Aviation Accident Summaries

Aviation Accident Summary LAX08FA203

Mount Charleston, NV, USA

Aircraft #1

N4063W

PIPER PA-32-300

Analysis

The pilot's initial course after takeoff would have put the airplane passing to the north of a mountain range. As the airplane continued the climb, the pilot changed course towards the mountainous terrain. The air traffic controller asked the pilot if he would be flying southwest of the mountain range, to which the pilot replied in the affirmative. The air traffic controller then terminated radar services. The airplane then made two heading changes and continued to fly into a mountain valley area. Witnesses located about 6 miles further into the valley observed the airplane flying at altitudes of 300 feet above ground level and below, and towards rising terrain. Witnesses additionally reported hearing steady engine noise consistent with high rpm. The airplane then collided with a tree and rising terrain at the base of a box canyon. The accident site was located at 7,660 feet, on a 10-degree uphill sloping valley floor. The accident site was about 6 miles west, and 860 feet above the final radar return, and 26 miles west, and 5,455 feet above the departure airport. Steep sloping canyon walls with elevations ranging between 10,000 and 11,918 feet surrounded the site immediately to the north, west, and south. From the accident site's elevation, the peak of the canyon's rim rose in excess of the airplane's climb performance capability. The calculated density altitude at the accident elevation was about 11,000 feet. The service ceiling for the airplane at a maximum gross weight was 16,250 feet. Within the valley area, about 4 miles west of the last radar return, a course reversal turn would have been possible using a bank angle of about 30 degrees. At the accident location, there was insufficient clearance from terrain to perform a course reversal. Investigators found no evidence of preimpact mechanical malfunctions or failures during the examination.

Factual Information

HISTORY OF FLIGHT On June 28, 2008, about 1450 Pacific daylight time, a Piper PA-32-300, N4063W, collided with mountainous terrain in Mount Charleston, Nevada. The pilot operated the airplane under the provisions of 14 Code of Federal Regulations Part 91. The certificated private pilot and three passengers were killed. The airplane was destroyed by post impact fire. The personal flight departed North Las Vegas Airport (VGT), Las Vegas, Nevada, at 1432, with a planned destination of Byron Airport (C83), Byron, California. Visual meteorological conditions prevailed, and no flight plan had been filed. Radar data provided by the Federal Aviation Administration (FAA) revealed that the airplane departed North Las Vegas at 1432, having been assigned a discreet transponder code of 7356. Review of voice communications provided by the United States Air Force (USAF), Nellis Air Traffic Control Facility, revealed that at 1434:40 the pilot established communications with Nellis Departure. The airplane was on a northwest course at a Mode C transponder altitude of 3,700 feet msl. The pilot reported his destination as, "Charlie 83 via Oscar 42." The controller replied, requesting a heading and altitude. The pilot responded, "Our heading will be two six one and that will be twelve thousand five hundred[feet]." Over the next 3 1/2 minutes the airplane climbed to an altitude of 5,000 feet on a course of about 305 degrees magnetic. The pilot then made the request to change heading to 230 degrees. The controller responded, "Roger, verify you are going to be heading southwest of the mountain range sir," to which the pilot replied, "Roger that." The airplane then began a climbing left to turn to about 240 degrees. For the following 3 1/2 minutes the airplane continued on that course, on a route adjacent to Kyle Canyon Road. At 1342, the controller stated, "Radar service terminated, squawk and maintain VFR, frequency change approved." To which the pilot replied, "changing to VFR, is there another frequency we can change to when we get out of this ridge?" The controller then provided a frequency to the pilot. Thereafter, radar data revealed that the discreet transponder code of 7356 terminated and the airplane then switched to a transponder code of 1200. Over the course of the next 2 1/2 minutes the airplane continued climbing and began a 20 degrees left turn, followed by a right turn to a heading of about 290 degrees. The last radar return was at an altitude of 6,800 feet, 20 miles west of North Las Vegas. A witness, who was a United States Forest Service employee, was located in his residence within the Mount Charleston valley area at the time of the accident. His residence was at an elevation of about 7,550 feet on the north facing slope of Griffith Peak, about 1 mile southeast of the accident site. He reported observing the airplane pass just below his elevation flying from east to west. He stated that the airplane was flying straight and level, did not appear to be gaining altitude, and that the noise produced by the engine correlated to what he believed was, "full throttle." A second witness located at a vantage point 1/2 mile southeast of the accident location at a 7,750-foot elevation, first observed the airplane flying below her, and just above the Mount Charleston Fire Station. She continued to observe the airplane follow Kyle Canyon Road to the west. The witness noted that the engine was running and that the wings appeared to be rocking. She looked away and heard a popping sound, and then observed a fire erupt in the area of Echo Way. A witness, who was a current USAF pilot, and also held a commercial pilot's certificate, was located at a similar vantage point. He stated that he was initially drawn to the sound of an airplane engine, and that he thought it was strange because he didn't expect to see an airplane flying in the valley. He looked northeast toward the sound and observed at his eye level, a single-engine airplane flying on a westbound heading. He observed the airplane to be flying straight and level, at what he described as a normal speed for the airplane type. He noted the airplane to be flying at approximately 300 feet above ground level, and 2000-feet laterally from his location. He observed no smoke or vapors emitting from the airplane, and reported that the engine sounded, "steady." He followed the airplane for 15 seconds until it passed behind trees and out of his view. About 15 seconds later he heard an explosion and observed fire to the west. Another witness, who held an airframe and powerplant mechanics certificate, stated that he was driving downhill along Echo Way, observing houses to his left. As he followed the road around a bend and to the southeast, he observed the airplane coming towards him from ahead and above. He described the airplane in a slight nose high attitude, which he correlated to a landing approach, with his car being in the position of the projected touchdown point. He observed the airplane's right wing collide with a tree located to the east of Echo Way. The airplane subsequently pitched down and then struck power lines adjacent to the road. The airplane then continued to fly over his car with an accompanying engine sound that he described as, "going full bore." The power lines then dropped to the ground and a power transformer fell in front of his car. He stopped the car, looked behind, and observed the airplane collide with the ground on the south side of Echo Way. The accident site was located at the 7,660-foot level, on the 10-degree uphill sloping valley floor of Kyle Canyon, at the base of Mount Charleston. The location was about 6 miles west of the final radar return, and about 26 miles west of North Las Vegas. Steep sloping canyon walls with elevations ranging between 10,000 and 11,918 feet surrounded the site to the north, west, and south. Mount Charleston is located west of North Las Vegas. Kyle Canyon Road runs in a westerly direction branching from State Highway 95. Kyle Canyon Road ultimately terminates in the Spring Mountain range at the base of Mount Charleston. United States Highway 95 runs from North Las Vegas to Beatty, California, in a northwesterly direction through a 3,000 to 4,000 foot elevation valley between mountain ranges. About 23 miles beyond North Las Vegas, the highway changes heading to the west, and passes north of the mountain range. At this point the highway follows a path that approximately parallels Kyle Canyon Road. Kyle Canyon Road is also paralleled 10 miles to the south by Charleston Boulevard. Charleston Boulevard follows a course towards the southern area of the mountain range, before turning southeast towards Las Vegas. The elevations of mountain peaks 10 miles to the south of the accident site range between 6,000 and 8,500 feet. PERSONNEL INFORMATION Pilot A review of FAA airman records revealed that the 37-year-old pilot held a private pilot certificate for airplane single-engine land, issued September 11, 2006, and a first-class airman medical certificate issued in March 2006, with no limitations. The pilot's logbook was not recovered for inspection. According to the pilot's flight instructor, the pilot had attained about 63 hours of total flight time as of September 2006, in preparation for his private pilot certificate checkride. The instructor stated that in January 2008, the pilot had commented that he was interested in taking a flight review, with emphasis on mountain flying. Family members stated to the National Transportation Safety Board investigator-in-charge (IIC) that twice a week since February 2007, the pilot flew round trip journeys between Byron and Carson City, Nevada, utilizing the accident airplane. Family members further noted that this was the first time the pilot had flown to the Las Vegas area; additionally this was the first time the passengers had all flown together with the pilot as a group. Student Pilot Rated Passenger The 36-year-old student pilot rated passenger held a combined student pilot and aviation medical certificate issued May 1994. He additionally held a mechanic's certificate with ratings for airplane and powerplant. AIRCRAFT INFORMATION The six-seat, low-wing, fixed-gear airplane, serial number 32-40095, was manufactured in 1966. It was powered by a normally aspirated Textron Lycoming IO-540-K1A5 300-hp engine, serial number L-4731-48, and equipped with a Hartzell constant-speed propeller. The airplane was not equipped with a turbocharger. Charred remnants of the maintenance logbooks were recovered in the airplane wreckage. Sections referring to the recent maintenance history were fire damaged. The Safety Board IIC obtained a work order from the maintenance facility that performed the last annual inspection on the airplane. The records indicated that an annual inspection and maintenance was performed on November 9, 2007, at a recorded tachometer time of 3,807.11 hours. The Safety Board IIC interviewed a mechanic at the maintenance facility that had performed work on the airplane on June 6, 2008. The mechanic provided a logbook entry for the maintenance performed. The entry stated that at a tachometer time of 3,815.78 hours, two engine cylinders were replaced, and routine maintenance was performed. In addition the propeller was removed, repaired, and then balanced. The mechanic stated that the repair work was performed in order to fix surface damage to the propeller. The tachometer and the hour-meter were observed at the accident site, and were fire damaged. Fueling records from North Las Vegas Air Terminal established that the airplane was last fueled at 1355 on the day of the accident, with the addition of 43.3 gallons of 100-octane aviation fuel. The fuel receipt noted that both inboard fuel tanks were "topped off," and each wing tip tank was serviced with the addition of 10 gallons of fuel. Performance The Safety Board IIC calculated a density altitude at the accident of about 11,000 feet at 7,660 feet msl. The performance data was calculated using information from the Piper PA-32-300 Owners Handbook for airplane serial numbers 32-40001 through 32-40545, which was applicable to the accident airplane. For the purpose of the calculations, the Safety Board IIC utilized an estimated gross weight at the time of the accident of 3,192 pounds, which was derived by the assumption of 504 pounds of fuel on board, and a combined total weight of pilot, passengers, and baggage of 888 pounds; the airplane's empty weight was about 1,800 pounds. Using a standard lapse rate of 2 degrees Celsius per 1,000 feet and the temperature for North Las Vegas, the calculated temperature at the accident site was about 29 degrees Celsius. Performance charts indicated that at a best rate of climb speed of 105 mph, the rate of climb at 2,205 feet msl would have been 750 feet per minute (fpm). The rate of climb at the accident elevation would have been 390 fpm. From the accident site's elevation, the peak of the canyon's rim rose about 4,300 feet over a distance of 2.1 miles along the airplane's impact heading. The accident site was located 26 miles from North Las Vegas Airport; the airplane departed North Las Vegas approximately 18 minutes prior to the accident. The service ceiling for the airplane at a maximum gross weight of 3,400 pounds was 16,250 feet. The Safety Board IIC calculated turning performance using the measured widths of the canyon and referencing Aerodynamics for Naval Aviators (NAVWEPS 00-80T-80), Figure 2.29, General Turning Performance (Constant Altitude, Steady Turn). When measured using a topological mapping program, the canyon width at a location 4 miles west of the last radar return, was about 3,000 feet when measured at an elevation of the 7,200 feet. The canyon width progressively decreased as the terrain rose to the west. The terrain immediately surrounding the accident site measured an approximate width of 100 feet. At a bank angle of 30 degrees, and an airspeed of 105mph, the turn radius would have equated to about 1,500 feet. METEOROLOGICAL INFORMATION The closest aviation weather observation station was located at North Las Vegas Airport. The elevation of the weather observation station was 2,205 feet msl. An aviation routine weather report was issued at 1453. It stated: winds from 110 degrees at 11 knots, gusting to 18 knots; visibility 10 statute miles; skies clear; temperature 39 degrees Celsius; dew point 1 degrees Celsius; altimeter 29.93 inches of Mercury. The FAA reported that there was no record of a pilot preflight weather briefing. WRECKAGE AND IMPACT INFORMATION The Safety Board IIC and representatives from the FAA, Piper Aircraft, and Textron Lycoming inspected the wreckage at the accident site. The first identified point of impact was located on the trunk of a 50-foot tree, 40 feet above ground level on the east side of Echo Way. Three utility power cables that paralleled Echo Way were observed to pass within 4 feet laterally of the impact point. Utility officials stated that these power lines were separated from their associated polls and reattached following the accident. The outboard section of the right wing and aileron were located at the base of the tree. The leading edge of the wing section was observed crushed 24 inches inboard of the wing tip. The crush was 18 inches deep, with a diameter consistent with that of the tree trunk at the impact point. The debris field continued across Echo Way on a heading of 275 degrees magnetic to the main accident site, located 450 feet from the first impact point. Several pieces of angularly cut wood were scattered along the wreckage path. Airframe The main wreckage consisted of the fuselage, vertical stabilizer and rudder, horizontal stabilator, and engine. Post impact fire consumed the entire fuselage structure, both wings, and the stabilator. The orientation of the fuselage was 240 degrees. The engine was aligned with the cabin and was observed in the inverted attitude. The fire damaged fuel selector valve was observed to be set at the left tip tank position. The flap handle was noted in the second detent position, which according to the Piper representative, corresponded to 25 degrees of flap extension. Propeller The propeller was attached to the crankshaft, and both blades exhibited chordwise abrasions, torsional s-bending, and leading edge gouges. The tip of one blade, measuring 2 inches in length, had separated in a jagged s-pattern and was located in the debris field. Engine The engine was damaged by fire. Cracks were observed in the engine crankcase, aft of the forward two cylinders. The top spark plugs were removed; the spark plug electrodes from cylinder number two, four, and six were gray, which corresponded to normal operation according to the Champion Aviation Check-A-Plug AV-27 Chart. The spark plugs from cylinders one, three, and five were observed oil-soaked. According to the engine manufacturer's representative, an inspection of the combustion chambers with a lighted borescope revealed no mechanical deformation of the valves, cylinder walls, or cylinder heads, and no evidence of foreign object ingestion was noted. The rocker box covers were removed and oil was observed in the valve areas. Investigators removed the propeller and manually rotated the crankshaft via the hub. The crankshaft rotated, and the valve stems were noted to each move approximately the same amount of lift. Valve train continuity was confirmed through to the accessory case, and thumb compression was obtained on all six cylinders. Both magnetos were thermally destroyed. Investigators removed both the engine, and propeller governor oil screens, and noted that they were clear and free of debris. The fuel injector servo was fractured at its mounting flanges and separated from the intake manifold; the mixture, throttle and propeller governor control linkages were observed attached to their respective control arms. The fuel screen was inspected and no particulate obstructions were found. Investigators found no evidence of preimpact mechanical malfunctions or failures during the examination. MEDICAL AND PATHOLOGICAL INFORMATION Autopsies were conducted by the Clark County N

Probable Cause and Findings

The pilot's failure to maintain clearance from mountainous terrain and his selection of a cruise altitude that provided inadequate terrain clearance. Contributing to the accident were the high density altitude and the rapidly rising terrain.

 

Source: NTSB Aviation Accident Database

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