Now that we know the R2-5 relay failure seems to be the cause of the failure of the TOWS why after all these years of operation did their maintenance people not put the RAT heater and failure to the TOWS together?

Why
 

well it depends all of the knowledge and the experience and system knowledge of the engineers and the crew at that certain moment no matter of the experience of the company totally. Some people are better than others and also stress could affect the clearity of the way you look at things. Thats Human I guess.
Maybe also if you really want to fix something or only to dispatch within limits of rules etc etc, maybe without really thinking or understanding why things are reacting the way they are.
Its always easy to say afterwards though.
just a thought


Wings 1011

... and for those of you not following this thread much, you can read all about it and actually see the scans of the reports yourselves by checking this very same thread about 10 days ago around post #1775 or a little before (around pages 88 forward)

i.e. cliking here:

http://www.pprune.org/rumours-news/3...madrid-89.html

Hopefully this won't be the 2,000th post on this thread but spending a week at the Reno Air Races gets you out of contact with daily info. How did this report get so little attention here 10 days ago. Today is the first I heard of it on a different forum. It was dated yesterday. I heard of a leak but no official report. I guess I can quit complaining about keeping FDR data secret now.

hey bubbers, I was at the reno air races a couple of days...wednesday and thursday a bit.

this thread must be award winning in terms of shear number of posts.

Many have suggested a third crewmember or other ways to be SURE...

there is only one way to be sure.

To every pilot who flys...ADMIT THAT YOU ARE HUMAN and MIGHT SCREW UP...as soon as you do that, you will check things over and over again.

sevenstrokeroll;
Agreed, and yet flight managers don't believe flight data from their own FOQA Program and refuse to acknowledge that serious mistakes can, and have been made, and we have a couple here who, whether they believe it or its merely macho bluster for public consumption, express the notion that they don't make mistakes and would advocate the dismissal those who do and that safety programs are apparently left-wing nanny-state conspiracies that trap only the "weak" but don't apply to the "strong". Go figure, that in the face of all the evidence to the contrary, that such an attitude remains sustainable. Why it is even a discussable point is surprising and disappointing but there it is.

100 pages and 2000 posts...

What occurs to me now is:

Including Madrid, there have been 'at least four'* occurences of DC-9/MD-80 take-offs without flaps/slats being set where the TOCWS hasn't worked....

DETROIT
LANZAROTTE
ZQA297/30's Post #919
MADRID

This does not endear one to the current (disparate) approach taken to collect and disseminate incident data, or co-ordinate and enforce effective preventativeactions... be it hardware, software, SOPs, training.

I have been re-reading the full Court of Inquiry into Trident/LHR/Staines fatal accident (1972 )
l.e. devices raised 60 kts and 2 miutes early in climb-out (apparently inexplicably, no VCR then)
Very experienced Captain on type, (3 others in cockpit) - but was stressed (possibly to point of subtle incapacitation)
Not specifically trained for that one eventuality (a configuration stall (rapid onset) and the shaker/stick push coming almost together)

It was thought at the time that this inadvertant device retraction was totally unprecedented, yet it was found subsequently that it had occurred twice before in the same airline: a knowledge trail was there, though a weak one.
There were many other factors of course, as always, mainly indirect ones (noise abatament profile just intiated, an unfortunate SOP etc)
NB. Many inquiry recommendations, one of which was '... nobody allowed in cockpit without a flying role or under training' i.e distraction by occupants of 4th seat

In both cases the aircraft wouldn't fly as expected and the crew couldn't work out quickly enough why - configuration!

The point - Prior warning information in both cases existed, but bureaucracy played its inevitable role and was 'downgraded' in relevance... eventually to be lost in the ether.

Yet another accident that couldn't/shouldn't have happened...but did.



* but how many has there actually been, 5, 6, 10 ?

Yes, SSR, I once did my final gear, flaps speedbrakes armed check at 200 ft and the speedbrakes were not armed in my 757. Realized we had not done the before landing checklist and did a speed read through the checklist to touchdown. Those killer items like others have mentioned are a way of fixing that day you didn't do the checklist properly. Yes, Reno was wonderful this year. Sorry Rare Bear blew his engine. Stegra is the one to watch again next year with Stevo Hinton.

A few days ago I mentioned a collection of cases where this happened on MD's or other's arplanes.

Obviously, the "tip of the iceberg", as even there I ommited another couple of cases where the mistake was caught right before the TOWS went off by one of the members of the crew or even passengers.

Here: http://www.pprune.org/4408886-post1910.html

Most are docummented and the reports available on ASRS.com

But I guess the "system" doesn't work all that well.

Could anyone please post a link to the report, preferrably to an english version?

Thanks and Regards,

MAX

Maintenance Manual:

D. Test Ram Air Temperature Probe Heater:

WARNING: NORMAL ELECTRICAL POWER SUPPLY TO VARIOUS SYSTEMS WILL BE INTERRUPTED WHEN GROUND CONTROL RELAY CIRCUIT BREAKERS ARE OPENED. MAKE CERTAIN THAT SWITCHES AND CONTROLS OF AFFECTED SYSTEMS ARE IN CORRECT POSITIONS TO PREVENT INADVERTENT OPERATION OR SHUTDOWN OF EQUIPMENT.

from douglas WWW.CRASH-AERIEN.COM :: Voir le sujet - Madrid : crash au décollage d'un MD82 de Spanair


. R_e_m_o_v_a_l_/_I_n_s_t_a_l_l_a_t_i_o_n__-__R_A_T__P_R_O_B_E_
A. Remove RAT PROBE
W_A_R_N_I_N_G_: TAG AND SAFETY CIRCUIT BREAKER.
(1) Open following circuit breaker:
C_i_r_c_u_i_t__B_r_e_a_k_e_r_ P_a_n_e_l__L_o_c_a_t_i_o_n_ P_a_n_e_l__A_r_e_a_
RAM AIR TEMP & PROBE Lower EPC RIGHT AC BUS. HEATER
(2) Remove six screws which hold the temperature probe to the fuselage.
(3) Gently ease the temperature probe outward from the mounting hole and disconnect and cap the electrical mating connector.
B. Install RAT PROBE
(1) Make certain that following circuit breaker is open, tagged, and safetied:
C_i_r_c_u_i_t__B_r_e_a_k_e_r_ P_a_n_e_l__L_o_c_a_t_i_o_n_ P_a_n_e_l__A_r_e_a_
RAM AIR TEMP & PROBE Lower EPC RIGHT AC BUS. HEATER(2) Clean RAT probe and aircraft mounting surfaces with solvent (2a) Apply an even light coat of silicone sealant (DMS 1799) to faying surfaces of RAT probe and mounting surfaces of aircraft.
Remove cap from electrical connector. Align temperature probe with air inlet facing forward; connect electrical connector to temperature probe receptacle in proper keyway. (4) Position temperature probe for final mounting. Apply
sealant (DMS 2013) under head of attaching screws, then insert and tighten six screw (4a) Clean excess sealant from around RAT probe and attaching screws.
(5) Ensure that METER SEL & HEAT selector switch (located on overhead switch panel) is in OFF position.
(6) Remove tag and close following circuit breaker:
C_i_r_c_u_i_t__B_r_e_a_k_e_r_ P_a_n_e_l__L_o_c_a_t_i_o_n_ P_a_n_e_l__A_r_e_a_

RAM AIR TEMP & PROBE HEATER

Lower EPC

RIGHT AC BUS.

(7) Place standard centigrade thermometer within or adjacent to RAM air temperature probe air inlet. Allow sufficient time (3 to 5 minutes) for thermometer reading to stabilize, note final stabilized ambient air temperature at probe.
(Temperature reading of RAT on Ram air and thrust rating indicator should agree with thermometer reading within ±2.0 degrees centigrade. On aircraft with electronic engine display panel, RAT is displayed on the electronic engine display panel.
(10) On aircraft with True Airspeed and Static Air Temperature (TAS/SAT) Indicator installed, press TAT pushbutton switch on TAS/SAT indicator. Note digital annunciation shown on Static Air Temperature (SAT) display, and compare with ambient air temperature measured at probe air inlet. Two readings should agree within ±2.0 degrees centigrPlace CADC selector switch to BOTH ON 1 position, repeat step (9).
(11) Place CADC switch to NORM.
4. A_d_j_u_s_t_m_e_n_t_/_T_e_s_t__R_A_T__P_r_o_b_e_
C_A_U_T_I_O_N_: MAKE CERTAIN THAT RAM AIR TEMPERATURE PROBE HEATER OPERATION IS LIMITED TO TWO MINUTES MAXIMUM, TO PREVENT DAMAGE.
A. RAT Probe Heater Check
W_A_R_N_I_N_G_: TAG AND SAFETY CIRCUIT BREAKERS.
(1) Open following circuit breakers.
N_O_T_E_: Circuit breakers are opened to prevent other heaters from operating during test.

Overhead
Circuit Breaker
CAPTAIN’S PITOT HEATER

Panel Location Panel Area
EMERGENCY DC BUS



FIRST OFFICER’S PITOT HEATER
AUX PITOT HEATER

Lower EPC
Lower EPC

ICE PROTECTION DC BUS
ICE PROTECTION DC BUS



RUDDER Q LIMITER HEATER

Lower EPC

RIGHT AC BUS



LEFT ANGLE-OF-ATTACK & VANE HEATER

Lower EPC

LEFT AC BUS



RIGHT ANGLE-OF-ATTACK & VANE HEATER

Lower EPC

RIGHT AC BUS



LEFT STATIC PORT HEATER Lower EPC
LEFT GROUND CONTROL Upper EPC RELAY

LEFT AC BUS MISC AC BUS.



C_A_U_T_I_O_N_: MAKE CERTAIN RAT PROBE PROTECTIVE COVER IS REMOVED.
(2) Verify RAM AIR TEMP & PROBE HEAT circuit breaker and RIGHT STATIC PORT HEATER circuit breaker on lower EPC circuit breaker panel are closed.
(3) Place METER SEL & HEAT switch on overhead panel to RAT probe position.
(4) Current reading on meter should read 6.5 to 8.5.
(5) Close LEFT GROUND CONTROL RELAY circuit breaker.
(6) Current reading on meter should read 0.0 to 0.5.
(7) Place METER SEL & HEAT switch to OFF position.
(Close following circuit breakers.

Overhead
Circuit Breaker
CAPTAIN’S PITOT HEATER

Panel Location Panel Area
EMERGENCY DC BUS



FIRST OFFICER’S PITOT HEATER
AUX PITOT HEATER
RUDDER Q LIMITER HEATER
LEFT ANGLE-OF-ATTACK & VANE HEATER
RIGHT ANGLE-OF-ATTACK & VANE HEATER
LEFT STATIC PORT HEATER
LEFT GROUND CONTROL RELAY

Lower EPC
Lower EPC
Lower EPC
Lower EPC
Lower EPC
Lower EPC Upper EPC

ICE PROTECTION DC BUS
ICE PROTECTION DC BUS
RIGHT AC BUS
LEFT AC BUS
RIGHT AC BUS
LEFT AC BUS MISC AC BUS.

(9) Return airplane to required configuration

The preliminary report is not "out" yet. If it depended on the CIAIAC, all the details would've been kept secret until they felt they were ready to share the parts they considered important, and hide those they didn't want shared.

Nonetheless, their own regulations and international OACI (anex 13) require that they publish a preliminary report within 30 days of the accident, which incidentally was 34 days ago.

Therefore, we can only post links to leaked copies of the DRAFT of the preliminary report (not the report itself). Those were handed out about 10 days ago to parties involved (manufacturers, operators, authorities, investigation bodies, etc).

Whenever the preliminary (or later, possibly years from now, the final) report is officially available, it will be available from CIAIAC site here:

Relación de accidentes e incidentes. Año 2008 - CIAIAC - Ministerio de Fomento

It's expected in about a week.

Meanwhile, you can find a link to a scan of the last page and a translation in english of it in a post by me of about 10 days ago here (page 87):

http://www.pprune.org/rumours-news/3...madrid-87.html

Also, a couple of pages later (89) there is also another post by me with links to scans of all the pages of the draft report and a translation of some of the important bits.

http://www.pprune.org/rumours-news/3...madrid-89.html

Then, on this other page (95) there is also a link to the whole document in pdf format:

http://www.pprune.org/rumours-news/3...ml#post4407786

I don't know if anybody has translated the whole document, but you can find translations of bits and pieces, like the part about the reversers, etc in those pages (87 and later). All the important details have been posted and commented there.

The short version is:
-It seems very likely the flaps weren't down.
-The TOWS alarms didn't sound. It seems likely that the R2-5 relay wasn't working.
-Spanair didn't have updated procedures requiring that the crew tested the TOWS before each flight, only once a day and whenever pilots changed or were absent from the cockpit for a long time. It seems Spanair never received news about these updates recommended by Boeing after Detroit's accident. Also, nobody (i.e. FAA) made those recommendations mandatory. The CIAIAC feels best action is to make pre-flight checks of TOWS mandatory on all countries with airplanes of similar designs.

Earlier RAT probe overheat and slat/flaps alarms?
 

El Mundo, citing first-hand access to the aircraft's maintenance log, wrote that in the days before the crash, there has been alarms and inspections regarding slats and flaps; and two events of overheated RAT probe on the day before the crash.
Original in Spanish: El sistema de despegue falló dos días antes de la tragedia
Automated English translation

Is this for real? If yes, it possible to sort out what the flat/slats alarms reported are about? And/or, is a reliable transcript of the maintenance log available?

flapless t/o
 

i have read all the posts here

apart from the a300 airbus (which was mentioned, although i worked for monarch and do not remember this)
is there any large commercial jet which routinely uses zero flap for take off and in what conditions would that be for please

also does that include zero le slats too?

thanks

If any do, would generally be to meet thrust limited initial climb gradient e.g. hot and high conditions. Vr would be increased and the appropriate length of runway needed of course! Slats, yes

I'm not sure, but I think the F100 took off with no flaps and didn't have slats.

but in icing conditions, would use flaps.

F100
 

Sure the F100 or the F70 does not have slats and to take-off with flap 0 (zero) is basicly std procedure. It requires a little bit longer RWY but not much. If heavy or short RWY or a steep initial climb is attended flap 8 would be prefered for T/O


Regards

Wings1011

Stall recovery technique in swept wing jets
 

A question from a lowly PPL: is using ailerons an accepted technique to counteract roll when a swept wing stalls?

I vividly remember my instructor insisting on not using ailerons but to use rudder input to counteract roll when stalled. Aileron input could make matters worse and introduce additional aerodynamic effects leading to an increased roll rate and eventually spin entry.

The Northwest accident report mentions substancial loss of lift because of aileron (and linked to this: spoiler) use during recovey. I am NOT suggesting this technique was used in the Madrid disaster!

I apologise in advance to the Sky Gods I might have offended by this post. Please remember I'm only a weekend Warrior (or should that be warrior?) :E

Johan

Wind shear technique
 

I'm afraid the crew did'nt recognise their stall condition ... They had no training to handle that.

But maybe they had received extensive training against "negative" windshear on initial climb. That happens when an airplane, shortly after take off enters a layer of considerable tailwind. That can happen on a calm morning, and not only in a stormy day.

The training emphasize keeping the aircraft in the stick shaker zone - "hanging on" - NOT lowering the nose ... Of course, airline pilots (most of them ...) let the yaw damper handle the rudder, and try keeping the wings level only with the stick.

Not lowering the nose is actually a key point when entering a negative wind shear during an approach. (so as not touching gear & flaps). But I disagree with this recommandation during climb ...

If that training is not properly put into perspective, it quicly becomes a (bad) habit for reacting to a stick shaker / stall condition.