Statuts: | Accident investigation report completed and information captured |
Date: | lundi 8 juin 1992 |
Heure: | 08:53 |
Type/Sous-type: | Beechcraft C99 Commuter |
Compagnie: | GP Express Airlines |
Immatriculation: | N118GP |
Numéro de série: | U-185 |
Année de Fabrication: | 1982 |
Heures de vol: | 9725 |
Cycles: | 11109 |
Moteurs: | 2 Pratt & Whitney Canada PT6A-36 |
Equipage: | victimes: 1 / à bord: 2 |
Passagers: | victimes: 2 / à bord: 4 |
Total: | victimes: 3 / à bord: 6 |
Dégats de l'appareil: | Détruit |
Conséquences: | Written off (damaged beyond repair) |
Lieu de l'accident: | 12 km (7.5 milles) NE of Anniston-County Airport, AL (ANB) ( Etats-Unis d'Amérique)
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Phase de vol: | En approche (APR) |
Nature: | Transport de Passagers Nat. |
Aéroport de départ: | Atlanta-William B. Hartsfield International Airport, GA (ATL/KATL), Etats-Unis d'Amérique |
Aéroport de destination: | Anniston-County Airport, AL (ANB/KANB), Etats-Unis d'Amérique |
Numéro de vol: | 861 |
Détails:After being cleared by air traffic control for the instrument landing system (ILS) approach to runway 05 at Anniston, the flight crew turned the airplane toward the north away from the airport in the erroneous belief that the airplane was south of the airport. The flight crew did not perform the manoeuvres specified on the approach chart, which required flying outbound from the airport, then performing the "procedure turn" back toward the airport. The investigation determined that in actuality, the airplane had intercepted the back course localizer signal for the ILS approach, and the flight crew had commenced the approach at a high airspeed about 2,000 feet above the specified altitude for crossing the final approach fix. The airplane continued a controlled descent until it impacted terrain.
Probable Cause:
PROBABLE CAUSE: "The failure of senior management of GP Express to provide adequate training and operational support for the start-up of the southern operation, which resulted in the assignment of an inadequately prepared captain with a relatively inexperienced first officer in revenue passenger service and the failure of the flight crew to use approved instrument flight procedures, which resulted in a loss of situational awareness and terrain clearance. Contributing to the causes of the accident was GP Express' failure to provide approach charts to each pilot and to establish stabilized approach criteria. Also contributing were the inadequate crew coordination and a role reversal on the part of the captain and first officer."
Accident investigation:
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Investigating agency: | NTSB |
Status: | Investigation completed |
Duration: | 267 days (9 months) | Accident number: | NTSB/AAR-93-03 | Download report: | Final report
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Opérations de secours
NTSB issued 6 Safety Recommendations
Issued: 06-JAN-1993 | To: FAA | A-92-133 |
REQUIRE, FOR AIRCRAFT THAT MUST BE OPERATED BY TWO CREWMEMBERS AND BE EQUIPPED WITH A FOUR-CHANNEL COCKPIT VOICE RECORDER (CVR), THE EXCLUSIVE USE OF THE THIRD CVR RADIO CHANNEL TO RECORD ONLY AUDIO SIGNALS FROM THE COCKPIT CREW INTERCOM SYSTEM AND THE TWO "HOT" BOOM MICROPHONES. (Closed - Unacceptable Action) |
Issued: 02-APR-1993 | To: FAA | A-93-35 |
REQUIRE THAT ALL PILOTS OPERATING AIRCRAFT UNDER 14 CFR PART 135 HAVE ACCESS TO THEIR OWN SET OF INSTRUMENT APPROACH CHARTS. (Closed - Unacceptable Action) |
Issued: 02-APR-1993 | To: FAA | A-93-36 |
REQUIRE THAT SCHEDULED AIR CARRIERS OPERATING UNDER 14 CFR PART 135 DEVELOP AND INCLUDE IN THEIR FLIGHT OPERATION MANUALS AND TRAINING PROGRAMS STABILIZED APPROACH CRITERIA. THE CRITERIA SHOULD INCLUDE SPECIFIC LIMITS OF LOCALIZER, GLIDESLOPE, AND VOR NEEDLE DEFLECTIONS AND RATES OF DESCENT, ETC., NEAR THE AIRPORT, BEYOND WHICH INITIATION OF AN IMMEDIATE MISSED APPROACH WOULD BE REQUIRED. (Closed - Acceptable Alternate Action) |
Issued: 02-APR-1993 | To: FAA | A-93-37 |
DEVELOP GUIDANCE AND EVALUATION CRITERIA FOR PRINCIPAL OPERATIONS INSPECTORS TO USE TO ENSURE THAT AIRLINE COCKPIT RESOURCE MANAGEMENT TRAINING PROGRAMS ADEQUATELY ADDRESS CREW INTERACTION, DECISION-MAKING PROCESS, INFORMATION GATHERING, FLIGHTCREW COMMUNICATION, AND LEADERSHIP SKILLS. (Closed - Acceptable Action) |
Issued: 02-APR-1993 | To: FAA | A-93-38 |
FOR AIRLINES THAT UTILIZE CONTRACTED FLIGHT AND GROUND TRAINING PROGRAMS, REQUIRE THAT PILOTS HIRED DIRECTLY TO BE CAPTAINS RECEIVE ADDITIONAL FLIGHT INSTRUCTION PERTAINING TO THE OPERATING ENVIRONMENT AND PROCEDURES UNIQUE TO THE AIRLINE FROM AN FAA-APPROVED COMPANY CHECK AIRMAN OR INSTRUCTOR, RATHER THAN ONLY FROM THE CONTRACTOR INSTRUCTOR. (Closed - Reconsidered) |
Issued: 02-APR-1993 | To: FAA | A-93-39 |
AMEND 14 CFR 135.243(C)(2) TO REQUIRE THAT THE PILOT-IN-COMMAND OF A COMMUTER AIR CARRIER FLIGHT THAT REQUIRES TWO CREWMEMBERS HAVE AT LEAST 100 HOURS OF FLIGHT TIME OR AN EQUIVALENT LEVEL OF TRAINING IN COMMUTER AIR CARRIER OPERATIONS REQUIRING TWO PILOTS. (Closed - Acceptable Action) |
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Photos
Plan
Ce plan montre l'aéroport de départ ainsi que la supposée destination du vol. La ligne fixe reliant les deux aéroports n'est pas le plan de vol exact.
La distance entre Atlanta-William B. Hartsfield International Airport, GA et Anniston-County Airport, AL est de 132 km (82 miles).
Accident location: Exact; as reported in the official accident report.
Les informations ci-dessus ne représentent pas l'opinion de la 'Flight Safety Foundation' ou de 'Aviation Safety Network' sur les causes de l'accident. Ces informations prélimimaires sont basées sur les faits tel qu'ils sont connus à ce jour.