DCA01MA034

NTSB accident investigation · Grumman Gulfstream III · Aspen, CO · March 30, 2001

Accident · FatalClass 1 · MajorFinal report
Date
March 29, 2001, 19:01 local (Mar 30, 2001, 02:01 UTC)
Place
Aspen, CO
Injuries
18 fatal
Damage
Destroyed
Phase of flight
Approach
Aircraft
N303GAGrumman Gulfstream III
Weather
Visual (VMC) · Night
Status
Completed · report May 8, 2003
Report
Board-adopted at Board Meeting
Investigation class
Class 1
NTSB office
Major Investigations Division
Safety recommendations
Yes
FAA report
20010329039249A
Case key
51979

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

On this page

Probable cause

the flight crew's operation of the airplane below the minimum descent altitude without an appropriate visual reference for the runway.

Contributing to the cause of the accident were the Federal Aviation Administration's (FAA) unclear wording of the March 27, 2001, Notice to Airmen regarding the nighttime restriction for the VOR/DME-C approach to the airport and the FAA's failure to communicate this restriction to the Aspen tower; the inability of the flight crew to adequately see the mountainous terrain because of the darkness and the weather conditions; and the pressure on the captain to land from the charter customer and because of the airplane's delayed departure and the airport's nighttime landing restriction.

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.

In flight collision with terrain/waterApproach
Pressure induced by othersOther personFactor
Light condition - dark nightFactor
Minimum descent altitude - continued belowFlightcrewCause
Inadequate surveillance,inadequate procedureFaa(organization)Factor
Improper decisionFlightcrewFactor
Material inadequateFaa(other/organization)Factor

Analysis

The Board's full report is available at http://www.ntsb.gov/Publictn/publictn.htm .

On March 29, 2001, about 1901:57 mountain standard time, a Gulfstream III, N303GA, owned by Airbourne Charter, Inc., and operated by Avjet Corporation of Burbank, California, crashed while on final approach to runway 15 at Aspen-Pitkin County Airport (ASE), Aspen, Colorado. The charter flight had departed Los Angeles International Airport (LAX) about 1711 with 2 pilots, 1 flight attendant, and 15 passengers. The airplane crashed into sloping terrain about 2,400 feet short of the runway threshold. All of the passengers and crewmembers were killed, and the airplane was destroyed. The flight was being operated on an instrument flight rules (IFR) flight plan under 14 Code of Federal Regulations (CFR) Part 135.

Factual narrative

The Board's full report is available at http://www.ntsb.gov/Publictn/publictn.htm .

History of flight

On March 29, 2001, about 1901:57 mountain standard time, a Gulfstream III, N303GA, owned by Airbourne Charter, Inc., and operated by Avjet Corporation of Burbank, California, crashed while on final approach to runway 15 at Aspen-Pitkin County Airport (ASE), Aspen, Colorado. The charter flight had departed Los Angeles International Airport (LAX) about 1711 with 2 pilots, 1 flight attendant, and 15 passengers. The airplane crashed into sloping terrain about 2,400 feet short of the runway threshold. All of the passengers and crewmembers were killed, and the airplane was destroyed. The flight was being operated on an instrument flight rules (IFR) flight plan under 14 Code of Federal Regulations (CFR) Part 135.

The captain and first officer for the charter flight reported to the Avjet facility at the Burbank-Glendale Pasadena Airport (BUR), Burbank, California, sometime before 1300 (1200 Pacific standard time) on the day of the accident. An Avjet captain stated, in a postaccident interview, that he saw the captain checking the ASE weather on a computer display and discussing the ASE weather with an Avjet charter department scheduler while at BUR. Another Avjet captain stated, in a postaccident interview, that he saw the first officer performing what appeared to be a routine airplane preflight inspection on N303GA on the ramp at BUR.

About 1200 (1100 Pacific standard time), the first officer contacted the Hawthorne, California, Automated Flight Service Station (AFSS) specialist for a weather briefing. A review of the audiotape indicated that the specialist informed the first officer of three National Weather Service (NWS) AIRMETs [Airman's Meteorological Information] pertinent to the flight to ASE, an 1141 weather observation for ASE, and the ASE forecast for 1300 to 1900. The specialist also informed the first officer that the approach procedure had been updated and that circling minimums were no longer authorized at night. During the briefing, the first officer filed the flight plan, identifying Garfield County Regional Airport in Rifle, Colorado, as the alternate airport.

The captain and first officer departed BUR at 1538 (1438 Pacific standard time) for a positioning flight to LAX, arriving there 11 minutes later. While at LAX, the captain and a charter department scheduler discussed the status of the passengers' arrivals (none were at the airport when the airplane arrived) and the weather currently being forecast for the flight's arrival time at ASE. Also, the captain and another Avjet captain discussed the nighttime landing restriction at ASE that required the airplane to land within 30 minutes after sunset. ASE's nighttime airport operating hours, according to an airport chart dated November 1, 1994, indicated that aircraft that did not meet FAA stage III noise criteria were not authorized to land at the airport on March 29 after 1858.

The airplane's departure from LAX at 1711 (1611 Pacific standard time) was 41 minutes later than originally scheduled because of the late arrival of the passengers, including the charter customer. The flight was planned for 1 hour 35 minutes, so the estimated arrival time at ASE was 1846-12 minutes before the airport's nighttime landing curfew.

Statements early in the cockpit voice recorder (CVR) recording indicated that the flight crew was aware of the nighttime landing restriction at ASE. The CVR transcript indicated that, about 1831:06, the captain stated, "well, there's the edge of night right here." About 1831:24, the first officer asked the captain about the time of official sunset for ASE. The captain replied "six twenty eight" and then stated, "so we get thirty minutes after sunset. so six fifty eight...about...seven o'clock."

About 1837:04, the first officer called for the approach briefing. The captain then stated, "we're...probably gonna make it a visual...if we don't get the airport over here we'll go ahead and shoot that approach" and "we're not going to have a bunch of extra gas so we only get to shoot it once and then we're going to Rifle." The first officer acknowledged this information. About 1839:56, the flight crew began to receive automated terminal information service (ATIS) information Hotel. Afterward, the first officer read back the wind, visibility, sky condition, and temperature information, and the captain acknowledged this information.

About 1844:22, the first officer made initial contact with ASE approach control. About 1844:43, the flight crew heard, over the ASE approach control frequency, the request of a Canadair Challenger 600 airplane, N527JA, for another approach to ASE. The approach controller then cleared N527JA to continue on the published missed approach procedure. About 1845:00, the first officer stated, "I hope he's doing practice approaches." About 3 seconds later, the captain asked the controller whether the pilot of N527JA was practicing or had actually missed the approach. The controller replied that the pilot had missed the approach and indicated that he had seen the airplane at 10,400 feet. The controller also informed the captain that two other airplanes were on approach to ASE. About 1845:32, the controller instructed the flight crew to turn to a 360º heading for vectors for the approach sequence.

While the airplane was descending into the terminal area, the CVR recorded the flight crew discussing the location of a highway near the airport. About 1845:45, the captain stated, "where's that...highway? can we get down in there?" About 11 seconds later, the captain stated, "can you see?" and the first officer stated, "I'm looking I'm looking...no." About 1846:26, the captain indicated, "I got it," and, about 2 seconds later, he asked the first officer, "can't really see up there can ya?" The first officer replied, over the next several seconds, "nope not really" and "I see a river but I don't see nothing else." About 1847:19, the first officer stated, "I see...some towns over here and the highway's leading that way but I'm not sure."

About 1847:30, the approach controller made a blanket broadcast that the pilot of an airplane (a Cessna Citation, N900MF) saw the airport at 10,400 feet and was making a straight-in approach, to which the first officer stated, "ah, that's good." (This airplane landed without incident at the airport about 10 minutes before the accident.) About 1847:41, the captain informed the controller that, "I can almost see up the canyon from here but I don't know the terrain well enough or I'd take the visual." About 1847:51, the first officer stated, "could do a contact but...I don't know," followed by his statement, "probably we could not...." The first officer also stated, about 1848:04, "remember that crazy guy in this Lear[jet] when we were...on the ground in Aspen last time and he [stated that he could] see the airport but he couldn't see it." The captain did not respond to either of the first officer's statements.

About 1848:51, the captain stated, "there's the highway right there." The first officer then asked the captain if he wanted to be set up on the approach, and the captain indicated that he was ready. About 1849:28, the captain asked the first officer whether he could see the highway, to which the first officer replied, "no it's clouds over here on this area I don't see it." About 1850:42, the captain stated, "but it's right there." About 6 seconds later, he stated, "oh I mean we'll shoot it from here I mean we're here but we only get to do it once." About 1850:54, the captain indicated to the flight attendant that, if the attempt to execute the approach was not successful, they would have to go to Rifle because "it's too late in the evening then to come around."

About 1851:54, the approach controller instructed the flight crew to turn to a heading of 050º. About 1853:09, the appr

Aircraft

Registration
N303GA
Reported as
Grumman Gulfstream III
Category
Airplane
Serial number
303
Airframe hours
7,266
Engines
Rolls-Royce Spey MK 511-8, 11,400 lbs thrust, turbo fanRolls-Royce Spey MK 511-8, turbo fan
Damage
Destroyed
Flight
Part 135
Operator
Avjet Corp
Registered owner
Avjet Corp
Airworthiness certificate
Standard, Normal
Last inspection
Continuous airworthiness · March 23, 2001 · 90 hours before
Departed
Los Angeles, CA
Flight plan
IFR
Airport
ASE · Aspen-Pitkin Co/Sardy Field, runway 15, 7,004 × 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 · 2

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
44
Injuries
Fatal
Certificate
Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, With waivers/limitations
Last flight review
December 8, 2000
Seat
Left
Toxicology
Performed
Flight hours
9,900 total · 1,475 in this make and model · 7,900 as pilot in command · 87 in the last 90 days · 21 in the last 30 days · 2 in the last 24 hours
Role
Co-pilot
Age
38
Injuries
Fatal
Certificate
Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
February 9, 2001
Seat
Right
Toxicology
Performed
Flight hours
5,500 total · 4,612 as pilot in command · 49 in the last 90 days · 10 in the last 30 days · 2 in the last 24 hours

Weather

Conditions
Visual (VMC) · Night
Wind
250° at 3 knots
Visibility
10 statute miles
Lowest ceiling
2,500 ft broken
Temperature
39 °F, dew point 36 °F
Altimeter
29.95 inHg

Docket · 105

The files NTSB released with the investigation on January 14, 2002, on NTSB’s docket system: statements, records, photos and specialists’ reports.

Pilot-operator aircraft accident report NTSB form 61201-2Item 1 · PDF · 6 pages · 322 KBOperations-human performance 2-factual report of group chairmanItem 2 · PDF · 12 pages · 72 KBOperations-human performance 2-attachment 1-interview summariesItem 3 · PDF · 58 pages · 191 KBOperations-human performance 2-attachment 2-aspen-pitkin county airport informationItem 4 · PDF · 7 pages · 876 KBOperations-human performance 2-attachment 3-N303GA flight log pageItem 5 · PDF · 2 pages · 113 KBOperations-human performance 2-attachment 4-fuel receipt burbankItem 6 · PDF · 2 pages · 131 KBOperations-human performance 2-attachment 5-N303GA flight log page recovered at scene of accidentItem 7 · PDF · 2 pages · 269 KBOperations-human performance 2-attachment 6-fuel receipt los angelesItem 8 · PDF · 2 pages · 77 KBOperations-human performance 2-attachment 7-avjet operations manual PIC responsibilitiesItem 9 · PDF · 2 pages · 30 KBOperations-human performance 2-attachment 8-nightime airport operating hoursItem 10 · PDF · 2 pages · 168 KBOperations-human performance 2-attachment 9-avjet operations manual standard calloutsItem 11 · PDF · 3 pages · 32 KBOperations-human performance 2-attachment 10-avjet training manual recurrent trainingItem 12 · PDF · 16 pages · 230 KBOperations-human performance 2-attachment 11-avjet training certificateItem 13 · PDF · 2 pages · 49 KBOperations-human performance 2-attachment 12-avjet training manual cfit awarenessItem 14 · PDF · 3 pages · 40 KBOperations-human performance 2-attachment 13-avjet training manual CRMItem 15 · PDF · 2 pages · 31 KBOperations-human performance 2-attachment 14-sample flight plansItem 16 · PDF · 7 pages · 258 KBOperations-human performance 2-attachment 15-N303GA flight releaseItem 17 · PDF · 2 pages · 88 KBOperations-human performance 2-attachment 16-avjet memorandum mountain airportsItem 18 · PDF · 2 pages · 30 KBOperations-human performance 2-attachment 17-CAPTAIN'S cell phone account record for 3-29-01Item 19 · PDF · 2 pages · 44 KBOperations-human performance 2-attachment 18-weight and balance informationItem 20 · PDF · 6 pages · 473 KBOperations-human performance 2-attachment 19-toxicology reportItem 21 · PDF · 5 pages · 171 KBOperations-human performance 2-attachment 20-avjet response to interiew conducted with FAA poiItem 22 · PDF · 2 pages · 88 KBATC 3-factual report of group chairmanItem 23 · PDF · 32 pages · 125 KBATC 3-addendum 1Item 24 · PDF · 17 pages · 74 KBATC 3-addendum 2-statement of mr wallace robertsItem 25 · PDF · 2 pages · 76 KBATC 3-attachment 1-transcript partialItem 26 · PDF · 3 pages · 40 KBATC 3-attachment 2-AIR traffic accident package itemsItem 27 · PDF · 30 pages · 1.1 MBATC 3-attachment 3-radar overlaysItem 28 · PDF · 2 pages · 271 KBATC 3-attachment 4-aspen ATCT ordersItem 29 · PDF · 74 pages · 1.8 MBATC 3-attachment 5-procedures data 1991 to presentItem 30 · PDF · 14 pages · 1.0 MBATC 3-attachment 6-VOR-DME or gps-c approach platesItem 31 · PDF · 2 pages · 261 KBATC 3-attachment 7-photos of tower and final approach areaItem 32 · PDF · 7 pages · 258 KBATC 3-attachment 8-procedures data PRE-1991Item 33 · PDF · 22 pages · 1.8 MBATC 3-attachment 9-night flight studiesItem 34 · PDF · 136 pages · 7.3 MBATC 3-attachment 10-H r 2739 section 517Item 35 · PDF · 1 page · 11 KBATC 3-attachment 11-reports and forms completed by mike ahernItem 36 · PDF · 5 pages · 324 KBATC 3-attachment 12-powerpoint presentation and supporting dataItem 37 · PDF · 17 pages · 545 KBATC 3-attachment 12A-supporting data to powerpoint presentationItem 38 · PDF · 4 pages · 56 KBATC 3-attachment 13-AVN-120 NOTAM documents and personnel statementsItem 39 · PDF · 14 pages · 447 KBATC 3-attachment 14A-ascii text file with radar data extractionsItem 40 · TXT · 1 pageATC 3-attachment 14B-ascii text file with radar data extractionsItem 41 · EXE · 1.3 MBATC 3-attachment 15-ZDV NOTAM distribution reportItem 42 · PDF · 5 pages · 69 KBATC 3-attachment 16-memos concerning terps 25LBItem 43 · PDF · 7 pages · 229 KBATC 3-attachment 17-VOR-DME or gps-c review recordsItem 44 · PDF · 19 pages · 970 KBATC 3-attachment 18-flight safety foundation paperItem 45 · PDF · 6 pages · 31 KBATC 3-attachment 19-FAA order 82001 excerptItem 46 · PDF · 6 pages · 24 KBATC 3-attachment 20-cast-cfit presentationItem 47 · PDF · 22 pages · 291 KBMeteorology 5-factual reportItem 48 · PDF · 21 pages · 413 KBMeteorology 5-attachment-goes 10 satellite image 0215ZItem 49 · PDF · 2 pages · 2.4 MBMeteorology 5-attachment-goes 10 satellite image 0200ZItem 50 · PDF · 2 pages · 5.5 MBMeteorology 5-attachment-weather radar image 0208ZItem 51 · PDF · 2 pages · 4.9 MBMeteorology 5-attachment-weather radar image 0202ZItem 52 · PDF · 2 pages · 107 KBMeteorology 5-attachment-weather radar image 0157ZItem 53 · PDF · 2 pages · 4.6 MBMeterological factual report-attachmentsItem 54 · PDF · 77 pages · 5.4 MBStructures-maintenance 7-factual report of group chairmanItem 55 · PDF · 7 pages · 24 KBStructures-maintenance 7-appendix a-photographsItem 56 · PDF · 1 page · 12 KBStructures-maintenance 7-photo 1 accident site with gully between initial impact point and wreckage debrisItem 57 · PDF · 1 page · 18 KBStructures-maintenance 7-photo 2 accident site looking at end of runwayItem 58 · PDF · 1 page · 16 KBStructures-maintenance 7-photo 3 initial impact point note angle formed in vegetation before initial impact pointItem 59 · PDF · 1 page · 31 KBStructures-maintenance 7-photo 4 left winglet and portion of wingItem 60 · PDF · 1 page · 29 KB
All 105 files on NTSB’s docket

FAA reports on this event · 1

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