# NTSB ERA16LA230: Piper PA28, N9836W, Hollywood, FL, June 25, 2016 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Limited investigation · Final report - Date: June 25, 2016, 17:45 local (21:45 UTC) - Place: Hollywood, FL - Coordinates: 26.001111, -80.240837 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=26.0011&lon=-80.2408&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Defining event: [Initial climb: Fuel contamination](https://openairdocs.org/ntsb-events/193) - Highest injury: Minor injuries - Injuries: 1 minor - Status: Completed, report May 25, 2017 - Report: Approved by Office Director - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO - NTSB case key (mKey): 93456 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA16LA230 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/93456/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=93456 - Page: https://openairdocs.org/ntsb/ERA16LA230 ## Probable cause The pilot’s inadequate preflight inspection of the fuel system, which resulted in a total loss of engine power due to water contamination. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Fuel system](https://openairdocs.org/ntsb-findings/01022800): Aircraft › Aircraft systems · Inadequate inspection (probable cause); cases with it: [Piper PA-28-140, 2 cases](https://openairdocs.org/ntsb-findings/01022800/cases.md?model=7102802), [All aircraft, 181 cases](https://openairdocs.org/ntsb-findings/01022800/cases.md) - [Fluids: fuel](https://openairdocs.org/ntsb-findings/01071010): Aircraft › Fluids/misc hardware · Fluid condition (probable cause); cases with it: [Piper PA-28-140, 32 cases](https://openairdocs.org/ntsb-findings/01071010/cases.md?model=7102802), [All aircraft, 1,695 cases](https://openairdocs.org/ntsb-findings/01071010/cases.md) - [Object/animal/substance: water/moisture](https://openairdocs.org/ntsb-findings/03022057): Environmental issues › Physical environment · Effect on equipment (probable cause); cases with it: [Piper PA-28-140, 1 case](https://openairdocs.org/ntsb-findings/03022057/cases.md?model=7102802), [All aircraft, 10 cases](https://openairdocs.org/ntsb-findings/03022057/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Initial climb: Fuel contamination](https://openairdocs.org/ntsb-events/193) (defining event); cases with it: [Piper PA-28-140, 4 cases](https://openairdocs.org/ntsb-events/193/sequence.md?model=7102802), [All aircraft, 225 cases](https://openairdocs.org/ntsb-events/193/sequence.md) ## Analysis The private pilot reported that, during an extended absence, a family member checked on his airplane and found that the right wing fuel cap was missing. The pilot ordered a new fuel cap, and it was installed on the airplane. After the pilot's return, about 1 week before the accident, he added fuel to the right tank and then drained it; he repeated the process several times and then performed an extended engine run-up and taxi check; he did not fly the airplane that day. On the day of the accident, he sampled both fuel tanks, performed a prolonged engine run-up, and taxied for about 30 to 45 minutes before departing on the accident flight. Shortly after takeoff, the engine lost all power. The pilot conducted a forced landing, and the airplane impacted terrain 1,000 ft from the departure end of the runway. Postaccident examination of the fuel system revealed the presence of water at the firewall-mounted fuel strainer. Although the pilot reported that he performed a thorough preflight inspection, it is likely that water remained in the fuel system, which resulted in the loss of engine power. ## Factual narrative On June 25, 2016, about 1745 eastern daylight time, a Piper PA-28-140, N9836W, was substantially damaged during a forced landing shortly after takeoff from North Perry Airport (HWO), Hollywood, Florida. The private pilot sustained minor injuries. Visual meteorological conditions prevailed, and no flight plan was filed for the local personal flight conducted under the provisions of 14 Code of Federal Regulations Part 91.According to a written statement provided by the pilot, several weeks before the accident, a family member noted that the airplane's right fuel tank cap was missing. The pilot ordered a new fuel cap that was installed and remained in place until his return. On June 18, the pilot added 3 gallons of fuel to the right fuel tank, drained it, and then repeated this process several times. He then started the engine with the left fuel tank selected, and switched to the right fuel tank to perform an extended engine run-up and taxi check; he did not fly the airplane that day. When the pilot arrived at HWO on the day of the accident, he sampled both fuel tanks, performed a prolonged engine run-up and taxied for about 30 to 45 minutes. During the subsequent takeoff, when the airplane was about 80 to 100 feet above ground level (agl), the engine started to "tremble," and then lost all power. The airplane impacted terrain about 1,000 feet beyond the departure end of the runway. A Federal Aviation Administration (FAA) inspector responded to the accident site and examined the wreckage. The airplane's nose and main landing gear were sheared off, and the left wing forward spar was separated at the wing root. One propeller blade was bent aft, the other blade was not damaged. Fuel sampled from the firewall-mounted fuel strainer contained mostly water. The airplane was equipped with a Lycoming O-320 series, 140-horsepower engine. The airplane had been operated for about 333 hours since its most recent annual inspection, which was performed on September 19, 2015. The pilot reported 262 hours of total flight experience, of which 98 hours were in the accident airplane make and model. ## Aircraft - Registration: [N9836W](https://openairdocs.org/deregistered/N9836W-2019-07-15), registration cancelled 2019-07-15, S/N 28-23342, built 1967 (OpenAirDocs) - Reported make and model: PIPER PA28 (140) - Registry model: [Piper PA-28-140](https://openairdocs.org/model/piper-pa-28-140) (registry code 7102802) (OpenAirDocs) - Registry engine: [Lycoming 0-320 series](https://openairdocs.org/engine/lycoming-0-320-series) (registry code 41508, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 28-23342 - Year built: 1967 - Airframe hours: 2557 - Engines: Lycoming O-320-E2A 140 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Standard, Normal - Last inspection: Annual, September 19, 2015, 1,565 hours before - Departed: HWO, Hollywood, FL - Destination: HWO, Hollywood, FL - Airport: HWO, North Perry, runway 10R, 3,255 × 100 ft, asphalt - Equipment: Stall warning system ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 32; injuries: minor; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, with waivers/limitations; last flight review August 20, 2015; seat: left; restraint: lap only; flight hours: 262 total, 98 in this make and model, 8 in the last 90 days, 4 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: 100° at 12 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 90 °F, dew point 72 °F - Altimeter: 30.06 inHg - Observed at: KHWO ## 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 20160625008239A](https://openairdocs.org/incident/20160625008239A), Jun 25, 2016: Piper PA-28-140, Hollywood, FL, Substantial damage. The pilot of a Piper pa 28-140 registered as N9836W departed runway 10R at north Perry airport and at approximately 80 feet experienced a trembling engine… ## Docket (3 files) The files NTSB released with the investigation on April 6, 2017, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=93456. 1.1 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 600 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40454452&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF - Photo (item 2, .PDF, 1 photo, 410 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40450779&FileExtension=.PDF&FileName=Photo-Master.PDF - Memorandum for Record - FAA Inspector (item 3, .PDF, 55 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40450780&FileExtension=.PDF&FileName=Memorandum%20for%20Record%20-%20FAA%20Inspector-Master.PDF 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.