Yet more on UAL 727 crash

From:         rdd@cactus.org (Robert Dorsett)
Date:         15 Feb 93 16:05:34 PST
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This is all from _Safety Last: The Dangers of Commercial Aviation:
an Indictment by an Airline Pilot_, by Captain X #1 (not to be confused with
the other Captain X--nice how these pilots take responsibility for their
opinions, isn't it? :-)), Dial Press, New York, 1972, pp. 220-224.  While my 
recollection was somewhat detailed, it differed from the reality in a few 
important, imaginative respects. :-)

To tell you where X is coming from:
    FAA is evil.
    NTSB is its cohort.
    Airlines pull the strings, and is thus absolute evil.
    Manufacturers do their best, but make faulty equipment.
    Chief pilots are the airline's lackeys.
    ALPA represents all that is good and honest.
    You are in mortal peril whenever you board an airplane.

All that aside, he does illustrate the sequence of events rather well. :-)
Note that regulatory comments are out of date, but to the best of my
knowledge, no standardized changes to MEL's have ever been made.


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On January 18, 1969, United's Flight 266, a Boeing 727, left Los Angeles
International terminal and received taxi clearance to runway 24.  An extended 
area of fog, rain and low clouds prevailed along most of the California
coastline.  The official airport weather was rain and fog, 700 feet scattered
clouds, measured 1000' broken, and a visibility of 3 miles.  

Captain Leonard Leverson, forty-nine, had recently completed upgrading 
training on the DC-8 and had not flown a 727 for forty-seven days (FAA 
allows a pilot to go as long as three months without flying before becoming
unqualified).  His first officer, Walter R. Schlemer, had logged nearly
2,000 hours in the tri-jet, and Engineer Ostrander, who was relatively new
at the game, had barely 500 hours, only 40 of them in the Boeing 727.

Captain Leverson had acknowledged his permission to taxi onto the active
runway.  At 6:16 PM, the tower issued the following instructions: "United
266 cleared for takeoff."

F/O Schlemer answered, "United 266 rolling."

The few remaining check list items were completed.

"Engine start switches."
"3 on."
"Antiskid."
"On.  Yeah, that's good."
"Oil cooler coming ground off."
"They're stabilized."

Captain Leverson said, "Take off thrust."

F/O Schlemer replied, "Set looks good."

As the craft gathered speed down the rain-soaked runway the jargon familiar
to all pilots was heard as the F/O called off vital speed information:
"100, 110, 120, VR, V2."

Captain Leverson gave the thumbs-up signal and called, "Gear up."

The tower operator's voice came over the cockpit speakers: "United 266, 
contact departure control."

"United 266 on departure."

"United 266, Los Angeles departure radar contact, turn right heading 270
degrees, report leaving 3,000."

"270 degrees wilco."

The efficient cockpit crew were startled by flashing red lights and the spine
tingling CLANG! CLANG! CLANG! of the emergency system.

"What the hell was that?" asked the Captain.

"Number one fire warning," Walter shouted.

"OK, let's take care of the warning."

"That puts us on one generator," said Walter.

As Leonard answered his first officer he was already starting a turnback to
the field: "Yeah, yeah, watch the electrical loading."

The flight was now over the Pacific Ocean and flying on instruments at night 
and in the clouds.  Walter was again working the radio: "Ah--departure, 
United 266."

"United 266 go ahead."

"Ah--we've had a fire warning on number-one engine, we shut down, we'd
like to come back."

"United 266, Roger.  What is your present altitude?  United 266,
maintain 3000 and say your altitude... United 266, say your altitude."

There was no time for the flight crew to bother with radio contacts.
Far more important things were happening in the cockpit.  The engineer's
panel resembled a giant pinball machine.  Warning lights were flashing 
rapidly, and there was little time to cope with them.

"We're going to get screwed up," said the engineer.  "I don't know what's
going on."  All cockpit instruments stopped functioning.  All that remained 
were the rate instruments, vertical speed, altimeter and air speed.  There
were no backup instruments.  With the existing flight conditions it would
be impossible to keep a plane right side up.

First Officer Schlemer, desperately trying to aid his captain, shouted,
"Keep it going up, Arnie.  You're a thousand feet... pull it up!"

The departure controller continued his frantic calls: "United 266, if you
hear us squawk 0200 or 0400... United 266, if you hear turn right heading
260 degrees."

The air traffic controller knew that the calls were in vain but he
could hope.  As the sweep of the radar antenna on his scope showed, one of
his targets was missing.  United 266 had disappeared into the ocean 11 miles 
off shore.  Thirty-eight more deaths added to the list of company and FAA
carelessness.

United was experiencing more than its share of engin shutdowns.  From 1966 to
1969 over seventy engines were shut down in flight.  Only ten proved to
be false-alarm warnings.  The Boeing Company issued a service bulletin, 
#25-15, in May 1968.  This directive made it optional to replace a sensor in
the engines so that an increase of 50 F would be necessary before a warning
would actuate the fire bell in the cockpit.  This was not done on the 
affected engine.

In January 1969 the No. 3 generator control panel was removed and replaced
with a panel that had been proved defective on eight differnt aircraft for
varying reasons.  But this was the one on board the night of the crash.  This
generator system had a long history of "bugs."  In September 1966 a Westing-
house service bulletin recommended replacement of a silicone rectifier
for their generators which supplied electricity to this aircraft.  This was 
not done.   The #3 generator was kicking up such a fuss that maintenance
reverted to their old standby, the MEL (the minimum equipment list which
specifies the number of components that can be malfunctioning on a flight).
So the generator was rendered inoperative.  The 727 had its blessings from 
the FAA to fly on two generators, which it did for a total of three days.  The 
craft had 41 flying hours on it during that period, but it was not repaired
at any of the stations because of the exigencies of available aircraft and
flight scheduling.

When Marvin Whitlock, senior vice president, Operations, for United, was
asked his opinion of this matter, he said, "I'm not proud of the 41 hours, but
I don't feel that way because of safety."

During the months of June and July of 1969, United Air Lines experienced three
more complete generator failures, but they were unable to duplicate each 
incident.  The cause of the failures is stil under investigation.

The board made the following conclusion: the entire electrical system was
placed on the #2 generator and it could not stand the load.  Yet they stil
maintain that a two-generator operation is safe.  ALPA recommends that "All
pilots not accept aircraft with an inoperative generator, as it is considered
by the association as unsafe."

The remains of the #1 engine were thoroughly examined and it was
determined that the fire extinguisher warning that the crew received was 
false, and that no traces of fire were found.  If the Westinghouse bulletin
had been heeded and an element of higher rating installed, the false warning
might never have come on and the accident could have been averted.

There are two vital switches within three inches of each other on the flight
engineer's panel: they galley power, which is a tremendous drain on the
electrical system, and the battery switch, which controls the essential power
to the vital intruments when the generators are inoperative.  Since these
two switches look identical in a dimly lit cockpit, during a confusing
episode it would be extremely easy to turn the wrong switch off, which is one
possibility in this accident.  As the galley power switch must be turned off 
to reduce the electircal load during an emergency condition, it would seem 
only proper that a guard be positioned over the battery switch.

Months prior to the accident, a United pilot wrote a letter to his chief pilot
suggesting that a guard be placed over the battery switch before it caused an
accident.  The answer was to the effect that his was the thirteenth letter 
to date with the same idea in mind.  United felt there was no need for such a
guard, although his efforts were appreciated.  No action was taken on the 
matter.  

On January 31, 1969, the FAA issued an airworthiness directive requiring all 
B-727 operators to provide a means to prevent inadvertent operation of the 
battery switch on those aircraft in which the battery control is located
within ten inches of the battery power switch.

Battery power can be a vital commodity as the preceding accident proves.  Yet
the majority of today's jets have this switch crowded on both sides with sim-
ilar ones; it looks like a row of tin soldiers.  They are not guarded, just
lying in wait to trigger another accident.

In spite of the warnings given by ALPA about dispatching an aircraft with one
of the generators inoperative, and obviously disregarding the crash of one of
their planes, United Air Lines has made no changes in their minimum equip-
ment list.  As of Januaary 1971 their MEL still allows a two-generator
operation.  And that's two years after the lesson should have been learned.


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