Crash of a De Havilland DHC-2 Beaver near Les Bergeronnes: 6 killed

Date & Time: Aug 23, 2015 at 1127 LT
Type of aircraft:
De Havilland DHC-2 Beaver
Operator:
Registration:
C-FKRJ
Flight Phase:
Flight
Flight Type:
Charter/Taxi (Non Scheduled Revenue Flight)
Survivors:
No
Site:
Plain, Valley
Schedule:
Lac Long - Lac Long
MSN:
1210
YOM:
1958
Location:
Les Bergeronnes
Quebec
Country:
Canada
Region:
North America
Crew on board:
1
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
6
Captain / Total flying hours:
5989
Captain / Total hours on type:
4230.00
Aircraft flight hours:
25223
Circumstances:
The float-equipped de Havilland DHC-2 Mk. 1 Beaver (registration C-FKRJ, serial number 1210), operated by Air Saguenay (1980) inc., was on a visual flight rules sightseeing flight in the region of Tadoussac, Quebec. At 1104 Eastern Daylight Time, the aircraft took off from its base on Lac Long, Quebec, for a 20-minute flight, with 1 pilot and 5 passengers on board. At 1127, on the return trip, approximately 2.5 nautical miles north-northwest of its destination (7 nautical miles north of Tadoussac), the aircraft stalled in a steep turn. The aircraft descended vertically and struck a rocky outcrop. The aircraft was substantially damaged in the collision with the terrain and was destroyed by the post-impact fire. The 6 occupants received fatal injuries. No emergency locator transmitter signal was captured.
Probable cause:
Findings as to causes and contributing factors:
1. The pilot performed manoeuvres with a reduced safety margin at low altitudes. As a result, these flights involved a level of risk that was unnecessary to attain the objectives of sightseeing flights.
2. With no restrictions on manoeuvres and no minimum altitude prescribed by the company prior to flight, the pilot flew according to his own limits and made a steep turn at approximately 110 feet above ground level.
3. When the pilot made a steep left turn, aerodynamic stalling ensued, causing an incipient spin at an altitude insufficient to allow control of the aircraft to be regained prior to vertical collision with the terrain.
4. The absence of an angle-of-attack indicator system and an impending stall warning device deprived the pilot of the last line of defence against loss of control of the aircraft.

Findings as to risk:
1. If lightweight flight data recording systems are not used to closely monitor flight operations, there is a risk that pilots will deviate from established procedures and limits, thereby reducing safety margins.
2. If Transport Canada does not take concrete measures to facilitate the use of lightweight flight data recording systems and flight data monitoring, operators may not be able to proactively identify safety deficiencies before they cause an accident.
3. If pilots do not obtain at least the regulatory rest periods, there is a risk that flights will be conducted when pilots are fatigued.
4. Unless all flights made are recorded in the pilot’s logbook and monitored by the company, it is possible that the pilot will not receive the required rest periods, which increases the risk of flights being conducted when the pilot is fatigued.
5. If flights made are not recorded in the aircraft’s journey logbook, it is possible that inspection and maintenance schedules and component lifetimes will be exceeded, increasing the risk of failure.
6. Unless safety management systems are required, assessed, and monitored by Transport Canada in order to ensure continual improvement, there is an increased risk that companies will not be able to identify and effectively mitigate the hazards involved in their operations.
7. If pilots do not receive stall training that demonstrates the aircraft’s actual behaviour in a steep turn under power, there is a high risk of loss of control.

Other findings:
1. The replacement of the ventral fin with Seafins on C-FKRJ was in compliance with the requirements of Kenmore Air Harbor Inc.’s supplemental type certificate.
2. The control wheel was in the left-hand position (pilot side) at the moment of impact.
3. Angle-of-attack indicator systems have been recognized as contributing to flight safety by improving pilot awareness of the stall margin at all times, thereby allowing pilots to react in order to prevent loss of control of the aircraft.
4. Stall warning systems have been recognized as a means of improving flight safety by providing a clear, unambiguous warning of an impending stall.
Final Report:

Crash of a Let L-410UVP in Červený Kameň: 4 killed

Date & Time: Aug 20, 2015 at 0921 LT
Type of aircraft:
Let L-410
Operator:
Registration:
OM-ODQ
Flight Phase:
Flight
Flight Type:
Skydiving / Paratroopers
Survivors:
Yes
Site:
Plain, Valley
Schedule:
Dubnica - Dubnica
MSN:
84 13 20
YOM:
1984
Location:
Červený Kameň
Trenčín Region
Country:
Slovakia
Region:
Europe
Crew on board:
2
Crew fatalities:
Pax on board:
17
Pax fatalities:
Other fatalities:
Total fatalities:
4
Captain / Total flying hours:
10625
Aircraft flight hours:
8021
Circumstances:
The twin engine aircraft was carrying 17 skydivers and two pilots and was performing a skydiving mission with another Let L-410 owned by the same operator. Registered OM-SAB, the second aircraft was carrying 17 skydivers and 2 pilots as well. Both crew were preparing a program for an airshow scheduled next Sunday August 23. While climbing to an altitude of about 1,400 - 1,500 metres, the pilot of OM-ODQ was trying to get closer to OM-SAB when both aircraft collided. All but three skydivers were able to bail out prior both aircraft crashed in a wooded area located north of the airfield. All four crew members were killed and three skydivers as well, one in OM-SAB and two in OM-ODQ.
Probable cause:
The main cause of the in-flight collision was a poor flight management on part of the OM-ODQ captain.
Contributing factors:
- The captain of OM-ODQ was using a mobile phone at the time of the collision,
- The total weight of OM-ODQ at the time of the accident was above MTOW.
Final Report:

Crash of a Let L-410MA in Červený Kameň: 3 killed

Date & Time: Aug 20, 2015 at 0921 LT
Type of aircraft:
Let L-410
Operator:
Registration:
OM-SAB
Flight Phase:
Flight
Flight Type:
Skydiving / Paratroopers
Survivors:
Yes
Site:
Plain, Valley
Schedule:
Dubnica - Dubnica
MSN:
75 04 05
YOM:
1975
Location:
Červený Kameň
Trenčín Region
Country:
Slovakia
Region:
Europe
Crew on board:
2
Crew fatalities:
Pax on board:
17
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
8404
Copilot / Total flying hours:
235
Aircraft flight hours:
5618
Circumstances:
The twin engine aircraft was carrying 17 skydivers and two pilots and was performing a skydiving mission with another Let L-410 owned by the same operator. Registered OM-ODQ, the second aircraft was carrying 17 skydivers and 2 pilots as well. Both crew were preparing a program for an airshow scheduled next Sunday August 23. While climbing to an altitude of about 1,400 - 1,500 metres, the pilot of OM-ODQ was trying to get closer to OM-SAB when both aircraft collided. All but three skydivers were able to bail out prior both aircraft crashed in a wooded area located north of the airfield. All four crew members were killed and three skydivers as well, one in OM-SAB and two in OM-ODQ.
Probable cause:
The main cause of the in-flight collision was a poor flight management on part of the OM-ODQ captain.
Contributing factors:
- The captain of OM-ODQ was using a mobile phone at the time of the collision,
- The total weight of OM-ODQ at the time of the accident was above MTOW.
Final Report:

Crash of an ATR42-300 near Oksibil: 54 killed

Date & Time: Aug 16, 2015 at 1455 LT
Type of aircraft:
ATR42-300
Operator:
Registration:
PK-YRN
Flight Phase:
Flight
Flight Type:
Scheduled Revenue Flight
Survivors:
No
Site:
Mountains
Schedule:
Jayapura - Oksibil
MSN:
102
YOM:
1988
Flight number:
TGN267
Location:
Oksibil
Special Region of Papua
Country:
Indonesia
Region:
Asia
Crew on board:
4
Crew fatalities:
Pax on board:
50
Pax fatalities:
Other fatalities:
Total fatalities:
54
Captain / Total flying hours:
25287
Captain / Total hours on type:
7340.00
Copilot / Total flying hours:
3818
Copilot / Total hours on type:
2640
Aircraft flight hours:
50133
Aircraft flight cycles:
55663
Circumstances:
An ATR 42-300 aircraft registered PK-YRN was being operated by PT Trigana Air Service on 16 August 2015 as scheduled passenger flight with flight number IL267 from Sentani to Oksibil. On board of this flight were 54 persons. This flight was the fifth flight of the day and the second flight from Sentani to Oksibil. The aircraft departed Sentani at 0522 UTC and estimated time of arrival Oksibil was at 0604 UTC. The Second in Command (SIC) acted as Pilot Flying while the Pilot in Command (PIC) acted as Pilot Monitoring. The weather at Oksibil reported that the cloud was broken (more than half area of the sky covered by cloud) and the cloud base was 8,000 feet (4,000 feet above airport elevation) and the visibility was 4 up to 5 km. The area of final approach path was covered by clouds. The flight cruising at 11,500 feet and at 0555 UTC, the pilot made first contact with Oksibil Aerodrome Flight Information Services (AFIS) officer, reported on descent at position Abmisibil and intended to direct left base leg runway 11. At 0600 UTC, Oksibil AFIS officer expected the aircraft would have been on final but the pilot had not reported, the AFIS officer contacted the pilot but did not reply. The AFIS officer informed Trigana in Sentani that they had lost contact with IL267. The aircraft wreckage was found on a ridge of Tanggo Mountain, Okbape District, Oksibil at approximately 8,300 feet AMSL at coordinates of 04°49’17.34” S, 140°29’51.18” E, approximately 10 NM from Oksibil Aerodrome on bearing of 306°. All occupants were fatally injured and the aircraft was destroyed by impact force and post impact fire. The Flight Data Recorder (FDR) and Cockpit Voice Recorder were recovered and transported to KNKT recorder facility. The recovery of FDR data was unsuccessful while the recovery of CVR data successfully retrieved accident flight data. The CVR did not record any crew briefing, checklist reading not EGPWS warning prior to impact. The CVR also did not record EGPWS altitude call out on two previous flights. The investigation concluded that the EGPWS was probably not functioning.
Probable cause:
The following findings were identified:
1. The aircraft had valid Certificate of Airworthiness and was operated within the weight and balance envelope.
2. All crew had valid licenses and medical certificates.
3. The flight plan form was filed with intention to fly under Instrument Flight Rule (IFR), at flight level 155, with route from Sentani to MELAM via airways W66 then to Oksibil. The MORA of W66 between Sentani to MELAM was 18,500 feet.
4. The flight was the 5th flight of the day for the crew with the same aircraft and the second flight on the same route of Sentani to Oksibil.
5. The CVR data revealed that the previous flight from Sentani to Oksibil the flight cruised at altitude of 11,500 feet and the approach was conducted by direct to left base runway 11.
6. The CVR data also revealed that on the accident flight, the flight cruised at altitude 11,500 feet and intended to direct left base leg runway 11 which was deviate from the operator visual guidance approach that described the procedure to fly overhead the airport prior to approach to runway 11.
7. The witness stated that most of the time, the flight crew deviated from the operator visual approach guidance. The deviation did not identify by the aircraft operator.
8. The downloading process to retrieve data from the FDR was unsuccessful due to the damage of the FDR unit that most likely did not record data during the accident flight. The repetition problems of the FDR unit showed that the aircraft operator surveillance to the repair station was not effective.
9. The CVR did not record any crew briefing, checklist reading and EGPWS altitude callout prior to land on two previous flights nor the EGPWS caution and warning prior to impact.
10. The spectrum analysis of the CVR determined that both engines were operating prior to the impact.
11. Several pilots, had behavior of pulling the EGPWS CB to eliminate the nuisance of EGPWS warning. The pilots stated that the reason for pulling the EGPWS CB was due to the pilots considered this warning activation was not appropriate for the flight conditions. The correction to this behavior was not performed prior to the accident.
12. The investigation could not determine the actual EGPWS CB position during the accident flight.
13. The installation of EGPWS by the aircraft operator was not conducted according to the Service Bulletin issued by the aircraft manufacturer.
14. The terrain data base installed in the EGPWS of PK-YRN was the version MK_VIII_Worldwide_Ver_471 that was released in 2014. The Oksibil Airport was not included in the high-resolution update in this version of terrain database.
15. The information for Oksibil published in AIP volume IV (Aerodrome for Light Aircraft/ALA) did not include approach guidance. The operator issued visual guidance of circling approach runway 11 for internal use.
16. The visual approach guidance chart stated that the minimum safe altitude was 8,000 feet while the aircraft impacted with terrain at approximately 8,300 feet. This indicated an incorrect information in the chart. The investigation considered that the pattern on the approach guidance chart was not easy to fly, as many altitudes and heading changes.
17. Several maintenance records such as component status installed on the aircraft and installation of EGPWS was not well documented. This indicated that the maintenance management was not well performed.
18. The investigation could not find any regulation that describes the pilot training requirement for any addition or modification of aircraft system which affect to the aircraft operation.
19. There was no information related to the status of ZX NDB published on NOTAM prior to the accident.
20. Several safety issues indicated that the organization oversight of the aircraft operator by the regulator was not well implemented.
Contributing Factors:
1. The deviation from the visual approach guidance in visual flight rules without considering the weather and terrain condition, with no or limited visual reference to the terrain resulted in the aircraft flew to terrain.
2. The absence of EGPWS warning to alert the crew of the immediate hazardous situation led to the crew did not aware of the situation.
Final Report:

Crash of a Cessna 208B Super Cargomaster off Saba Island

Date & Time: Aug 12, 2015 at 1205 LT
Type of aircraft:
Cessna 208B Grand Caravan
Operator:
Registration:
N924FE
Flight Phase:
Flight
Flight Type:
Cargo
Survivors:
Yes
Site:
Lake, Sea, Ocean, River
Schedule:
San Juan – Basseterre
MSN:
208B-0024
YOM:
1987
Flight number:
FDX8124
Location:
Juancho E. Yrausquin (Saba Island)
Dutch Antilles
Country:
Dutch Antilles
Region:
Central America
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The pilot departed San Juan-Luis Muñoz Marín Airport at 1049LT on a cargo flight to Basseterre-Robert L. Bradshaw International Airport, Saint Kitts & Nevis. The flight was performed by Mountain Air Cargo on behalf of FedEx. The pilot continued the flight at FL110 until 1139LT, reduced his altitude down to FL100 and maintained this level until 1153LT. At this moment, the aircraft was descending between 600 and 800 feet per minute and the pilot decided to divert to the Juancho E. Yrausquin Airport located on Saba Island, Dutch Antilles. While approaching to island from the south, the pilot realized he would not make it, so he attempted to ditch the aircraft some 900 metres off shore. The pilot evacuated the cabin and was quickly rescued while the aircraft sank by a depth of about 1,500 feet. According to the pilot, he decided to divert to the nearest airport due to a loss of engine power.

Crash of a De Havilland DHC-2 Beaver near Barkárdal: 1 killed

Date & Time: Aug 9, 2015 at 1445 LT
Type of aircraft:
De Havilland DHC-2 Beaver
Operator:
Registration:
N610LC
Flight Phase:
Flight
Flight Type:
Ferry
Survivors:
Yes
Site:
Mountains
Schedule:
Akureyri – Keflavik
MSN:
1446
YOM:
1960
Location:
Barkárdal
Northeastern Region (Norðurland eystra)
Country:
Iceland
Region:
Europe
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
22000
Captain / Total hours on type:
250.00
Circumstances:
At 14:01 on August 9th, 2015, a pilot along with a friend, a contracted ferry flight pilot, planned to fly airplane N610LC, which is of the type De Havilland DHC-2 Beaver, under Visual Flight Rules (VFR) from Akureyri Airport to Keflavik Airport in Iceland. The purpose of the flight was to ferry the airplane from Akureyri to Minneapolis/St. Paul in the United States, where the airplane was to be sold. The airplane was initially flown in Eyjafjörður in a northernly direction from Akureyri, over Þelamörk and then towards and into the valley of Öxnadalur. The cloud ceiling was low and it was not possible to fly VFR flight over the heath/ridge of Öxnadalsheiði. The airplane was turned around in the head of the valley of Öxnadalur and flown towards the ridge of Staðartunguháls, where it was then flown towards the heath/ridge of Hörgárdalsheiði at the head of the valley of Hörgárdalur. In the valley of Hörgárdalur it became apparent that the cloud base was blocking off the heath/ridge of Hörgárdalsheiði, so the airplane was turned around again. The pilots then decided to fly around the peninsula of Tröllaskagi per their original backup plan, but when they reached the ridge of Staðartunguháls again the pilots noticed what looked like a break in the cloud cover over the head of the valley of Barkárdalur. A spontaneous decision was made by the pilots to fly into the valley of Barkárdalur. The valley of Barkárdalur is a long narrow valley with 3000 – 4500 feet high mountain ranges extending on either side. At the head of the valley of Barkárdalur there is a mountain passage at an elevation of approximately 3900 ft. About 45 minutes after takeoff the airplane crashed in the head of the valley of Barkárdalur at an elevation of 2260 feet. The pilot was severely injured and the ferry flight pilot was fatally injured in a post crash fire.
Probable cause:
Causes:
- According to the ITSB calculations the airplane was well over the maximum gross weight and the airplane’s performance was considerably degraded due to its overweight condition.
Weather
- VFR flight was executed, with the knowledge of IMC at the planned flight route across Tröllaskagi. The airplane was turned around before it entered IMC on two occasions and it crashed when the PF attempted to turn it around for the third time.
- Favorable weather on for the subsequent flight between Keflavik Airport and Greenland on August 10th may have motivated the pilots to fly the first leg of the flight in poor weather conditions on August 9th.
Terrain
- The pilots failed to take into account the geometry of the valley of Barkárdalur, namely its narrow width and the fast rising floor in the back of the valley.
Contributing factors:
CRM - Inadequate planning
- The W&B calculations performed by the PF prior to the flight were insufficient, as the airplane’s weight was well over the maximum gross weight of the airplane.
- The plan was to look for an opening (in the weather), first in the head of the valley of Öxnadalur, then the head of Hörgárdalur and finally in the head of Barkárdalur.
- The decision to fly into the valley of Barkárdalur was taken spontaneously, when flying out of the valley of Hörgárdalur and the pilots noticed what looked like a break in the cloud cover over the head of the valley of Barkárdalur.
CRM – Failed to conduct adequate briefing
- A failure of CRM occurred when the PNF did not inform the PF of the amount of fuel he added to the airplane prior to the flight.
Overconfidence
- The special ferry flight permit the pilots received for the ferry flight to Iceland in 2008 may have provided the pilots with a misleading assumption that such loading of the airplane in 2015 was also satisfactory.
Continuation bias
- The pilots were determined to continue with their plan to fly to Keflavik Airport, over the peninsula of Tröllaskagi, in spite of bad weather condition.
Loss of situational awareness
- The pilots were not actively managing the flight or staying ahead of the aircraft, taking into account various necessary factors including performance, weather and terrain.
- The airplane most likely incurred severe carburetor icing in Barkárdalur.
Final Report:

Crash of a Casa CN-235M-100 in Agustín Codazzi: 11 killed

Date & Time: Jul 31, 2015 at 1430 LT
Type of aircraft:
Casa-Nurtanio CN-235 (IPTN)
Operator:
Registration:
FAC1261
Flight Phase:
Flight
Flight Type:
Military
Survivors:
No
Site:
Plain, Valley
Schedule:
Palanquero – Valledupar – Barranquilla
MSN:
C-118
YOM:
1997
Location:
Agustín Codazzi
Cesar
Country:
Colombia
Region:
South America
Crew on board:
11
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
11
Circumstances:
The aircraft departed Palanquero AFB on a flight to Barranquilla with an intermediate stop in Valledupar. While cruising in poor weather conditions, the crew informed ATC about an engine failure when radio contact was lost. The aircraft entered an uncontrolled descent and crashed in a field located near Agustín Codazzi, some 50 km south of Valledupar. The aircraft was totally destroyed by impact forces and there was no fire. All 11 crew members were killed. The airplane was completing a special mission on behalf of the Colombian Intelligence Forces.
Crew:
Maj Adalberto Ramírez,
Lt Sergio Bojacá,
2nd Lt Luisa Salazar,
2nd Lt Andrés Rojas,
1st Tec Juan Carlos Correa,
Tec Jorge Iván Angulo,
Tec Giovany Roa,
Tec Tercero Juan Camilo Rivera,
Tec Tercero Hawer Moreno,
Tec Elkin Sierra,
Tec Édgar Contreras.

Crash of a Cessna 207A Skywagon near Point Howard: 1 killed

Date & Time: Jul 17, 2015 at 1318 LT
Type of aircraft:
Cessna 207 Skywagon/Stationair
Operator:
Registration:
N62AK
Flight Phase:
Flight
Flight Type:
Scheduled Revenue Flight
Survivors:
Yes
Site:
Mountains
Schedule:
Juneau – Hoonah
MSN:
207-0780
YOM:
1984
Flight number:
K5202
Location:
Point Howard
Alaska
Country:
United States of America
Region:
North America
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
845
Captain / Total hours on type:
48.00
Aircraft flight hours:
26613
Circumstances:
The company flight coordinator on duty when the pilot got her "duty-on" briefing reported that, during the "duty-on" briefing, he informed the commercial pilot that most flights to the intended destination had been cancelled in the morning due to poor weather conditions and that one pilot had turned around due to weather. No record was found indicating that the pilot used the company computer to review weather information before the flight nor that she had received or retrieved any weather information before the flight. If she had obtained weather information, she would have seen that the weather was marginal visual flight rules to instrument flight rules conditions, which might have affected her decision to initiate the flight. The pilot subsequently departed for the scheduled commuter flight with four passengers on board; the flight was expected to be 20 minutes long. Review of automatic dependent surveillance-broadcast data transmitted by the airplane showed that the airplane's flight track was farther north than the typical track for the destination and that the airplane did not turn south toward the destination after crossing the channel. Data from an on board multi-function display showed that, as the airplane approached mountainous terrain on the west side of the channel, the airplane made a series of erratic pitch-and-roll maneuvers before it impacted trees and terrain. Post-accident examination of the airframe and engine revealed no mechanical malfunctions or anomalies that would have precluded normal operation. One of the passengers reported that, after takeoff, the turbulence was "heavy," and there were layers of fog and clouds and some rain. Based on the weather reports, the passenger statement regarding the weather, and the flight's erratic movement just before impact, it is likely that the flight encountered instrument meteorological conditions as it approached the mountainous terrain and that the pilot then lost situational awareness and flew into trees and terrain. According to the company's General Operations Manual (GOM), operational control was delegated to the flight coordinator for the accident flight, and the flight coordinator and pilot-in-command (PIC) were jointly responsible for preflight planning, flight delay, and flight release, which included completing the flight risk assessment (FRA) process. This process required the PIC to fill out an FRA form and provide it to the flight coordinator before flight. However, the pilot did not fill out the form. The GOM stated that one of the roles of the flight dispatcher (also referred to as "flight coordinator") was to assist the pilot in flight preparation by gathering and disseminating pertinent information regarding weather and any information deemed necessary for the safety of flight. It also stated that the dispatcher was to assist the PIC as necessary to ensure that all items required for flight preparation were accomplished before each flight. However, the flight coordinator did not discuss all the risks and weather conditions associated with the flight with the pilot, which was contrary to the GOM. When the flight coordinator who was on duty at the time the airplane was ready to depart did not receive a completed FRA, he did not stop the flight from departing, which was contrary to company policy. By not completing an FRA, it is likely the total risks associated with the accident flight were not adequately assessed. Neither the pilot nor the flight coordinator should have allowed the flight to be released without having completed an FRA form, which led to a loss of operational control and the failure to do so likely contributed to the accident. Interviews with company personnel and a review of a sampling of FRA forms revealed that company personnel, including the flight coordinators, lacked a fundamental knowledge of operational control theory and practice and operational practices (or lack thereof), which led to a loss of operational control for the accident flight. The company provided no formal flight coordinator training nor was a formal training program required. All of the company's qualified flight coordinators were delegated operational control and, thus, were required by 14 Code of Federal Regulations Section 119.69 to be qualified through training, experience, and expertise and to fully understand aviation safety standards and safe operating practice with respect to the company's operation and its GOM. However, the company had no formal method of documenting these requirements; therefore, it lacked a method of determining its flight coordinators' qualifications. In post-accident interviews, the previous Federal Aviation Administration (FAA) principal operations inspector (POI), who became the frontline manager over the certificate, stated that the company used the minimum regulatory standard when it came to ceiling and visibility requirements and that the company did not have any company minimums in place. He further stated that a cloud ceiling of 500 ft and 2 miles visibility would not allow for power-off glide to land even though the company was required to meet this regulation. When asked if he believed the practice of allowing the pilot to decide when to fly was adequate, he said it was not and there should have been route altitudes. However, no action was taken to change SeaPort's operations. The POI at the time of the accident stated that she was also aware that the company was operating contrary to federal regulatory standards for gliding distance to shore. A review of FAA surveillance activities of the company revealed that the POI provided surveillance of the company following the accident, including an operational control inspection, and noted deficiencies with the company's operational procedures; however, the FAA did not hold the company accountable for correcting the identified operational deficiencies. If the FAA had conducted an investigation or initiated an enforcement action pertaining to the company's apparent disregard of the regulatory standard for maintaining glide distance before the accident similar to the inspection conducted following the accident, it is plausible the flight would not have departed or continued when glide distance could not be maintained. The FAA's failure to ensure that the company corrected these deficiencies likely contributed to this accident which resulted, in part, from the company's failure to comply with its GOM and applicable federal regulations, including required glide distance to shore. The company was the holder of a Medallion Shield until they voluntarily suspended the Shield status but retained the "Star" status and continued advertising as a Shield carrier. Medallion stated in an email "With this process of voluntarily suspension, there will be no official communication to the FAA…" Given that Medallion advertises that along with the Shield comes recognition by the FAA as an operator who incorporates higher standards of safety, it seems contrary to safety that they would withhold information pertaining to a suspension of that status.
Probable cause:
The pilot's decision to initiate and continue visual flight into instrument meteorological conditions, which resulted in a loss of situational awareness and controlled flight into terrain.
Contributing to the accident were the company's failure to follow its operational control and flight release procedures and its inadequate training and oversight of operational control
personnel. Also contributing to the accident was the Federal Aviation Administration's failure to hold the company accountable for correcting known regulatory deficiencies and ensuring that it complied with its operational control procedures.
Final Report:

Crash of a Canadair CL-215-1A10 in Faraklo

Date & Time: Jul 17, 2015 at 1305 LT
Type of aircraft:
Canadair CL-215
Operator:
Registration:
1070
Flight Phase:
Flight
Flight Type:
Fire fighting
Survivors:
Yes
Site:
Mountains
MSN:
1070
YOM:
1980
Location:
Faraklo
Peloponnese / Πελοπόννησος
Country:
Greece
Region:
Europe
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The crew was engaged in a fire fighting mission over the Peloponnese Area when he encountered technical problems. He attempted an emergency landing when the aircraft crash landed in a hilly terrain. Both pilots escaped uninjured and the aircraft was damaged beyond repair.

Crash of a Tupolev TU-95MS near Litovko: 2 killed

Date & Time: Jul 14, 2015 at 1650 LT
Type of aircraft:
Tupolev TU-95
Operator:
Registration:
RF-94204
Flight Phase:
Flight
Flight Type:
Survey / Patrol / Reconnaissance
Survivors:
Yes
Site:
Plain, Valley
Schedule:
Ukrainka - Ukrainka
MSN:
00854
YOM:
1984
Location:
Litovko
Khabarovsk Krai
Country:
Russia
Region:
Asia
Crew on board:
7
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
The crew was performing a training/reconnaissance mission out from Ukrainka AFB. While cruising at an altitude of 5,000 metres in clouds and icing conditions, three of the four engines failed. At an altitude of 3,500 metres, all seven crew members bailed out and the aircraft crashed in a tundra located some 30 km from Litovko, Amur district of the Khabarovsk region. Five crew members survived while two others were killed. The registration of the 'Bear' was dual RF-94204 and 77 Red.
Probable cause:
Triple engine failure while flying icing conditions.
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