N8KB

HISTORY OF FLIGHT

On June 3, 1997, about 1040 hours mountain standard time, a Beech 95-B55, N8KB, collided with terrain during a routine fire reconnaissance of the San Carlos Indian Reservation (SCIR), San Carlos, Arizona. The aircraft was being operated by Safford Aviation, under an exclusive use contract to the Bureau of Indian Affairs as a public-use aircraft. The mission was a routine fire patrol conducted under 14 CFR Part 91 of the Federal Aviation Regulations. Visual meteorological conditions prevailed and no flight plan was filed. The aircraft was destroyed during the impact sequence and subsequent postcrash fire. The certificated commercial pilot and his observer received fatal injuries. The aircraft had previously been in contact with the San Carlos Dispatch radio operator and was giving agency flight following reports. The flight originated at San Carlos at 1007.

There were no known eyewitnesses to the accident. According to the Bureau of Indian Affairs, the crew of N8KB (referred to in their logs as P-2) called the San Carlos dispatch at 1027 and reported their location was Baskin Tank, and that they were en route to Elwood Tank. The dispatcher tried to reach P-2 via aircraft radio on an agency FM frequency at 1051, and again at 1054, with no response. At 1057, another fire patrol aircraft, H350, a Bell 206L1, took off and proceeded to Coupon Tank due to black smoke being reported. At 1156, H350 landed at the incident site and discovered the downed aircraft. The aircraft came to rest in a portion of the Black River Canyon, which is located in Apache County, Arizona.

A copy of the SCIR dispatch log was obtained and reviewed. The log noted in a 1007 entry "P2 off ground...enroute to Seneca." The flight was recorded as reporting "over Salt Crossing heading to Black River Crossing" at 1018. At 1027, the aircraft reported "passing Baskin Tank heading to Elwood Tank." The dispatcher tried to call P-2 again at 1051 and received no response. He tried to make radio contact with them again at 1054, without success. At 1117, the dispatchers contacted the operator of the aircraft and asked them to contact Prescott Flight Service station. According to calculations provided by the operator, at normal patrol airspeeds, the elapsed time from Baskin Tank to the crash site would have been approximately 13 minutes, with a distance traveled of about 32 miles.

A thorough review of dispatch logs from all available sources revealed discrepancies with respect to the time(s) various events were noted to have occurred.

The chief pilot of Safford Aviation was interviewed regarding the patrol route and the timing of the position reports. He concluded that the aircraft was on a "normal" morning reconnaissance flight and that both the route and timing of the reporting points were consistent with all other flights over the past 4 years. Additionally, he opined that "the speed of the aircraft (estimated to be an average ground speed of 145.2 mph) was within normal parameters for this mission flown." A map, which is appended to this report, depicts the actual route flown with a solid red line, and the intended route of flight with a dashed red line. Additionally, the map shows the known reporting points/timing of the accident flight. The previous 4 days worth of dispatch logs were reviewed during the investigation and they disclosed that the route and timing of the position reports were consistent with the accident flight.

The FAA Air Route Traffic Control Center (ARTCC) at Albuquerque, New Mexico, controls the airspace over the area of the accident site and the patrol mission route. The Quality Assurance specialists at Albuquerque ARTCC stated that the radar coverage in the area of the accident has a general floor of 9,500 feet msl. At the Safety Board's request, Albuquerque ARTCC examined their recorded radar data for the date of the accident. For a time frame from 15 minutes before to 15 minutes after the accident, no primary or secondary 1200 beacon codes were observed. Additionally, the Jackel MOA (military operations area) was inactive from 1020 to 1350 local time. According to Prescott Flight Service station, there were no ELT signals reported at the time in question for this area.

The Safety Board was informed that there were individuals present at the Black River pump station near the accident site. The occupants of the station were identified and interviewed by telephone on September 10, 1997. A witness stated that to the best of his recollection he called in and reported seeing smoke from the accident site "about 10 AM." He said he was standing out on the porch on the west side of the house, which was located about 3 miles west of the pump station, when he noticed a "big ball of smoke." He said the smoke then disappeared and later reappeared as a light brown haze. He reported that he did not "hear any noise or explosion." He also said he did not see the airplane fly over the house that particular day. He stated that the reconnaissance airplane usually came over the pump station from west to east, but that this particular day he did not see the airplane fly overhead.

A review of the SCIR "Aircraft Pre-Accident Plan and Hazard Map Instructions" booklet stated that an aircraft will be initially considered "overdue" when it has not completed a required check-in by radio or telephone within the time frame specified in the flight following request. This time frame may be an elapsed period of time such as every 15 minutes for reconnaissance flights, or may be ETA at a destination or reporting point. Dispatchers or persons responsible for flight following are responsible for initiating actions and documenting all actions, contact, conversations and times, as specified by the Pre-Accident Plan.

During the fire patrol missions, the aircraft uses two FM frequencies for radio contact with dispatch. The aircraft transmits on 171.700 MHz and receives on 172.425 MHz. According to the operator of the aircraft, had the aircraft encountered some sort of mechanical malfunction, which would have allowed the pilot to make a distress call, they would have utilized the guard frequency as called out in procedures specified in the contract. The operator stated in a memorandum dated September 25, 1997, that the "guard" or emergency frequency is a FM frequency of 168.625 MHz, which is monitored by both the USDA and DOI agencies. He explained that the radios installed in his aircraft transmit at 10 watts output. In order to activate the guard frequency, the pilot or observer need only flip a toggle switch located on the face of the radio which is located directly in front of the observer. The operator said that if the pilot initiated a call on the guard frequency from the position of the crash site, it "would have probably been received by several different agencies." He stated that based on his experience flying, various USFS locations in Winslow, Phoenix, Tucson, Springerville, and Silver City, as well as the Bureau Land Management (BLM) dispatch in Safford, would have heard the transmission. The operator said he found that the San Carlos Indian Reservation Dispatch does not have the capability to monitor the Guard frequency. Review of available records disclosed no evidence of contact between any of these stations and the aircraft on the date of the accident.

The Safety Board performed a test fight and was not able to contact San Carlos dispatch on the guard frequency, but was able to communicate on the guard frequency with the USFS in Tucson, Arizona. An on-site inspection of the dispatch communication capabilities at San Carlos revealed that they can only transmit and receive on the FM frequencies 171.700 MHz and 172.425 MHz, and the Unicom frequency of 122.8 MHz. They do not have the capability of utilizing the simplex guard frequency of 168.425 MHz. Additionally, the White River Indian Reservation does not have the capability to monitor the guard frequency without "being notified ahead of time and reprogramming the radio frequency." The operator in his summary stated that there were four possibilities for the accident aircraft to declare an emergency: Guard Frequency on FM, primary forestry frequency, Unicom frequency 122.8 (which San Carlos monitors), and the emergency frequency of 121.5. He said that the pilot was very familiar with the options to make a distress call.

PERSONNEL INFORMATION

The crew for the mission consisted of a pilot and observer. During the investigation, material and records concerning the crews training and experience were examined from the FAA Airman's Record Center, Safford Aviation, and the DOI Office of Aircraft Services. Occupant seating positions were identified by the Pima County Forensic Science Center, with the pilot in the left front seat and the observer in the right front seat. The pilot was an employee of Safford Aviation and the observer worked for the Bureau of Indian Affairs.

The pilot was the director of maintenance for Safford Aviation and had collateral duties as a pilot in the company's 14 CFR Part 135 on-demand air taxi operation, and for the fire patrol contract. Review of FAA airman records disclosed that he held a commercial pilot certificate, with airplane ratings for single engine land, multiengine land, and instruments. His most recent second-class medical certificate was issued on January 6, 1997, without limitations.

The pilot's personal flight records were not recovered and were believed by family members to have been on the aircraft. According to all sources of information, the pilot had accrued a total flight time of about 1,610 hours, with 795 in multiengine aircraft, and 110 hours in the Beech 95-B55. His most recent check rides in accordance with the provisions of 14 CFR 135 were completed on April 8, 1997, in a Aero Commander 500 aircraft. Additionally, on May 6, 1997, the pilot completed an Interagenc...