CHI00LA176

NTSB accident investigation · Beech B200 · Joliet, IL · June 29, 2000

Accident · Minor injuriesLimited investigationFinal report
Date
June 29, 2000, 08:00 local (13:00 UTC)
Place
Joliet, IL
Injuries
2 minor, 3 uninjured
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N780CABeech B200
Weather
Visual (VMC) · Day
Status
Completed · report April 6, 2001
Report
Approved by Office Director
FAA report
20000629039619A
Case key
49567

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

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Probable cause

the failure of the pilot to obtain fuel and the inadequate preflight planning and preparation by the pilot. Factors to the accident were the fuel exhaustion and the ravine at the end of the runway.

Sequence of events

NTSB’s coding before 2008: each occurrence and phase of flight, and the causes and factors under it. The codes are defined in NTSB’s coding manual.

Loss of engine power(total) - nonmechanicalCruise
Fluid,fuel - exhaustionFactor
Refueling - not verifiedPilot in commandCause
Preflight planning/preparation - inadequatePilot in commandCause
Forced landingEmergency descent/landing
OverrunEmergency landing
On ground/water encounter with terrain/waterEmergency landing
Terrain condition - ravineFactor

Analysis

The night before the day of the accident flight the pilot requested that the aircraft's main fuel tanks be filled. The aircraft was not fueled. The morning of the accident, the pilot checked the fuel quantity gauges and noted that they were reading lower than expected. The pilot indicated that there has been a history of inaccurate readings on the fuel gauges. The flight departed for a 45-minute flight to another airport to pick up passengers. The aircraft then departed for Romeoville, Illinois. While descending for landing the pilot felt a surge from the right engine, which subsequently stopped producing power. After completing the checklists, the pilot feathered and secured the engine. Continuing the descent the left engine also stopped producing power. During the forced landing, the pilot was unable to stop the aircraft on the runway. The aircraft overran the end of the runway and went into a ravine, causing substantial damage to the nose and right engine. Approximately 5 gallons of fuel was drained from the aircraft. The manufacturer tested the fuel quantity gauges. The report shows that the gauges were operating correctly for displaying indication for the main fuel tanks, but not for fuel quantity for the auxiliary tanks. Once re-calibrated, the gauges operated within tolerances for all fuel tanks.

Factual narrative

On June 29, 2000, at approximately 0800 central daylight time, a Beech B200 Super King Air, N780CA, piloted by an airline transport pilot, sustained substantial damage during an emergency landing and overrun on runway 12 (2,940 feet by 100 feet, asphalt), at the Joliet Regional Airport, Joliet, Illinois, following a total loss of engine power in cruise. The business flight was operating under the provisions of 14 CFR Part 91, and was operating on an Instrument Flight Rules flight plan. Visual meteorological conditions prevailed at the time of the accident. The pilot and two passengers reported no injuries; two passengers reported minor injuries. The flight departed the Lee C. Fine Memorial Airport, Kaiser Lake Ozark, Missouri at 0710, en route to the Lewis University Airport, Romeoville, Illinois.

According to a statement by the pilot, he requested Executive Beechcraft at the Kansas City Airport to fill the main fuel tanks on 780CA the night before the accident flight, but made no instructions for filling the auxiliary fuel tanks.

A statement by Executive Beechcraft states, "According to our records we did not fuel King Air 200 Registered N780CA on June 29, 2000."

The pilot reported, "I then checked the fuel quantity gauges for the main fuel tanks...the fuel quantity gauge indicated just about a needle width above 1100 pounds of fuel, and the fuel quantity gauge for the right main tank indicated almost 1150 pounds of fuel. I then checked the fuel quantity gauges for the auxiliary tanks by selecting the fuel quantity switch to 'auxiliary'...the fuel gauges indicated just above -0- on the left auxiliary fuel tank gauge and just below the -0- on the right auxiliary fuel tank gauge. (The fuel quantity gauge needles should have indicated between 1225 pounds of fuel and 1275 pounds of fuel in each main tank.)"

"For the past three years, July 1, 1997 to June 30, 2000, we have documented the history in N780CA's...maintenance logbooks of the erratic and unpredictable behavior of both the main and auxiliary fuel quantity indicators! Repairs conducted in accordance with the manufacturer's recommended specifications to effect a permanent fix of these irregular fuel quantity indications have not been successful."

The pilot continued, "Deja vu. A little over a year ago I was scheduled to pick up our folks in Chicago for a day trip. I called in my fuel order to Executive Beechcraft...ramp and top the mains." [fill the main tanks with fuel]

..."Leveling at 5000 feet MSL [mean sea level] heading NE [northeast], my cruise check found the main fuel gauges had gone to about 600 pounds indicated in the left main fuel tank and just above the yellow caution fuel markings for the right main fuel tank. I didn't know what to believe...gauges were unreliable. Did I have a capacitance problem with the fuel gauges, or had Executive Beechcraft forgot to fill my fuel order...again?"

"After landing, I taxied to the West side of the airport where we have hangar space rented and I can find [mechanic], my mechanic. ([Mechanic] holds A&P [airframe and powerplant] and the IA [inspection authorization] licenses. [Mechanic] is also a commercial, multi-engine rated pilot.) I was really in a foul mood. I asked [mechanic] to check out the fuel gauges as fast as he was capable of doing and get me on my way to Chicago. [Mechanic] made the comment that we should first check and see how much fuel EB [Executive Beechcraft] had put onboard when they topped off the mains. Surprise...EB had not fueled N180CA [accident aircraft] as requested per my fuel order. They had no record of my request. I went ballistic!!! We have a screwed up fuel measurement system that we have been trying to fix in accordance with instructions from the manufacturer, and now I can't trust EB to fill my fuel orders. (I've caught EB twice in 2000 NOT FILLING my fuel orders...'it wasn't written down on our ramp list'.)"

The pilot stated that while 19 nm from the Lewis University Airport (LOT), he felt a surge on the right engine. The pilot secured and feathered the right engine. While continuing the descent to LOT the left engine surged. According to the pilot, "I knew right then and there that I had some type of a fuel condition problem...and it was confirmed when I checked the fuel gauges again and saw the fuel quantity needles in the yellow fuel caution range! N780CA was out of fuel...."

The pilot attempted to land on runway 12 at Joliet, but was unable to stop the aircraft on the available runway surface. The aircraft ran off the end of the runway into a ravine that is situated at the end of runway 12.

Approximately five gallons of a fuel like substance was drained from the aircraft in a post-accident examination.

The manufacturer tested the fuel quantity gauges. According to a report by the Federal Aviation Administration Inspector who oversaw the test, "The first procedure was to test the indicators in their arrival state. Both indicators were checked for main tank channel [main fuel tank quantity indications] accuracy and auxiliary tank channel [auxiliary fuel tank quantity indications] accuracy. Both indicators tested within tolerance or very close to tolerance on the main channel. However, both indicators were considerably off on the auxiliary channel. Indicator, [left fuel quantity gauge] showed 282.67 lbs. [pounds of fuel] high at the '0' and '300' lbs. check points. Indicator, [right fuel quantity gauge] showed 273.3 lbs. high at the '0' and '300' lbs. check points. These are the only two check points that are checked on the auxiliary channel."

"The indicators were then put through the complete test and calibration procedures. Both indicators were able to be calibrated and passed all test procedures with no abnormalities noted."

Aircraft

Registration
N780CA
Reported as
Beech B200
Category
Airplane
Serial number
BB-1547
Engine
P&W PT6A-42, 850 horsepower, turbo prop
Damage
Substantial damage
Flight
Executive/Corporate · Part 91
Operator
Ruand Inc.
Registered owner
Raytheon Aircraft Credit Corpo
Airworthiness certificate
Standard, Normal
Last inspection
AAIP · May 11, 2000
Departed
AIZ · Kaiser Lake Osa, MO
Destination
LOT · Romeoville, IL
Flight plan
IFR
Airport
JOT · Joliet Regional, runway 12, 2,940 × 100 ft, asphalt

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
50
Certificates
Flight instructor, Airline transport, Commercial
Airplane ratings
Multi-engine land, Single-engine sea, Single-engine land
Instrument ratings
Airplane
Medical
Class 2, Valid Medical--w/ waivers/lim
Seat
Left
Flight hours
17,000 total · 7,000 in this make and model · 15,700 as pilot in command · 218 in the last 90 days · 74 in the last 30 days · 2 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
290° at 9 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
64 °F, dew point 55 °F
Altimeter
29.00 inHg
Observed at
MDW, 25 nm away

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.