Uncontained engine failure, Boeing B, July 29, 1999

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Transcription:

Uncontained engine failure, Boeing 747-269B, July 29, 999 Micro-summary: This Boeing 747-269B experienced an uncontained engine failure on climb. Event Date: 999-7-29 at ADT Investigative Body: (NTSB), USA Investigative Body's Web Site: http://www.ntsb.gov/ Cautions:. Accident reports can be and sometimes are revised. Be sure to consult the investigative agency for the latest version before basing anything significant on content (e.g., thesis, research, etc). 2. Readers are advised that each report is a glimpse of events at specific points in time. While broad themes permeate the causal events leading up to crashes, and we can learn from those, the specific regulatory and technological environments can and do change. Your company's flight operations manual is the final authority as to the safe operation of your aircraft! 3. Reports may or may not represent reality. Many many non-scientific factors go into an investigation, including the magnitude of the event, the experience of the investigator, the political climate, relationship with the regulatory authority, technological and recovery capabilities, etc. It is recommended that the reader review all reports analytically. Even a "bad" report can be a very useful launching point for learning. 4. Contact us before reproducing or redistributing a report from this anthology. Individual countries have very differing views on copyright! We can advise you on the steps to follow. Aircraft Accident Reports on DVD, Copyright 26 by Flight Simulation Systems, LLC All rights reserved. www.fss.aero

NTSB ID: ANC99LA99 Aircraft Registration Number: N77CK Occurrence Date: Occurrence Type: 7/29/999 Accident Most Critical Injury: Investigated By: NTSB Location/Time Nearest City/Place ANCHORAGE Zip Code Local Time Time Zone AK 992 ADT Airport Proximity: Off Airport/Airstrip Aircraft Information Summary Aircraft Manufacturer Boeing Distance From Landing Facility: Model/Series 747-269B Direction From Airport: Type of Aircraft Sightseeing Flight: No Narrative Brief narrative statement of facts, conditions and circumstances pertinent to the accident/incident: Air Medical Transport Flight: On July 29, 999, about Alaska daylight time, a Boeing 747-269B airplane, N77CK, had an uncontained engine failure during climb-out from the Anchorage International Airport, Anchorage, Alaska. The flight was being conducted under Title 4, CFR Part 2, as a nonscheduled international cargo flight, operated by Kitty Hawk International, Inc., as Flight 28. There were no injuries to the five crewmembers aboard. Visual meteorological conditions prevailed at the time of departure from Anchorage, and an instrument flight plan had been filed for the flight to Bangkok, Thailand. During an interview with the (NTSB) investigator-in-charge on July 3, a company quality assurance official stated that about 2 minutes after departure, the crew noted a loud "thump," followed by a change in the number three engine instrument indications. He said that one of the crewmembers went to the back of the airplane to visually check the status of the engine, and noted there was a "fist-sized hole in the side of the engine cowling." The quality assurance official stated that the captain shut down the number three engine, returned to Anchorage International Airport, and landed without further incident. A postaccident inspection revealed that the inboard aileron sustained substantial damage. On July 3, 999, the airplane was three-engine ferried from Anchorage to the operator's maintenance base in Oscoda, Michigan, where the engine was removed. The engine was subsequently shipped to a maintenance facility in Tel Avia, Israel, for disassembly and examination. On September 7, 999, the engine was disassembled under the direction of an NTSB Powerplant Group Chairman, and in the presence of the parties to the investigation. The disassembly revealed that there were eleven 2nd stage turbine blades that were fractured in the midspan area, and one other 2nd stage turbine blade that was elongated and necked down in the midspan area, with most of the shroud tip rubbed off. The turbine exhaust case had a 6 /2-inch long hole between the case front flange and the front mount rail. The Powerplants Group completed its examination of the engine on September 8. A copy of the Group Chairman's report is included in this report. An examination of the engine maintenance records revealed the engine was removed from service due to a cracked diffuser case on August, 998, at 43,946 hours total time, and,629 cycles. During this maintenance procedure, an overhauled turbine exhaust case was installed. The engine records revealed that when the turbine exhaust case was overhauled, FAA Airworthiness Directive (AD) 96-2- was complied with by incorporating Chromalloy Anniston Division's, No - Page

NTSB ID: ANC99LA99 Occurrence Date: 7/29/999 Narrative (Continued) Supplemental Type Certificate (STC) SE47AT-D. The intent of STC SE47AT-D is to comply with FAA Airworthiness Directive (AD) 96-2- by increasing the wall thickness of the turbine exhaust case, thus providing enhanced containment capabilities in the event of an internal engine failure. A portion of the turbine exhaust case was sent to the 's Materials Laboratory for examination. A Safety Board metallurgist confirmed that both the hardness and microstructure were consistent with design specifications stipulated in Chromally Anniston Division's STC. A copy of the NTSB materials laboratory factual report is included in this report. - Page a

NTSB ID: ANC99LA99 Occurrence Date: 7/29/999 Landing Facility/Approach Information Airport Name Airport ID: Airport Elevation Runway Used Runway Length Runway Width Ft. MSL Runway Surface Type: Runway Surface Condition: Type Instrument Approach: NONE VFR Approach/Landing: Aircraft Information Aircraft Manufacturer Boeing Model/Series 747-269B Serial Number 24 Airworthiness Certificate(s): Normal Landing Gear Type: Retractable - Tricycle Homebuilt Aircraft? No Number of Seats: 8 Engine Type: Turbo Fan - Aircraft Inspection Information Type of Last Inspection Continuous Airworthiness - Emergency Locator Transmitter (ELT) Information Certified Max Gross Wt. Engine Manufacturer: P&W Date of Last Inspection 7/999 8 LBS Number of Engines: 4 Model/Series: Rated Power: JT9D-7J 486 LBS Time Since Last Inspection Airframe Total Time 268 Hours 9727 Hours ELT Installed? Yes ELT Operated? No ELT Aided in Locating Accident Site? Owner/Operator Information Registered Aircraft Owner KITTY HAWK INTERNATIONAL, INC. Operator of Aircraft Same as Reg'd Aircraft Owner Street Address 63 SKYWAY STREET City OSCODA Street Address Same as Reg'd Aircraft Owner City MI Zip Code 487 Zip Code Operator Does Business As: - Type of U.S. Certificate(s) Held: Air Carrier Operating Certificate(s): Cargo Operator Designator Code: K4HA Operating Certificate: Operator Certificate: Regulation Flight Conducted Under: Part 2: Air Carrier Type of Flight Operation Conducted: Non-scheduled; International; Cargo - Page 2

First Pilot Information Name NTSB ID: ANC99LA99 Occurrence Date: 7/29/999 City Date of Birth Age 4 Sex: U Seat Occupied: Left Principal Profession: Civilian Pilot Certificate Number: Certificate(s): Airline Transport Rating(s): Multi-engine Land; Single-engine Land Rotorcraft/Glider/LTA: Instrument Rating(s): Instructor Rating(s): Type Rating/Endorsement for Accident/Incident Aircraft? Yes Current Biennial Flight Review? Medical Cert.: Class Medical Cert. Status: Valid Medical--w/ waivers/lim. Date of Last Medical Exam: 4/999 - Flight Time Matrix All A/C This Make and Model Single Engine Mult-Engine Night Actual Instrument Simulated Rotorcraft Glider Lighter Than Air Total Time Pilot In Command(PIC) 62 Instructor Last 9 Days Last 3 Days Last 24 Hours 23 4 Seatbelt Used? Yes Shoulder Harness Used? Yes Toxicology Performed? No Second Pilot? Yes Flight Plan/Itinerary Type of Flight Plan Filed: IFR Departure Point Airport Identifier Departure Time Time Zone ANCHORAGE AK ANC ADT Destination Airport Identifier BANGKOK VTBD Type of Clearance: Type of Airspace: IFR Class G Weather Information Source of Briefing: Company Method of Briefing: - Page 3

NTSB ID: ANC99LA99 Occurrence Date: 7/29/999 Weather Information WOF ID Observation Time Time Zone WOF Elevation WOF Distance From Accident Site Direction From Accident Site Ft. MSL NM Deg. Mag. Sky/Lowest Cloud Condition: Unknown Ft. AGL Condition of Light: Day Lowest Ceiling: Unknown Ft. AGL Visibility: SM Altimeter: 29. "Hg Temperature: - C Dew Point: C Wind Direction: Density Altitude: Ft. Wind Speed: Gusts: Weather Condtions at Accident Site: Visual Conditions Visibility (RVR): Ft. Visibility (RVV) SM Intensity of Precipitation: Unknown Restrictions to Visibility: Type of Precipitation: Accident Information Aircraft Damage: Substantial Aircraft Fire: Aircraft Explosion Classification: U.S. Registered/U.S. Soil - Injury Summary Matrix First Pilot Second Pilot Student Pilot Flight Instructor Check Pilot Flight Engineer Cabin Attendants Other Crew Passengers Fatal Serious Minor TOTAL 2 2 - TOTAL ABOARD - Other Ground - GRAND TOTAL - - Page 4

NTSB ID: ANC99LA99 Occurrence Date: 7/29/999 Administrative Information Investigator-In-Charge (IIC) CLINTON O. JOHNSON Additional Persons Participating in This Accident/Incident Investigation: TERRENCE R MUSICK (FAA) 4 WEST INT'L AIRPORT ROAD ANCHORAGE, AK 992 - Page