WPR21LA151

NTSB accident investigation · Piper PA-28-140 · Yacolt, WA · March 29, 2021

Accident · Minor injuriesClass 3 · LimitedFinal report
Date
March 29, 2021, 15:47 local (22:47 UTC)
Place
Yacolt, WA
Injuries
2 minor
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N665FLPiper PA-28-140
Defining event
Enroute-cruise: Loss of engine power (partial)
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
FAA
FAA report
20210329004679A
Case key
102838

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

A partial loss of power caused by carbon build up in the cylinders, which prevented the exhaust valves from seating properly. Contributing to the accident was flying in moderate icing conditions which resulted in reduced aircraft performance and vibrations.

Findings · 2

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.

Engine (reciprocating): recip eng cyl sectionAircraft › Aircraft power plant · Damaged/degradedPiper PA-28-140: 6 casesAll aircraft: 373 casesProbable cause
Temp/humidity/pressure: conducive to structural icingEnvironmental issues › Conditions/weather/phenomena · Effect on equipmentPiper PA-28-140: 1 caseAll aircraft: 103 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 airplane was the subject of a Federal Aviation Administration Alert Notification (ALNOT) when the pilot reported a rough running engine and then radio contact was lost with the airplane. A few hours later, the airplane’s wreckage was located by Navy search and rescue in heavily forested terrain. The pilot reported that while in cruise flight at 8,000 ft mean sea level (msl), and in instrument meteorological conditions (IMC), he felt a vibration in the airplane and thought it was from airframe icing, however he soon realized that the engine was running rough. He applied carburetor heat and requested a lower altitude. However, the engine seemed to run worse and lose power, so the pilot requested vectors to the nearest airport. While being vectored and after exiting IMC, he elected to make a forced landing in a nearby clearing. While the pilot reported no airframe icing, a review of weather conditions in the area and a sounding model performed over the accident site revealed that the freezing level was about 3,227 ft mean sea level (msl) and supported broken to overcast clouds from about 3,000 ft to 8,000 ft msl and icing in the clouds. Additionally, AIRMET Zulu was current over the area for occasional moderate icing conditions from the freezing level, estimated at 3,000 ft, to 12,000 ft msl. It is likely that airplane experienced moderate icing conditions that contributed to the decrease in the airplane’s performance and some of the vibrations felt by the pilot. Postaccident examination of the engine revealed that during manual rotation, thumb compression was not obtained on the Nos. 1 and 3 cylinders. Borescope examination of the cylinder’s interior revealed carbon deposits lodged in the area where the exhaust valve seats, preventing proper sealing.

Factual narrative

On March 29, 2021, about 1547 Pacific daylight time, a Piper PA-28-140 airplane, N665FL, was substantially damaged when it was involved in an accident near Yacolt, Washington. The pilot and pilot rated passenger sustained minor injuries. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The airplane was the subject of a Federal Aviation Administration Alert Notification (ALNOT) when the pilot reported a rough running engine and then radio contact was lost with the airplane. A few hours later, the airplane’s wreckage was located by Navy search and rescue in heavily forested terrain about 5 miles east of Yacolt, Washington. The pilot reported that while at cruise altitude about 8,000 ft mean sea level, and in instrument meteorological conditions (IMC), he felt a vibration in the airplane and initially thought that it was airframe icing. There was none and realized that the engine started to run rough. He applied carburetor heat and requested a lower altitude. However, the engine seemed to run worse and lose power, so the pilot requested vectors to the nearest airport. While being vectored and after exiting IMC, he elected to make a forced landing in a nearby clearing. The airplane impacted several trees and was substantially damaged during the landing. A review of the weather conditions in the area by a National Transportation Safety Board (NSTB) senior meteorologist revealed that a low-pressure trough extended from northern Idaho and across Washington around the time of the accident. The accident site was located ahead of the trough in an area of westerly winds and overcast cloud cover. An area of continuous snow was depicted north of the accident site near Tacoma, Washington. A sounding model run over the accident site revealed that the freezing level was about 3,227 ft mean sea level (msl) with broken to overcast clouds from about 3,000 ft to 8,000 ft msl and icing in the clouds. Additionally, AIRMET Zulu was current over the area for occasional moderate icing conditions from the freezing level, estimated at 3,000 ft, to 12,000 ft msl. Two jet aircraft reported and confirmed the moderate icing below 8,000 ft. Flying in moderate icing conditions would decrease the airplane’s performance and additionally potentially cause vibrations. Postaccident examination of the engine revealed that during manual rotation, thumb compression was not obtained on the Nos. 1 and 3 cylinders. Additionally, leaking air was heard from the exhaust piping. A compression check revealed that the No. 1 cylinder was 5 psi, and the No. 3 cylinder was 0 psi. Borescope examination of the cylinder’s interior revealed that the No. 3 cylinder exhibited scoring on the walls and had carbon deposits lodged in the area where the exhaust valve seats. Examination of the other cylinders revealed a similar built up of carbon deposits, except that the No. 2 cylinder had substantially less build up than the other two. No other anomalies wereobserved that would have precluded normal operation. The pilot reported that the last annual inspection was accomplished about 6 months before the accident and the airplane had accumulated 25 hours since that inspection. The engine had accumulated about 1,929 hours since overhaul.

Aircraft

Registration
N665FL
Reported as
Piper PA-28-140
Category
Airplane
Serial number
28-7125587
Built
1971
Airframe hours
3,842
Engine
Lycoming O-360-A1A, 180 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Operator
Treetop Flyers LLC
Registered owner
Treetop Flyers LLC
Airworthiness certificate
Standard, Normal
Last inspection
Annual · September 2, 2020
Departed
BDN · Bend, OR
Destination
TIW · Tacoma, WA
Flight plan
IFR
Equipment
Stall warning system, Electronic flight bag or handheld device, ADS-B

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
Pilot
Age
75
Injuries
Minor
Certificates
Commercial, Flight instructor, Airline transport, Flight engineer
Airplane ratings
Multi-engine land, Single-engine land, Single-engine sea
Instrument ratings
Airplane
Medical
Class 3, With waivers/limitations
Last flight review
March 20, 2020
Seat
Left
Restraint
3-point
Flight hours
19,427 total · 498 in this make and model · 13,831 as pilot in command · 11 in the last 90 days · 7 in the last 30 days · 4 in the last 24 hours
Role
Pilot-rated passenger
Injuries
Minor
Certificate
Private
Airplane ratings
Single-engine land
Seat
Right

Weather

Conditions
Visual (VMC) · Day
Wind
350° at 3 knots
Visibility
10 statute miles
Lowest ceiling
3,500 ft broken
Temperature
57 °F, dew point 45 °F
Altimeter
30.09 inHg
Observed at
KPDX, 21 nm away
METAR
METAR KPDX 292253Z 35003KT 10SM BKN035 14/07 A3009 RMK AO2 SLP189 T01440072

Docket · 4

The files NTSB released with the investigation on January 26, 2023, on NTSB’s docket system: statements, records, photos and specialists’ reports. 4.8 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.