Accident Details
Probable Cause and Findings
loss of aircraft control for undetermined reason(s).
Aircraft Information
Registered Owner (Historical)
Analysis
HISTORY OF FLIGHT
On February 22, 1997, at 0623 hours Hawaiian standard time, a Beech H18, N7969K, operated by Polynesian Airways, Inc., as flight 222, crashed on runway 8L at the Honolulu International Airport, Ohau, Hawaii. The flight was operated under 14 CFR Part 135, and the airplane was primarily transporting U.S. mail. The airplane was substantially damaged upon impacting the runway and thereafter was destroyed by fire. The airline transport certificated pilot and a cargo loader, the sole passenger, received minor injuries. Visual meteorological conditions prevailed, and a visual flight rules flight plan was filed. The nighttime flight was originating at the time of the accident. The intended destination was on the island of Lanai, Hawaii.
According to the pilot, upon arrival for work the cargo loader had already loaded about 1/2 of the airplane. The loader finished his work, and the pilot completed the cargo manifest form which indicated that the airplane was near its maximum allowable gross weight and within its center of gravity (CG) limits.
The pilot performed a preflight inspection of the airplane, and he did not report observing any maintenance discrepancies or anomalies. The pilot and the loader boarded the airplane, and the engines were started without evidence of malfunction. They taxied for takeoff, performed an engine run-up, and completed all checklist items without any indication of problems.
The pilot further indicated that he provided a standard takeoff briefing regarding engine failure possibilities to the loader. He received an air traffic clearance for departure, and at 0622:35 he acknowledged the clearance and proceeded to takeoff on runway 8L from the intersection of taxiway Lima. This location was between 1,000 and 1,500 feet short of the midfield location. (See the airport diagrams.)
In the pilot's report, he made the following statement to the National Transportation Safety Board regarding the sequence of events which then occurred:
"Takeoff acceleration was normal. Rotation occurred at 90 (VMC + 5). I left the gear down and accelerated toward blue line (120). Suddenly, the airplane yawed to the left as though the left engine had lost power. I confirmed the mixtures, throttles and props were forward and unsuccessfully tried to maintain directional control with full right rudder. It was then necessary to lower the nose immediately because of severe yawing and rolling tendencies leaving little time to do anything other than maintain directional control and land the aircraft. The impact sheared off the gear, but was not enough to cause any deceleration related injuries."
The loader also provided a statement to the Safety Board. In pertinent part, the loader did not report that the pilot had initially experienced any difficulties handling the airplane, and nothing unusual was noted until after liftoff. Between 3 and 5 seconds after becoming airborne the airplane yawed left.
As the airplane slid to a stop a fire started. The pilot and loader exited the airplane through the cockpit windshield. The airplane came to rest near the United Airlines terminal, and the crash was witnessed by several employees who were located outside the terminal on the ramp. The accident was also observed by several airport security officers. In summary, the witnesses reported that the maximum altitude which the airplane gained during its brief flight was between 75 and 100 feet above ground level. As the airplane descended its wings rocked back and forth, and the airplane impacted the runway while in a left bank.
PERSONNEL INFORMATION
Pilot-in-Command.
The pilot holds an airline transport pilot certificate with an airplane multiengine land rating. He has commercial privileges in single engine land airplanes. The pilot also holds a flight instructor certificate with airplane single engine and multiengine land and instrument airplane privileges. The pilot satisfactorily completed a FAR Part 135 airman competency/proficiency flight check in a Beech D18 on November 27, 1996.
A review of the pilot's recent flying experience in the accident airplane revealed that he had flown the airplane on 20 flights during February, 1997.
The pilot reported that during the accident flight he had been the only person handing the flight controls. The pilot also reported that he had planned to terminate his employment with Polynesian Airways following the flight.
Loader.
The loader holds a private pilot certificate with airplane single engine, multiengine, and instrument airplane ratings. During the accident flight, the loader had occupied the cockpit's front right seat. The loader reported having no flying responsibilities during the flight, and indicated he had not handled any of the flight controls.
The loader reported to the Federal Aviation Administration (FAA) coordinator that the evening before the flight he had worked between 2200 and 0200 at another job site. Thereafter, he did not sleep. Around 0330 he picked up the mail cargo and transported it to Polynesian Airways whereupon he commenced loading it into the accident airplane. He was involved with the loading process for approximately 2 hours.
AIRCRAFT INFORMATION
Structural Modification.
The airplane had been modified to facilitate hauling cargo. Some of the modifications included replacing the tail wheel with a nose wheel (Volpar conversion), and changes to the load weight limits of the fuselage floor. The airplane's revised maximum takeoff and landing weights were 9,900 and 9,500 pounds, respectively.
Airplane Records.
The FAA examined the operator's records in conjunction with its examination of the airplane. The airplane contained a document on which crewmembers listed discrepancies and the operator listed its corrective maintenance action. The document was found devoid of any comments.
The airplane's total time since new could not be verified because of discrepancies in the operator's records. The times listed in this report are approximations.
In summary, the FAA further reported that a comparison between logbook entries and airplane data plate information revealed discrepancies. For example, the serial number listed on the right engine's data plate did not match its logbook entry. The left engine's propeller governor had been installed without corresponding written (return to service) documentation. No logbook evidence was found for installation of the right engine's propeller governor. Both engines' propellers had been operated for 294.4 hours beyond required inspection times. Based upon logbook entries, the required interval between AAIP inspections had been exceeded. The "Flight Handbook" revision was not current and did not contain the supplement for installation of the Volpar gear. A 30-day recurring airworthiness directive had not been complied with.
Fuel Load Accuracy.
On February 28, 1997, the pilot verbally reported to the Safety Board that during his preflight inspection of the airplane he determined that the two main fuel tanks held the standard quantity of fuel necessary for the flight. As listed on the airplane's flight load manifest form, the total fuel weight was 600 pounds. The auxiliary fuel tanks were empty.
The Safety Board observed a wooden dip stick in the airplane wreckage. The stick was inscribed with markings which were, according to the operator, indexed to reflect the quantity of fuel contained in the airplane's fuel tanks.
A review of the airplane's manuals revealed no provision for using a homemade style dip stick to determine the fuel quantity. No calibration data or FAA authorization was found for using the dip stick. The pilot reported that he had never checked the accuracy of the dip stick.
The Safety Board requested that the operator provide evidence to validate the accuracy of the fuel quantity markings on the dip stick. The operator reported that because the stick was also used on another of its Beech 18 airplanes, he would check its accuracy with that airplane. The operator subsequently reported that the stick was found inaccurately marked and indicated he would discontinue its usage.
Loading Procedure and Airplane Weight.
The operator received its U.S. Postal Service cargo accompanied by weight manifests indicating the mail's weight to the nearest pound. The operator also received freight. The loader reported that he placed the cargo into the airplane and noted the fuselage station at which it was positioned. Thereafter, the loader proceeded into the company office and prepared the load manifest for the pilot.
Upon the Safety Board's examination of the accident flight's manifest, it was noted that four of the six weight totals associated with specific fuselage station locations had been rounded off to the nearest 100 pound increment, and the fifth and sixth weight totals had been rounded off to the nearest 10 and 50 pound increments. The manifest indicated that, based upon these rounded off weights, the airplane had been loaded to 9,843 pounds, or 57 pounds under its certificated maximum takeoff weight.
Because of the fire damage, no postimpact documentation of the cargo's actual weight was made. Also, the cargo's preimpact location in the airplane could not be verified. No provision for rounding off the cargo weight in the manner described by the pilot was found in the company's FAA approved operating specifications or in the operator's manuals.
METEOROLOGICAL INFORMATION
Several witnesses located on the ramp outside the United Airlines terminal reported that the wind was calm at the time of the accident. Following the accident, the plume of smoke which emanated from the burning airplane went straight upward. No discernable wind was noticed.
WRECKAGE AND IMPACT INFORMATION
Air traffic control personnel reported that the airplane initiated its takeoff roll in an easterly direction on runway 8L near ...
Data Source
Data provided by the National Transportation Safety Board (NTSB). For more information on this event, visit the NTSB Records Search website. NTSB# LAX97FA108