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Mid-air collision over Brasil

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Mid-air collision over Brasil

Old 3rd Oct 2006, 11:06
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Folha Online http://www1.folha.uol.com.br/folha/c...5u126635.shtml

They are reporting this morning that the Legacys planned route involved a level change when they turned onto airway UZ6 from UW2, from FL370 to FL360. Mr Sharkeys account indicates that the Legacy was still at FL370 shortly before the collision.

They also state that ATC were receiving primary returns (no altitude or identification) only from the Legacy for 15 minutes at or around the time of the collision and that the pilots of the Legacy reported a communcations failure shortly before the collision. The reason being floated for this is that the pilots were showing off for the new owners and had turned off TCAS for this reason.

Folha also comments on possible communications errors between control centres and the fact that this region is not noted for reliable radar and communications cover.

As ever, there will be a sequence of events that worked together to bring down GOL 1907, some human, some technical, the avoidance of any one of which would have saved lives. The full details will only be known when the FDR, CVR, and ATC data has been analysed.

BTW, being held after a fatal accident is normal here, and in many other countries, and is not an indication of guilt or culpability.

Last edited by alemaobaiano; 3rd Oct 2006 at 12:17. Reason: Link error, thanks Newforest
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Old 3rd Oct 2006, 11:32
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Your folha link doesn't work, maybe this one will.
http://www.folha.uol.com.br/
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Old 3rd Oct 2006, 11:46
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If the "tail" section with 100 bodies was located 1 km away from the center wing box section, then it appears the aft fuselage might be basically intact. It appears that the center wing box is missing the aft fuselage in the photographs. I don't see much of the foward fuselage attached to the wing box either. Because it appears that the center wing box (with wings attached) fell without much forward velocity, this suggests that the 738 may have broken up not long before ground impact, since the center wing box and the aft fuselage seem to be basically intact. I would think a higher altitude breakup would cause smaller pieces to be scattered farther. A mid-air breakup suggests loss of control, but this is all speculation.

This link suggested that a mid-air breakup was indeed the case.

http://www1.folha.uol.com.br/folha/c...5u126632.shtml

This is a link to a number of articles on the accident, from folha online.

http://www1.folha.uol.com.br/folha/e.../2006/voo1907/

Last edited by Flight Safety; 3rd Oct 2006 at 11:59.
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Old 3rd Oct 2006, 12:03
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If the reporter's version of events is to be believed, (I admit, there's no guarantee his rcollections will prove to be accurate), the two aircraft seem to have been on reciprocal tracks on the same airway, so one single mistake by one person, be it a controller or a pilot, was enough to cause this tragedy when coupled with some as yet unknown malfunction to a TCAS system.

Long time Ppruners will be familiar with these threads from the very early days of Pprune.

http://www.pprune.org/go.php?go=/pub/tech/MidAir2.html

http://www.pprune.org/go.php?go=/pub/tech/MidAir.html


This stuff was written ten years ago, (I know, because I wrote it), and still there is amazing resistance within the industry from pilots, ATC and regulators to offset tracking.
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Old 3rd Oct 2006, 12:25
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you often get resistance when a paradigm shift is required. With increased navigation accuracy, the performance of the entire system needs also to be improved so that the increased accuracy can't ensure that two aircraft will be EXACTLY in the same space at the same time. TCAS (assuming it is actually fitted and working) only goes part way and is expensive. Lateral offsets will also assist. But what is really needed is a paradigm shift with 'surveillance' where it is no longer an 'eye in the sky' (i.e.ATC) but the pilots themselves that know exactly where other aircraft are in relation to their own and can plan ahead, rather than take last minute evasive actions based on third parties or TCAS. So what we need is 'surveillance' in the cockpit i.e. ATC-like information on traffic displays with ALL aircraft suitable equipped. Coupled with this is mutual ATC-pilot and pilot-pilot 'rules' as to how to behave (i.e. like TCAS does). And the technology must be affordable and in ALL aircraft. I beleive there is real urgency to deliver this technology to cockpits and overcome political issues such as funding and equipment mandates.
As they say, if you think safety is expensive...
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Old 3rd Oct 2006, 12:32
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1. the list of equipment to be recovered also includes some of the TCAS brains as they may contain some data of interest, not just ATC tapes/strips, CVR and DFDR. The maintenance QAR as well, if available.

2. Remember that with both aircraft on GPS navigation you have increased the lateral overlap, and with Reduced Vertical Separation Minimum, you have increased the vertical overlap.

3. The mid-air geometry does not matter much if you have two perfectly serviceable aircraft hitting one another at high speed.
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Old 3rd Oct 2006, 12:44
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Now navigation system on new aircrafts are so accurate, that aircrafts fly always excactly on the centerline of the airway With a few inches precision, at the exact altitude.

So if by misunderstanding both aircrafts fly the same airways at the same alt but in opposite directions (providing tcas doesn't work) there is a 100% chance they will touch each other.

I heard that on new airbus when flying to remote aeras such Africa, the navigation system is randomly selecting a track not exactly on the airways centerline but within a few Nm offset to reduce the risk of such collisions.

I am exact or wrong, someone could confirm what i said.
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Old 3rd Oct 2006, 12:53
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It was common practice in the 70s to offset altitudes 100-200 feet over Africa.
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Old 3rd Oct 2006, 14:03
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I think I said it 10 years ago in one of the two links I posted above, and if not, I certainly said it in other posts here on Pprune back then when I was pushing for the adoption of offset tracking, preferably an inbuilt, automatic offset in FMCs at cruising levels. I said then that nothing would change until 300+ North American passengers died. (This was after the USAF C141 hit a Luftwaffe TU154(?) head on off the West African coast in circumstances that might well prove to have been very similar to what led to this tragic crash.)

At the time, I mentioned that a handful of military aviators dead just wasn't enough to shake up the system. I pray to God that 155 South American dead will be enough to force 'The System', (and that 'System' includes all of us), into recognising that ultra accurate IRS/GPS navigation systems have made accidents like this more rather than less likely.

We've had official permission to fly offset over India now for a year or two. I don't believe I have EVER seen ONE other aircraft employing offset tracking in all the time it's been allowed, and I know of very few people who actually use it in trans Atlantic airspace (NATS) unless it's to avoid wake turbulence of an aircraft immediately ahead.
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Old 3rd Oct 2006, 14:18
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isn't it funny ( tragically so) that if planes were on VOR airways, that VOR's would have enough slop in receivers and autopilot couplers that no one would be right on the centerline.

I recall reading how in the Aural Range days (.- -. ) how pilots would fly to one side as the definition of the beam was sharper.

to barit 1, being 100 feet off on altitude would have been enough wouldn't it?

I read just today that the crew of the legacy said their TCAS did not issue a warning.

While it is too soon to know for sure, couldn't a bonafide failure of equiment, including the new transponder in this brand new plane be part of the equation ? This would accomplish the same thing as if the pilots had turned off their transponder. AS the legacy survived, a check of the transponder, TCAS, and cables/antennas are in order.
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Old 3rd Oct 2006, 14:23
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Exemptions

It is quite common for aircraft on delivery to be granted exemptions from carrying items like fully functioning TCAS and even transponders. If you don't have a transponder and rely on pressure altimeter (set to departure QNH instead of 1013.2) then TCAS on the other a/c has no chance. BTW, QNE is not a pressure setting (earlier post), it is the flight level equivalent of altitude at very high airports.
RS

Last edited by R Slicker; 3rd Oct 2006 at 14:25. Reason: text error
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Old 3rd Oct 2006, 14:35
  #252 (permalink)  
 
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Hi everyone,
I´ve been too busy flying these last few days,so I haven´t look at all posts here,just the few last ones.Anyways,flying jetliners in Brazil for the last 20 years,I´d like to offer some comments on things I´ve just read here.First,someone said something regarding a "block altitude" between 370 and 390...NEVER heard or seen anything like that in this country,in fact,ATC here is very,very conservative when it comes to flight levels,sometimes generating even complaints from pilots flying at very different speeds requesting same levels(i.e. the airplane ahead faster requesting same FL).Sometimes we do have in that particular area some comm dificulties,but to my recollection,there´s no radar gap or "blackout" in that airspace.Another point is,although i do not fly for GOL,I do know many of its pilots,for we have worked for the same airline in the past,and believe me,the operational discipline in the airline is very,very tight.There´s no doubt at all,that someone screwd up big time on this accident,but I guess we just have to wait for the result of the investigation,cuz quoting the media when aviation matters are concerned,at least in Brazil,it´s absolutely foolish.
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Old 3rd Oct 2006, 15:43
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Originally Posted by Johnbr
quoting the media when aviation matters are concerned,at least in Brazil,it´s absolutely foolish.
Quoting the general media anywhere is perhaps not the best thing to do, but that doesn't stop people doing it as it is our only source of information. The media here is very similar to that in many other countries, there are responsible news sources and sensationalist ones and hopefully the professionals on this board can spot which is which before quoting their material.

Last edited by alemaobaiano; 3rd Oct 2006 at 15:44. Reason: Can't spell
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Old 3rd Oct 2006, 17:32
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Colliding With Death at 37,000 Feet, and Living

The wing and tail of the Embraer Legacy 600 were damaged in what seems to have been a collision with a Boeing 737 in Brazil on Friday

J. SHARKEY
Published: October 3, 2006

With the window shade drawn, I was relaxing in my leather seat aboard a $25 million corporate jet that was flying 37,000 feet above the vast Amazon rainforest. The 7 of us on board the 13-passenger jet were keeping to ourselves.

Without warning, I felt a terrific jolt and heard a loud bang, followed by an eerie silence, save for the hum of the engines.

And then the three words I will never forget. “We’ve been hit,” said Henry Yandle, a fellow passenger standing in the aisle near the cockpit of the Embraer Legacy 600 jet.

“Hit? By what?” I wondered. I lifted the shade. The sky was clear; the sun low in the sky. The rainforest went on forever. But there, at the end of the wing, was a jagged ridge, perhaps a foot high, where the five-foot-tall winglet was supposed to be.

And so began the most harrowing 30 minutes of my life. I would be told time and again in the next few days that nobody ever survives a midair collision. I was lucky to be alive — and only later would I learn that the 155 people aboard the Boeing 737 on a domestic flight that seems to have clipped us were not.

Investigators are still trying to sort out what happened, and how — our smaller jet managed to stay aloft while a 737 that is longer, wider and more than three times as heavy, fell from the sky nose first.

But at 3:59 last Friday afternoon, all I could see, all I knew, was that part of the wing was gone. And it was clear that the situation was worsening in a hurry. The leading edge of the wing was losing rivets, and starting to peel back.

Amazingly, no one panicked. The pilots calmly starting scanning their controls and maps for signs of a nearby airport, or, out their window, a place to come down.

But as the minutes passed, the plane kept losing speed. By now we all knew how bad this was. I wondered how badly ditching — an optimistic term for crashing — was going to hurt.

I thought of my family. There was no point reaching for my cellphone to try a call — there was no signal. And as our hopes sank with the sun, some of us jotted notes to spouses and loved ones and placed them in our wallets, hoping the notes would later be found.

I was focused on a different set of notes when the flight began. I’ve contributed the “On the Road”column for The New York Times business-travel section every week for the last seven years. But I was on the Embraer 600 for a freelance assignment for Business Jet Traveler magazine.

My fellow passengers included executives from Embraer and a charter company called ExcelAire, the new owner of the jet. David Rimmer, the senior vice president of Excel Aire, had invited me to ride home on the jet his company had just taken possession of at Embraer’s headquarters here.

And it had been a nice ride. Minutes before we were hit, I had wandered up to the cockpit to chat with the pilots, who said the plane was flying beautifully. I saw the readout that showed our altitude: 37,000 feet.

I returned to my seat. Minutes later came the strike (it sheared off part of the plane’s tail, too, we later learned).

Immediately afterward, there wasn’t much conversation.

Mr. Rimmer, a large man, was hunched in the aisle in front of me staring out the window at the newly damaged wing.

“How bad is it?” I asked.

He fixed me with a steady look and said, "I don’t know."

I saw the body language of the two pilots. They were like infantrymen working together in a jam, just as they had been trained to do.

For the next 25 minutes, the pilots, Joe Lepore and Jan Paladino, were scanning their instruments, looking for an airport. Nothing turned up.

They sent out a Mayday signal, which was acknowledged by a cargo plane somewhere in the region. There had been no contact with any other plane, and certainly not with a 737 in the same airspace.

Mr. Lepore then spotted a runway through the darkening canopy of trees.

“I can see an airport,” he said.

They tried to contact the control tower at what turned out to be a military base hidden deep in the Amazon. They steered the plane through a big wide sweep to avoid putting too much stress on the wing.

As they approached the runway, they had the first contact with air traffic control.

“We didn’t know how much runway we had or what was on it,” Mr. Paladino would say later that night at the base in the jungle at Cachimbo.

We came down hard and fast. I watched the pilots wrestle the aircraft because so many of their automatic controls were blown. They brought us to a halt with plenty of runway left. We staggered to the exit.

“Nice flying,” I told the pilots as I passed them. Actually, I inserted an unprintable word between “nice” and “flying.”

“Any time,” Mr. Paladino, said with an anxious smile.

Later that night they gave us cold beer and food at the military base. We speculated endlessly about what had caused the impact. A wayward weather balloon? A hot-dogging military fighter jet whose pilot had bailed? An airliner somewhere nearby that had blown up, and rained debris on us?

Whatever the cause, it had become clear that we had been involved in an actual midair crash that none of us should have survived.
In a moment of gallows humor at the dormlike barracks where we were to sleep, I said, “Maybe we are all actually dead, and this is hell — reliving college bull sessions with a can of beer for eternity.”

About 7.30 p.m. Dan Bachmann, an Embraer executive and the only one among us who spoke Portuguese, came to the table in the mess hall with news from the commander’s office. A Boeing 737 with 155 people on board was reported missing right where we had been hit.

Before that moment, we had all been bonding, joking about our close call. We were the Amazon Seven, living now on precious time that no longer belonged to us but somehow we had acquired. We would have a reunion each year and report on how we used our time.

Instead we now bowed our heads in a long moment of silence, with the sound of muffled tears.

Both pilots, experienced corporate jet pilots, were shaken by the ordeal. “If anybody should have gone down it should have been us,” Mr. Lepore, 42, of Bay Shore, N.Y., kept saying.

Mr. Paladino, 34, of Westhampton, N.Y., was barely able to speak. “I’m just trying to settle in with the loss of all those people. It is really starting to hurt,” he said.

Mr. Yandle told them: “You guys are heroes. You saved our lives.” They smiled wanly. It was clear the weight of all this would remain with them forever.

The next day, the base was swarming with Brazilian authorities investigating the accident and directing search operations for the downed 737, which an officer told me lay in an area less than 100 miles south of us that could be reached only by whacking away by hand at dense jungle.

We also got access to our plane, which was being pored over by inspectors. Ralph Michielli, vice president for maintenance at ExcelAire and a fellow passenger on the flight, took me up on a lift to see the damage to the wing near the sheared-off winglet.

A panel near the leading edge of the wing had separated by a foot or more. Dark stains closer to the fuselage showed that fuel had leaked out. Parts of the horizontal stabilizer on the tail had been smashed, and a small chunk was missing off the left elevator.

A Brazilian military inspector standing by surprised me by his willingness to talk, although the conversation was limited by his weak English and my nonexistent Portuguese.

He was speculating on what happened, but this is what he said: Both planes were, inexplicably, at the same altitude in the same space in the sky. The southeast-bound 737 pilots spotted our Legacy 600, which was flying northwest to Manaus, and made a frantic evasive bank. The 737 wing, swooping into the space between our wing and the high tail, clipped us twice, and the bigger plane then went into its death spiral.

It sounded like an impossible situation, the inspector acknowledged. “But I think this happened,” he said. Though no one can say for certain yet how the accident occurred, three other Brazilian officers told me they had been informed that both planes were at the same altitude.

Why did I — the closest passenger to the impact — hear no sound, no roar of a big 737?

I asked Jeirgem Prust, a test pilot for Embraer. This was the following day, when we had been transferred from the base by military aircraft to a police headquarters in Cuiaba. That’s where authorities had laid claim to jurisdiction and where the pilots and passengers of the Legacy 600, including me, would be questioned until dawn by an intense police commander and his translators.

Mr. Prust took out a calculator and tapped away, figuring the time that would be available to hear the roar of a jet coming at another jet, each flying at over 500 miles an hour in opposite directions. He showed me the numbers. “It’s far less than a split second,” he said. We both looked at the pilots slouched on couches across the room.

“These guys and that plane saved our lives,” I said.

“By my calculations,” he agreed.

I later thought that perhaps the pilot of the Brazilian airliner had also saved our lives because of his quick reactions. If only his own passengers could say the same.

At the police headquarters, we were required to write on a sheet of paper our names, addresses, birthdates, occupations and levels of education, plus the names of our parents. We were all also required to submit to an examination by a physician with long hair who wore a white gown that draped almost to his shins. We were required to strip to the waists for photographs front and back.

This, explained the physician, whose name I did not get but who described himself to me as a “forensic doctor,” was to prove that we had not been tortured “in any way.”

Again gallows humor rose despite our attempts to discourage it.

“This guy’s the coroner,” Mr. Yandle explained later, and then added, “I think that means we are actually dead.”

But laughs, such as they were, died out by now as we thought again and again of the bodies still unclaimed in the jungle, and how their lives and ours had intersected, literally and metaphorically, for one horrible split second.
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Old 3rd Oct 2006, 18:14
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As someone who has watched an aircraft disintegrate around them and lived to tell the tale all I can say as more and more details become available the greater my sense of loss becomes.

Those poor guys in the front of the 737 rode it all the way to the ground. The report for this one will be one of the most chilling stories we will ever see.

Multiple layers of safety redundancy have been eroded to let the “Golden BB” through the Swiss cheese. It appears that no matter how many safety devices can be installed we are still only human.
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Old 3rd Oct 2006, 19:19
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speaks for many of us.

from the reporters account and the early speculation by the inspector , it would seem that the GOL 737 may have taken evasive action at the last microsecond


it is also apparent that it was head on, that an offset would have saved them, that being 100' up or down might have saved them.

The question now is: why were two planes on IFR clearances not seperated by customary altitude/direction of flight rules?

Is it a mechanical problem, an altimeter miss set? it does happen

an improper clearance, no radar monitoring of altitude?


a misunderstood clearance?


as I mentioned before, a movie of the 50's or 60's, called, "THE CROWDED SKY" aslo a book by the same name, covered exactly this type of collision and how altimetry, communication and human factors resulted in a mid air.
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Old 3rd Oct 2006, 19:28
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hog driver...
Multiple layers of safety redundancy have been eroded to let the “Golden BB” through the Swiss cheese. It appears that no matter how many safety devices can be installed we are still only human.
When I began in radio news nearly 50 years ago, MAC's were not that all uncommon. Look at it now: how often do they happen? The holes aren't lining up as often anymore, not nearly as much as when I began.

(Note: I have never used anything on PPRUNE in my job; I'm here solely because I lived next to an airport, my father worked in the Corsair plant, I worked in the Sikorsky plant, and two of my neighbors were pilots.)
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Old 3rd Oct 2006, 19:38
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Originally Posted by loulou
Now navigation system on new aircrafts are so accurate, that aircrafts fly always excactly on the centerline of the airway With a few inches precision, at the exact altitude.
So if by misunderstanding both aircrafts fly the same airways at the same alt but in opposite directions (providing tcas doesn't work) there is a 100% chance they will touch each other.
I heard that on new airbus when flying to remote aeras such Africa, the navigation system is randomly selecting a track not exactly on the airways centerline but within a few Nm offset to reduce the risk of such collisions.
I am exact or wrong, someone could confirm what i said.
You know this debate has been going on for years, at least since the 90's when I were a PPL!
Randomised Minor route offsets (not just using the OFFSET function) should be inbuilt into the FMC.. I don't know one person who disagrees with this (except perhaps the engineers)
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Old 3rd Oct 2006, 19:39
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read the following from the reporters article...consider if the 737 pilots reacted so quickly, as any of us might have, and the amount of control input, saving the Legacy, may have caused an accelerated stall/upset further dooming the flight.

do not misread this as anything against the 737 pilots or anyone else...high altitude flying with massive control inputs can be tricky.

head on, we are trained to both turn right.

fighter pilots are taught to turn and to keep enemy in sight

whatever the backgrounds, I think we can all understand why TCAS gives vertical escape maneuvers and not horizontal maneuvers (though TCAS 3 may have that).

if the 737 had pulled up, the belly might have hit the legacy, the 737 might have survived, dooming the legacy.


It is also time to revist recognition lights in cruise flight and not just at low altitudes ( landing lights on, a redesign of non retractable types).


again, do not consider this an attack on pilots, just a method for starting a debate on collision avoidance.



READ on:

A Brazilian military inspector standing by surprised me by his willingness to talk, although the conversation was limited by his weak English and my nonexistent Portuguese.

He was speculating on what happened, but this is what he said: Both planes were, inexplicably, at the same altitude in the same space in the sky. The southeast-bound 737 pilots spotted our Legacy 600, which was flying northwest to Manaus, and made a frantic evasive bank. The 737 wing, swooping into the space between our wing and the high tail, clipped us twice, and the bigger plane then went into its death spiral.

It sounded like an impossible situation, the inspector acknowledged.
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Old 3rd Oct 2006, 20:24
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RVSM or not, 370 is certainly not the altitude to go Northwest.

Given the collision site is "100 miles" north of SBCC which rounds up to S08 W56 this is 675 NM or 90 minutes flying Northwest of BRS where the changeover from 370 to 360 should have taken place. (UW2 to UZ6)

Last edited by threemiles; 3rd Oct 2006 at 20:44.
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