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Safety Recommendation Details

Safety Recommendation A-19-004
Details
Synopsis: This report discusses the March 8, 2017, accident involving Ameristar Air Cargo, Inc., dba Ameristar Charters, flight 9363, a Boeing MD-83 airplane, which overran the departure end of runway 23L at Willow Run Airport, Ypsilanti, Michigan, after the captain executed a rejected takeoff. The 110 passengers and 6 flight crewmembers evacuated the airplane via emergency escape slides; however, one slide failed to inflate and could not be used. One passenger received a minor injury, and the airplane sustained substantial damage. Safety issues identified in this report include the lack of a means to enable flight crews of Boeing DC-9/MD-80 series and 717 model airplanes to verify before takeoff that the elevators are not jammed, the need for improved in-service inspection techniques for critical rotating parts of all engines, the need for lower ground gust criteria for elevator physical inspections and operational checks by maintenance personnel for Boeing DC 9/MD-80 series and 717 model airplanes, the potential inadequacy of ground gust limit loads for the certification of transport-category airplanes, the lack of procedures for operators of Boeing DC-9/MD-80 series and 717 model airplanes to monitor the wind that affects parked airplanes, the lack of procedures for weather observers related to sign off and backup augmentation responsibilities during a facility evacuation, and evacuation slide malfunction. As a result of this investigation, the National Transportation Safety Board makes three safety recommendations to the Federal Aviation Administration and three recommendations to The Boeing Company.
Recommendation: TO THE FEDERAL AVIATION ADMINISTRATION: Determine if the ground gust limit loads contained in Title 14 Code of Federal Regulations 25.415 adequately ensure that critical flight control systems are protected from hazards introduced by ground gusts that contain dynamic, vertical wind components.
Original recommendation transmittal letter: PDF
Overall Status: Open - Initial Response Received
Mode: Aviation
Location: Ypsilanti, MI, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA17FA076
Accident Reports: Runway Overrun During Rejected Takeoff Ameristar Air Cargo, Inc., dba Ameristar Charters, flight 9363 Boeing MD-83, N786TW Ypsilanti, Michigan, March 8, 2017
Report #: AAR-19-01
Accident Date: 3/8/2017
Issue Date: 3/8/2019
Date Closed:
Addressee(s) and Addressee Status: FAA (Open - Initial Response Received)
Keyword(s):

Safety Recommendation History
From: FAA
To: NTSB
Date: 5/21/2019
Response: -From Daniel K. Elwell, Acting Administrator: The Federal Aviation Administration (FAA) revised Title 14, Code of Federal Regulations (14 CFR) 25.415, Ground Gust Conditions, and published the associated Advisory Circular (AC) 25.415-1, in December 2014. The AC describes acceptable means for showing compliance with the requirements of 14 CFR 25.415 for gust load conditions on the flight control systems and surfaces that are assumed to occur while the airplane is taxiing and when parked. Furthermore, the NTSB investigation revealed that some gust conditions may include dynamic, vertical wind components on flig4t control systems and surfaces of parked airplanes that are not addressed in the current regulation. The FAA will review the information provided by the NTSB to determine the adequacy of the current regulations and guidance. We anticipate our review to be finalized by October 2019 and based on the results, we will determine if further actions are necessary to address this safety recommendation.

From: NTSB
To: FAA
Date: 3/8/2019
Response: On February 14, 2019, the NTSB adopted its report, Runway Overrun during Rejected Takeoff, Ameristar Air Cargo, Inc., dba Ameristar Charters, flight 9363, Boeing MD-83, N786TW, Ypsilanti, Michigan, March 8, 2017, NTSB AAR-19/01. The details of this accident investigation and the resulting safety recommendations may be found in the attached report, which can also be accessed at http://www.ntsb.gov. As a result of this investigation, the NTSB identified the following safety issues: • Lack of a means to enable flight crews of Boeing DC-9/MD-80 series and 717 model airplanes to verify before takeoff that the elevators are not jammed. • Need for lower ground gust criteria for elevator physical inspections and operational checks by maintenance personnel for Boeing DC 9/MD-80 series and 717 model airplanes. • Potential inadequacy of ground gust limit loads for the certification of transport category airplanes. • Lack of procedures for operators of Boeing DC-9/MD-80 series and 717 model airplanes to monitor the wind that affects parked airplanes. • Lack of procedures for weather observers related to sign off and backup augmentation responsibilities during a facility evacuation. • Evacuation slide malfunction. Accordingly, the NTSB makes the following safety recommendations to the FAA. Additional information regarding these recommendations can be found in the noted sections of the report. • Determine if the ground gust limit loads contained in Title 14 Code of Federal Regulations 25.415 adequately ensure that critical flight control systems are protected from hazards introduced by ground gusts that contain dynamic, vertical wind components. (A 19-4) (See section 2.4.1) • Ensure the operators of Boeing DC-9/MD-80 series and 717 model airplanes have procedures that define who is responsible for monitoring the wind that affects parked airplanes and for notifying maintenance personnel when conditions could meet or exceed the ground gust criteria specified in the Aircraft Maintenance Manual. (A-19-5) (See section 2.4.3.) • Revise Order JO 7900.5D, Surface Weather Observing, Change 1, to specify sign off procedures and backup augmentation responsibilities for all types of weather-observing personnel when they are unable to perform their prescribed duties from their normal duty station during normal duty hours. (A-19-6) (See section 2.6.3.) In our report on the March 8, 2017, accident in Ypsilanti, Michigan, we also classified two previously issued safety recommendations: • Require all 14 Code of Federal Regulations Part 139 certificated airports to upgrade all runway safety areas that could, with feasible improvements, be made to meet the minimum standards established by Advisory Circular 150/5300-13, “Airport Design.” The upgrades should be made proactively, not only as part of other runway improvement projects. (A 03-11, classified “Closed—Acceptable Action” in Section 2.5) • Require all 14 Code of Federal Regulations Part 139 certificated airports to install engineered materials arresting systems in each runway safety area available for air carrier use that could not, with feasible improvements, be made to meet the minimum standards established by Advisory Circular 150/5300-13, “Airport Design.” The systems should be installed proactively, not only as part of other runway improvement projects. (A-03-12, classified “Closed—Acceptable Action” in Section 2.5) The NTSB is vitally interested in these recommendations because they are designed to prevent accidents and save lives. We would appreciate a response within 90 days, detailing the actions you have taken or intend to take to implement these recommendations. When replying, please refer to the safety recommendations by number. We encourage you to submit your response to correspondence@ntsb.gov. If your reply exceeds 20 megabytes, including attachments, please e-mail us at the same address for instructions. Please do not submit both an electronic copy and a hard copy of the same response.