WPR09LA374

NTSB accident investigation · Air Tractor AT-301 · Firebaugh, CA · July 29, 2009

Accident · No injuriesLimited investigationFinal report
Date
July 29, 2009, 04:15 local (11:15 UTC)
Place
Firebaugh, CA
Injuries
1 uninjured
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N23189Air Tractor AT-301
Defining event
Enroute: Fuel exhaustion
Weather
Visual (VMC) · Day
Status
Completed · report July 22, 2010
Report
Approved by Office Director
NTSB office
Western Pacific Region
Parties
Federal Aviation Administration
FAA report
20090729014389A
Case key
74400

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

On this page

Probable cause

A total loss of engine power due to fuel exhaustion that was due to the failure of company ground personnel to refuel the airplane. Contributing to the accident was unsuitable terrain for a forced landing.

Findings · 3

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Terrain: rough terrainEnvironmental issues › Physical environment · Contributed to outcomeAir Tractor AT-301: 3 casesAll aircraft: 442 casesProbable cause
Fluids: fuelAircraft › Fluids/misc hardware · Fluid levelAir Tractor AT-301: 7 casesAll aircraft: 1,695 casesProbable cause
Action: lack of actionPersonnel issues › Action/decision · Ground crewAir Tractor AT-301: 2 casesAll aircraft: 792 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Analysis

The single-engine airplane experienced a total loss of engine power five minutes after takeoff during an aerial application flight. The pilot attempted a forced landing to an alfalfa field he was preparing to spray, but after touching down, the airplane impacted an angle ditch and nosed over. The airplane sustained substantial damage to its empennage. A Federal Aviation Administration (FAA) safety inspector examined the airplane on the morning of the accident and reported finding that both wing tanks were void of any fuel, and there was no evidence of any leakage. When the inspector revealed this to the pilot, the pilot stated that company personnel had fueled the airplane about 10 minutes prior to the accident. The pilot added that company policy is for the ground crew to fuel after each load, normally with 30 gallons of fuel to each wing tank while loading the plane with pesticide. The pilot supplied a company fuel log that indicated the airplane was fueled 4 times on the day of the accident. A subsequent examination and engine run performed by an airframe and power plant mechanic revealed no anomalies with the engine that would have precluded normal operation.

Factual narrative

On July 29, 2009, about 0415 Pacific daylight time, an Air Tractor Inc. AT-301, N23189, sustained substantial damage during a forced landing following a loss of engine power about 5 nautical miles northwest of Firebaugh, California. The commercial pilot was not injured. Visual meteorological conditions prevailed for the aerial application flight, which was conducted in accordance with 14 Code of Federal Regulations Part 137, and a flight plan was not filed. The flight departed from a private airstrip about 4 miles east of Dos Palos, California, at 0410. In a statement submitted to the Safety Board investigator-in-charge (IIC), the pilot reported that while approaching the field to be sprayed the airplane's engine lost power. The pilot stated that after making a forced landing the airplane impacted an angle ditch and nosed over, which resulted in substantial damage to the airplane's empennage. A Federal Aviation Administration (FAA) inspector, who responded to the accident site, reported that when he arrived he noted that no fuel was in either wing tank, and that no fuel was heard in the tanks, nor could he hear any sloshing of fuel in the tanks. The inspector further reported that when the fuel caps were opened no fuel exited and no fumes were present. When asked by the inspector who fueled the airplane, the pilot said that it was company personnel, that they always do both fuel and pesticide, and that they typically put 30 gallons of fuel in each tank. The pilot provided the IIC with a fuel load sheet, which indicated that the airplane was fueled prior to the 4th load after a change of airstrips took place at 0300; the accident occurred on the 4th load. A certificated FAA airframe and powerplant mechanic stated that an inspection of the engine revealed no abnormalities, either external or internal. The mechanic reported that a check of the opening and closing of the valves were normal with the rotation of the engine, that all 9 cylinders maintained adequate compression, that the blower impeller turned 10 to 1 with engine rotation, and that he dialed the crankshaft and found it within limits. The mechanic installed a serviceable propeller and conducted an engine run at full power, with normal manifold pressure and revolutions per minute (RPM) achieved; the magnetos checked normal. The mechanic stated that after the engine was shut down he removed the oil screen and found no foreign metal or debris. The mechanic reported that he found the engine to be airworthy for normal operation.

Aircraft

Registration
N23189
Reported as
Air Tractor AT-301
Category
Airplane
Serial number
301-0366
Airframe hours
6,478
Engine
Pratt & Whitney R-1340, 600 horsepower, reciprocating
Damage
Substantial damage
Flight
Aerial application · Part 137
Operator
Bob J. Spain
Registered owner
Spain Air Inc.
Airworthiness certificate
Special, Restricted (Special)
Last inspection
Annual · July 24, 2009 · 194 hours before
Departed
Dos Palos, CA
Destination
Dos Palos, CA

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
74
Injuries
None
Certificate
Commercial
Airplane ratings
Single-engine land
Medical
Class 2, With waivers/limitations
Last flight review
December 14, 2007
Seat
Single
Flight hours
35,000 total · 25,000 in this make and model · 35,000 as pilot in command · 200 in the last 90 days · 100 in the last 30 days · 6 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Visibility
10 statute miles
Lowest ceiling
None
Temperature
68 °F, dew point 57 °F
Altimeter
29.75 inHg
Observed at
MAE, 23 nm away

Docket · 4

The files NTSB released with the investigation on May 10, 2010, on NTSB’s docket system: statements, records, photos and specialists’ reports. 1.4 MB in all.

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.