# NTSB CHI01LA264: Beech 23, N2367J, West Bend, WI, August 6, 2001 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Limited investigation · Final report - Date: August 5, 2001, 20:39 local (Aug 6, 2001, 01:39 UTC) - Place: West Bend, WI - Coordinates: 43.460395, -88.189476 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=43.4604&lon=-88.1895&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Highest injury: Minor injuries - Injuries: 2 minor - Status: Completed, report January 2, 2002 - Report: Approved by Office Director - Parties: FAA-Milwaukee, Wisconsin FSDO - NTSB case key (mKey): 52975 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CHI01LA264 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/52975/pdf - Page: https://openairdocs.org/ntsb/CHI01LA264 ## Probable cause The pilot not following the aircraft fuel management procedures. Factors were the fuel starvation, the low altitude, the manufacturers service instruction not complied with, and the tree. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of engine power, takeoff - initial climb - procedures/directives - not followed, pilot in command (cause) - fluid,fuel - starvation (contributing factor) - maintenance,service bulletin/letter - not complied with (contributing factor) - altitude - low (contributing factor) - Forced landing, emergency descent/landing - In flight collision with object, emergency descent/landing - object - tree(s) (contributing factor) - In flight collision with terrain/water, emergency descent/landing ## Analysis The airplane lost engine power during the takeoff portion of a touch and go and subsequently impacted a tree and the ground before coming to rest. A postaccident examination showed that the left wing fuel tank was compromised and the right wing fuel tank was intact. Fuel could not be seen in the right fuel tank by visual inspection through the fuel filler opening. Fuel was found in the carburetor fuel bowl. The fuel selector valve was found with the selector positioned for the right wing fuel tank. Four gallons of fuel was added to the right wing fuel tank and an engine run performed. The engine was run from idle to 1,500 RPM and no anomalies were noted. No anomalies were found that could be associated with a preexisting condition. The pilot stated that he began the flight with 10 gallons of fuel in each wing tank and he indicated, in his written report, that there were 20 gallons of fuel on board at the last takeoff. The "Pilot's Operating Handbook and FAA Approved Airplane Flight Manual" for the aircraft states, "Do not take off when the Fuel Quantity Gages indicate in the *Yellow Band or with less than 11 gallons in each main tank." It was found during the postaccident examination of the aircraft that the fuel quantity gages were not marked with yellow bands. ## Factual narrative On August 5, 2001, at 2039 central daylight time, a Beech model 23, N2367J, piloted by a private pilot, sustained substantial damage during a forced landing following a loss of engine power during initial climb after takeoff from runway 24 (3,898 feet by 75 feet), at the West Bend Municipal Airport, West Bend, Wisconsin. The 14 CFR Part 91 personal flight was operating in visual meteorological conditions and was not on a flight plan. The pilot and his one passenger received minor injuries. The local flight originated at about 2000. A postaccident examination of the aircraft was conducted. The left wing fuel tank was compromised. The right wing fuel tank was intact. Fuel could not be seen in the right fuel tank by visual inspection through the fuel filler opening. Fuel was found in the carburetor fuel bowl. The fuel selector valve was found with the selector positioned for the right wing fuel tank. Four gallons of fuel were added to the right wing fuel tank and an engine run performed. The engine was run from idle to 1,500 RPM and no anomalies were noted. No anomalies were found that could be associated with a preexisting condition. The pilot said, in a written statement, that he was returning from a 30 minute flight and was performing a touch and go. He said that on the takeoff portion of the touch and go, he experienced a complete loss of engine power approximately 200 feet AGL. He said, "There were several popping sounds from the engine before it quit. I tried to restart but had no success. I chose a relatively open spot in front of me and did my best to keep the aircraft under control. At about 10 feet AGL the left wing contacted a tree. This spun the aircraft sharply and the aircraft landed flat." The pilot stated to a Federal Aviation Administration Inspector that he began the flight with 10 gallons of fuel in each wing tank. In his written report, the pilot indicated that there were 20 gallons of fuel on board at the last takeoff. The "Pilot's Operating Handbook and FAA Approved Airplane Flight Manual" for the aircraft states in Section II; FUEL MANAGEMENT Do not take off when the Fuel Quantity Gages indicate in the *Yellow Band or with less than 11 gallons in each main tank. Maximum slip duration: 30 seconds *Yellow band was installed by BEECHCRAFT S.I. No. 0624-281. It was found during the postaccident examination of the aircraft that the fuel quantity gages were not marked with yellow bands. ## Aircraft - Registration: [N2367J](https://openairdocs.org/deregistered/N2367J-2003-11-20), registration cancelled 2003-11-20, S/N M-325, built 1963 (OpenAirDocs) - Reported make and model: Beech 23 - Registry model: [Beech 23](https://openairdocs.org/model/beech-23) (registry code 1151202) (OpenAirDocs) - Registry engine: [Lycoming 0-320 series](https://openairdocs.org/engine/lycoming-0-320-series) (registry code 41508, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: M-325 - Airframe hours: 2415 - Engines: Lycoming O-320 160 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Registered owner: Donald W. McLean - Airworthiness certificate: Standard, Utility - Last inspection: Annual, January 18, 2001, 53 hours before - Departed: ETB, West Bend, WI - Airport: ETB, West Bend Muni, runway 24, 3,898 × 75 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 19; injuries: minor; private; airplane ratings: single-engine land; medical: class 3, valid medical--no waivers/lim.; last flight review July 31, 2000; seat: left; flight hours: 130 total, 120 in this make and model, 37 in the last 90 days, 18 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: 0° at 0 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 79 °F, dew point 73 °F - Altimeter: 30.10 inHg - Observed at: ETB ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20010805026959A](https://openairdocs.org/incident/20010805026959A), Aug 5, 2001: Beech 23, Westbend, WI, No damage. (.19) On August 5, 2001, at 2039 central daylight time, a Beech model 23, N2367J, piloted by a private pilot, sustained substantial damage during a forced… ## Other investigations on N2367J (2) From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. - [NTSB NYC67D0037](https://openairdocs.org/ntsb/NYC67D0037), May 22, 1966: Beech 23 (N2367J), Spring Valley, NY, substantial damage - [NTSB UNK64X1136](https://openairdocs.org/ntsb/UNK64X1136), Apr 2, 1964: Beechcraft 23 (N2367J), El Dorado, KS, substantial damage From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.