NTSB Factual Report

HISTORY OF FLIGHT

On July 15, 1998, about 1155 central daylight time, a Cessna 150E, N3549J, registered to Bay Banners, Inc., experienced an in-flight loss of control and crashed shortly after takeoff from a private airstrip near Panama City Beach, Florida. Visual meteorological conditions prevailed at the time and no flight plan was filed for the 14 CFR Part 91 banner towing flight. The airplane was substantially damaged and the commercial-rated pilot, the sole occupant, was fatally injured. The flight originated from the airstrip about 5 minutes earlier.

According to the president of the operator, the day before the accident the pilot complained of a battery charging problem in the accident airplane. Both he and the pilot checked the engine and discovered that the bracket that secured the alternator to the engine "needed work." The day of the accident, both he and the pilot removed a bracket from another airplane and installed it in the accident airplane. The pilot installed the engine cowling and before departure, added a total of 27.2 gallons of automotive fuel to the fuel tanks, as documented by the fuel truck meter sheet. According to a ground crewmember of the operator, it was the pilot's first banner of the day and he heard the pilot start the engine and observed the pilot taxi to the runway but did not or could not hear the pilot perform an engine run-up before takeoff. The flight departed then circled the airport to return to pick up the banner. The pilot picked up the banner, but immediately dropped it when the lead pole was 3 feet off the ground. The ground crewmember did not hear a change in engine sound during the climb and heard the pilot report that he was returning to the field. Another company pilot who was airborne at the time and located about 1.5 miles from the crash site observed the airplane climb to about 300-350 feet agl without the banner. The airplane was observed banking to the right about 20 degrees from the runway heading then observed the airplane in a 30-degree angle of bank to the left. At the point where the witness thought the pilot should roll out of the bank to align the airplane with the extended runway centerline, the airplane rolled further to the left then began to spin to the left. He and the ground crewmember then lost sight of the airplane due to obstructions.

PERSONNEL INFORMATION

Review of the pilot's records revealed that he had received 16.3 hours of banner tow training between May 9 through May 15, 1998, at an airport located in Bunnell, Florida. The operator of the airplane stated that the accident pilot returned to his facility after receiving the training but his insurance company required additional training. The pilot's logbook indicates that on June 8, 1998, he received an additional 4.2 hours of flight training on two separate flights. The first flight lasting 1.6 hours included 10 pickups with 20, 5-foot letters; and the second flight lasting 2.6 hours, included 15 pickups with 20, 5-foot letters. The pilot's logbook then indicates that he received a checkout by the operator on June 17, 1998, on a flight that lasted 1 hour. The paperwork provided by the operator indicates that the pilot began towing banners for his company on June 19, 1998. Since that date the pilot had accumulated about 128 hours towing banners, in the same make and model airplane. The pilot was authorized to tow a banner that contained up to 55, 5 foot-tall letters. The accident banner contained 38 letters.

The pilot had a known allergy to peanut butter which according to the pilot's wife, included an upper respiratory reaction. According to the president of the operator, between 0900 and 1100 on the day of the accident, the pilot had eaten an unknown number of cheese and peanut butter crackers that was provided by him personally.

According to FAA records, the pilot and the president of the operator were not certificated airframe and/or powerplant mechanics. Additional information pertaining to the pilot is contained on page 2 of the Factual Report Aviation.

AIRCRAFT INFORMATION

Review of the maintenance records revealed that the airplane was modified in January 1978, with the installation of a Lycoming O-320-E2D, engine, in accordance with a Supplemental Type Certificate, STC SA750CE. According to the installation instructions, an auxiliary fuel pump and an engine driven fuel pump were required to be installed; the engine did not have an engine-driven fuel pump. Additionally, as the airplane was not previously equipped with an auxiliary fuel pump, the fuel pump was required to be wired into the dome light circuit, with a 10-amp fuse. According to the modified aircraft owner's manual, the auxiliary fuel pump was required to be on for takeoff and climb. The engine that was installed at the time of the accident was the same by serial number that was installed in accordance with the STC in 1978. Review of the engine logbook revealed that the engine was overhauled on February 7, 1997, and signed off for approval for return to service by a A&P-rated mechanic. That same mechanic had signed off the last annual inspection on June 22, 1998. Additionally, the mechanic had, as documented by two Major Repair and Alteration Forms (FAA Form 337), modified two other Cessna 150 airplanes in accordance with STC SA750CE, which were being operated at the time of the accident, by the same operator. The airplane operator at the time of the accident was operating a total of 5, including the accident airplane, Cessna 150s with the 150-horsepower engine installed. Four of the five airplanes had an engine-driven fuel pump installed.

Additionally, review of the maintenance records indicate that the airframe and engine were modified in accordance with two separate (STC's) to allow the use of automotive fuel. The listed STC was for several engine models, none of which were installed when the STC was accomplished. An STC to allow the use of automotive fuel is available for the engine that was installed at the time of the accident. The airplane was equipped with long range fuel tanks that had a total capacity of 38 gallons.

The engine that was installed in the airplane at the time of the accident was originally sent to the Cessna Aircraft Company in late 1972, and installed in a Cessna 172M, with the registration number of N20586. According to personnel from the Cessna Aircraft Company, the engine in a Cessna 172M did not have an engine-driven fuel pump installed. Additional information pertaining to the accident aircraft is contained on page 2 of the Factual Report-Aviation.

METEOROLOGICAL INFORMATION

Visual meteorological conditions prevailed at the time of the accident. Additional information pertaining to weather is contained in the weather information blocks on pages 3 and 4 of the Factual Report-Aviation.

WRECKAGE AND IMPACT INFORMATION

The crash site was located about 1,400 feet from the departure end of the runway in a wooded area that contained trees and brush. The airplane came to rest on a magnetic heading of 030 degrees with all components necessary to sustain flight. The leading edge of the left wing exhibited evidence of chordwise crushing and the leading edge of the right wing exhibited evidence of a tree impact. The leading edge of the right wing was twisted down about 90 degrees. Examination of the elevator and rudder flight control cables revealed no evidence of preimpact failure or malfunction. Examination of the flap and left aileron control cables revealed that the down aileron cable and the flap cables were failed due to overload. The rear spar of the left wing was observed to be displaced. The flaps were determined to be extended about 10 degrees and no tow cables were connected at the tow hitch. Two each tow cables were observed outside the cockpit near the pilot's door. The airplane with attached engine was removed from the crash site for further examination.

Further examination of the airframe revealed that automotive fuel was noted in the left wing fuel tank, which was breached, and also in fuel lines in the engine compartment area. Examination of the fuses on the instrument panel revealed that the fuel pump fuse (identified as being 15 amp 32 volt) was blown. No other fuses were blown. Examination of the wiring for the fuel pump revealed that it was wired into a circuit that contained the rotating beacon, starter switch, cigarette lighter, and dome light. The cigarette lighter was found in the glove box during the wreckage examination. Examination of the wiring revealed no evidence of electrical arching. Examination of the fuel vent system revealed no evidence of blockage. Electrical power was supplied directly to the fuel pump and the automotive type starter solenoid, both were found to operate. The ignition switch was also operationally tested with no evidence of failure or malfunction. The engine was removed from the airplane for further examination.

Examination of the engine revealed crankshaft, camshaft, and valve train continuity. Thumb compression was noted from all cylinders. The engine was rotated by hand, and each magneto was found to operate normally. The throttle and mixture control cables were failed near each control arm and no evidence of preimpact failure or malfunction was noted. The carburetor was impact damaged and the composite float was destroyed. The fuel inlet screen was clean; and the carburetor bowl was clean. No evidence of preimpact failure or malfunction of the carburetor was noted. The engine was sent to the manufacturer's facility for an engine run. The results are an attachment to this report.

MEDICAL AND PATHOLOGICAL INFORMATION

A postmortem examination of the pilot was performed by Marie A. Herrmann, M.D., District Medical Examiner, Panama City, Florida. The cause of death was listed as closed head injury and multiple fractures due to blunt impact of head and extremities. Toxicological analysis of specimens of the pilot was performed by the FAA Toxicology and Accident Research Laboratory. The results were negative for carbon monoxide, cyanide, ethanol, and tested drugs. Toxicological testing was also performed by the University of Florida Diagnostic Referral Laboratories. The results were negative for ethanol and a comprehensive drug screen.

ADDITIONAL DATA/INFORMATION

A fuel sample was taken from the fuel filter of the truck and from the fuel nozzle under pressure. The fuel sample from the fuel filter contained a small amount of particle contamination. No water was present in either sample.

Weight and Balance calculations were performed based on the current empty weight of the airplane, the known weight of the pilot, and a full fuel load. The calculations revealed that the aircraft was 23 pounds over gross weight on takeoff and 17 pounds over gross weight at the time of the accident.

The wreckage minus the retained engine and carburetor was released to Mr. Bob Jones, of AIG Aviation, on October 28, 1998. The retained engine and carburetor were also released to Mr. Jones on October 28, 1998.

NTSB Probable Cause

The failure of the pilot to maintain airspeed (Vs) and the inadvertent stall by the pilot. Contributing to the accident was the intentional operation of the airplane by the pilot in an over gross weight condition resulting in a higher stall speed, and failure of maintenance personnel to install the engine driven fuel pump and the improper wiring of the auxiliary fuel pump contrary to the STC installation instructions 20 years and 6 months earlier. Also contributing was the inadequate annual inspection of the airplane by other maintenance personnel for failure to note that the engine did not have an engine driven fuel pump installed.