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|
Attributes | |
ACN | 788656 |
Time | |
Date | 200805 |
Local Time Of Day | 1201 To 1800 |
Place | |
Locale Reference | navaid : uim.vor |
State Reference | TX |
Altitude | msl single value : 25000 |
Aircraft 1 | |
Controlling Facilities | artcc : zfw.artcc |
Operator | common carrier : air carrier |
Make Model Name | MD-80 Series (DC-9-80) Undifferentiated or Other Model |
Operating Under FAR Part | Part 121 |
Flight Phase | climbout : intermediate altitude |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
ASRS Report | 788656 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
ASRS Report | 788657 |
Events | |
Anomaly | non adherence : published procedure non adherence : company policies other anomaly other |
Independent Detector | aircraft equipment other aircraft equipment : fuel low pressure lights |
Resolutory Action | other |
Supplementary | |
Problem Areas | Flight Crew Human Performance |
Primary Problem | Flight Crew Human Performance |
Narrative:
We had completed all normal checklists and departed without incident. The climb checks were all normal with fuel checked and feeding normally; the main tanks remained full and fuel was decreasing from the center tank. In the climb I noticed that the aft center fuel boost pump was on; all the other pumps were off. I immediately turned all pumps on. The main tanks were still full; the center tank was still decreasing at the time this was done. I thought I had excellent checklist discipline. When challenged on a checklist I normally look and; if possible; touch the item I am responding to. I remember the center aft switch being on with the APU running from when I looked up to turn all boost pumps on for the just prior to engine start checklist. I am at a loss to explain how I could have reported all pumps on when only one was on; but that is the confign I found in the climb out. I will obviously redouble my vigilance in the cockpit to make sure that the checklist compliance matches the level I thought I was performing to. Supplemental information from acn 788657: preflight routine was running slightly behind schedule and when the ground crew called the cockpit ready to push; the before starting engines checklist had yet to be started. So the checklist was begun; perhaps somewhat hurriedly and with less deliberateness than it deserved. The flight departed uneventfully but midway through climb to altitude the master caution light illuminated along with inlet fuel pressure low light for both the left and right sides. At the time the fuel panel was configured with the aft center pump on and the rest of the pumps off; as it was when only the APU was running on the ground. With this confign fuel use was normal during climb out checklists; since the center tank was feeding the engines until it fell below the level where the aft pump could pull suction. Remaining fuel pumps were turned on and the flight continued without further incident. I am sure we covered this item during the before starting engines checklist; however; I think we were trying to accomplish this checklist as quickly as we reasonably could. There is no way to accomplish preflight duties effectively while in a hurry; so; I believe; if we approached this checklist with more deliberateness and vigilance; we would not have missed this item. My personal failure was that I did not verify that checklist items were appropriately accomplished and; therefore; provided poor backup.
Original NASA ASRS Text
Title: MD80 FLT CREW DEPARTS WITH ONLY 28 VOLT CENTER TANK PUMP OPERATING; CAUSING INLET LOW PRESSURE LIGHTS DURING CLIMB.
Narrative: WE HAD COMPLETED ALL NORMAL CHKLISTS AND DEPARTED WITHOUT INCIDENT. THE CLB CHKS WERE ALL NORMAL WITH FUEL CHKED AND FEEDING NORMALLY; THE MAIN TANKS REMAINED FULL AND FUEL WAS DECREASING FROM THE CTR TANK. IN THE CLB I NOTICED THAT THE AFT CTR FUEL BOOST PUMP WAS ON; ALL THE OTHER PUMPS WERE OFF. I IMMEDIATELY TURNED ALL PUMPS ON. THE MAIN TANKS WERE STILL FULL; THE CTR TANK WAS STILL DECREASING AT THE TIME THIS WAS DONE. I THOUGHT I HAD EXCELLENT CHKLIST DISCIPLINE. WHEN CHALLENGED ON A CHKLIST I NORMALLY LOOK AND; IF POSSIBLE; TOUCH THE ITEM I AM RESPONDING TO. I REMEMBER THE CTR AFT SWITCH BEING ON WITH THE APU RUNNING FROM WHEN I LOOKED UP TO TURN ALL BOOST PUMPS ON FOR THE JUST PRIOR TO ENG START CHKLIST. I AM AT A LOSS TO EXPLAIN HOW I COULD HAVE RPTED ALL PUMPS ON WHEN ONLY ONE WAS ON; BUT THAT IS THE CONFIGN I FOUND IN THE CLBOUT. I WILL OBVIOUSLY REDOUBLE MY VIGILANCE IN THE COCKPIT TO MAKE SURE THAT THE CHKLIST COMPLIANCE MATCHES THE LEVEL I THOUGHT I WAS PERFORMING TO. SUPPLEMENTAL INFO FROM ACN 788657: PREFLT ROUTINE WAS RUNNING SLIGHTLY BEHIND SCHEDULE AND WHEN THE GND CREW CALLED THE COCKPIT READY TO PUSH; THE BEFORE STARTING ENGS CHKLIST HAD YET TO BE STARTED. SO THE CHKLIST WAS BEGUN; PERHAPS SOMEWHAT HURRIEDLY AND WITH LESS DELIBERATENESS THAN IT DESERVED. THE FLT DEPARTED UNEVENTFULLY BUT MIDWAY THROUGH CLB TO ALT THE MASTER CAUTION LIGHT ILLUMINATED ALONG WITH INLET FUEL PRESSURE LOW LIGHT FOR BOTH THE L AND R SIDES. AT THE TIME THE FUEL PANEL WAS CONFIGURED WITH THE AFT CTR PUMP ON AND THE REST OF THE PUMPS OFF; AS IT WAS WHEN ONLY THE APU WAS RUNNING ON THE GND. WITH THIS CONFIGN FUEL USE WAS NORMAL DURING CLBOUT CHKLISTS; SINCE THE CTR TANK WAS FEEDING THE ENGS UNTIL IT FELL BELOW THE LEVEL WHERE THE AFT PUMP COULD PULL SUCTION. REMAINING FUEL PUMPS WERE TURNED ON AND THE FLT CONTINUED WITHOUT FURTHER INCIDENT. I AM SURE WE COVERED THIS ITEM DURING THE BEFORE STARTING ENGS CHKLIST; HOWEVER; I THINK WE WERE TRYING TO ACCOMPLISH THIS CHKLIST AS QUICKLY AS WE REASONABLY COULD. THERE IS NO WAY TO ACCOMPLISH PREFLT DUTIES EFFECTIVELY WHILE IN A HURRY; SO; I BELIEVE; IF WE APCHED THIS CHKLIST WITH MORE DELIBERATENESS AND VIGILANCE; WE WOULD NOT HAVE MISSED THIS ITEM. MY PERSONAL FAILURE WAS THAT I DID NOT VERIFY THAT CHKLIST ITEMS WERE APPROPRIATELY ACCOMPLISHED AND; THEREFORE; PROVIDED POOR BACKUP.
Data retrieved from NASA's ASRS site as of May 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.