# NTSB LAX01FA014: Beech 35-33, N1344G, Monterey, CA, October 15, 2000 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: October 15, 2000, 12:44 local (19:44 UTC) - Place: Monterey, CA - Coordinates: 36.612777, -121.871109 - Nearby events: https://openairdocs.org/map.md?lat=36.6128&lon=-121.8711&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 2 fatal - Status: Completed, report August 6, 2003 - Report: Approved by Office Director - Parties: Teledyne Continental Motors, WP-FSDO San Jose, CA, Raytheon Aircraft Company - NTSB case key (mKey): 50478 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX01FA014 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/50478/pdf - Page: https://openairdocs.org/ntsb/LAX01FA014 ## Probable cause The pilot's inadequate in-flight planning/decision by which he conducted visual flight into instrument meteorological conditions and his failure to maintain control of the airplane. Contributing factors were low ceiling, spatial disorientation and lack of instrument rating. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight encounter with weather, takeoff - initial climb - weather condition - low ceiling (contributing factor) - in-flight planning/decision - inadequate, pilot in command (cause) - lack of experience, pilot in command (contributing factor) - vfr flight into imc - attempted, pilot in command (cause) - Loss of control - in flight, descent - uncontrolled - aircraft control - not maintained, pilot in command (cause) - spatial disorientation, pilot in command (contributing factor) - In flight collision with terrain/water, descent - uncontrolled - terrain condition - water ## Analysis The non-instrument rated pilot, on a special visual flight rules departure clearance, encountered instrument meteorological conditions upon climbing into a layer of clouds. The pilot experienced spatial disorientation, commenced an uncontrolled descending spiral, and impacted the ocean. Prior to departure from the 254-foot msl airport, the pilot had been advised of the local weather conditions, which indicated the cloud base was about 700 feet agl, and the weather was deteriorating, with a decreasing ceiling and lowering visibility. A witness observed the airplane takeoff. The witness reported losing sight of the airplane seconds after it entered the base of the overlying marine layer of stratus clouds. Recorded radar data indicates that within 2 minutes the airplane had climbed to about 1,400 feet, whereupon it entered a right graveyard-like spiral from which it did not recover. Other witnesses located on the shoreline or in boats on the bay reported hearing the sound of an airplane in a dive and observed the airplane fly out of the clouds, diving steeply toward the water. The airplane pulled out of the dive, and then rolled inverted while climbing. Upon reaching the apex of its short climb it dropped suddenly into what appeared to be a straight downward dive and descended at a near 90-degree angle straight into the water. At no time did the airplane's engine sound as if it were under stress, faltering, or sputtering. The extensively crushed and fragmented wreckage was recovered from the bay and examined, with no preimpact mechanical malfunctions or failures identified. ## Factual narrative HISTORY OF FLIGHT On October 15, 2000, about 1244 Pacific daylight time, a Beech 35-33, N1344G, operated by the pilot, experienced an in-flight loss of control during initial climb from the Monterey Peninsula Airport, Monterey, California. Thereafter, while in an uncontrolled descent, the airplane impacted and sank into an area of the Pacific Ocean known as the Monterey Bay National Marine Sanctuary, about 2 miles northwest of the airport from where the pilot had departed about 1242. The personal flight to Sacramento, California, was performed under 14 CFR Part 91. The airplane was destroyed, and the noninstrument rated private pilot and pilot-rated passenger were fatally injured. After issuing the pilot of N1344G a special visual flight rules (SFVR) departure clearance, at 1241:24, the Monterey Airport local air traffic controller cleared N1344G to takeoff from runway 28L, and the airplane departed. At 1244:45, the controller stated "Bonanza four four golf radar contact lost say altitude." The controller did not receive any reply from the airplane. A pilot-witness, in another airplane waiting in sequence for takeoff behind the accident pilot, provided a statement to the National Transportation Safety Board investigator regarding her observations. According to this witness, the pilot occupied the left seat in the accident airplane, and the instrument rated passenger was in the right seat. The airplane's acceleration and initial climb appeared normal. The witness lost sight of the airplane seconds after it departed when it entered the base of the overlying layer of clouds located above and west of the airport. A jogger, located near the coastline, reported that he heard the sound of an airplane in a dive and observed the airplane fly out of the clouds, diving toward the water. The airplane pulled out of the dive, and then rolled sideways while climbing. Upon "reaching the apex of its short climb..." it "dropped suddenly into what appeared to be a straight downward dive." The airplane descended at what appeared to be a 90-degree angle, and it "dove straight into the water." At no time did the airplane's engine sound as if it were under stress, faltering, or sputtering. The jogger stated that "it sounded very strong." Numerous other witnesses, who were in boats, also reported observing the airplane during its last few seconds of flight. One boater reported, "I first heard the plane...under full throttle." The plane climbed, went inverted, rolled into a dive, and hit the water at full speed. Another boater commented that "it appeared like he (the airplane) came out of the heavy fog...." Another boater reported that he was between 300 and 500 yards from the crash site. According to this witness, the airplane "flew out of the low clouds at an angle of approximately 45 to 60 degrees toward the sea." Five additional boaters reported observing the airplane bank right until becoming inverted and hearing the engine at full throttle. Three other boaters reported the airplane was attempting to pullout of a fall and "it was out of control." The airplane pulled up, the right wing dipped, the plane rolled and twisted counterclockwise (cork screwed) and went up, twisting back almost toward the direction from which it came. It was inverted. Then, it appeared to stall and descend straight down into the water. PERSONNEL INFORMATION Pilot. The left seated pilot held a private pilot certificate and was rated to fly single engine land airplanes. She did not possess an instrument rating. Her last third-class medical certificate was issued in February 1999, with the restriction that corrective lenses be worn. The pilot's husband reported that his wife's total flight time was about 2,320 hours, all of which were obtained flying the accident airplane. The husband indicated that his wife was current in the airplane, and she had flown it earlier during the week. The pilot's last biennial flight review was satisfactorily accomplished in May 2000. Pilot-rated Passenger. The right-seated pilot-rated passenger held a commercial pilot certificate and was rated to fly single engine and multiengine land airplanes. She possessed an instrument rating. In addition, she held a certified flight instructor (CFI) certificate for single engine and multiengine land airplanes, and instruments. Her CFI certificate bore an expiration date of May 31, 2001. The pilot-rated passenger's last third-class medical certificate was issued in October 1998, with the restriction that corrective lenses be worn for near and distant vision. In October 1998, the pilot reported to the Federal Aviation Administration (FAA) that her total flight time was 2,525 hours. AIRCRAFT INFORMATION The airplane's airworthiness certificate was issued in 1959, in the standard normal category. Since 1971, the airplane has been registered in the name of the pilot's husband, an FAA certificated airframe and powerplant mechanic. The husband's name appears in the airplane's airframe and engine logbooks as the person having performed maintenance during the previous year. FAA personnel reviewed the airplane's maintenance records and reported, in part, that several airworthiness directives had not been recorded as to their method of compliance. Also, several required yearly inspections were not recorded in the logbooks. The airplane's owner reported to the Safety Board investigator that the airplane was not equipped with an autopilot or a dual control yoke. It had a "throw over" type control column. The airplane was equipped with the requisite instruments to fly into instrument meteorological conditions. He also stated that the airplane's fuel tanks were nearly full at the time of the accident. METEOROLOGICAL INFORMATION In pertinent part, at 1213, Monterey Peninsula Airport (elevation 254 feet mean sea level (msl)) reported its weather as the surface wind was from 320 degrees at 7 knots; visibility was 5 miles in mist; and a broken ceiling existed at 700 feet above ground level (agl). About 10 minutes after the accident, at 1254, Monterey reported its surface wind was from 310 degrees at 7 knots. The visibility had decreased to 4 miles in mist. The overcast ceiling had lowered to 500 feet agl. A witnesses to the accident airplane's departure reported that, at the time of the accident, a low elevation marine layer of stratus clouds prevailed over the airport. The witness indicated that the clouds extended westward beyond the shoreline and over the water. Regarding the accident pilot's knowledge of the local weather conditions, at 1206, the Monterey ground controller advised the pilot to "standby" because the airport was "just about to go IFR." ("IFR" refers to instrument flight rules and indicates that the airport's weather conditions are below that which is required for flight under visual flight rules (VFR)." One minute later, upon being advised that the airport's ceiling was 700 broken, the pilot requested a SVFR departure clearance. At 1218, the ground controller issued the pilot a clearance to taxi for takeoff and inquired if the pilot had heard the weather he had given other aircraft. The pilot responded "that's affirmative." At 1223, the pilot was issued a SVFR departure clearance. In pertinent part, the pilot was instructed to "maintain special VFR" while in the airport's airspace. The pilot read back the clearance to the controller. AIDS TO NAVIGATION A review of the FAA's records of facility operation was performed. All electronic aids to navigation pertinent to the accident site area and the airplane's route of flight following its departure from Monterey were reported functional at the time of the accident. COMMUNICATION The Monterey air traffic control tower's air-to-ground radio communication tapes were reviewed for evidence of communication difficulties and anomalies. ## Aircraft - Registration: [N1344G](https://openairdocs.org/deregistered/N1344G-2001-01-23), registration cancelled 2001-01-23, S/N CD-23 (OpenAirDocs) - Reported make and model: Beech 35-33 - Registry model: [Beech 35-33](https://openairdocs.org/model/beech-35-33) (registry code 1151402) (OpenAirDocs) - Category: Airplane - Serial number: CD-23 - Airframe hours: 4335 - Engines: Continental IO-470-J1 225 horsepower reciprocating - Damage: Destroyed - Flight: Personal, Part 91 - Operator: Betty L. Alair - Registered owner: Neil C. Alair - Airworthiness certificate: Standard, Normal - Last inspection: Annual, June 1, 2000, 19 hours before - Departed: MRY, Monterey, CA - Destination: SAC, SACRAMENTO, CA - Airport: MRY, Monterey Peninsula ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 65; injuries: fatal; private; airplane ratings: single-engine land; medical: class 3, valid medical--w/ waivers/lim; last flight review May 25, 2000; seat: left; toxicology performed; flight hours: 2,320 total, 2,320 in this make and model, 2,320 as pilot in command ## Weather - Conditions: Instrument (IMC), Day - Wind: 310° at 7 knots - Visibility: 4 statute miles - Lowest ceiling: 500 ft overcast - Temperature: 55 °F, dew point 52 °F - Altimeter: 30.05 inHg - Observed at: MRY, 2 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 (OpenAirDocs). - [Accident 20001015036169A](https://openairdocs.org/incident/20001015036169A), Oct 15, 2000: Beech 35BEECH, Monterey, CA, No damage. (-23) On October 15, 2000, N1344G a Beechcraft model 35-33 departed Monterey airport at approx. 12:42 local time. At approx. 12:44 and about 2 miles northwest… 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.