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Attributes | |
ACN | 803421 |
Time | |
Date | 200810 |
Place | |
Locale Reference | airport : zzz.airport |
State Reference | US |
Altitude | agl single value : 0 |
Aircraft 1 | |
Make Model Name | Helicopter |
Person 1 | |
Affiliation | other |
Function | maintenance : inspector |
Qualification | technician : inspection authority |
Experience | maintenance lead technician : 25 |
ASRS Report | 803421 |
Events | |
Anomaly | maintenance problem : improper documentation maintenance problem : improper maintenance non adherence : company policies non adherence : far non adherence : published procedure |
Independent Detector | other other : 1 |
Resolutory Action | none taken : detected after the fact |
Consequence | other |
Factors | |
Maintenance | contributing factor : tooling performance deficiency : inspection performance deficiency : non compliance with legal requirements performance deficiency : testing performance deficiency : scheduled maintenance |
Supplementary | |
Problem Areas | Maintenance Human Performance Chart Or Publication Company |
Primary Problem | Maintenance Human Performance |
Narrative:
The aircraft was in for airframe composite repair and a scheduled 100 hour inspection. It is an aircraft equipped to provide live news broadcasting. During the inspection; certain components were removed by news station personnel with the repair stations knowledge. These were documented. A mechanic decided to remove the remaining equipment even though there was no direction/written squawk in the work package to do this. Numerous cables and harnesses were cut with diagonal cutters without regard to power bus connections or system interfacing. Several news component containment racks were removed. Upon return to service; the aircraft was weighed. The mechanics weighing the aircraft disregarded the manufacturer's (scales) instructions and did not perform the required calibration and zeroing checks of the load cells. The director of maintenance was aware of the equipment removal; but did nothing to ensure proper documentation. The scale weight and balance was not entered into the flight manual. FAA supplemental type certificate form was completed for the unauthorized equipment removal. In addition; a supplemental type certificated windshield was installed without the proper recording of installation (FAA supplemental type certificate form). The aircraft was returned to service. Callback conversation with reporter revealed the following information: reporter stated that he is one of three inspection authorities at the repair station servicing numerous helicopters. The shop foreman is one of the three ia inspectors. He was very upset seeing the failure to follow procedures; the undocumented work; the use of weighing equipment that wasn't properly calibrated and the lack of communication regarding work that was accomplished on the ecureuil AS350 helicopter. The 337 he referred to; was an FAA 337 supplemental type certificate form; used for maintenance record keeping when installing and removing aircraft equipment not originally certificated for an aircraft. In this case; the replaced windshield was an after market windshield; and although pma approved; the stc-337 form was required. Reporter stated he found out later; the cut cables and harnesses were no longer active electrical harnesses; because the central power box; that controls the electronic routing in the cables and harnesses; and originally configured for the news crews video monitors; had already been removed. Reporter also stated the ecureuil AS350 is a single engine type and has a composite shell; but the load bearing section of the helicopter is of aluminum substructure.
Original NASA ASRS Text
Title: AN IA RATED LEAD MECHANIC REPORTS ABOUT IMPROPER; UNDOCUMENTED MAINT AND FAILURE TO FOLLOW PROCEDURES; ON A ECUREUIL AS350 HELICOPTER; THAT INCLUDED NUMEROUS CABLES AND HARNESSES CUT WITH DIAGONAL CUTTERS.
Narrative: THE ACFT WAS IN FOR AIRFRAME COMPOSITE REPAIR AND A SCHEDULED 100 HR INSPECTION. IT IS AN ACFT EQUIPPED TO PROVIDE LIVE NEWS BROADCASTING. DURING THE INSPECTION; CERTAIN COMPONENTS WERE REMOVED BY NEWS STATION PERSONNEL WITH THE REPAIR STATIONS KNOWLEDGE. THESE WERE DOCUMENTED. A MECH DECIDED TO REMOVE THE REMAINING EQUIP EVEN THOUGH THERE WAS NO DIRECTION/WRITTEN SQUAWK IN THE WORK PACKAGE TO DO THIS. NUMEROUS CABLES AND HARNESSES WERE CUT WITH DIAGONAL CUTTERS WITHOUT REGARD TO PWR BUS CONNECTIONS OR SYS INTERFACING. SEVERAL NEWS COMPONENT CONTAINMENT RACKS WERE REMOVED. UPON RETURN TO SVC; THE ACFT WAS WEIGHED. THE MECHS WEIGHING THE ACFT DISREGARDED THE MANUFACTURER'S (SCALES) INSTRUCTIONS AND DID NOT PERFORM THE REQUIRED CALIBRATION AND ZEROING CHKS OF THE LOAD CELLS. THE DIRECTOR OF MAINT WAS AWARE OF THE EQUIP REMOVAL; BUT DID NOTHING TO ENSURE PROPER DOCUMENTATION. THE SCALE WT AND BAL WAS NOT ENTERED INTO THE FLT MANUAL. FAA SUPPLEMENTAL TYPE CERTIFICATE FORM WAS COMPLETED FOR THE UNAUTH EQUIP REMOVAL. IN ADDITION; A SUPPLEMENTAL TYPE CERTIFICATED WINDSHIELD WAS INSTALLED WITHOUT THE PROPER RECORDING OF INSTALLATION (FAA SUPPLEMENTAL TYPE CERTIFICATE FORM). THE ACFT WAS RETURNED TO SVC. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: REPORTER STATED THAT HE IS ONE OF THREE INSPECTION AUTHORITIES AT THE REPAIR STATION SERVICING NUMEROUS HELICOPTERS. THE SHOP FOREMAN IS ONE OF THE THREE IA INSPECTORS. HE WAS VERY UPSET SEEING THE FAILURE TO FOLLOW PROCEDURES; THE UNDOCUMENTED WORK; THE USE OF WEIGHING EQUIPMENT THAT WASN'T PROPERLY CALIBRATED AND THE LACK OF COMMUNICATION REGARDING WORK THAT WAS ACCOMPLISHED ON THE ECUREUIL AS350 HELICOPTER. THE 337 HE REFERRED TO; WAS AN FAA 337 SUPPLEMENTAL TYPE CERTIFICATE FORM; USED FOR MAINT RECORD KEEPING WHEN INSTALLING AND REMOVING ACFT EQUIPMENT NOT ORIGINALLY CERTIFICATED FOR AN ACFT. IN THIS CASE; THE REPLACED WINDSHIELD WAS AN AFTER MARKET WINDSHIELD; AND ALTHOUGH PMA APPROVED; THE STC-337 FORM WAS REQUIRED. REPORTER STATED HE FOUND OUT LATER; THE CUT CABLES AND HARNESSES WERE NO LONGER ACTIVE ELECTRICAL HARNESSES; BECAUSE THE CENTRAL POWER BOX; THAT CONTROLS THE ELECTRONIC ROUTING IN THE CABLES AND HARNESSES; AND ORIGINALLY CONFIGURED FOR THE NEWS CREWS VIDEO MONITORS; HAD ALREADY BEEN REMOVED. REPORTER ALSO STATED THE ECUREUIL AS350 IS A SINGLE ENGINE TYPE AND HAS A COMPOSITE SHELL; BUT THE LOAD BEARING SECTION OF THE HELICOPTER IS OF ALUMINUM SUBSTRUCTURE.
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.