United States of America

While on a cross-country flight, according to radar data and weather information, the pilot descended below terrain clearance altitude and entered IMC conditions. The aircraft impacted a mountain peak approximately 100 feet below the summit. No flight plan had been filed and the pilot was not instrument rated.

The pilot said he performed three-point touchdown, landing to the east on a grass airstrip. He said, '... as we landed, the tail wanted to come up, so I pulled the stick all the way back and held
it back ... while I was reaching to lift the flaps off.' The pilot said that before he got the flaps retracted, he noticed the tail was coming up again. He ensured that the power was off and his feet were off the brakes. 'The airplane came up on its nose. We were almost stopped before we flipped on our back over the nose.' The pilot said that when he later returned to the airplane, he noticed the 'T-handle brake lever was 3/4 engaged.' Examination of the airplane revealed heavy longitudinally running grass rubbing on both tires. The brake discs were free and the wheels rotated freely. An examination of the field showed a pair of parallel-running tire marks moving toward the north side of the landing strip, and 11 succeeding slashes in the ground running perpendicular to the parallel tire tracks on the airplane's left side. An examination of the remaining airplane systems revealed no anomalies. Wind conditions, reported 14 minutes after the accident, were 010° at 7 knots.

During the takeoff climb, the airplane turned sharply right, went into a steep bank and collided with terrain. The airplane began a right turn immediately after departure and appeared to be going slow. A witness was able to distinguish the individual propeller blades on the right engine, while the left engine propeller blades were indistinguishable. The airplane stopped turning and flew for an estimated 1/4-mile at an altitude of 100 feet. The airplane then continued the right turn at a steep bank angle before disappearing from sight. Then the witness observed a plume of smoke. White and gray matter, along with two ferrous slivers, contaminated the chip detector on the right engine. The airplane had a rudder assist system installed. The rudder assist provided additional directional control in the event of a loss of power on either engine. The NATOPS manual specified that the rudder assist switch should be in the ON position for takeoff, landing, and in the event of single-engine operation. The rudder boost switch was in the off position, and the rudder boost actuator in the empennage was in the retracted (off) position. The owner had experienced a problem with the flight controls the previous year and did not fly with the rudder assist ON. The accident flight had the lowest acceleration rate, and attained the lowest maximum speed, compared to GPS data from the seven previous flights. It was traveling nearly 20 knots slower, about 100 knots, than the bulk of the other flights when it attempted to lift off. The airplane was between the 2,000- and 3,000-foot runway markers (less than halfway down the runway) when it lifted off and began the right turn. Due to the extensive disintegration of the airplane in the impact sequence, the seating positions for the three occupants could not be determined. One of the occupants was the aircraft owner, who held a private certificate with a single-engine land rating, was known to have previously flown the airplane on contract flights from both the left and right seats. A second pilot was the normal copilot for all previous contract flights; his certificates had been revoked by the FAA. The third occupant held an airline transport pilot certificate and had never flown in the airplane before. Prior to the accident flight, the owner had told an associate that the third occupant was going to fly the airplane on the accident flight.

The pilot was departing from Lansing, Michigan, when he reported engine problems. The aircraft subsequently lost power to both engines. Fuel receipts were found that indicate that the aircraft was serviced with 25 gallons of jet fuel in each wing tank. No preexisting anomalies were found with regard to the aircraft or its systems. An FAA inspector interviewed the person that had fueled the aircraft and that person stated he had used a JET-A fuel truck to fuel the accident aircraft. The inspector also interviewed the safety director of the company that provided the fueling service. The safety director told the inspector that the fuel truck used to fuel the accident aircraft was found to have a small nozzle installed on one of the hoses and not the wide nozzle used on jet fueling trucks. He also said that, '...the small nozzle was used for the purpose of fueling tugs at the airport and that the small nozzles were immediately removed from all jet refueling trucks so that this could not happen again.'

The pilot canceled the IFR flight plan as the aircraft crossed the VOR and reported the airport in site. The last radio contact with Air Traffic Control was at 0935:16. The crew did not report any problems before or during the accident flight. The distance from the VOR to the airport was 4 nautical miles. Witnesses saw the airplane enter right traffic at a low altitude, for a landing on runway 36, then turn right from base leg to final, less than a 1/2-mile from the approach end of the runway. Witnesses saw the airplane pitch up nose high, and the right wing dropped. The airplane than struck trees west of the runway, struck wires, caught fire, and impacted on a hard surface road. This was a training flight for the left seat pilot to retake a Learjet type rating check ride he had failed on March 24, 2000. He failed the check ride, because while performing an ILS approach in which he was given a simulated engine failure, and he was transitioning from instruments to VFR, he allowed the airspeed to decrease to a point below Vref [landing approach speed]. According to the company's training manual, "...if a crewmember fails to meet any of the qualification requirements because of a lack in flight proficiency, the crewmember must be returned to training status. After additional or retraining, an instructor recommendation is required for reaccomplishing the unsatisfactory qualification requirements." The accident flight was dispatched by the company as a training flight. On the accident flight a company check airman was in the right seat, and the check ride was set up for 0800, April 5,2000. The flight arrived an hour and a half late. The left seat pilot's, and the company's flight records did not indicate any training flights, or any other type of flights, for the pilot from March 24, 2000, the date of the failed check flight, and the accident flight on April 5, 2000. The accident flight was the first flight that the left seat pilot was to receive retraining, and was the only opportunity for him to demonstrate the phase of flight that he was unsuccessful at during the check flight on March 24th. Examination of the
airframe and engine did not reveal any discrepancies.

The flight was approaching a private airport (elevation 983 feet msl), that did not have an instrument approach system, during instrument meteorological conditions. The pilot informed the air traffic controller that he had the airport in sight, and cancelled his instrument flight plan. The twin turbofan airplane impacted a tree approximately 4,000 feet northeast of the airport in an upright position. The airplane then impacted the ground in an inverted position approximately 200 yards from the initial impact with the tree. The weather observation facility located 16 miles northeast of the accident site was reporting an overcast ceiling at 400 feet agl, and visibility 4 statute miles in mist. The weather observation facility elevation was 541 feet msl. Local residents in the vicinity of the accident site stated that there was heavy fog and drizzle at the time of the accident. The pilot had filed an alternate airport (with a precision instrument approach); however, he elected not to divert to the alternate airport. Examination of the wreckage did not reveal any evidence of pre-impact anomalies that would have prevented operation of the airplane.

The captain was the flying pilot for the night landing on runway 01 in instrument meteorological conditions (IMC), with a right cross wind from 110 degrees at 14 gusting 18 knots, drizzle, and a wet runway. Prior to starting the approach, the flightcrew determined that the landing approach speed (Vref) and the approach speed (Vapp) were 122 and 128 knots, respectively. DFDR data showed the airplane flying on autopilot as it passed the middle marker at 200 feet AGL at 130 knots on the ILS approach. Approximately 3 seconds after the first officer called "runway in sight twelve o'clock," the captain disconnected the autopilot, while at a radio altitude of 132 feet and on a heading of approximately 18 degrees. Within approximately 11 seconds after the autopilot disconnect, the glideslope and localizer deviation increased. The first officer called "runway over there." Approximately 5 seconds before touchdown, the airplane rolled right, then left, then right. DFDR data-based performance calculations showed the airplane crossed the threshold at an altitude of 35 feet and 130 knots. The airplane touched down 2,802 feet from the approach end of the 5,495-foot runway (844- foot displaced threshold) at 125 knots on a heading of 10 degrees. The airplane overran the runway and struck a ditch 175 feet beyond the departure end of the runway. Landing roll calculations showed a ground roll of 2,693 feet after touchdown, consisting of 1,016 feet ground roll before braking was initiated and 1,677 feet ground roll after braking was initiated until the airplane exited the pavement. According to Saab, for a wet runway, the aircraft would have needed 1,989 feet from the time of braking initiation to come to a complete stop. The American Eagle Airlines, Inc., FAA approved aircraft operating manual (AOM), states in part: Stabilized approaches are essential when landing on contaminated runways. Landing under adverse weather conditions, the desired touch-down point is still 1,000 feet from the approach end of the runway. Touchdown at the planned point. Cross the threshold at Vapp, then bleed off speed to land approximately Vref -5. Use reverse, if needed. To achieve maximum braking effect on wet runway, apply maximum and steady brake pressure. In 1992, the City of Killeen submitted a proposal that included extending the north end of runway 01 by 194 feet. The FAA originally disapproved the proposal, in part, because the runway extension decreased the length of the runway safety area (RSA) which was already shorter than the recommended 1,000 feet for a 14 CFR Part 139 certificated airport. The proposal was subsequently approved and a drainage ditch was installed in the north RSA, perpendicular to the runway and approximately 175 feet north of the departure end of runway 01. In 1993, the airport received FAA Part 139 certification. The 1998 and 1999, FAA airport certification inspection reports noted the inadequate RSA; however, neither letter of correction, sent from the FAA to the City of Killeen following the inspections, mentioned the RSA. Following this accident, the ILS runway 01 was flight checked by the FAA and all components were found to be operating within prescribed tolerances. Examination of the airplane found no anomalies that would have prevented it from operating per design prior to departing the runway and encountering the ditch.

On March 5, 2000, about 1811 Pacific standard time (PST), Southwest Airlines, Inc., flight 1455, a Boeing 737-300 (737), N668SW, overran the departure end of runway 8 after landing at Burbank-Glendale-Pasadena Airport (BUR), Burbank, California. The airplane touched down at approximately 182 knots, and about 20 seconds later, at approximately 32 knots, collided with a metal blast fence and an airport perimeter wall. The airplane came to rest on a city street near a gas station off of the airport property. Of the 142 persons on board, 2 passengers sustained serious injuries; 41 passengers and the captain sustained minor injuries; and 94
passengers, 3 flight attendants, and the first officer sustained no injuries. The airplane sustained extensive exterior damage and some internal damage to the passenger cabin. During the accident sequence, the forward service door (1R) escape slide inflated inside the airplane; the nose gear collapsed; and the forward dual flight attendant jump seat, which was occupied by two flight attendants, partially collapsed. The flight, which was operating on an instrument flight rules flight plan, was conducted under 14 Code of Federal Regulations (CFR) Part 121. Visual meteorological conditions (VMC) prevailed at the time of the accident, which occurred
in twilight lighting conditions.

The airplane collided with frozen pack ice, three miles from the airport, during a GPS instrument approach. Instrument conditions of 3/4 mile visibility in snow and fog were reported at the time of the accident. The pilot stated that he began a steep descent with the autopilot engaged. He indicated that as the airplane crossed the final approach course, the autopilot turned the airplane inbound toward the airport. He continued the steep descent, noted the airplane had overshot the course, and the autopilot was not correcting very well. He disengaged the autopilot and manually increased the correction heading to intercept the final approach course. During the descent he completed the landing checklist, extended the landing gear and flaps, and was tuning both the communications and navigation radios. The pilot said he looked up from tuning the radios to see the sea ice coming up too quickly to react, and impacted terrain. The pilot relayed there were no pre accident anomalies with the airplane, and that he 'did not stay ahead of the airplane.'

On February 16, 2000, about 1951 Pacific standard time, Emery Worldwide Airlines, Inc., (Emery) flight 17, a McDonnell Douglas DC-8-71F (DC-8), N8079U, crashed in an automobile salvage yard shortly after takeoff, while attempting to return to Sacramento Mather Airport (MHR), Rancho Cordova, California, for an emergency landing. Emery flight 17 was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 121 as a cargo flight from MHR to James M. Cox Dayton International Airport (DAY), Dayton, Ohio. The flight departed MHR about 1949, with two pilots and a flight engineer on board. The three flight crew members were killed, and the airplane was destroyed. Night visual meteorological conditions prevailed for the flight, which operated on an instrument flight rules (IFR) flight plan.