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Senate Inquiry, Hearing Program 4th Nov 2011

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Senate Inquiry, Hearing Program 4th Nov 2011

Old 2nd Feb 2013, 21:42
  #961 (permalink)  
 
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The perils of a warts and all investigation

Oleo is correct, the names of the CASA members on the investigation and special audit team are freely available. A look at the list of inspectors shows that as well as the usual flying ops and airworthiness inspectors there was one of the relatively new breed of Safety Systems Inspectors. Their task is not only to look at the effectiveness of the systems that should have plugged the holes in the cheese and not only the systems of the operator but also the regulatory systems that should have plugged the holes.

Rumour has it that the latter were raised particularly in relation to the fatigue risk management system that CASA had previously approved. Being the devil's advocate and highlighting deficiencies in your employer is fraught with danger but that is the lot of a proper investigation and apparently the inspector concerned was given a pineapple previously for, when asked to examine CASA's responses to ATSB safety recommendations from the Lockhart River accident, he did not hold back on criticising those responses ( or lack of them). Admittedly the pineapple was purported to have been launched not from the person that requested the report but from the person who attracted the criticism. Or so I hear.
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Old 3rd Feb 2013, 05:27
  #962 (permalink)  
 
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How's it done...?

Not by the Manual that's for sure. That might be a bit of a guide to help tidy up the paperwork..AFTER the event and or "investigation"

Had a good laugh on reading 2.4.1.. Natural Justice and Accountability..2 things that CASA doesnt give a rats about, and..
2.4.2 Impartiality....Ha Ha Ha...pull the other one ! You can kiss that one adieu as well.

From direct experience CASA MO is in REVERSE of the requirements of the AGIS,and their own enforcement manual.

Penalty notice /AIN ...FIRSToff. (ie deemed GUILTY of offence)
Then an "investigation" that wasnt really/totally 1/2 arsed by an "investigator", one S Cremerius whose Part 111 appointment came a couple of weeks later. Other investigations found people in my favour, Cremerius found none. Que?? Just following the CB line,... guilty of course so
dont let the truth get in the way of the CASA agenda!

Alas,at great cost to the taxpayer it all went tits up. And a complaint to the current ICC re the MO of the Manager Compliance and Enforcement doesnt warrant any attention because my complaint was for something more than 12 months ago.!! Thats right... any old BS will do.!
Funny that, they dont give a rats if yr FOI takes 2 years to finally get SFA.

GO you good Senators, GO!!!!
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Old 3rd Feb 2013, 11:21
  #963 (permalink)  
 
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Mr Spike, interesting sir, very interesting. If your sources are also correct then it certainly appears that FF are harvesting a frickin pineapple plantation?

Industry complaint to the ICC? Score a pineapple?
Industry prove that CASA are incorrect over their interpretation of an issue? Score a pineapple.
Industry disagree on an audit finding or an NCN stemming from op surveilance? Score a pineapple?
Work for CASA and do the right thing, act with fairness and integrity toward industry? Score a pineapple.
Highlight a CASA deficiency or incorrect action in regards to an internal matter? Score a pineapple?
CASA - Write some silly comments making the Senators out to be buffoons, then apologise, brown nose and eat a poo poo sandwich? Dodge a pineapple.
CASA - Trick ICAO and FAA with circus acts and amazing tricks against a darkened background? Dodge a pineapple.
Continually lie and deceive by promising completed regulations for decades then simply stall and play magic tricks until a new government is elected and then start playing the same game over again? Dodge a pineapple.
Respond to Senators questions with imbecile comments, 'take it on notice' (and never come back with an answer), and treat Senators with contempt? DESERVED PINEAPPLE.

I think Mr Spike also made an interesting but brief reference to Lockhart River? Although a different topic I interested in hearing more about this? I have always said that FF dodged a bullet on Lockhart, and the Norfolk mess as well as Canley Vale seems to be rapidly building a profile of Regulatory ignorance, arrogance, incompetence and bot bot covering. Again I believe that decades of individuals avoiding accountability has created a horrid culture of 'we shall do as we f&king please and you can all get stuffed'. A royal commission needs to be granted, there no longer is any other option.

Last edited by my oleo is extended; 3rd Feb 2013 at 11:25.
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Old 3rd Feb 2013, 13:40
  #964 (permalink)  
 
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Oleo,

It looks like you've just written the unwritten rule to the casa chess game?
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Old 3rd Feb 2013, 21:44
  #965 (permalink)  
 
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Depth perception.

FS #991 – and Oleo # 993. Two clear posts which bring us to a fork in the road. Both pathways forward are murky, muddy and guarded by ferocious beasts.

One path takes us down into the operational levels and to the resignations of two very well qualified safety inspectors; where to say the least, the timing is interesting. Where the Lockhart farce raises it's ugly head in the mix and there still remain questions of the RCA not signed by the well qualified individual who raised them, but signed by a person considerably less professionally qualified and regarded. It would be interesting indeed to have the two highly qualified persons in question provide their 'expert' version of the "facts and circumstances", i.e. who rogered who and who paid.

The other path takes us upwards toward departmental governance, to the ever ready legal crew who seem to manage the most extraordinary twisting, bending and shaping of the rules to suit a pre determined outcome, with an ease that beggars the imagination. This leads to the high altitude plateau of oversight and thus to management, the board and minister.

I feel a Royal Commission is a heavy, expensive blunt instrument to crack the Pel Air nut. A Judicial no holds barred enquiry into this one event will tear the lid off a can of worms. I believe the Senate is almost there; they cannot, for the sake of public credibility be fobbed off with another soft white paper. In an election year it will be interesting to see which path they take – in any event both pathways meet at the well of truth and the public safety.

It has been suggested that the Senate is, at the end of the day, powerless. It's time to take the kid gloves off and demonstrate where true power lays; and NO, it is not within the halls of Fort Fumbles.

Last edited by Kharon; 3rd Feb 2013 at 21:50.
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Old 3rd Feb 2013, 22:47
  #966 (permalink)  
 
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Mr Kharon, indeed, the good Senators may only retain enough power to open the can of worms and not have the power and permission to take the matters to a higher playing field, time will tell. One thing is for certain, the way things are currently going I think there is enough coming to light to ensure that when a large smoking hole finally becomes a reality (and it will), there will have been enough evidence raised about the governments inaction and posturing to ensure some mighty big legal action is actioned against these clowns. Then again, it's you and I the taxpayer who cough up for it in the end and those in higher places that shall not be named remain fully protected and unaccountable.

Mr Chocolate biscuit, the CASA chess game contains many many processes. Written rules, unofficial rules, rules for some and rules for others, secretive and clandestine rules, no rules, supernatural occult rules and a smattering of pony poo rules. The game contains 'winner takes all' rules, 'you are the weakest link rules', rules pertaining to trough wallowing and rules about the rules. You have hypothetical rules, rules in which accountability for players actions don't exist, rules that are discussed, articulated, philosophised and excitedly discussed at round table meetings by men wearing slippers and smoking cigars while sitting on leather couches in dark libraries at secret locations where blood letting and touching each others plonkers is the norm!

Yes, Mr Biscuit, many a twist to this Chess Game. But you ain't seem nothing yet, wait till you see the game of 'Tautology' when released in full after almost 24 years under development.

Last edited by my oleo is extended; 3rd Feb 2013 at 22:52.
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Old 4th Feb 2013, 01:05
  #967 (permalink)  
 
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Next hearing date 15th feb.

Have just been informed by Sen Heffernan's office that the next public hearing is to be held on the 15th in CB.



"empty skies are safe skies"
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Old 4th Feb 2013, 02:00
  #968 (permalink)  
 
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Working notes.

In response to requests for additional information, the following working notes are offered.

Please be aware these are only draft working notes and completely unverified. Whilst we cannot attest to their probity they will provide a springboard for detailed analysis, for those who enjoy the research challenge.

Download - For_Research_Only.

PAIN_Net... DO NOT track downloads. Relax troops.

P4 – AKA – Ferret.

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Old 4th Feb 2013, 02:41
  #969 (permalink)  
 
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Kharon,
That seems like an odd process, for an Inspector to issue a NCN yet someone else puts their signature on it? Is that legal? How and why would somebody else sign it? Does that comply with CASA's SPM? I wonder what the Operators think of this?

Stan, good news.
Hopefully CASA will provide the Senators with a specific date for the release of the new regs?
Hopefully CASA will provide the Senators with clear and precise answers and where necessary the evidence to ALL questions that have been 'taken on notice' over the past 14 months?

PAIN,
Some robust reading indeed. I am sure that FF legal team will be busy scurrying through all this and burning the midnight candle?

Senators,
You would by now be painfully aware by way of submissions, interviews and ongoing discussions that the CASA, ATSB and ASA are in a parlours state of disrepair. The heads of the snakes need removing. The sheer scale of risk that the industry is exposed to by the actions and inactions of the over sighting bodies is beyond words and comprehension. You are intelligent men well versed in the politics, spin and deflection trotted out during inquiries of this nature. But so are many others, aware of the state of play within Australian aviation safety. The more that eeks out and the more that people are not held to account means the more unsettled industry becomes and the more accountable individuals in government shod become for choosing to turn a blind eye and ignore the warnings. The facts have been well and truly exposed, are those in power still prepared to sit on their fat a#ses and play ignorant?
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Old 4th Feb 2013, 02:54
  #970 (permalink)  
 
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Post Valentine's Massacre??

Stan also heard from a reliable source that the next public hearing is the 15th, pity it wasn’t the 14th we could have dubbed it the ‘Valentine’s Massacre Mark II’! Anyway should be confirmed tomorrow when the Senate sits.

Going off the PAIN reference and spike’s post….
“Rumour has it that the latter were raised particularly in relation to the fatigue risk management system that CASA had previously approved. Being the devil's advocate and highlighting deficiencies in your employer is fraught with danger but that is the lot of a proper investigation and apparently the inspector concerned was given a pineapple previously for, when asked to examine CASA's responses to ATSB safety recommendations from the Lockhart River accident, he did not hold back on criticising those responses ( or lack of them). Admittedly the pineapple was purported to have been launched not from the person that requested the report but from the person who attracted the criticism. Or so I hear.”
….my money is that spike would be referring to BC rather than MC, although both gentleman have CVs that would put them in the top 2% of experts in Human Factors in aviation for Australia, if not the world!

Going off Oleo’s post maybe compiling a list of questions might help to clear some of the bullshit and corruption we’re beginning to get flooded with here!

Q1/ So why did they both jump ship(BC&MC)? And the timing is very suss, especially BC (August 2010)??

Q2/ And those countersigned RCAs WTF is that all about?

Q3/ And in a normal world should some of those RCAs have required a ‘Safety Alert’?


Following assessment of the response and on the Recipient Response portion of the RCA carry out the following actions:


Complete the Verification and Action section; this section must record objective evidence to support the decision for acquittal.

Complete the name and file reference sections.



Acquit the audit response by signing the document.



Notify the Auditee of the acceptance of the response in accordance with the local field office procedures.



Forward the acquitted RCA and supporting documentation on the file to the data entry operator for entry into the support systems (see data entry Guidelines for ASSP and Pentana).



Enter the RCA information into the relevant support systems.



Ensure all RCA acquittal and closure documentation is filed on the appropriate audit file.





Q4/ So where is the acquittal documentation for the RCAs, hmm maybe they’ve got a stuck TRIM or no one could manage to hit the Pentana?

There’s a possible RRAT committee document request in there me thinks??

The more that is revealed the more the reeking pooh piles up!

Last edited by Sarcs; 4th Feb 2013 at 03:42.
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Old 4th Feb 2013, 12:45
  #971 (permalink)  
 
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Sarcs, BC may have signed off on the RCA's but my source tells me that the 'author of the RCA's' has more qualifications than BC! There are more twists to this than in Michael Jacksons colon.
It would also be rumoured that there has been quite a number of audits in which others sign off on RCA's they have not written themselves.

I am lead to believe that BC left not because he was pushed but rather because he had a gutful of the FF shenanigans, silliness and also because his salary was a lamentable joke. Indeed there was not room for him to dine at the trough with those more royal than he.
He was 'hand picked' by a former colleague and went back to the RAAF to apply his HF trade, along with a more robust remuneration package and a uniform that makes the Skulls Friday outfits look like rejected St Vinnies clothes!

I am still curious about one thing. The Special Auditor of Pelair after the Norfolk accident was, according to Spike, also involved in a special review of Transairs handy work at Lockhart. Why? Lockhart occurred several years before Norfolk, and Lockhart was all done and dusted, closed off, finished , finalised, finito. So why review the whole accident again? For the majority of us it would be a natural part of any investigation once all the dust settles and the clock had ticked forward, review, improve, change and learn. But we are talking about FF here, anything and every they do has an alterior motive, and dicing with Lockhart several year later is very suspicious indeed.

Is there a 'Lockhart special review' document out there awaiting the Senators perusal? Is there something out there that our friends at Stalag CASA are a little nervous about?

Last edited by my oleo is extended; 4th Feb 2013 at 12:49.
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Old 4th Feb 2013, 21:41
  #972 (permalink)  
 
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Lockhart - Norfolk - ALIU

Spurred by Oleo's comment I contacted the inspector involved and he does have a Masters in HF etc. although CASA had him remove the appropriate post nominal from his business card as it embarrasses those "superiors" who only qualified in preschool finger painting and pooh flinging.

As for the Lockhart paper he said it was a test to see if he was appropriate material for the ALIU manager's position prior to Norfolk and when he bagged CASA's responses in the paper he wasn't surprised to learn that he was judged to not fit the position even though he was an accident investigator with a previous employer. Still, he finds it all an amusing memory now that he has had to retire.
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Old 4th Feb 2013, 23:53
  #973 (permalink)  
 
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Spike, interesting insight. It would seem CASA have really been concentrating on all those important things in life - business cards, fancy letters after ones name, not promoting any underling who is more qualified than the nimwits farther up the ladder. As for prioritising safety matters?? Hmmmm.
You are correct about the finger painting aspect. But that stopped a year or two ago after the old geriatrics hands cramped up with arthritis. Now they place a brush in their mouths and paint the canvass that way. It's quite effective and they are good at it because they are use to bobbing for apples .

As a sidepoont, EASA have released their 2013 - 2016 European Aviation Safety Plan, with SMS on its way. It certainly beats any folly that CASA has in play within its own structure (oh sorry, did I forget the SPM which is around 13 years in production) and it pi#ses over Albo's silly White Paper and any glossy spin documents the CASA Board has ever churned out. I simply can't imagine CASA with its own SMS, after all a SMS does incorporate accountability, which not surprisingly is not a CASA strong point. Perhaps CASA execs should shun Montreal as their choice of taxpayer funded holiday destination and head to Europe instead?

It is time for 'out with the old geezers, in with the new'.

Last edited by my oleo is extended; 4th Feb 2013 at 23:55.
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Old 5th Feb 2013, 00:52
  #974 (permalink)  
 
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Oleo you said:
Sarcs, BC may have signed off on the RCA's but my source tells me that the 'author of the RCA's' has more qualifications than BC! There are more twists to this than in Michael Jacksons colon.
It would also be rumoured that there has been quite a number of audits in which others sign off on RCA's they have not written themselves.
If you take a close look at the SAR (version II so far??) that Flight Nurse Karen Casey was able to get under FOI and then look at the list of RCAs:

http://www.casa.gov.au/wcmswr/_asset...-ef12-5471.pdf

You'll see that other than the first 13 RCAs that were signed by the FOI assigned to Pel-Air the rest, although appearing to be written by various Special Audit Team members (including BC), are countersigned and filled out by the Audit Skulldinator....

FS said: As for the Lockhart paper he said it was a test to see if he was appropriate material for the ALIU manager's position prior to Norfolk and when he bagged CASA's responses in the paper he wasn't surprised to learn that he was judged to not fit the position even though he was an accident investigator with a previous employer. Still, he finds it all an amusing memory now that he has had to retire.
So Spike it was more a test of whether he would tow the party line? And the dude failed miserably...so Messr RW gets the gig because he is itching to feed at the trough and has previously been a reasonable master of spin and obfuscation and considered more than a match for the numpties at the bureau...hmm makes sense I guess???

For those interested I also found this interesting released FOI documentation, which is a copy of an audit on Pel-Air in March 2008:
http://www.casa.gov.au/wcmswr/_asset...ef12-10004.pdf
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Old 5th Feb 2013, 02:22
  #975 (permalink)  
 
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Sarcs, it's interesting reviewing these 2 audits independently. Some highlights (or should I say highshites) are:

- In 2008 80% of the 20 FLT crew reviewed had no evidence of life jacket/raft training. Then after the ditching in 2009 the special audit found inadequate life raft refresher training. Not much changed in 12 months.
- In 2008 that audit uncovered basically nil FRMS training. Then again in 2009 after the ditching the special audit found inadequate FRMS policy/procedures.
- And the RCA's. Mr RC signed the RCA's that were written by Mr MH, Mr BC and Mrs KS. WTF?

Although questions about Pelair are obvious and inevitable, my interest is in the Regulators oversight, ability and activities during this time period. What were they doing? The similarities to Lockhart are more than concerning. CASA is meant to be oversighting safety yet here are 2 accidents that occurred not long after CASA had been 'hanging around'? Is the role of the CASA pretty much redundant? They certainly don't appear to add any value to safety? They certainly don't seem capable of identifying risk prior to accidents? Proactive vs reactive I hear you say? The CASA are reactive! And as far as I am concerned when it comes to organisational culture CASA are pathological. If they were an airline I would rather take my chances and cross the pacific ocean on a Segway than fly with them.

The holes in the cheese are big enough to fly a Starlifter through. How much longer? Over to you Senators.
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Old 6th Feb 2013, 02:16
  #976 (permalink)  
 
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As the stomach churns.

It's a fair question – just how much individual, unchecked power does a manager have?

When you get down and dirty on the Special Procedures Manual (SPM) and Safety Trend Index (STI) system you find that Transair, of Lockhart River fame had an audited STI score of 15, the normal red flag is raised at seven. Safety alert, No, Show cause, No? kick in the pants, No?; but shortly afterward they are granted significant changes in the AOC despite clear evidence that under the 'robust' CASA system this was the last thing that should happen.

There is no empirical evidence that the Operations Manual was significantly amended to rectify any of the items reflected in their STI score. There is no data to support the idea that the audit was 'audited' and that changes, if any, were ticked off. The failings in the oversight system were huge and 15 people died.

Pel Air - same - same. Only in this case we have the auditors investigating their audit: now how in all the hells does that happen? Even more intriguing are the resignations shortly afterward by people who were eminently qualified to assess the operation, the audit and the proposed corrections.

In part, the 'investigation' process, was supposedly to determine if previous RCA and audited deficiencies had been corrected; and that both the CASA and P-A systems were functioning correctly. So we task the auditors to examine their own work – sorry, but why am I not surprised that despite a fairly hefty STI count and no positive proof of improvement a Safety Alert was waived and evidence deeply buried. P-A was back in business within a Christmas week of the "changes" being initiated. It would take a week of hard work just make to amendments let alone have them tested, accepted, executed and ticked off. The required training programs alone would have taken a week full to complete.

Seems there exists either a massive systematic failure; or a truck load of discretionary power at work. Compared to Hardy, Barrier, Airtex and a couple of others where the 'managers' discretion is used to produce the desired outcome you just have to ask questions of the system, the integrity of the audit and the investigation process. Is the system there to ensure a safety outcome, or to produce a safe outcome under discretionary privilege? Quick twirl of the red pen – problems all go away; shut up or resign. Men of integrity did.

I find it intriguing that Airtex had independent, senior, experienced ICAO 'qualified' auditors determine a clean bill of health for the operation and were shot down in flames by, shall we say, slightly less qualified people; and had a safety alert issued on the flimsiest grounds; yet P-A in seven days, over Christmas manage to convince almost the same audit/ investigating team that all was well.

Here Johnny, mark your own exam paper. What a system. Unbelievable? check it out your self, all there on the public record.

Last edited by Kharon; 6th Feb 2013 at 02:19.
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Old 6th Feb 2013, 02:45
  #977 (permalink)  
 
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Mr Kharon,
FF BNE hold monthly Risk Review Group (RRG) meetings. Do they review risk, or do they drink green tea and eat wafers while musing over EBA travel perks and counting frequent flyer points? How are operators 'slipping through the system'? One former Field Office Manager (RW) used to accept inspectors phone calls to operators as 'Op Surveillance'! It's all about KPI's and numbers, more smoke and mirrors. Now he 'liaises' with the ATSB. What a farce, a complete joke.
Maybe the Senators can ask to review such documents? There should be minutes, albeit they will be hidden deep within that blackhole called TRIM.

Robert S McNamara wrote a book called 'The Fog Of War'. Well we could write a book called 'The Fog Of CASA', a political tale of spin, uselessness and magic tricks, an analysis of what purpose do they serve at all.
CASA reside in their own fog, and just like Richard The Third, will some day in the future be found buried beneath a supermarket carpark, that day can't come soon enough.
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Old 6th Feb 2013, 04:31
  #978 (permalink)  
 
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Shooting the messenger

Unfortunately for those who consider CASA to be a disfunctional organisation, Paul Phelan's article "shooting the messenger" proves the opposite.

https://senate.aph.gov.au/submission...7-e114756fe994

If only it had some connection with flight SAFETY!!!

47 years, 24,000 incident free hours don't count for much ?

Thanks again Paul.
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Old 6th Feb 2013, 05:20
  #979 (permalink)  
 
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The Allure of Evil.

Great job Stan and Paul – it's a big read but most satisfactory.

MOIE# 1007 "CASA reside in their own fog, and just like Richard The Third, will some day in the future be found buried beneath a supermarket car park, that day can't come soon enough."
There are many parts of Richard III that have relevance; glad they found the old bugger, although we'll never know the true story – ring any bells ??

When Richard claims that his deformity is the cause of his wicked ways, he seems to be manipulating us for sympathy, just as he manipulates the other characters throughout the play.

As a result, Richard III does not explore the cause of evil in the human mind so much as it explores its operation, depicting the workings of Richard’s mind and the methods he uses to manipulate, control, and injure others for his own gain.

“Why, I can smile and murder whiles I smile,
And cry 'content' to that which grieves my heart,
And wet my cheeks with artificial tears,
And frame my face for all occasions”

Last edited by Kharon; 6th Feb 2013 at 05:22. Reason: Beer o'clock ?
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Old 6th Feb 2013, 06:51
  #980 (permalink)  
 
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JQ Safety Manager rumoured to be returning to the nest?

My source tells me the former CASA Safety Systems Specialist who went to JQ as Safety Manager is about to reappear at CASA as EM Operations now that Hood (the Norfolk sacrificial lamb) is going to ASA. All rumour of course.
Makes sense, the GWM love 'yes men', and I don't think the JQ Safety Manager enjoyed his last venture in front of the Senators, nor did Boston Bruce or Greg Russell! Reminds me of a scene out of Monty Python And The Holy Grail - 'brave brave Sir Robin'...NOT.

CASA chess game and musical chairs indeed. (If all true).

Last edited by my oleo is extended; 6th Feb 2013 at 06:53.
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