37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 83309 |
Time | |
Date | 198803 |
Day | Sun |
Local Time Of Day | 0601 To 1200 |
Place | |
Locale Reference | airport : sea |
State Reference | WA |
Altitude | msl bound lower : 4300 msl bound upper : 5000 |
Environment | |
Flight Conditions | VMC |
Light | Daylight |
Aircraft 1 | |
Controlling Facilities | tracon : sea |
Operator | common carrier : air carrier |
Make Model Name | Widebody, Low Wing, 4 Turbojet Eng |
Navigation In Use | Other |
Flight Phase | cruise other descent other |
Route In Use | enroute : on vectors |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Experience | flight time last 90 days : 240 flight time total : 17500 |
ASRS Report | 83309 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : commercial pilot : instrument pilot : flight engineer |
Experience | flight time last 90 days : 95 flight time type : 95 |
ASRS Report | 83206 |
Events | |
Anomaly | altitude deviation : excursion from assigned altitude non adherence : far non adherence : clearance |
Independent Detector | other flight crewa |
Resolutory Action | flight crew : returned to intended course or assigned course |
Consequence | Other |
Supplementary | |
Primary Problem | Ambiguous |
Air Traffic Incident | other |
Situations | |
ATC Facility | procedure or policy : unspecified |
Narrative:
During the last phase of radar vectoring for an ILS approach to runway 16R at sea/tac airport, our flight was cleared for the approach, told to maintain 210 KTS to anvil, cross anvil at 3000', and change to tower frequency at park plus some other details all as rapidly as the controller could get the words out of his mouth. The copilot was flying and I was handling the radios. The clearance was totally impossible to assimilate as it had been rattled off so quickly. When the controller was asked to repeat, the second clearance was just as fast and difficult to understand. During the time my attention was focused on the clearance repetition, the copilot left 5000' our cleared altitude for 3000' since he believed it was ok to descend to cross anvil at 3000' from our present position. We were not on a published transition segment or route so it was not safe to descend until intercepting localizer. I noticed we were descending through 4500' and instructed the copilot to immediately climb back to 5000'. The altitude actually reversed at 4300'. It has bothered me how I could have missed that descent to 4500' since the cockpit was totally sterile and I had called out leaving 6000' for 5000' and observed the V/south at about 500 FPM at about 5300'. If the V/south has not settled down to 500 FPM with 500' remaining to descend, it has always been my operating procedure to remind the copilot of this fact just in case he has had a lapse in planning to level off. We can only conclude that upon hearing the 3000' crossing clearance, he must have increased his rate of descent before leveling off, just when my attention was diverted to the rapid fire clearance, which on the second transmission I was trying to copy, so as not to miss it a second time. The flight conditions were visual, in and out of clouds, so the danger quotient was low, but to leave a final vector altitude before intercepting the localizer from a position off a transition route has proven fatal in the past. A clearance to cross a fix at a certain altitude from a vector off the localizer west/O having been issued a solid altitude limit invites trouble. It is a little non standard, just like almost everything else the controllers do at sea. Almost all clrncs are rattled off in machine gun fashion, one controller seemingly trying to be faster than the next, for some mistakenly macho reason. It is noticeable that pilot replies come back deliberately slowed in hopes of slowing down the controller some. I have experienced other non standard or loose procedures at sea. Among them are, once being cleared just after liftoff to change heading to avoid conflict with an inbound commuter flight, blueprint for trouble, especially in a maximum load bound for tokyo. The turn was refused. Others include amazing speed reductions well into flap extension range on vectors to the final approach in instrument conditions, only to be given a speed increase out of flap range mins later. Smacks of controller training. Departure handling is also non standard and loose. On 2 occasions from a mountain #1 standard instrument departure after turning to the prescribed 070 degree heading and a subsequent radar vector, the controller questioned why we were not heading for ellensburg. Our pretkof clearance did indeed include the ellensburg transition, this we were well aware of, but we were left on a radar vector heading and had not been cleared to ellensburg. The SID reads radar vectors to the transition or assigned route--no such clearance had been issued. On the second occasion, I had warned the copilot that this sort of thing happens at sea and sure enough, the controller did it again! As commander of the aircraft there is no escaping the responsibility for descending out of 5000' during our approach. The purpose of this report is to focus attention on the factors which set up the error. Supplemental information from acn 83206: controller gave multiple commands, very fast among which was descend to 3000', cross anvil at 3000', maintain 210 KTS (? A heading change).
Original NASA ASRS Text
Title: ACR WDB ALT DEVIATION EXCURSION FROM CLRNC ALT. GENERAL COMPLAINT ABOUT SEA APCH CTLR TECHNIQUE AND SPEECH RATE.
Narrative: DURING THE LAST PHASE OF RADAR VECTORING FOR AN ILS APCH TO RWY 16R AT SEA/TAC ARPT, OUR FLT WAS CLRED FOR THE APCH, TOLD TO MAINTAIN 210 KTS TO ANVIL, CROSS ANVIL AT 3000', AND CHANGE TO TWR FREQ AT PARK PLUS SOME OTHER DETAILS ALL AS RAPIDLY AS THE CTLR COULD GET THE WORDS OUT OF HIS MOUTH. THE COPLT WAS FLYING AND I WAS HANDLING THE RADIOS. THE CLRNC WAS TOTALLY IMPOSSIBLE TO ASSIMILATE AS IT HAD BEEN RATTLED OFF SO QUICKLY. WHEN THE CTLR WAS ASKED TO REPEAT, THE SECOND CLRNC WAS JUST AS FAST AND DIFFICULT TO UNDERSTAND. DURING THE TIME MY ATTN WAS FOCUSED ON THE CLRNC REPETITION, THE COPLT LEFT 5000' OUR CLRED ALT FOR 3000' SINCE HE BELIEVED IT WAS OK TO DSND TO CROSS ANVIL AT 3000' FROM OUR PRESENT POS. WE WERE NOT ON A PUBLISHED TRANSITION SEGMENT OR ROUTE SO IT WAS NOT SAFE TO DSND UNTIL INTERCEPTING LOC. I NOTICED WE WERE DSNDING THROUGH 4500' AND INSTRUCTED THE COPLT TO IMMEDIATELY CLB BACK TO 5000'. THE ALT ACTUALLY REVERSED AT 4300'. IT HAS BOTHERED ME HOW I COULD HAVE MISSED THAT DSCNT TO 4500' SINCE THE COCKPIT WAS TOTALLY STERILE AND I HAD CALLED OUT LEAVING 6000' FOR 5000' AND OBSERVED THE V/S AT ABOUT 500 FPM AT ABOUT 5300'. IF THE V/S HAS NOT SETTLED DOWN TO 500 FPM WITH 500' REMAINING TO DSND, IT HAS ALWAYS BEEN MY OPERATING PROC TO REMIND THE COPLT OF THIS FACT JUST IN CASE HE HAS HAD A LAPSE IN PLANNING TO LEVEL OFF. WE CAN ONLY CONCLUDE THAT UPON HEARING THE 3000' XING CLRNC, HE MUST HAVE INCREASED HIS RATE OF DSCNT BEFORE LEVELING OFF, JUST WHEN MY ATTN WAS DIVERTED TO THE RAPID FIRE CLRNC, WHICH ON THE SECOND XMISSION I WAS TRYING TO COPY, SO AS NOT TO MISS IT A SECOND TIME. THE FLT CONDITIONS WERE VISUAL, IN AND OUT OF CLOUDS, SO THE DANGER QUOTIENT WAS LOW, BUT TO LEAVE A FINAL VECTOR ALT BEFORE INTERCEPTING THE LOC FROM A POS OFF A TRANSITION ROUTE HAS PROVEN FATAL IN THE PAST. A CLRNC TO CROSS A FIX AT A CERTAIN ALT FROM A VECTOR OFF THE LOC W/O HAVING BEEN ISSUED A SOLID ALT LIMIT INVITES TROUBLE. IT IS A LITTLE NON STANDARD, JUST LIKE ALMOST EVERYTHING ELSE THE CTLRS DO AT SEA. ALMOST ALL CLRNCS ARE RATTLED OFF IN MACHINE GUN FASHION, ONE CTLR SEEMINGLY TRYING TO BE FASTER THAN THE NEXT, FOR SOME MISTAKENLY MACHO REASON. IT IS NOTICEABLE THAT PLT REPLIES COME BACK DELIBERATELY SLOWED IN HOPES OF SLOWING DOWN THE CTLR SOME. I HAVE EXPERIENCED OTHER NON STANDARD OR LOOSE PROCS AT SEA. AMONG THEM ARE, ONCE BEING CLRED JUST AFTER LIFTOFF TO CHANGE HDG TO AVOID CONFLICT WITH AN INBND COMMUTER FLT, BLUEPRINT FOR TROUBLE, ESPECIALLY IN A MAX LOAD BOUND FOR TOKYO. THE TURN WAS REFUSED. OTHERS INCLUDE AMAZING SPD REDUCTIONS WELL INTO FLAP EXTENSION RANGE ON VECTORS TO THE FINAL APCH IN INSTRUMENT CONDITIONS, ONLY TO BE GIVEN A SPD INCREASE OUT OF FLAP RANGE MINS LATER. SMACKS OF CTLR TRNING. DEP HANDLING IS ALSO NON STANDARD AND LOOSE. ON 2 OCCASIONS FROM A MOUNTAIN #1 STANDARD INSTRUMENT DEP AFTER TURNING TO THE PRESCRIBED 070 DEG HDG AND A SUBSEQUENT RADAR VECTOR, THE CTLR QUESTIONED WHY WE WERE NOT HDG FOR ELLENSBURG. OUR PRETKOF CLRNC DID INDEED INCLUDE THE ELLENSBURG TRANSITION, THIS WE WERE WELL AWARE OF, BUT WE WERE LEFT ON A RADAR VECTOR HDG AND HAD NOT BEEN CLRED TO ELLENSBURG. THE SID READS RADAR VECTORS TO THE TRANSITION OR ASSIGNED ROUTE--NO SUCH CLRNC HAD BEEN ISSUED. ON THE SECOND OCCASION, I HAD WARNED THE COPLT THAT THIS SORT OF THING HAPPENS AT SEA AND SURE ENOUGH, THE CTLR DID IT AGAIN! AS COMMANDER OF THE ACFT THERE IS NO ESCAPING THE RESPONSIBILITY FOR DSNDING OUT OF 5000' DURING OUR APCH. THE PURPOSE OF THIS RPT IS TO FOCUS ATTN ON THE FACTORS WHICH SET UP THE ERROR. SUPPLEMENTAL INFO FROM ACN 83206: CTLR GAVE MULTIPLE COMMANDS, VERY FAST AMONG WHICH WAS DSND TO 3000', CROSS ANVIL AT 3000', MAINTAIN 210 KTS (? A HDG CHANGE).
Data retrieved from NASA's ASRS site as of August 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.