LAX01FA011

The aircraft collided with the ground in a near vertical nose down descent during an attempted return-to-runway maneuver in the takeoff initial climb. The airplane taxied from parking at the terminal building to runway 36 and took off without a clearance from ground or local control. Both controllers attempted to stop the airplane by using a red light gun signal control; however, the airplane did not stop. The controllers did not see the airplane stop in the run-up area. Other witnesses, including an FAA airworthiness inspector reported that just beyond the departure end of the 5,000-foot-long runway, the airplane began a tight left turn, as if attempting to return to the runway. The left bank continued to increase until the nose dropped and the airplane descended vertically to ground impact, about 1,000 feet from the approach end of runway 18. The FAA inspector saw a trail of smoke coming from the airplane during the initial climb. The pilot ordered the fuel about 1 hour prior to takeoff and supervised the process; 15 gallons were put in each tip tank and none was added to the main tank. No determination could be made as to the quantity in the main tank at departure. The pilot pointed out two empty oil cans laying on the ground by the airplane's nose and asked the refueler if he could throw them away for him. The refueler did not observe the pilot placing the oil in the engine or complete any other aspect of a preflight inspection. The pilot, who is an A & P, performed all maintenance activities on the aircraft. Notations in the maintenance records show an unresolved 1-pint per hour oil consumption rate over the last 10 months. The pilot's personal flight logbook reflected that between 1989 and the date of the accident, the pilot had flown 100 hours total, all in the accident airplane. The most recent 6 months of activity consisted of three flights in April, two flights in May, and two flights in July. The aircraft fuel system consists of a main fuselage tank (which extends into the root area of each wing), and a left and right tip tank. The main tank has a capacity of 39 gallons, and each tip tank has a 34-gallon capacity. The normal operating procedures section of the pilot operating handbook states that for starting, takeoff and climb, the fuel selector should be selected to the main tank, and that the electric fuel boost pump be used for takeoff and when switching fuel tanks. No hydraulic deformation was noted to the ruptured main fuel tank, and no fuel was found in the tank. The vent lines and ports for all three fuel tanks were clear and unobstructed. The fuel selector was visually examined by looking in the ports for each of the tanks. The ball cock opening was found positioned between the main tank and the left tip tank; the opening was about 40 percent open to the left tip and about 10 percent open to the main tank. The electric fuel boost pump switch was in the OFF position. The fuel gages showed 3/4 full for both tip tanks and 9 gallons for the main tank. The avionics master switch was in the OFF position. The No. 1 communications radio was selected to 125.1 (the local control frequency), while the No. 2 communications radio was on 121.1. For the audio control panel, the transmitter was selected to the No. 1 communications radio and the speaker was selected to the No. 2 communications radio. Borescope examination of the cylinder interiors revealed deposits of rust on the cylinder walls. No other preimpact anomaly was found during an examination of the engine or the airframe systems.

History of flight

On October 13, 2000, at 1034 hours Pacific daylight time, a Navion G, N2434T, collided with the ground during an attempted return-to-runway maneuver in the takeoff initial climb at the Henderson, Nevada, airport. The airplane was owned and operated by the pilot under 14 CFR Part 91 of the Federal Aviation Regulations. The airplane was destroyed in the accident sequence and the private pilot, the sole occupant, sustained fatal injuries. Visual meteorological conditions prevailed and included variable winds at 4 knots. The personal flight was originating at the time of the occurrence and was destined for Bakersfield, California.

According to statements from controllers in the non-federal air traffic control tower at the Henderson airport, the airplane taxied from parking at the terminal building to runway 36 and took off without a clearance from ground or local control. Both controllers attempted to stop the airplane by using a red light gun signal control; however, the airplane did not stop. The controllers did not see the airplane stop in the run-up area.

In addition to the controllers, four ground witnesses, including a Federal Aviation Administration (FAA) airworthiness inspector from the Las Vegas Flight Standards District Office, observed the accident sequence. The witnesses reported that just beyond the departure end of the 5,000-foot-long runway, the airplane began a tight left turn, as if attempting to return to the runway. The left bank continued to increase until the nose dropped and the airplane descended vertically to ground impact, about 1,000 feet from the approach end of runway 18. The witnesses said the nose was almost 90 degrees to the horizon when it impacted the ground. The FAA inspector stated that he observed a trail of smoke coming from the airplane during the initial climb.

The airport technician who refueled the airplane was interviewed on October 13. He stated that the pilot ordered the fuel about 1-hour prior to takeoff and was present during the fueling process. The pilot removed and replaced the fuel caps himself. The initial fueling order from the pilot was for 10 gallons in each tip tank, and, during the fueling, he changed the order to 15 gallons in each tip tank. The pilot pointed out two empty oil cans laying on the ground by the airplane's nose and asked the refueler if he could throw them away for him. The refueler did not observe the pilot placing the oil in the engine or complete any other aspect of a preflight inspection. According to the refueler, the pilot had a normal demeanor.

Other airport employees were interviewed who were present when the pilot arrived on Tuesday, October 10, and when he paid for his fuel just prior to departure. According to their statements, when the pilot arrived on October 10 he was very agitated and upset, and told the employees that he had violated the Las Vegas Class B airspace on his way to Henderson. On the morning of the accident, the pilot had a normal demeanor.

Personnel information

The pilot's airman and medical records files in the FAA Airman and Medical Certification Branches in Oklahoma City, Oklahoma, were reviewed. In addition, a personal flight logbook covering the period from March 5, 1989, to the accident was examined.

According to the FAA records, the pilot held a private pilot certificate, with airplane ratings for single engine land and sea. The most recent issuance of the certificate was dated December 13, 1958. He held a third-class medical certificate issued March 14, 2000, without limitations. He also held a mechanic certificate with airframe and powerplant ratings, which was issued June 19, 1995.

The personal flight logbook began on March 5, 1989, when the pilot purchased the accident airplane. The log reflected a total time as of the accident of 1,060 hours. Between the first entry in 1989 and the date of the accident, the pilot had accrued about 100 hours total, all in the accident airplane. The most recent 6 months of activity consisted of three flights in April, two flights in May, and two flights in July. The last entry in the record is dated July 22, 2000. The log record noted that a biennial flight review was accomplished on February 3, 1999.

Aircraft information

The Navion Aircraft model G, serial number 4-2434, was manufactured in April 1962. According the aircraft maintenance records and the recording tachometer in the cockpit, it had accumulated a total time in service of 1,857 hours. The most recent annual inspection was recorded as completed on April 3, 2000, 14 hours prior to the accident. Examination of the airframe log entries disclosed that from November 1995 to March 29, 2000, the pilot performed all maintenance activities on the aircraft. The annual inspection on April 3 was accomplished by another individual with an FAA Inspection Authorization.

According to the maintenance records, the Continental IO-470-H engine, serial number 87083-2, was the original Navion factory installation in the airframe and had accumulated a total time equal to that recorded for the airframe. The engine logbook does not reflect the accomplishment of a 100-hour inspection or sign-off coinciding with the annual inspection recorded in the airframe record.

Review of the airframe and engine logbook record entries disclosed that the pilot entered discrepancies in the remarks column of the flight record page. The only unresolved discrepancies found in either record were the notation of a 1-pint per hour oil consumption rate, which is listed in entries dated January 11 and March 29, 2000.

The aircraft fuel system consists of a main fuselage tank (which extends into the root area of each wing) and a left and right tip tank. The main tank has a capacity of 39 gallons, and each tip tank has a 34-gallon capacity. Section 2 of the Navion Aircraft owners manual for the model G contains normal operating procedures. The paragraphs dealing with starting, takeoff, and climb all state that the fuel selector should be selected to the main tank for these operations, and that the electric fuel boost pump be used for takeoff and when switching fuel tanks.

Examination of refueling records at the Henderson Executive Airport disclosed that the airplane was last fueled about 1-hour prior to takeoff with the addition of 15-gallons of 100LL aviation gasoline to each tip tank. According to the refueling technician, the pilot was present during the fueling process and removed and replaced the fuel caps himself. No fuel was added to the fuselage tank and investigators could not make an independent determination on the quantity it may have contained.

There were no reported problems with any aircraft fueled before or after the accident aircraft.

Meteorological information

The closest official aviation weather observation station is the McCarran International Airport, which is located 8 miles north northwest of the Henderson airport. The 1056 METAR for McCarran was reporting in part, clear skies with a 10 mile visibility and variable winds at 4 knots. The 0956 observation was reporting similar sky and visibility conditions with calm winds. No unusual meteorological phenomena were observed by any witness to the accident.

Communications

The non-federal control tower at the Henderson airport uses a VHF frequency of 125.1 for local control, and 127.8 for ground control. In addition, the airport has a UNICOM frequency of 122.95, which is monitored by the airport operations personnel. Certified re-recordings of the local and ground control frequencies were obtained from the tower and reviewed. No transmissions identified as coming from the accident aircraft were heard during the tape review. The individual in airport operations who was monitoring the UNICOM frequency stated that no transmissions were heard from the accident aircraft.

Aerodrome information

At an elevation of