# NTSB WPR13FA281: Piper PA-30, N830SS, Idaho Falls, ID, June 22, 2013 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: June 22, 2013, 13:35 local (19:35 UTC) - Place: Idaho Falls, ID - Coordinates: 43.508056, -112.068885 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=43.5081&lon=-112.0689&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Defining event: [Initial climb: Fuel contamination](https://openairdocs.org/ntsb-events/193) - Highest injury: Fatal - Injuries: 2 fatal, 1 serious - Status: Completed, report August 28, 2014 - Report: Approved by Office Director - NTSB office: Western Pacific Region - Parties: FAA-FSDO, Lycoming Engines, Piper Aircraft - ADs cited in the narratives: [AD 83-10-01](https://openairdocs.org/ad/83-10-01) (OpenAirDocs) - NTSB case key (mKey): 87270 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=WPR13FA281 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/87270/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=87270 - Page: https://openairdocs.org/ntsb/WPR13FA281 ## Probable cause A loss of power to the right engine during the initial climb due to fuel contamination and the pilot's failure to maintain adequate airspeed and airplane control. Contributing to the accident was the pilot's inadequate preflight check of the airplane. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Fluids: water](https://openairdocs.org/ntsb-findings/01071030): Aircraft › Fluids/misc hardware · Not specified (probable cause); cases with it: [Piper PA-30, 1 case](https://openairdocs.org/ntsb-findings/01071030/cases.md?model=7103002), [All aircraft, 13 cases](https://openairdocs.org/ntsb-findings/01071030/cases.md) - [Action: incorrect action selection](https://openairdocs.org/ntsb-findings/02041010): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Piper PA-30, 1 case](https://openairdocs.org/ntsb-findings/02041010/cases.md?model=7103002), [All aircraft, 397 cases](https://openairdocs.org/ntsb-findings/02041010/cases.md) - [Performance/control parameters: airspeed](https://openairdocs.org/ntsb-findings/01062010): Aircraft › Aircraft oper/perf/capability · Not attained/maintained (probable cause); cases with it: [Piper PA-30, 10 cases](https://openairdocs.org/ntsb-findings/01062010/cases.md?model=7103002), [All aircraft, 1,681 cases](https://openairdocs.org/ntsb-findings/01062010/cases.md) - [Use of equip/info: aircraft control](https://openairdocs.org/ntsb-findings/02063040): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Piper PA-30, 28 cases](https://openairdocs.org/ntsb-findings/02063040/cases.md?model=7103002), [All aircraft, 9,295 cases](https://openairdocs.org/ntsb-findings/02063040/cases.md) - [Inspection: preflight inspection](https://openairdocs.org/ntsb-findings/02061510): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Piper PA-30, 7 cases](https://openairdocs.org/ntsb-findings/02061510/cases.md?model=7103002), [All aircraft, 551 cases](https://openairdocs.org/ntsb-findings/02061510/cases.md) - [Temp/humidity/pressure: high density altitude](https://openairdocs.org/ntsb-findings/03031020): Environmental issues › Conditions/weather/phenomena · Effect on operation (probable cause); cases with it: [Piper PA-30, 2 cases](https://openairdocs.org/ntsb-findings/03031020/cases.md?model=7103002), [All aircraft, 278 cases](https://openairdocs.org/ntsb-findings/03031020/cases.md) - [Aircraft capability: maximum weight](https://openairdocs.org/ntsb-findings/01061035): Aircraft › Aircraft oper/perf/capability · Capability exceeded (probable cause); cases with it: [Piper PA-30, 1 case](https://openairdocs.org/ntsb-findings/01061035/cases.md?model=7103002), [All aircraft, 152 cases](https://openairdocs.org/ntsb-findings/01061035/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Initial climb: Fuel contamination](https://openairdocs.org/ntsb-events/193) (defining event); cases with it: [Piper PA-30, 6 cases](https://openairdocs.org/ntsb-events/193/sequence.md?model=7103002), [All aircraft, 225 cases](https://openairdocs.org/ntsb-events/193/sequence.md) - [Maneuvering: Loss of control in flight](https://openairdocs.org/ntsb-events/240); cases with it: [Piper PA-30, 24 cases](https://openairdocs.org/ntsb-events/240/sequence.md?model=7103002), [All aircraft, 5,002 cases](https://openairdocs.org/ntsb-events/240/sequence.md) - [Uncontrolled descent: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Piper PA-30, 37 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=7103002), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The rear passenger reported that shortly after departure, about 100-200 feet above ground level, the right engine surged. Two witnesses on the ground reported hearing several "pops" before the airplane banked sharply to the right. The airplane collided with the terrain shortly thereafter. The confined distribution of wreckage was consistent with a low-altitude aerodynamic stall. A witness, who fueled the accident airplane, noted that he did not see the pilot sump the airplane's fuel tanks during the preflight. Fuel samples obtained after the accident from the fuel strainer assemblies tested positive for water contamination. During the postaccident engine examination, the fuel strainer assemblies were disassembled, and the filter elements, selector valve housing assemblies, and both fuel bowl assemblies exhibited water contamination, rust, and deposits. Visible sediment and rust were observed in several fuel system components on both engines. The airplane's single-engine performance could not be calculated using the airplane's performance charts because the airplane was over the maximum weight by 176.85 lbs. Further, the calculated density altitude was 6,108 feet. The surge and a possible power reduction to the right engine was likely due to the fuel contamination. Although the airplane was over its maximum weight and took off in a high density altitude—both of which would have affected the airplane's performance—the pilot still failed to maintain adequate airspeed and control of the airplane. ## Factual narrative HISTORY OF FLIGHT On June 22, 2013, about 1335 mountain daylight time, a Piper, PA-30, N830SS, registered to and operated by the private pilot, collided with the ground following a loss of aircraft control during takeoff initial climb at Idaho Falls Regional Airport (IDA), Idaho Falls, Idaho. The personal business flight was operated under the provisions of 14 Code of Federal Regulations Part 91 with no flight plan filed. Visual meteorological conditions prevailed. The private pilot and one passenger were fatally injured and one passenger was seriously injured. The airplane was substantially damaged. The flight was departing IDA with a destination of Jackson Hole Airport (JAC), Jackson, Wyoming. About 1300, the pilot had the airplane refueled at his hangar. In a written statement from a ramp employee, as he was refueling the accident airplane he observed the pilot performing his preflight and walk-around. After the pilot completed the preflight, he began replacing the fuel caps and securing the covers over the fuel caps. The ramp employee did not see the pilot sump the airplane's fuel tanks during the preflight. The ramp employee finished the refueling and returned back to the fixed-base operator (FBO). He further stated that he heard the accident airplane takeoff from runway 17 and then 3 popping sounds. Another witness observed the airplane departing south bound above the tree line and heard several pops. The airplane then banked to the right and collided with terrain about 200 feet from his location. During a conversation with the National Transportation Safety Board (NTSB) investigator-in-charge, the rear seat passenger recalled the departure and flight. He said the accident airplane was 'topped-off' with fuel and the pilot performed a preflight at the owner's hangar. After taxiing to the runway and getting a clearance from air traffic control (ATC), they started their takeoff roll. Just after departing the runway he recalls seeing white and yellow lights from the instrument panel and then the sound of the right engine surging. About 100-200 feet above ground level the pilot said there was a leak on the right wing. The airplane banked sharply to the right and the pilot said to "brace for impact". The airplane collided with terrain west of the departure end of runway 17 and adjacent the main entrance road to IDA. PERSONNEL INFORMATION The pilot, age 64, held a private pilot certificate with an airplane single-engine land, multi-engine land, and instrument airplane rating. A third-class airman medical certificate was issued in February 3, 2010, with limitations stating that he must wear corrective lenses. The pilot reported on his most recent medical certificate application; that he had accumulated 1,850 total and no flight hours in the last 6 months. The pilot's medical was not valid at the time of the accident. AIRCRAFT INFORMATION The four-seat, low-wing, twin-engine, retractable-gear airplane, serial number (S/N) 30-1958, was manufacturedin 1969 by Piper Aircraft and was powered by two Lycoming IO-320-C1A engines, both rated at 160 horsepower. The airplane was also equipped with two Hartzell constant speed propellers. The airplane was maintained under the manufacturer's approved inspection program. Review of the maintenance logbooks revealed an annual inspection was completed on May 11, 2013 at a Hobbs meter reading of 526.0 hours and an airframe total time of 2,711.7 hours. Logbooks also revealed that a 100-hour inspection was completed on both engines on May 10, 2013 and May 11, 2013 with an engine time since major overhaul of 1,032.7 hours each. According to the maintenance documentation, during the last annual inspection, a new fuel tank bladder was installed on the left inboard tank and fuel flow transducers and fuel injectors were installed on both engines. The documentation also reported that several Airworthiness Directives were complied with and one of which was AD 83-10-01, which requires inspection every 50 hours to prevent retention of water and deterioration of the fuel system. The AD requires in part removal of the fuel strainers, and to inspect the screens. On May 20, 2013, avionics work was performed by Intermountain Aerospace in Idaho Falls, Idaho. No flight time was recorded between the last annual and the avionics work. METEOROLOGICAL INFORMATION A review of recorded data from the Idaho Falls International Airport automated weather observation station, located near the accident site, revealed at 1253; wind was from 210 degrees at 14 knots gusting to 22 knots, visibility 10 statute miles, few clouds at 4,300 feet above ground level, temperature 18 degrees Celsius, dew point 4 degrees Celsius, and an altimeter setting of 30.08 inches of Mercury. At 1353; wind was from 220 degrees at 15 knots gusting to 24 knots, visibility 10 statute miles, few clouds at 6,000 feet above ground level, temperature 19 degrees Celsius, dew point 2 degrees Celsius, and an altimeter setting of 30.07 inches of Mercury. Using the reported weather conditions and field elevation, the calculated density altitude was about 6,108 feet. According to the METAR at 1253, the crosswind component for the departure would have been 9 knots from the right. COMMUNICATIONS According to a written statement to the Federal Aviation Administration (FAA), ATC gave the clearance for take-off for runway 17 and the read-back of the clearance was the last transmission made by the accident airplane. The ATC controller stated that after giving the clearance the accident airplane started its departure roll and departed about 3,000 feet down the runway and climbing. She then turned her attention to the inbound traffic, when shortly after she heard "what sounded like an engine revving up". The controller immediately looked for the accident airplane and heard the impact sound and saw a dust cloud rise from the area near the accident site. AIRPORT INFORMATION The Idaho Falls Regional Airport (IDA) is a controlledairport that operates under class D airspace. The reported field elevation for the airport was 4,744 feet mean sea level (msl). The airport is equipped with two asphalt runways (17/35) and (2/20). Runway 17/35 is 4,051 feet in length and 75 feet wide with a 0.2 percent positive gradient. Standard traffic pattern for runway 17 are left turns. The runway surface is asphalt and was in good condition. WRECKAGE AND IMPACT INFORMATION Examination of the accident site revealed that the airplane impacted terrain about 500 feet west of the departure end of runway 17 at an elevation of about 4,750 feet msl. The handheld GPS coordinates for the accident site were recorded as N43 30.7155', W112 03.9069'. The aircraft came to rest with the wings and cabin area inverted. The aft section of the fuselage from the empennage to the rear cabin area was partially separated, crushed and found between the cabin area and the ground. The empennage remained partially attached to the aft fuselage. The cabin area came to rest on a magnetic heading of about 300-degrees. The wreckage debris remained within a 70 foot radius of the main wreckage. The first identified point of contact (FIPC) with terrain was a ground scar and multiple straight impressions of about 6 inches in width and about 50 feet in length. The FIPC contained fragments of painted filler material. Extending from the impressions are 3 deep ground scars about 30 to 50 feet from the FIPC. The first of the ground scars show propeller strikes. The second was a large flat portion of disturbed dirt. The third ground scar shows propeller strikes in the dirt near the left propeller assembly that was half buried in the soil. Further down the impression a small area of disturbed dirt and grass contained painted filler material. The cabin roof and forward fuselage section including the nose cone was about 30 feet further down the debris path. The outboard right wing including the tip tank was next in the debris path near the main wreckage. The right propeller assembly was found near the main wreckage and exhibited chord-wise scratching and buffing near the tips. The blades were bent and had missing material from one. The main wreckage came to rest about 100 feet beyond the FIPC. The engines separated from both wings and remained partially attached by control cables and various wires. The right engine came to rest upright on the ground forward of the right wing. The left engine came to rest on the bottom side of the left wing near the fuselage belly. According to witnesses, smoke and fire was visible from the left engine and was extinguished by use of a dry chemical fire extinguisher. There were no fire suppression activities that included the use of water at any time. WEIGHT AND BALANCE A weight and balance was calculated and the aircraft's CG was within limits. The weight of the airplane was over maximum gross weight by 176.85 lbs. MEDICAL AND PATHOLOGICAL INFORMATION An autopsy was performed on the pilot on June 24,2013, by the Bonneville County Coroner's Office, Idaho Falls, Idaho. The autopsy findings included "severe blunt force trauma," and the report listed the specific injuries. The cause of death was severe blunt force trauma as a result of an aircraft accident. Forensic toxicology was performed on specimens from the pilot by the FAA Bioaeronautical Sciences Research Laboratory, Oklahoma City, Oklahoma. The toxicology report stated no carbon monoxide, ethanol or drugs were detected in the specimens. TESTS AND RESEARCH The examination of the recovered airframe and engines was conducted on June 24, 2013. Fuel samples were obtained from the fuel strainer assemblies and tested positive for water contamination. The fuel strainer assemblies were disassembled and the filter elements, selector valve housing assemblies and both fuel bowl assemblies revealed water contamination, rust and deposits. During the examination of the engines, fuel samples were obtained and were tested positive for water contamination. Visible sediment and rust were observed in several fuel system components on both engines. See the examination report in the public docket for further information. Two fuel samples were sent to the Core Laboratories in Deer Park, Texas for further examination. According to their report the results for both samples are consistent with aviation gasoline (100LL). ADDITIONAL INFORMATION The airplane's single engine performance data could not be calculated utilizing the aircraft performance charts due to the aircraft being operated above the certified gross weight of 3,725 pounds. The airplane was out of operating limitations by 176.85 lbs. ## Aircraft - Registration: [N830SS](https://openairdocs.org/deregistered/N830SS-2018-03-07), registration cancelled 2018-03-07, S/N 30-1958, built 1969 (OpenAirDocs) - Reported make and model: PIPER PA-30 - Registry model: [Piper PA-30](https://openairdocs.org/model/piper-pa-30) (registry code 7103002) (OpenAirDocs) - Registry engine: [Lycoming IO-320 series](https://openairdocs.org/engine/lycoming-io-320-series) (registry code 41509, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 30-1958 - Airframe hours: 2711 - Engines: LYCOMING IO-320 SERIES 160 horsepower reciprocating; LYCOMING IO-320 SERIES 160 horsepower reciprocating - Damage: Substantial damage - Fire: On-Ground - Flight: Personal, Part 91 - Operator: Schell Mark - Registered owner: Schell Mark J DBA - Airworthiness certificate: Standard, Normal - Last inspection: Annual, May 11, 2013 - Departed: IDA, Idaho Falls, ID - Destination: KJAC, Jackson Hole, WY - Airport: KIDA, Idaho Falls Regional Airport, runway 17, 4,051 × 75 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 64; injuries: fatal; private; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 3, with waivers/limitations; seat: left; toxicology performed; flight hours: 1,271 total, 1,097 as pilot in command ## Weather - Conditions: Visual (VMC), Day - Wind: 210° at 14 knots, gusting 22 - Visibility: 10 statute miles - Lowest ceiling: 9,500 ft broken - Temperature: 64 °F, dew point 39 °F - Altimeter: 30.07 inHg - Observed at: KIDA ## 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 20130622010619A](https://openairdocs.org/incident/20130622010619A), Jun 22, 2013: Piper PA-30, Idaho Falls, ID, Destroyed, 2 fatal. On June 22, 2013 at 1340 MDT aircraft N830SS was involved in an accident, at Idaho Falls Regional Airport (ida). The aircraft was full of fuel. The souls… ## Docket (14 files) The files NTSB released with the investigation on August 14, 2014, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=87270. 8.1 MB in all. - Materials Laboratory 15 - Factual Report 13-078 (item 1, .PDF, 89 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40402914&FileExtension=.PDF&FileName=Materials%20Laboratory%2015%20-%20Factual%20Report%2013-078-Master.PDF - Witness Statement - Ker (item 2, .PDF, 735 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415102&FileExtension=.PDF&FileName=Witness%20Statement%20-%20Ker-Master.PDF - Record of Conversation - Jacob Hymas (item 3, .PDF, 48 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415103&FileExtension=.PDF&FileName=Record%20of%20Conversation%20-%20Jacob%20Hymas-Master.PDF - Record of Conversation - Shawn Poulos (item 4, .PDF, 118 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415104&FileExtension=.PDF&FileName=Record%20of%20Conversation%20-%20Shawn%20Poulos-Master.PDF - Calculated Weight and Balance-Piper (item 5, .PDF, 44 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415105&FileExtension=.PDF&FileName=Calculated%20Weight%20and%20Balance-Piper-Master.PDF - Maintenance Order Form - Last Annual (item 6, .PDF, 1.9 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415106&FileExtension=.PDF&FileName=Maintenance%20Order%20Form%20-%20Last%20Annual-Master.PDF - ATC Statement (item 7, .PDF, 1.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415107&FileExtension=.PDF&FileName=ATC%20Statement-Master.PDF - Ramp Employee-Statement and Service Order (item 8, .PDF, 1.5 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415108&FileExtension=.PDF&FileName=Ramp%20Employee-Statement%20and%20Service%20Order-Master.PDF - Statement of Party Representatives to NTSB Investigation - Lycoming Engines (item 9, .PDF, 137 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415109&FileExtension=.PDF&FileName=Statement%20of%20Party%20Representatives%20to%20NTSB%20Investigation%20-%20Lycoming%20Engines-Master.PDF - Statement of Party Representatives to NTSB Investigation - Piper Aircraft (item 10, .PDF, 108 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415110&FileExtension=.PDF&FileName=Statement%20of%20Party%20Representatives%20to%20NTSB%20Investigation%20-%20Piper%20Aircraft-Master.PDF - Release of Aircraft Wreckage, NTSB Form 6120.15 (item 11, .PDF, 57 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415111&FileExtension=.PDF&FileName=Release%20of%20Aircraft%20Wreckage,%20NTSB%20Form%206120.15-Master.PDF - Toxicological Report (item 12, .PDF, 60 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415112&FileExtension=.PDF&FileName=Toxicological%20Report-Master.PDF - Photo 1. Onsite Photo (looking North) (item 13, .PDF, 1.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415114&FileExtension=.PDF&FileName=Photo%201.%20Onsite%20Photo%20(looking%20North)-Master.PDF - Photo 2. Onsite Photo (looking West) (item 14, .PDF, 1.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40415113&FileExtension=.PDF&FileName=Photo%202.%20Onsite%20Photo%20(looking%20West)-Master.PDF 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.