A NARROW BODY. BECAUSE I WAS IN THE MIDDLE OF A JOB ON THE B737 I FINISHED REPAIRING THE BROKEN FEED WIRE TO THE #2 WINDOW; REPLACED WHC AND EAU; AND PUSHED IN ALL BREAKERS. CHK AND TESTED WINDOW HEAT IN WHICH THE #2 WINDOW HEAT WAS OPERATING OK. I STARTED WORKING ON THE B747 UNTIL THE END OF SHIFT. I RECEIVED A CALL FROM THE SHIFT SUPVR TELLING ME THE B737 LNDG AT ANOTHER ARPT HAD THE REVERSERS DEPLOYED BUT WOULD NOT STOW ON ROLLOUT. PLTS SHUT THE ENGS DOWN AND WERE TOWED TO GATE. MAINT NOTICED THAT THE EAU WAS MISSING. A NEW EAU WAS INSTALLED AND THE ORIGINAL EAU WAS FOUND LAYING INSIDE E&E COMPARTMENT ON TOP OF THE DRIP CURTAIN ABOVE THE E&E DOOR OPENING. PREVENTIVE MEASURES: DO NOT RUSH TO FINISH JOB NO MATTER WHAT STRESS IS PUT ON YOU. NOT GETTING ENOUGH SLEEP (FATIGUE). PRESSURE FROM MGMNT AND LEADS; POOR LIGHTING INSIDE THE E&E; AND WORKING OUTSIDE IN THE EARLY MORNING. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: REPORTER STATED BEING PULLED OFF THE WINDOW HEAT JOB FOR OTHER WORK DID CONTRIBUTE TO HIS DISTRACTION WHEN RETURNING TO FINISH THE WINDOW HEAT PROBLEM. THE ENGINE ACCESSORY UNIT (EAU) MAY NOT HAVE BEEN PROPERLY SECURED IN THE ELECTRONIC RACK. ALSO; DUE TO THE REMOVAL OF THE EAU BLACK BOX; A TEST OF THE EAU AND REVERSER OPERATION WAS REQUIRED BUT NOT ACCOMPLISHED. REPORTER ADDED HE WAS INFORMED THE ACFT WOULD NOT HAVE BEEN CAPABLE OF A GO AROUND MANEUVER BECAUSE THE REVERSERS WOULD NOT STOW AFTER DEPLOYMENT WITH THE EAU BOX NOT CONNECTED.
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.