WPR18LA271

NTSB accident investigation · Cessna TU206 · Brenham, TX · September 20, 2018

Accident · No injuriesClass 3 · LimitedFinal report
Date
September 20, 2018, 15:22 local (20:22 UTC)
Place
Brenham, TX
Injuries
2 uninjured
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N756NNCessna TU206
Defining event
Approach: Fuel starvation
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
Federal Aviation FSDO
FAA report
20180920013939A
Case key
98331

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

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Probable cause

The pilot's improper fuel management during the landing approach, which resulted in a total loss of engine power due to fuel starvation. Contributing to the accident was his failure to follow the published emergency procedures after the loss of engine power.

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.

Fluids: fuelAircraft › Fluids/misc hardware · Fluid managementCessna TU206G: 2 casesAll aircraft: 1,695 casesProbable cause
Use of equip/info: use of checklistPersonnel issues › Task performance · PilotCessna TU206G: 2 casesAll aircraft: 336 casesProbable cause
Action: incomplete actionPersonnel issues › Action/decision · PilotCessna TU206G: 1 caseAll aircraft: 105 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

After completing a photographic mission, the pilot determined that there was adequate fuel remaining to reach his intended destination with a 45-minute reserve. During the landing approach, the engine began to lose power and the pilot switched from the left to right fuel tank, which the fuel gauges indicated had more fuel remaining; however, the engine did not respond, and shortly thereafter, the engine lost total power. The airplane impacted trees and a fence during the subsequent forced landing short of the runway. Enough fuel for about one hour of flight was drained from the right main fuel tank after the accident, but both the tip tanks and the left main tank were empty. Examination did not reveal any pre-impact anomalies with the airframe or engine that would have precluded normal operation. The pilot reported that he switched fuel tanks every hour during the flight but had failed to select the fuller tank during the landing approach as required by the manufacturer's Pilot's Operating Handbook (POH). Allowing a tank to run dry was allowable per the POH, but it required the engagement of the auxiliary fuel pump after the other tank was selected. Likewise, the emergency procedures for an engine failure in flight required the use of the auxiliary fuel pump. The pilot had correctly planned for the airplane’s fuel consumption but failed to select the fullest tank during the critical landing phase, which resulted in the loss of engine power due to fuel starvation. The pilot stated that due to the airplane’s low altitude at the time of the loss of power, he did not have time to perform any items on the emergency checklist, and as such, did not turn on the fuel pump; however, the checklist was short and of sufficient significance that it should have been automatic to the pilot. Engagement of the fuel pump would likely have restarted the engine.

Factual narrative

On September 20, 2018, about 1522 central daylight time, a Cessna TU206G, N756NN, was substantially damaged when it was involved in an accident near Brenham, Texas. The airline transport pilot and passenger were not injured. The airplane was operated by The United States Department of Agriculture as a public flight. After completing a series of photographic assignments in Central and North Texas, the pilot determined there was adequate fuel remaining to reach the destination airport with a 45-minute reserve. After circumnavigating rain showers, he began the landing approach. About 5 miles from the airport, the engine began to lose power. The pilot noticed that the left fuel tank gauge indicated a lower quantity than the right, so he switched the fuel selector valve from the left to right tank; however, the engine did not respond, and shortly thereafter, the engine lost total power. The pilot reported that due to the airplane's low altitude, he did not perform any items on the emergency checklist, but instead focused his attention on executing a forced landing. The airplane impacted a tree just before touchdown and impacted a fence during the landing roll. The airplane was equipped with long-range fuel tanks as well as tip tanks, which contained a usable fuel quantity of 76 and 27 gallons, respectively. Fuel from the tip tanks was transferred to the main tanks when needed using a transfer pump. The airplane was equipped with the standard factory main fuel tank gauges, along with a CGR-30P electronic engine monitor manufactured by Electronics International. The unit had a fuel totalizing feature and was capable of displaying and recording fuel consumption and engine parameters, including cylinder and exhaust gas temperatures, fuel flow and pressure, and fuel remaining. The pilot reported that, before departure, he filled the airplane to capacity, and the recovered data indicated that he correctly set the fuel quantity in the totalizer to 103 gallons upon system startup. The engine operated continuously for 4 hours and 54 minutes, during which the average fuel flow was about 18.5 gallons per hour (gph), fuel pressure was 10 lbs per square inch (psi), and the engine speed was about 2,450 rpm. All engine parameters remained stable throughout the flight and appeared consistent with the airplane’s performance specifications documented in the manufacturer's Pilot's Operating Handbook (POH). The CGR-30P's calculated fuel remaining quantity decreased in a linear manner throughout, and 4 hours and 51 minutes after engine start, the quantity remaining reached 17.8 gallons. Over the final 3 minutes of the flight, the engine speed dropped to 1,510 rpm, and fuel flow and pressure decreased to 1.6 gph and 1.4 psi, respectively. Although the left wing sustained impact damage, none of the airplane's four fuel tanks were breached. Aircraft recovery personnel drained about 18 gallons of fuel from the right main fuel tank and reported that both the tip tanks and theleft main tank were empty. The airplane was examined by a mechanic under the supervision of a Federal Aviation Administration inspector. The examination did not reveal any pre-impact airframe or engine anomalies that would have precluded normal operation. The pilot reported that he switched fuel tanks every hour and planned an average fuel consumption of 18 gallons per hour. He reported that he had allowed a fuel tank in the accident airplane to run dry in the past, but the engine had always restarted after he switched tanks. The emergency procedures section of the POH provided the following guidance for an engine failure in flight: (1) Airspeed - 75 KIAS. (2) Fuel Selector Valve and Quantity - CHECK. (3) Mixture - RICH. (4) Auxiliary Fuel Pump - ON for 3-5 seconds with throttle 1/2 open; then OFF. (5) Ignition Switch - BOTH (or START if propeller is stopped). (6) Throttle - ADVANCE slowly. The POH permitted the exhaustion of a fuel tank in flight but required that the auxiliary fuel pump be engaged for a short period after the fullest tank had been selected. The POH also suggested that the pump be run briefly before exhausting the tank, to confirm its operation. The first item in the before landing checklist stated, "Fuel Selector Valve – FULLER TANK".

Aircraft

Registration
N756NN
Reported as
Cessna TU206 (G)
Category
Airplane
Serial number
U20604225
Built
1977
Airframe hours
4,242.7
Engine
Continental TSIO-520, 310 horsepower, reciprocating
Damage
Substantial damage
Flight
Public aircraft - federal · Public use
Operator
US Department of Agriculture
Registered owner
US Department of Agriculture
Airworthiness certificate
Standard, Normal
Last inspection
Annual · June 1, 2018 · 71 hours before
Departed
SJT · San Angelo, TX
Destination
11R · Brenham, TX
Airport
11R · Brenham Muni, runway 16, 6,003 × 75 ft, asphalt
Equipment
Data recorder, Auto-pilot, ADS-B, Stall warning system, Electronic flight bag or handheld device

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
65
Injuries
None
Certificates
Commercial, Airline transport, Flight engineer
Airplane ratings
Multi-engine land, Single-engine sea, Single-engine land
Instrument ratings
Airplane
Medical
Class 2, Waiver time limited special
Last flight review
June 29, 2018
Seat
Left
Restraint
3-point
Flight hours
7,152 total · 2,000 in this make and model · 6,856 as pilot in command · 56 in the last 90 days · 31 in the last 30 days · 10 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
100° at 3 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
77 °F, dew point 75 °F
Altimeter
29.94 inHg
Observed at
K11R, 6 nm away

Docket · 5

The files NTSB released with the investigation on June 8, 2021, on NTSB’s docket system: statements, records, photos and specialists’ reports. 26.0 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.