WPR18CA172

NTSB accident investigation · Dornier Alpha JET · Sacramento, CA · June 14, 2018

Accident · No injuriesData collectionFinal report
Date
June 14, 2018, 11:38 local (18:38 UTC)
Place
Sacramento, CA
Injuries
2 uninjured
Damage
Substantial damage
Phase of flight
Landing
Aircraft
N2165Dornier Alpha JET
Defining event
Landing: Landing gear not configured
Weather
Visual (VMC) · Day
Status
Completed · report April 8, 2019
Report
Approved by Office Director
NTSB office
Western Pacific Region
Parties
Federal Aviation Administration
FAA report
20180614015489A
Case key
97502

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

The pilot’s failure to extend the landing gear before landing. Contributing to the accident was the pilot’s and the flight instructor’s failure to adequately monitor the workload.

Findings · 6

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.

Action: forgotten action/omissionPersonnel issues › Action/decision · Student/instructed pilotDornier ALPHA-JET: 2 casesAll aircraft: 440 casesProbable cause
Use of equip/info: use of equip/systemPersonnel issues › Task performance · PilotDornier ALPHA-JET: 1 caseAll aircraft: 1,391 casesProbable cause
Attention/monitoring: task monitoring/vigilancePersonnel issues › Psychological · Instructor/check pilotDornier ALPHA-JET: 2 casesAll aircraft: 330 casesProbable cause
Air traffic/operating proc: traffic pattern procedureEnvironmental issues › Operating environment · Effect on personnelDornier ALPHA-JET: 1 caseAll aircraft: 7 cases

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 pilot-under-instruction planned a visual, simulated no-flap approach and landing during an instructional flight in a twin-engine advanced jet trainer. Audio data provided by the Federal Aviation Administration indicated that the pilot requested a left closed traffic, simulated no-flap pattern and stated that he needed to go out about 4 miles upwind. By the time the air traffic tower controller responded, the pilot had already started the crosswind turn; therefore, the controller cleared him to the overhead pattern, left closed traffic. Subsequently, the controller initially instructed the pilot to make the base turn when able but then instructed him to turn immediately to be sequenced in front of slower traffic on a 5-mile final approach. The controller stated that he would give the pilot the 4 miles he requested on the next pattern. The pilot accepted the turn clearance and reported to the controller that he was turning. A review of radar data indicated that, during the final turn, the airplane overshot the final approach by over 1,800 ft to the northwest. Subsequently, the airplane landed on its belly and sustained substantial damage to the bottom of the fuselage. A postlanding fire ensued. The filed company report stated that flying a no-flap approach and landing required maintaining a higher airspeed during the final turn, and when established on final approach, the airspeed had to be quickly bled off. The higher approach speed, difficulty of maintaining airspeed, and the early turn to final increased the pilot's workload during the simulated no-flap pattern. While on final approach, the pilot extended the air brakes, which are typically extended just before lowering the landing gear but failed to extend the landing gear. The flight instructor failed to notice the omission, which resulted in a gear-up landing. The pilots reported no preimpact mechanical malfunctions or failures with the airplane that would have precluded normal operation.

Factual narrative

During an instructional flight, in a twin-engine advanced jet trainer, a visual, simulated no-flap approach and landing was planned. Audio data provided by the Federal Aviation Administration (FAA) indicated that the pilot requested a left closed traffic, simulated no-flap pattern, and stated that he needed to go out about 4-miles on upwind. By the time the controller in the Air Traffic Control Tower (ATCT) responded, the pilot had already started the crosswind turn and therefore the controller cleared him to the overhead pattern, left closed traffic. Subsequently, the controller initially instructed the pilot to make the base turn when able, but then instructed him to turn now, in order to be sequenced in front of slower traffic, on a 5-mile final approach. The controller further stated to the pilot that they would get him the 4-miles on the next pattern. The pilot accepted the turn clearance and reported back to the controller that he was in a turn. A review of radar data indicated that during the final turn, the airplane overshot the final approach by over 1,800 ft to the northwest. The filed company report further stated that flying a no-flap approach and landing required maintaining a higher airspeed during the final turn and when established on final approach, the airplane's airspeed had to be quickly bled off. The higher approach speed, difficulty of maintaining airspeed, combined with the early turn to final, increased the pilot's workload during the simulated no-flap pattern. While on final approach, the pilot extended the air brakes, which are typically extended just prior to lowering the landing gear, but inadvertently failed to extend the landing gear. The flight instructor failed to notice the omission. Subsequently, the airplane landed on its belly and sustained substantial damage to the bottom of the fuselage. A post landing fire ensued. The pilots reported no preimpact mechanical malfunctions or failures with the airplane that would have precluded normal operation.

Aircraft

Registration
N2165
Reported as
Dornier Alpha JET (No Series)
Category
Airplane
Serial number
0165
Built
1982
Airframe hours
2,912.5
Engines
Snecma Larzac 04-C6, 2,870 lbs thrust, turbo fanSnecma Larzac 04-C6, 2,870 lbs thrust, turbo fan
Damage
Substantial damage
Fire
On-Ground
Flight
Instructional · Part 91
Operator
Blue City Holding LLC
Registered owner
H211 LLC
Airworthiness certificate
Special, Experimental (Special)
Last inspection
Condition · October 30, 2017
Departed
NUQ · Mountain View, CA
Destination
MHR · Sacramento, CA
Airport
MHR · Sacramento Mather, runway 22L, 11,301 × 150 ft, asphalt
Equipment
Auto-pilot, Angle of attack indicator, Video recording device, Stall warning system, Electronic multifunction display, Onboard weather, Handheld GPS, Electronic primary flight display

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 · 2

As NTSB recorded them. NTSB leaves out names.

Role
Flight instructor
Age
49
Injuries
None
Certificates
Flight instructor, Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
February 5, 2018
Seat
Rear
Restraint
5-point
Flight hours
9,138 total · 136 in this make and model · 9 in the last 90 days · 2 in the last 30 days · 1 in the last 24 hours
Role
Pilot
Age
47
Injuries
None
Certificate
Airline transport
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
May 14, 2018
Seat
Front
Restraint
5-point
Flight hours
7,900 total · 154 in the last 90 days · 27 in the last 30 days · 0 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
230° at 8 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
79 °F, dew point 52 °F
Altimeter
29.76 inHg
Observed at
MHR

Docket · 4

The files NTSB released with the investigation on February 12, 2019, on NTSB’s docket system: statements, records, photos and specialists’ reports. 2.7 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.