What happened
The FAA’s narrative, in sentence case. The FAA writes it in capitals and removes private details.
Pilot stated that the purpose of the flight was to practice night landings in the pattern with his fiance. After a thorough preflight the pilot:
· Primed engine 4 times – mixture full rich – throttle ½ inch open – engaged starter for 10-15 seconds, no start.
· Waited 1 minute.
· Primed engine 5 times – throttle full open then closed then open ½ inch – engage starter for 10-15 seconds, engine acted like it wanted to start but no start.
· Waited 1 minute.
· Primed engine 2 times – throttle between ¼ and ¾ - engage starter for 20 seconds, engine acted like it wanted to start but no start.
· Waited 5 minutes
· Used “flooded start” procedure – throttle full open – mixture idle cut off – engage starter – smelled an oily smoky smell, passenger opened the door and saw smoke, and pilot saw a glow on left side of aircraft.
· Pilot used “engine fire during start” procedure – fuel selector off – mixture idle cut off – starter engaged for about 5 seconds. Smoke started filling the cabin and pilot and
Passenger evacuated aircraft.
Pilot tried to put the fire out with the onboard fire extinguisher but was unable. Airport fire department was called to extinguish the fire. Passenger injured herself while evacuating the aircraft. The passenger fell getting off the wing, scraping her leg and elbow and has a bump on her wrist.
During the investigation it was revealed that the flying club's checklist that was in the aircraft did not match the airplane's flying manual (AFM) procedures for cold start, hot start, and flooded start, and the procedures were wrong.
It was also determined that there was supposed to be an AFM supplemental checklist to the normal cold start procedure per the peterson aircraft flight manual supplement that was not installed in the airplane flying manual (improper install) that was onboard the aircraft at the time of the fire. The pilot had no access to the new starting procedure. In my opinion, not having the AFM supplemental checklist start procedure may have contributed to the fire.
As the FAA filed it
PILOT STATED THAT THE PURPOSE OF THE FLIGHT WAS TO PRACTICE NIGHT LANDINGS IN THE PATTERN WITH HIS FIANCE. AFTER A THOROUGH PREFLIGHT THE PILOT:
· PRIMED ENGINE 4 TIMES – MIXTURE FULL RICH – THROTTLE ½ INCH OPEN – ENGAGED STARTER FOR 10-15 SECONDS, NO START.
· WAITED 1 MINUTE.
· PRIMED ENGINE 5 TIMES – THROTTLE FULL OPEN THEN CLOSED THEN OPEN ½ INCH – ENGAGE STARTER FOR 10-15 SECONDS, ENGINE ACTED LIKE IT WANTED TO START BUT NO START.
· WAITED 1 MINUTE.
· PRIMED ENGINE 2 TIMES – THROTTLE BETWEEN ¼ AND ¾ - ENGAGE STARTER FOR 20 SECONDS, ENGINE ACTED LIKE IT WANTED TO START BUT NO START.
· WAITED 5 MINUTES
· USED “FLOODED START” PROCEDURE – THROTTLE FULL OPEN – MIXTURE IDLE CUT OFF – ENGAGE STARTER – SMELLED AN OILY SMOKY SMELL, PASSENGER OPENED THE DOOR AND SAW SMOKE, AND PILOT SAW A GLOW ON LEFT SIDE OF AIRCRAFT.
· PILOT USED “ENGINE FIRE DURING START” PROCEDURE – FUEL SELECTOR OFF – MIXTURE IDLE CUT OFF – STARTER ENGAGED FOR ABOUT 5 SECONDS. SMOKE STARTED FILLING THE CABIN AND PILOT AND
PASSENGER EVACUATED AIRCRAFT.
PILOT TRIED TO PUT THE FIRE OUT WITH THE ONBOARD FIRE EXTINGUISHER BUT WAS UNABLE. AIRPORT FIRE DEPARTMENT WAS CALLED TO EXTINGUISH THE FIRE. PASSENGER INJURED HERSELF WHILE EVACUATING THE AIRCRAFT. THE PASSENGER FELL GETTING OFF THE WING, SCRAPING HER LEG AND ELBOW AND HAS A BUMP ON HER WRIST.
DURING THE INVESTIGATION IT WAS REVEALED THAT THE FLYING CLUB'S CHECKLIST THAT WAS IN THE AIRCRAFT DID NOT MATCH THE AIRPLANE'S FLYING MANUAL (AFM) PROCEDURES FOR COLD START, HOT START, AND FLOODED START, AND THE PROCEDURES WERE WRONG.
IT WAS ALSO DETERMINED THAT THERE WAS SUPPOSED TO BE AN AFM SUPPLEMENTAL CHECKLIST TO THE NORMAL COLD START PROCEDURE PER THE PETERSON AIRCRAFT FLIGHT MANUAL SUPPLEMENT THAT WAS NOT INSTALLED IN THE AIRPLANE FLYING MANUAL (IMPROPER INSTALL) THAT WAS ONBOARD THE AIRCRAFT AT THE TIME OF THE FIRE. THE PILOT HAD NO ACCESS TO THE NEW STARTING PROCEDURE. IN MY OPINION, NOT HAVING THE AFM SUPPLEMENTAL CHECKLIST START PROCEDURE MAY HAVE CONTRIBUTED TO THE FIRE.
NTSB investigation
The NTSB’s investigation of this event, with its probable cause and findings. Matched to this report by N-number and date.