IMPROPER MAINT PROC USED AND INSPECTOR FAILED TO CATCH ERROR. ACFT LATER LOSES #1 ENG AS IT COMES OFF IT'S DIAGONAL INTERNAL SUPPORTS.

Date: 1994-02 · Aircraft: B747-100 · Phase: ground

Anomalies: aircraft-equipment-problem-critical|deviation-discrepancy-procedural-other-unknown

Synopsis

IMPROPER MAINT PROC USED AND INSPECTOR FAILED TO CATCH ERROR. ACFT LATER LOSES #1 ENG AS IT COMES OFF IT'S DIAGONAL INTERNAL SUPPORTS.

Narrative

I GAVE AN OK TO CLOSE OF HYD COMPARTMENT ON #1 ENG ON FEB/94. PER CITEX. CALLBACK CONVERSATION WITH RPTR REVEALED THE FOLLOWING INFO: RPTR WAS CALLED BACK FOR ADDITIONAL INFO TO FILL IN THE 'SKETCHY' RPT FILED WITH ASRS. THE INCIDENT DEALS WITH THE FINAL INSPECTION OF A B-747-200 THAT WAS TO BE RETURNED TO SVC FOR FLT DUTY. THE PREVIOUS INSPECTOR HAD PERFORMED AN INSPECTION FOR ACFT DAMAGE WITHIN THE NACELLE AND ENG SUPPORT AREA; CALLED AN 'ADT' INSPECTION. HE HAD STATED THAT IT WAS NOT NECESSARY TO REMOVE THE REAR DIAGONAL SAFETY CAPS OVER THE SAFETY PINS DURING HIS INSPECTION AND LABELED THE PAPER WORK 'N/A'. SPECULATION HAS IT THAT SOMEONE (ACR COULD NOT FIND OUT WHO THIS WAS) LATER REMOVED THE SAFETY CAPS AND SINCE THERE WAS NO PAPER WORK FOR THE REMOVAL; THERE WAS NO PAPER WORK FOR THEIR RE-INSTALLATION. THE RPTR; AN INSPECTOR AS WELL; LOOKED INTO THE NACELLE SUPPORT AREA AND GAVE THE MECHS THE OK TO CLOSE IT UP. HE FAILED TO SEE THAT THE CAPS WERE MISSING. DURING THE COURSE OF THE 5 DAYS ENSUING THIS INSPECTION THE REAR SAFETY PINS VIBRATED LOOSE AND THE ACFT LOST THE FRONT AND REAR SUPPORTS ON A LNDG AT NRT ARPT DURING REVERSING. FIRE ENSUED AS THE ENG PIVOTED ON IT'S CTR SUPPORTS AND DRAGGED ON THE RWY. FIRE WAS CTLED AND ACFT OTS A LONG TIME. RPTR STATES THAT THE ACR IS USUALLY IN A RUSH FOR THEIR ACFT AND THIS BEING A WKEND; THE MAINT CREWS WERE SHORTHANDED DURING THE INSPECTION. CREWS FELT 'PUSHED'. RPTR IS SUBJECT TO FAA PENALTIES AND ACR FINES TO A SUBSTANTIAL DEG. THE ACR'S PAPER WORK HAS BEEN CHANGED TO CORRECT SIT.

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Source: NASA Aviation Safety Reporting System (public domain). Reports are voluntary submissions and are not verified by NASA.