# NTSB SEA95FA120: Cessna 175A, N6970E, Moab, UT, June 17, 1995 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: June 16, 1995, 22:00 local (Jun 17, 1995, 04:00 UTC) - Place: Moab, UT - Coordinates: 38.529418, -109.549148 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=38.5294&lon=-109.5491&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed, report January 29, 1996 - Report: Approved by Office Director - NTSB case key (mKey): 42055 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=SEA95FA120 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/42055/pdf - Page: https://openairdocs.org/ntsb/SEA95FA120 ## Probable cause THE PILOT'S FAILURE TO MAINTAIN PROPER ALTITUDE IN THE VISUAL FLIGHT RULES (VFR) TRAFFIC PATTERN. CONTRIBUTING TO THE ACCIDENT WERE THE PILOT'S FAILURE TO FOLLOW DISPATCH PROCEDURES, THE DARK NIGHT CONDITIONS, AND THE UNAVAILABILITY OF THE AIRPORT'S PILOT-CONTROLLED RUNWAY AND PRECISION APPROACH PATH INDICATOR (PAPI) LIGHTS. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight collision with terrain/water, approach - vfr pattern - base leg/base to final - dispatch procedures - not followed, pilot in command (contributing factor) - light condition - dark night (contributing factor) - lack of recent experience in type operation, pilot in command - airport facilities,runway edge lights - unavailable (contributing factor) - airport facilities,visual apch slope ind(vasi) - unavailable (contributing factor) - proper altitude - not maintained, pilot in command (cause) - terrain condition - rough/uneven ## Analysis THE PILOT WAS PERFORMING A NIGHT VFR APPROACH INTO THE UNCONTROLLED AIRPORT WHEN THE AIRCRAFT IMPACTED THE TERRAIN ONE AND ONE HALF MILES FROM THE RUNWAY. A WITNESS OBSERVED THE AIRCRAFT IN THE TRAFFIC PATTERN AND INDICATED THE AIRPLANE GROUND TRACK APPROXIMATED THE TRAFFIC PATTERN FOR RUNWAY 21 EXCEPT THAT THE AIRCRAFT LOOKED LOWER TO THE GROUND THAN A NORMAL PATTERN. THIS WITNESS SAW THE AIRPLANE MAKE A LEFT TURN, SIMILAR TO A BASE TURN, AND DESCEND FROM VIEW BEHIND A RIDGE LINE. THE ACCIDENT FLIGHT OCCURRED ABOUT 16 HOURS AFTER THE START OF THE PILOT'S DUTY DAY. THE COMPANY OPERATIONS MANUAL STATES THAT DUTY ASSIGNMENTS SHOULD NOT EXCEED 14 HOURS. FLIGHT SERVICE HAD BRIEFED THE PILOT BEFORE HIS DEPARTURE THAT THE RUNWAY LIGHTS AT HIS DESTINATION WERE OUT OF SERVICE. ## Factual narrative HISTORY OF FLIGHT On June 16, 1995, approximately 2200 mountain daylight time, a Cessna 175A, N6970E, being operated by Corporate Aircraft Service (CAS) of Rifle, Colorado under a letter of agreement with its principal operator Mountain Flying Service (MFS) of Moab, Utah, was destroyed in an inflight collision with terrain 1 1/2 miles northeast of Canyonlands Airport, Moab, Utah. The airline transport pilot, who was the sole occupant of the aircraft, was fatally injured. The 14 CFR 91 flight had originated at Salt Lake City International Airport and was attempting to land at Canyonlands, although no flight plan had been filed. The weather at Canyonlands on the night of the 16th was described by witnesses as raining with strong and gusty winds. The airplane was on the 14 CFR 135 operating certificates of both CAS and MFS, and was under the operational control of CAS on the day of the accident. Under this arrangement, Canyonlands was a "satellite base" for CAS flight operations, with Rifle being the "main base." The aircraft flight log, which was recovered from the aircraft wreckage, indicated that the accident flight was the sixth flight of the day. According to the log, the pilot had flown 6.3 hours on his first five flights with the first takeoff of the day at 0645. In his report on the accident, the CAS director of operations stated the following regarding the pilot's flight activity for the day: "On the morning of Friday June 16...[the pilot] departed CNY airport [Canyonlands] at approximately 0645 local time. He flew to GJT [Grand Junction, CO] to [pick up] 3 [passengers] and take them to Sandwash Airport. He then returned to CNY by 1040 local time and called Corporate Aircraft Services (CAS) dispatch number to report that he was back at CNY. He informed CAS that he had a tentative flight from Monument Valley [a private airstrip operated by MFS, located approximately 19 nautical miles north of Kayenta, AZ] to SLC [Salt Lake] for that afternoon around 1500 local time and that he would call back if it was for certain....the pilot did not call CAS dispatch to confirm the flight....It was...the impression left with CAS dispatch that he had not flown since the Sandwash flight on the morning of the 16th. He failed to confirm the Monument Valley flight with CAS dispatch or any segment of it therefore CAS was unaware of his activity." The CAS dispatch log for N6970E for June 16th recorded only the first three flights of the day (Canyonlands-Grand Junction-Sandwash-Canyonlands). The aircraft flight log indicates that the pilot flew from Canyonlands to Monument Valley airstrip, departing Canyonlands at 1500, and then flew from Monument Valley to Salt Lake City. The aircraft flight log contained discrepancies in the time entries for these flights, indicating arrival at Monument Valley at 2215 UTC (1615 MDT), with both departure and arrival times for the Monument Valley-Salt Lake flight logged as 2200 UTC. According to a transcript of Cedar City AFSS telephone traffic on the night of the accident, the pilot called the AFSS at 1957 and requested a standard briefing for a flight from Salt Lake City to Moab. He indicated that he intended to depart in "twenty or thirty minutes" and gave his estimated time en route as 1 hour and 20 minutes. The transcript indicates that during this briefing, the briefer relayed an AIRMET weather advisory for turbulence along the route along with area forecasts indicating forecast conditions for the southern half of Utah as: broken clouds at 8,000 to 10,000 feet above mean sea level (MSL) with tops at 20,000 feet above MSL, and widely scattered thunderstorms (possibly severe) with cumulonimbus tops up to 40,000 feet above MSL. According to the transcript, she also relayed to the pilot a Notice to Airmen (NOTAM) that the runway lights at Canyonlands were out of service. The transcript indicates that the pilot did not file a flight plan for the Salt Lake to Moab flight during this call. Subsequent transcripts of radio communication on Salt Lake's air traffic control (ATC) frequencies indicate that N6970E was cleared for takeoff from Salt Lake at 2030 and departed Salt Lake's Class B airspace to the south at 2035. The ATC transcript indicates that Salt Lake Departure Control cleared N6970E to leave its frequency at 2039. The FAA's air traffic accident package contains no further record of communication between N6970E and ATC agencies after this point. A witness at Canyonlands reported that between 2200 and 2230 on the 16th, he heard an aircraft over the field. He stated that he ran to the airport office (normally closed after 1800 according to the Airport/Facility Directory), saw the aircraft heading northeast, and broadcast on the Canyonlands UNICOM frequency: "Aircraft circling over Canyonlands, this is Canyonlands UNICOM." He stated that he received a reply to the effect of "Oh I didn't think anybody was home," but that the aircraft did not identify itself. He stated that he intended to tell the aircraft to wait while he turned on the runway lights manually (he indicated that only the pilot-control apparatus was inoperative), but that the aircraft did not reply after he twice broadcast "Aircraft over Canyonlands, this is Canyonlands UNICOM, go ahead." The witness stated that he did not observe the unidentified aircraft again and that he subsequently assumed that the pilot did not intend to land at Canyonlands. The witness then became concerned about the aircraft he had observed. He stated that he listened to 121.5 MHz using a handheld radio and did not hear anything. He also stated that he then contacted both Cedar City AFSS and the Denver Air Route Traffic Control Center (ARTCC) to inquire about aircraft inbound to Canyonlands. He stated that both agencies replied that there were no flight plans filed into Canyonlands at that time. Another witness at Canyonlands observed an aircraft over the field between 2200 and 2215. She stated that the aircraft turned toward the northeast along a ground track approximating the traffic pattern for runway 21, but that the airplane looked lower than the normal traffic pattern altitude. She stated that the aircraft made a descending left turn "as if turning base", then disappeared from view. Taken to the vantage point from which she observed the aircraft and asked to indicate which direction it was when it disappeared, she pointed toward a ridge northeast of the airport which obstructed the wreckage of N6970E from view. She indicated that the aircraft maintained a steady, descending flight path, with no abrupt changes, until it disappeared. She stated that the airplane had its landing lights on, and that while the wind made it difficult to hear the airplane, the engine noise she could hear over the wind sounded normal. The operator stated that the pilot was scheduled for two days off following the day of the accident and that he did not become aware that N6970E was missing until Sunday evening (6/18), when CAS dispatch attempted unsuccessfully to contact the pilot. He stated that during follow-up inquiries as to the pilot's whereabouts, it was discovered that the airplane was not located at Canyonlands. When the airplane and pilot could not be located, the airplane was listed as missing at approximately 2230 on Sunday night. About 0645 Monday morning (6/19), the wreckage was spotted by another aircraft. The accident occurred during the hours of darkness at approximately 38 degrees 46.5 minutes North and 109 degrees 44 minutes West. PERSONNEL INFORMATION The pilot held an airline transport pilot certificate with commercial privileges for single-engine land airplanes. He was also a certificated flight instructor with single-engine, multi- engine, and instrument instructor ratings. His logbook indicates that he had over 4,600 hours total time, including 140 night hours, and 67 hours in the 90 days before the accident. ## Aircraft - Registration: [N6970E](https://openairdocs.org/deregistered/N6970E-1997-10-06), registration cancelled 1997-10-06, S/N 56470 (OpenAirDocs) - Reported make and model: CESSNA 175A - Registry model: [Cessna 175A](https://openairdocs.org/model/cessna-175a) (registry code 2072504) (OpenAirDocs) - Category: Airplane - Serial number: 56470 - Airframe hours: 7313 - Engines: LYCOMING O-360-A1A 180 horsepower reciprocating - Damage: Destroyed - Flight: Positioning, Part 91 - Operator: Hoffman, Paul, doing business as Corporate Aircraft Service - Registered owner: Wischmeyer, Jim - Airworthiness certificate: Standard, Normal - Last inspection: 100 hour, May 20, 1995, 48 hours before - Departed: SLC, SALT LAKE CITY, UT - Destination: CNY - Airport: CNY, Canyonlands, runway 21 ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 46; commercial, airline transport; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--w/ waivers/lim; seat: left; toxicology performed; flight hours: 4,671 total, 59 in this make and model, 4,598 as pilot in command, 67 in the last 90 days, 48 in the last 30 days, 8 in the last 24 hours ## Weather - Conditions: Visual (VMC), Night/dark - Wind: 180° at 10 knots - Visibility: 50 statute miles - Lowest ceiling: 6,000 ft overcast - Temperature: 72 °F, dew point 30 °F - Observed at: U34, 26 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 19950616046179A](https://openairdocs.org/incident/19950616046179A), Jun 16, 1995: Cessna 175A, Moab, UT, Destroyed, 1 fatal. Impacted ground behind a ridge while circling unlighted airport. No anomalies. Pilot fatigue factor indicated. 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.