37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 894615 |
Time | |
Date | 201006 |
Place | |
Locale Reference | ZZZ.ARTCC |
State Reference | US |
Environment | |
Light | Daylight |
Aircraft 1 | |
Make Model Name | B737-300 |
Operating Under FAR Part | Part 121 |
Flight Phase | Cruise |
Component | |
Aircraft Component | Fuel Crossfeed |
Person 1 | |
Function | Pilot Flying Captain |
Qualification | Flight Crew Air Transport Pilot (ATP) |
Events | |
Anomaly | Deviation - Procedural Published Material / Policy Inflight Event / Encounter Weather / Turbulence |
Narrative:
We were on our return leg flying at FL310. Weather was over all good; but numerous times along our route we deviated off course to avoid build-ups. [ATC] centers all were very helpful in working with our deviations and helping us avoid the weather threats. Somewhere [along the route] my center fuel tanks emptied and I turned those pumps off. Noticing an approx 500 pound imbalance between the left and right mains; I initiated the standard cross feed procedure to balance the tanks. We then again started a series of deviations to avoid weather and I lost track of my cross feed situation. Good 40 or more minutes passed until we finally re-established a clear flight path on course. It was then that I discovered I had a serious imbalance of fuel to deal with. My right tank was near 2000 pounds and my left tank was at 8000 pounds. I immediately reversed the pump pressures to attempt to reverse the imbalance as much as I could prior to landing. It was obvious to me that I didn't have enough time to correct my self-induced problem. I reconfigured to all pumps on and cross feed closed while vectoring in the traffic pattern and landed with approximately 1600 pounds in my right tank and 6000 pounds in my left tank. The imbalance did produce a heavy left wing; but I had no problem accomplishing a smooth and uneventful landing. I have gone over and over this event trying to figure out how I put myself into this situation and I have determined that it was a series of events that contributed. 1.) my normal cross feed procedure is to verbalize to my first officer that I am cross feeding; but due to our course deviations over an extended period of time; I didn't do that this time. 2.) I normally pull the parking brake light cap off the light and hold it in my hand while cross feeding. This is a technique I saw others use over many years on the 737 and it serves as a constant reminder that something isn't normal....but again due to our course deviation activities; I didn't grab the light cap. 3.) I think after working around weather and finally seeing clear skies ahead; I relaxed and got complacent.....thinking of my deadhead home and thinking of my next four days off with my family. 4.) finally; I think the entire day started off rushed....I received a call from daily scheduling waking me up from a sound sleep.....can I be at the airport to catch a deadhead...yes....then arriving from my deadhead 30 minutes before departure time and having to walk to the concourse to my flight. Boarding is in process; I couldn't meet and greet my crew and give them my normal briefing. The first officer was doing the preflight and the flight attendants were already in the boarding process.....I felt pressured and behind. We did push within 5 minutes of schedule; but then worked our way down accomplishing numerous course deviations along the way. I needed to sit back and catch my breath and that is when I got complacent and the imbalance happened. First and foremost....I must always revert to my normal anal and other recommended procedures (verbalizing to the first officer and using the light cap) for cross feeding despite what other distractions may be occurring. Secondly; as events start building and happening faster than I feel I can work with; I must slow everything down and refocus on all tasks at hand; prioritizing and using all available resources to help me accomplish my flight safely. I move myself from green to yellow to red and was only able to return to a marginal yellow condition at the completion of the flight. I'm not proud of what I allowed to happen. I know I have dodged a big bullet and I know I have learn from an event that will stay with me the rest of my career. Maybe my event can be shared and help others refocus as well.
Original NASA ASRS Text
Title: A B737 Captain reported losing track of his crossfeed configuration and landing with an imbalance.
Narrative: We were on our return leg flying at FL310. Weather was over all good; but numerous times along our route we deviated off course to avoid build-ups. [ATC] Centers all were very helpful in working with our deviations and helping us avoid the weather threats. Somewhere [along the route] my center fuel tanks emptied and I turned those pumps off. Noticing an approx 500 LB imbalance between the left and right mains; I initiated the standard cross feed procedure to balance the tanks. We then again started a series of deviations to avoid weather and I lost track of my cross feed situation. Good 40 or more minutes passed until we finally re-established a clear flight path on course. It was then that I discovered I had a serious imbalance of fuel to deal with. My right tank was near 2000 LBS and my left tank was at 8000 LBS. I immediately reversed the pump pressures to attempt to reverse the imbalance as much as I could prior to landing. It was obvious to me that I didn't have enough time to correct my self-induced problem. I reconfigured to all pumps on and cross feed closed while vectoring in the traffic pattern and landed with approximately 1600 LBS in my right tank and 6000 LBS in my left tank. The imbalance did produce a heavy left wing; but I had no problem accomplishing a smooth and uneventful landing. I have gone over and over this event trying to figure out how I put myself into this situation and I have determined that it was a series of events that contributed. 1.) My normal cross feed procedure is to verbalize to my First Officer that I am cross feeding; but due to our course deviations over an extended period of time; I didn't do that this time. 2.) I normally pull the parking brake light cap off the light and hold it in my hand while cross feeding. This is a technique I saw others use over many years on the 737 and it serves as a constant reminder that something isn't normal....but again due to our course deviation activities; I didn't grab the light cap. 3.) I think after working around weather and finally seeing clear skies ahead; I relaxed and got complacent.....thinking of my deadhead home and thinking of my next four days off with my family. 4.) Finally; I think the entire day started off rushed....I received a call from daily scheduling waking me up from a sound sleep.....can I be at the airport to catch a deadhead...yes....then arriving from my deadhead 30 minutes before departure time and having to walk to the concourse to my flight. Boarding is in process; I couldn't meet and greet my crew and give them my normal briefing. The First Officer was doing the preflight and the flight attendants were already in the boarding process.....I felt pressured and behind. We did push within 5 minutes of schedule; but then worked our way down accomplishing numerous course deviations along the way. I needed to sit back and catch my breath and that is when I got complacent and the imbalance happened. First and foremost....I must ALWAYS revert to my normal anal and other recommended procedures (verbalizing to the First Officer and using the light cap) for cross feeding despite what other distractions may be occurring. Secondly; as events start building and happening faster than I feel I can work with; I MUST slow everything down and refocus on ALL tasks at hand; prioritizing and using all available resources to help me accomplish my flight safely. I move myself from Green to Yellow to Red and was only able to return to a marginal Yellow condition at the completion of the flight. I'm not proud of what I allowed to happen. I know I have dodged a big bullet and I know I have learn from an event that will stay with me the rest of my career. Maybe my event can be shared and help others refocus as well.
Data retrieved from NASA's ASRS site as of April 2012 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.