# NTSB LAX05FA032: Piper PA-32R-301T, N803ZG, Santa Barbara, CA, November 11, 2004 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: November 10, 2004, 22:01 local (Nov 11, 2004, 06:01 UTC) - Place: Santa Barbara, CA - Coordinates: 34.699165, -119.658889 - Nearby events: https://openairdocs.org/map.md?lat=34.6992&lon=-119.6589&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 3 fatal - Status: Completed, report June 28, 2006 - Report: Approved by Office Director - Parties: National Air Traffic Controller's Association, Lycoming Engines, Federal Aviation Administration, New Piper Aircraft - NTSB case key (mKey): 60558 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX05FA032 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/60558/pdf - Page: https://openairdocs.org/ntsb/LAX05FA032 ## Probable cause The pilot's failure to select and maintain an adequate terrain avoidance cruise altitude. Contributing factors were the dark nighttime conditions, the rising mountainous terrain, and the Federal Aviation Administration controller's failure to issue a terrain-related safety alert. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight collision with terrain/water, cruise - light condition - dark night (contributing factor) - terrain condition - mountainous/hilly (contributing factor) - altitude/clearance - inadequate, pilot in command (cause) - other psychological condition, pilot in command (contributing factor) - procedures/directives - not followed, atc personnel(artcc) (contributing factor) - safety advisory - not issued, atc personnel(artcc) (contributing factor) ## Analysis The airplane collided with upsloping high mountainous terrain during level controlled cruise flight on a night cross-country. Prior to takeoff, the pilot informed the air traffic controller (ATC) that he had received the airport's weather. A broken sky condition existed with layers about 5,500 and 7,000 feet mean sea level (msl). When the pilot subsequently climbed from 4,900 to 5,200 feet and requested information from ATC about the elevation of the clouds, he acknowledged that he "seems to be in a little bit of clouds...sort of in and out." The pilot continued climbing into clearer conditions. The flight continued and the airplane tracked near the centerline of Victor Airway 183, which had a published course of 195 degrees. The pilot was familiar with the roundtrip route between his Santa Barbara home-base airport and Bakersfield, and he had previously flown over the route. During the last few minutes of the radar-recorded flight, the pilot was generally cruising about 6,500 feet, as indicated by the mode C altitude reporting transponder. The pilot was receiving radar flight following service from a controller at the Los Angeles Air Route Traffic Control Center. The controller observed the airplane and was aware that the minimum enroute altitude (MEA) for airplanes on instrument clearances along the airway was 9,000 feet. The controller and the pilot had sectional aeronautical charts available for use that depicted a 6,840-foot msl mountain peak along the flight route. The pilot's course did not vary as he approached and impacted the mountain during the dark nighttime flight. The bearing between the initial point of impact (IPI) and the Santa Barbara Municipal Airport was 197 degrees. Also, the bearing and distance between the IPI and the main wreckage was 198 degrees and 0.25 miles. The controller did not issue a terrain-related safety alert, as required by a Federal Aviation Administration order. ## Factual narrative HISTORY OF FLIGHT On November 10, 2004, about 2201 Pacific standard time, a Piper PA-32R-301T (Saratoga), N803ZG, cruised into rising mountainous terrain about 17 nautical miles (nm) north of Santa Barbara, California. J. P. III, Enterprises, Inc., owned and operated the airplane, which was piloted by its owner. The airplane was destroyed during multiple impacts with trees and terrain, and by the post impact ground fire. Visual meteorological conditions prevailed in the vicinity of the accident site, located in the Dick Smith wilderness area of the Los Padres National Forest. The flight was performed under the provisions of 14 CFR Part 91, and no flight plan had been filed. The non-instrument rated private pilot and two passengers were fatally injured during the dark nighttime business flight. One of the passengers was a non-certificated student pilot. The flight originated from Bakersfield, California, at 2137. During the flight the pilot was returning to his home-base airport. At 2129, the pilot of N803ZG contacted the Meadows Field Air Traffic Control Tower in Bakersfield, and he advised the controller that he intended to fly to Santa Barbara. The pilot indicated that he planned to fly under visual flight rules (VFR) and that he had received the airport's terminal information service (ATIS) broadcast information. At 2136:51, the controller cleared the pilot to takeoff from runway 30R. About 3 minutes later the airplane was radar identified on its assigned transponder squawk code. The Federal Aviation Administration's (FAA) recorded radar data indicates that the airplane turned to a southerly heading and proceeded toward Santa Barbara over a route nearly paralleling federal airway V183, on its 196-degree radial. At 2140:47, the pilot indicated that he was climbing through 3,600 feet mean sea level (msl), and that he intended to climb to 6,500 feet msl. About 3 minutes later the pilot made the following transmission: "Bakersfield departure Saratoga eight zero three zulu golf." The controller responded and stated "Saratoga three zulu golf go ahead." At 2143:59, the pilot stated: "I seem to be in a little bit of uh clouds here what uh are my ceilings and uh can I fly over them?" About this time the airplane's altitude was between 4,900 and 5,200 feet, according to the airplane's mode C altitude encoding transponder. The controller responded and stated: "I do not have any current base and tops reports the uh ceiling at Meadows Field is uh ceiling five thousand broken uh with a scattered layer at four thousand four hundred. I do not have any tops are you I M C?" The pilot responded at 2144:20 and stated: "uh no I am actually eh sort of in and out but I just don't want to get in I M C." About this time the airplane was approaching 5,400 feet. At 2144:43, the controller advised the pilot that the minimum instrument flight rules (IFR) altitude about 5 miles ahead of the pilot was 3,000 feet, and that 12 miles ahead it was 5,100 or 6,500 feet, depending upon the direction flown. Thereafter, farther south it was 10,000 feet. The pilot responded to the controller and stated, "did you say tops are at ten thousand feet?" The controller replied "no no no those last altitudes I mentioned were my minimum IFR altitudes issued if you were an IFR aircraft…." The pilot responded and stated, "Roger okay I'll just (stay under) that thank you." According to the FAA's recorded radar data, about this time the airplane was approaching 6,000 feet. At 2147:02, the pilot stated to the controller that "it looks like the tops of the clouds here for your information is about six point five so I'm just going to go up to eight point five." The controller responded by stating "you have good VFR flight uh above those clouds." The pilot replied that it was nice and smooth and clear as a bell. Thereafter, at 2149:14, the controller told the pilot to contact the Los Angeles Air Route Traffic Control Center (ARTCC). About this time the airplane had climbed through approximately 8,200 feet. The pilot contacted the Los Angeles ARTCC and spoke with the radar Sector 2 controller. The Sector 2 controller identified the pilot's airplane and issued the pilot the Santa Barbara altimeter setting, 30.11 inches of mercury. The pilot acknowledged the altimeter setting. Radar data shows that over the next 11 minutes the airplane climbed to 8,400 feet and then descended, reaching 6,400 feet at 2154. The Sector 2 controller initiated an automated handoff to Santa Barbara Approach Control, but the handoff was not accepted. Meanwhile, the southbound airplane continued flying between 6,300 and 6,500 feet until 2200:24, when it disappeared from radar. Its last recorded position was 34 degrees 42.056 minutes north latitude by 119 degrees 38.585 minutes west longitude, about 6,300 feet (transponder altitude). When the airplane's radar target was lost the airplane's track went into coast status. At 2202, the Sector 2 controller tried to reestablish radio contact with the airplane, advising the pilot that radar contact was lost, and instructing the pilot to report San Marcus VOR. There was no response from the pilot. The Sector 2 controller called the pilot two more times without success. The controller then called Santa Barbara approach control to advise them that she was unable to communicate with the airplane. The Santa Barbara controller had not taken the handoff from the Sector 2 controller because he could not see the target. It was approaching the end of the work shift for the Sector 2 controller, and she departed the facility after responding to an inquiry initiated by the Santa Barbara controller. The Sector 2 controller updated the Santa Barbara controller with the latest information she had regarding the airplane that had disappeared. The Sector 2 controller informed the Santa Barbara controller that "I didn't terminate him I just lost radio and radar with him." When the pilot failed to arrive home, a concerned family member reported the airplane overdue. A series of additional events occurred involving FAA personnel in which their denial of having provided services to the airplane was found to be in error. (See the National Transportation Safety Board's Air Traffic Control Group Chairman's Factual Report for additional details.) The United States Air Force Rescue Coordination Center provided local authorities with the coordinates for the airplane's last known position. The following morning the accident site was located approximately 1/3-mile south of the airplane's last recorded radar position. No witnesses reported observing the accident. The accident time was estimated by the Safety Board investigator. It was based upon the time at which radar data was lost and the airplane's average ground speed during its last 2 minutes of recorded flight. PERSONNEL INFORMATION Pilot. In 1982 the pilot was issued a private pilot certificate with the following ratings: Airplane single engine land. On August 24, 2004, he was again issued a private pilot certificate with the same ratings. On the certificate application form, the pilot indicated that his total flight time was 295.4 hours. According to FAA records, on September 27, 2004, the pilot's total flight time was indicated as being 390 hours. Flight Training. The pilot based his airplane at the Santa Barbara Municipal Airport. According to information contained in the pilot's personal flight record logbook, and according to statements made by two certified flight instructors (CFI) who provided instruction to the pilot, the pilot was competent and he had above average flying skills. Passenger (non-certificated student pilot). The passenger's flight record logbook indicates he commenced taking flying lessons on August 12, 2004. All lessons were in a Cessna 172. The last lesson was on November 9, the day p ## Aircraft - Registration: [N803ZG](https://openairdocs.org/deregistered/N803ZG-2017-07-06), registration cancelled 2017-07-06, S/N 3257357, built 2004 (OpenAirDocs) - Reported make and model: Piper PA-32R-301T - Registry model: [Piper PA-32R-301T](https://openairdocs.org/model/piper-pa-32r-301t) (registry code 7103220) (OpenAirDocs) - Registry engine: [Lycoming TIO-540 series](https://openairdocs.org/engine/lycoming-tio-540-series) (registry code 41569, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 3257357 - Engines: Lycoming TIO-540-AH1A 300 horsepower reciprocating - Damage: Destroyed - Fire: On-Ground - Flight: Business, Part 91 - Operator: Juan F. Padilla - Registered owner: J. P. III Enterprises, Inc. - Airworthiness certificate: Standard, Normal - Departed: BFL, Bakersfield, CA - Destination: SBA, Santa Barbara, CA - Airport: SBA, Santa Barbara Municipal ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 50; injuries: fatal; private; airplane ratings: single-engine land; medical: class 3, with waivers/limitations; last flight review August 1, 2004; toxicology performed; flight hours: 322 total, 19 in this make and model, 205 as pilot in command, 40 in the last 90 days, 5 in the last 30 days, 2 in the last 24 hours ## Weather - Conditions: Visual (VMC), Night/dark - Wind: calm - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 50 °F, dew point 46 °F - Altimeter: 30.12 inHg - Observed at: SBA, 19 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 20041110029849A](https://openairdocs.org/incident/20041110029849A), Nov 10, 2004: Piper PA32R301T, Santa Barbara, CA, Destroyed, 3 fatal. (-23) On November 10, 2004, about 2200 pacific standard time, a Piper PA-32R-301T, N803ZG, cruised into trees and rising mountainous terrain about 17 nautical… 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.