VOEPASS 2283 [PASSAREDO CALLSIGN] PRELIMINARY REPORT - LOSS OF CONTROL IN-FLIGHT (LOC-I)

 

You can set this video for full screen and resolution 720p

SOURCE: CENIPA

LOC-I LOSS OF CONTROL IN-FLIGHT

Date: 9 August 2024

(UTC): 9 August 2024

Time: 16:22

City: VINHEDO - SÄO PAULO - BRASIL

Aerodrome: OUTSIDE THE AERODROME

Local: RESIDENTIAL AREA OF THE CITY

Damage to third

parties: YES

Injuries Function on Board Quantity

FATAL CREW 4

FATAL PASSENGERS 58

 

History

 

At 14:58 UTC, the aircraft took off from SBCA (Coronel Adalberto Mendes da Silva Airport, Cascavel, State of Paraná), bound for SBGR (Guarulhos - Governador André Franco Montoro - Airport, Guarulhos, State Of SOO Paulo) on a public regular passenger transport flight with 04 crew and 58 passengers on board. With the aircraft flying along the route, and after encountering icing conditions, control Of the aircraft was lost and it crashed into the ground.

 

Aircraft Involved

Registration marks: PSVPB

Location of latest takeoff: SBCA - ADALBERTO MENDES DA SILVA

Location of intended landing: SBGR - GOVERNADOR ANDRÉ FRANCO MONTORO

Type of operation: REGULAR

Phase of flight: CRUISE

Aircraft damage: DESTROYED

 

Sequence of events

Based on the information collected at the initial field Investigation, as well as recordings from the Flight Data Recorder (FDR) and Cockpit Voice Recorder (CVR), the Investigation Committee identified the sequence of events preceding the aircraft's collision with the ground. The time reference utilized is UTC (Universal Time Coordinated).

• 14:58:05 - the aircraft initiated takeoff from the runway 15 of SBCA, with 58 passengers and 04 crew on board;

• - the PROPELLER ANTI-ICING 1 and 2 were turned on;

• 15:14:56 - the Electronic Ice Detector connected to the Centralized Crew Alert System (CCAS) emitted an alert signal upon passing FL130;

• - the AIRFRAME DE-ICING was turned on;

• 15:15:42 - a single chime was heard in the cockpit. Subsequently, the crew commented on the occurrence of an AIRFRAME DE-ICING Fault, and that they would turn it Off;

• 151549 - the AIRFRAME DE-ICING was turned off,

- the Electronic Ice Detector ceased emitting the alert signal.

• 1516125

• 1517:08

- the Electronic Ice Detector emitted an alert signal.

- the Electronic Ice Detector stopped emitting the alert signal;

- the Electronic Ice Detector emitted an alert signal;

- the Electronic Ice Detector stopped emitting the alert signal.

- the Electronic Ice Detector emitted an alert signal;

- the Electronic Ice Detector stopped emitting the alert signal;

- the Electronic Ice Detector emitted an alert signal;

- the SIC (pilot Second in Command) made radio contact with the airline's operational dispatcher at

Guarulhos airport, for coordination of the aircraft arrival;

• - At the same time of the SIC's coordination with the operational dispatcher, a flight attendant called

over the intercom. The SIC asked her to hold on moment and continued speaking with the dispatcher,

• - the Electronic Ice Detector stopped emitting the alert signal. At this time, the SIC was asking the

flight attendant for information that would be passed to the operational dispatcher;

• 16:17:32 - the Electronic Ice Detector emitted an alert signal; at this time, the PIC was informing the passengers about the SBGR local conditions and estimated time of landing,

• 16:17:41- the AIRFRAME DE-ICING was turned on;

• 16:18:41 - at a speed of 191 kt., the CRUISE SPEED LOW alert was triggered. Concomitantly, the SIC was about to finish relaying some information to the operational dispatcher;

• 16:18:47 - the PIC started the briefing relative to the approach for landing in SBGR. Concomitantly, APP-SP made a radio call, and instructed him to change to frequency 123.25MHz;

• 16:18:55 — a single chime was heard in the cockpit. At this time, the communication with APP-SP was taking place;

• - the AIRFRAME DE-ICING was turned off;

• 16:19:16 - the crew made a call to APP-SP (Sao Paulo Approach Control) on the frequency 123.25 MHz;

• 16:19:19 - APP-SP requested the PS-VPB aircraft to maintain FL170 due to traffic;

• 16:19:23 - the crew replied to APP-SP that they would maintain flight level and that they were at the ideal point of descent, waiting for clearance;

• 16:19:28 - at a speed of 184 kt., the DEGRADED PERFORMANCE alert was triggered, together with a single chime. The alert was triggered concomitantly with the exchange of messages between APP-SP and the Crew;

• - APP-SP acknowledged the message and requested the aircraft to wait for clearance;

• 16:19:31 - Passaredo 2283 aircraft reported receipt of the message and thanked ATC;

• - the PIC resumed delivering the approach briefing;

• - the Second in Command (SIC) commented, "a lot of icing";

• - the AIRFRAME DE-ICING was turned on for the third time;

• - APP-SP cleared the aircraft to fly direct to SANPA position, maintaining FL170, and informed that the descent would be authorized in two minutes;

• 16:20:39 - the crew acknowledged the flight instruction received (last communication performed by the flight crew);

• - the aircraft started a right turn in order to fly to SANPA position.

• 16:20:57 — during the turn, at a speed of 169 the INCREASE SPEED alert was triggered, in conjunction with a single chime. Immediately afterwards, vibration noise was heard in the aircraft, simultaneously with the activation of the stall alert;

• 16:21:09 - control of the aircraft was lost, and it entered an abnormal flight attitude until colliding with the ground. The aircraft rolled to the left to a bank-angle of 52 degrees, and then rolled to the right to a bank- angle of 94 degrees, performing a 180-degree turn in a clockwise direction. Subsequently, the turn was reversed to an anticlockwise direction, with the aircraft completing five full rotations in a flat spin before crashing into the ground.

Click on image to see it isolated

The ICING light would blink with the detection of an Icing condition and the Anti-Icing and/or De-lcing  (AIFRAME) were not selected to ON, followed by single chime. The light would remain illuminated in a continuous fashion with the systems turned on.

 

Anti-Icing and De-Icing Systems

 

The Anti-lcing functions were energized electrically, whereas the De-icing ones were provided by means of pneumatic pressure.

 

The APM system needed to be checked by the crew on a daily basis, and in case of a failure, an amber-colored FAULT message would illuminate on the APM panel.

If the aircraft's drag increased due to ice accumulation and performance was degraded, resulting in loss of cruise speed, alerts in three levels were triggered and presented to the pilots on both alert panels Of the APM, as follows:

• 1st Level - CRUISE SPEED LOW

The blue-colored message would indicate performance degradation Of around 10%, with reduction Of the Indicated Air Speed (IAS) during the cruise phase by at least 10 kt. below the speed computed by the APM.

This alert would be triggered only during the cruise phase.

• 2nd Level - DEGRADED PERFORMANCE

The amber-colored message would be followed by a single chime and a master caution alert, indicating a significant performance degradation in the range between 22% and 28%, induced by a significant increase in aerodynamic drag, causing a drop in cruise IAS of around 15 to 20 knots below the speed computed by the APM. This alert could be triggered during climb, cruise, Or descent.

• 3rd Level - INCREASE SPEED.

The amber-colored message would appear flashing, followed by a single chime and a master caution alert, indicating that the degraded performance condition had worsened , reaching an IAS value below the ICING BUG + 10 kt. This alert could be triggered during climb, cruise, or descent.

 

The pilot has set the ICING BUG SPEED for SEVERE ICING CONDITION to 165 Knots.

In addition to the speed alerts (emitted by the APM), the airspeed indicators of the left- and right-hand cockpit stations had BUGS for reference, particularly for minimum speed maneuvers at low bank, flaps O', and icing conditions (VMLBO ICING), The said BUGS could be adjusted manually.

 

The ICING BUG needed to be adjusted by the pilots for each flight in accordance with the aircraft's weight, in order to indicate the minimum speed for a flight in icing conditions and with flaps retracted. The VMLBO ICING.

The Risk of Encountering Hail Relative to CB Cloud Position

Pilots Have Had Limited Information About Weather Conditions Over The Oceans

New Forecast System Helps Transoceanic Flights Avoid Storms

 Science Daily

Dec. 11, 2012

A new NASA-funded prototype system developed by the National Center for Atmospheric Research (NCAR) of Boulder, Colo., now is providing weather forecasts that can help flights avoid major storms as they travel over remote ocean regions. The eight-hour forecasts of potentially dangerous atmospheric conditions are designed for pilots, air traffic controllers and others involved in transoceanic flights.

Click on the link below for real time weather forecast:

http://www.rap.ucar.edu/projects/ocn/realtime_sys/global_extrap/

Tradução Humana em 12 DEZ 2012

by George Rocha

 Novo Sistema de Previsão Ajuda Voos Transoceânicos a Evitar Tempestades

11 DEZ 2012

Um novo sistema protótipo baseado na NASA desenvolvido pelo Centro Nacional para Pesquisa Atmosférica (CNPA) de Bloulder, Colorado, agora está fornecendo previsão neteorológica que pode ajudar voos a evitar tempestades quando eles viajam sobre regiões remotas de oceanos. A previsão de oito horas de condições atmosféricas potencialmente perigosas são planejadas para pilotos, controladores de tráfego aéreo e outros envolvidos em voos transoceânicos.

Clicar no link abaixo para previsão meteorológica em tempo real:

http://www.rap.ucar.edu/projects/ocn/realtime_sys/global_extrap/

The NCAR-based system combines satellite data and computer weather models to produce maps of storms over much of the world's oceans. The system is based on products that NCAR has developed to alert pilots and air traffic controllers about storms and related hazards, such as turbulence and lightning, over the continental United States. Development of the forecasts was spurred in part by the 2009 crash of Air France Flight 447, which encountered a complex of thunderstorms over the Atlantic Ocean. The system was funded by NASA's Applied Sciences Program, which supports efforts to discover and demonstrate innovative and practical uses of NASA Earth science and satellite observations. NCAR worked with the Massachusetts Institute of Technology's Lincoln Laboratory, the Naval Research Laboratory, and the University of Wisconsin-Madison to create the system. "These new forecasts can help fill an important gap in our aviation system," said NCAR's Cathy Kessinger, lead researcher on the project. "Pilots have had limited information about atmospheric conditions as they fly over the ocean, where conditions can be severe. By providing them with a picture of where significant storms will be during an eight-hour period, the system can contribute to both the safety and comfort of passengers on flights."	O sistema CNPA combina dados de satélite e modelos computadorizados de meteorologia para produzir mapas de tempestades sobre muitos dos oceanos do mundo. O sistema é baseado em produtos que o CNPA desenvolveu para alertar pilotos e controladores de tráfego aéreo acerca de tempestades e riscos, tais como turbulência e raios, sobre o continente dos Estados Unidos. O desenvolvimento das previsões foi estimulado em parte pela queda do Air France Voo 447, o qual encontrou um complexo de tempestade com trovoadas sobre o Oceano Atlântico. O sistema foi fundado pelo Programa de Ciências Aplicadas da NASA, o qual apoia esforços para descobrir e demonstrar  observações inovativas e uso prático de observações de satélite e ciência da Terra pela NASA. O CNPA trabalhou com o Laboratório Lincoln do Instituto de Tecnologia de Massachusetts, o Laboratório de Pesquisa Naval e a Universidade Wisconsin-Madison para criarem o sistema. “Estas novas previsões podem ajudar preencher uma lacuna importante em nosso sistema de aviação”, disse Cathy Kessinger do CNPA, pesquisadora lider no projeto. “Pilotos têm tido informação limitada acerca de condições atmosféricas quando eles voam sobre o oceano, onde condições podem ser severas. Ao supri-los com uma imagem de onde tempestades significantes estarão durante um período de oito horas, o sistema pode contribuir para ambos, a segurança e conforto dos passageiros nos voos".
The forecasts, which continue to be tested and modified, cover most of the Atlantic and Pacific oceans, where NCAR has real-time access to geostationary satellite data. The forecasts are updated every three hours.	As previsões, as quais continuam ser testadas e modificadas, cobrem muito dos oceanos Atlântico e Pacífico, onde o CNPA tem acesso em tempo real a dados de satélites geoestacionários. As previsões são atualizadas a cada três horas.
Pilots of transoceanic flights currently get preflight briefings and, in certain cases involving especially intense storms, in-flight weather updates every four hours. They also have onboard radar, but that information is of limited value for strategic flight planning while en route. "Turbulence is the leading cause of injuries in commercial aviation," said John Haynes, Applied Sciences Program manager at NASA Headquarters in Washington. "This prototype system is of crucial importance to pilots and is another demonstration of the practical benefit of NASA's Earth observations."	Pilotos de voos transoceânicos atualmente conseguem briefings pré-voo e, em certos casos envolvendo especialmente tempestades intensas, a meteorologia em voo atualiza a cada quatro horas. Eles também têm a bordo radar, mas essa informação é de valor limitado para planejamento estratégico do voo enquanto em rota. “Turbulência é a causa lider de lesões na aviação comercial”, disse John Haynes, gerente do Programa de Ciências Aplicadas no Centro de Operações da NASA em Washington. "Este sistema protótipo é de crucial importância para pilotos e é uma outra demostração do benefício prático de observações da Terra pela NASA.
Pinpointing turbulence associated with storms over the oceans is far more challenging than it is over land because geostationary satellites, unlike ground-based radar, cannot see within the clouds. Thunderstorms may develop quickly and move rapidly, rendering the briefings and weather updates obsolete. Onboard radars lack the power to see long distances or through dense clouds. As a result, pilots often must choose between detouring hundreds of miles around potentially stormy areas or flying directly through a region that may or may not contain intense weather. Storms may be associated with hazardous windshear and icing conditions in addition to lightning, hail and potentially severe turbulence.	Apontar com precisão turbulência associada com tempestades sobre oceanos é de longe muito mais desafiante do que ela é sobre o terreno por causa de satélites geoestacionários, diferente de radar baseado no solo, eles não podem ver dentro de nuvens. Tempestades com trovoadas podem se desenvolver apressadamente e se moverem rapidamente, tornando os briefings e atualizações meteorológicas obsoletos. Os radares a bordo faltam a potência para ver em longas distâncias ou através de nuvens densas. Como um resultado, pilotos frequentemente devem escolher entre desviar centenas de milhas em volta de áreas potencialmente tempestuosas   ou voarem diretamente através de uma região que pode ou não pode conter condições meteorológicas intensas. Tempestades podem ser associadas com riscos de ‘'windshear’  22 e condições de formação de gelo em adição a raios, granizo e turbulência potencialmente severa.
To create the forecasts, Kessinger and her colleagues first turned to geostationary satellite measurements to identify regions of the atmosphere that met two conditions: particularly high cloud tops and water vapor at high altitudes. These two conditions are a sign of powerful storms and strong updrafts that can buffet an aircraft. The scientists next used fuzzy logic and data fusion techniques to home in on storms of particular concern, and applied object tracking techniques and simulations of wind fields to predict storm locations at hourly intervals out to eight hours.	Para criarem as previsões, Kessinger e colegas dela, primeiro voltaram-se para medições de satélite geoestacionário para identificarem regiões de atmosfera que encontravam duas condições: topos de nuvens particularmente altos e vapor de água em altitudes elevadas. Estas duas condições são um sinal de tempestades potenciais e correntes de ar acendentes fortes que podem esbofetear uma aeronave. Os cientistas em seguida usaram lógica indistinta e técnicas de fusão de dados para se dirigirem para tempestades de interesse particular, e aplicaram técnicas de rastreamento de objeto e simulações de campos de vento para predizerem localizações de tempestade em intervalos horários de cada oito horas.
Researchers verified the forecasts using a variety of data from NASA Earth observations, including the Tropical Rainfall Measuring Mission (TRMM) satellite.	Os pesquisadores verificaram as previsões usando uma variedade de dados de observações da Terra pela NASA, incluindo o satélite da Missão de Medição de Precipitação Tropical (MMPT).
"These advanced techniques enable us to inform pilots about the potential for violent downdrafts and turbulence, even over the middle of the ocean where we don't have land-based radar or other tools to observe storms in detail," Kessinger said.	“Estas técnicas avançadas capacitam-nos para informar pilotos acerca do potencial para correntes de ar descendentes violentas e turbulência, mesmo acima do meio do oceano onde nós não temos radar fixado em solo ou ferramentas para observar tempestades em detalhes”, disse Kessinger.
The forecasts can be viewed at: http://go.nasa.gov/W0doRu	As previsões podem ser vistas em:   http://go.nasa.gov/W0doRu

 

22 National Aeronautics and Space Administration, Langley Research Center (June 1992). "Making the Skies Safer From Windshear". http://web.archive.org/web/20100329221032/http://oea.larc.nasa.gov/PAIS/Windshear.html. Retrieved 2012-11-16.

 

 

Pilot's Guide to Ground Icing by NASA

http://aircrafticing.grc.nasa.gov/courses_ground.html

Pilot's Guide to Ground Icing   (below are some scraps from the course)

Who should take this course?



Every pilot who could encounter ground icing - whether their aircraft needs to be cleaned or protected from frozen contamination.

What is covered in this course?


The problems caused by ground icing


When you are likely to encounter ground icing


The basics about aircraft de/anti-icing fluids


How to de-ice and anti-ice your aircraft


How long will it take?


That depends on you. This course is designed to let you determine what you need to know given the type of flying that you do. You can spend as litle as 60 minutes going through the highlights, but you can take much longer (2-3 hours) if you explore all related information and interactive features.

If the Airspeed Indicator reads ZERO during the takeoff roll, the PITOT tube is BLOCKED. If you do not REJECT the takeoff, but continue to climb-out, the Airspeed Indicator will appear to function shortly after takeoff, but will give you misleading information. If the STATIC ports are not blocked, the Indicated Airspeed will INCREASE with altitude, not AIRSPEED. As the airplane climbs, the Indicated Airspeed eventually exceed the actual airspeed.

Do not be tricked into increasing the pitch attitude and/or reducing thrust - these could cause a perfectly flying airplane to stall.

Videos

Airport hit by heavy snow click here to watch some Snow Removal Videos at airports

Polished Frost Takeoffs No More - effective February 1, 2010

FAR 135.227:

a) No pilot may take off an aircraft that has frost, snow, or ice adhering to any rotor blade, propeller, windshield, wing, stabilizing or control surface, to a powerplant installation, or to an airspeed, altimeter, rate of climb, or flight attitude instrument system, except under the following conditions:

(1) Takeoffs may be made with frost adhering to the wings, or stabilizing or control surfaces, if the frost has been polished to make it smooth.


(2) Takeoffs may be made with frost under the wing in the area of the fuel tanks if authorized by the administrator.

U.S. air safety regulators have decided, after almost 50 years, that it's no longer safe for private and cargo aircraft to fly with "polished frost'' on their wings.

Frozen Contaminants and their Causes

Federal Aviation Administration

14 CFR Parts 91, 125 and 135

SUMMARY: The FAA is removing certain provisions in its regulations that allow for operations with "polished frost'' (i.e., frost polished to make it smooth) on the wings and stabilizing and control surfaces of  aircraft. The rule is expected to increase safety by not allowing operations with ``polished frost,'' which the FAA has determined increases the risk of unsafe flight.

DATES: These amendments become effective February 1, 2010.

  Although polishing frost is currently permitted under part 91 subpart F, and parts 125 and 135, current FAA guidance developed subsequent to the implementation of those regulations cautions against this practice.

There are at least 12 \1\ known accidents in which individuals attempted to smooth or polish frost, but the aircraft failed to generate enough lift and crashed shortly after takeoff.\2\ The U.S.

National Transportation Safety Board (NTSB) has urged operators to ensure that critical surfaces are free of contamination prior to take off.

The FAA has determined that an unsafe condition exists if all wing surfaces, other than those under the wing in the area of the fuel tanks,\3\ and other critical surfaces are not uniformly smooth upon takeoff and is therefore removing references to ``polished frost'' from the regulations. This final rule requires operators, when performing operations under part 91 subpart F, part 125, or part 135, to remove all frost from critical surfaces in order to achieve uncontaminated surface smoothness.

In the NPRM, the FAA identified four alternatives to polishing frost that operators may use to comply with this rule. Those alternatives are: (1) Using wing covers to prevent frost accumulation on wings, (2) waiting for frost to melt, (3) storing the aircraft in a heated hangar, or (4) deicing the wing surface. The FAA identified the use of wing covers to prevent frost accumulation on wing surfaces as the lowest-cost alternative for complying with this rule.

Summary of the Final Rule

This final rule removes language from part 91 subpart F, and parts 125 and 135, which permits aircraft to takeoff with frost that has been polished to make it smooth (``polished frost'') on critical surfaces.

Under the final rule, operators will be required to remove any frost adhering to critical surfaces prior to takeoff. Additionally, the rule restructures language in parts 91, 125, and 135 to clarify that aircraft must have functioning deicing or anti-icing equipment to fly under IFR into known or forecast light or moderate icing conditions, or under VFR into known light or moderate icing conditions.

Ice, snow, and frost are frozen contaminants, and they can form and accumulate on exterior aircraft surfaces on the ground. Weather causes this accumulation as do ground operational conditions conducive to icing. In either case, atmospheric conditions vary the type of accumulation, the amount, etc. Generally, icing conditions (during flight or ground operations) occur and ice protection systems or procedures should be activated when the outside air temperature (OAT) is below 50_F (10_C) and visible moisture is present or when there is standing water, ice, or snow on runways or taxiways.

Aircraft in flight experience a variety of atmospheric conditions which alone or together

can produce ice formations on the aircraft and its components. These conditions include:

• Supercooled clouds.

These are clouds containing water droplets that have remained in the liquid state even though the ambient temperature may be below 32F.
These droplets are very small (five to 100 microns), and they freeze on impact with another object. Water droplets have remained liquid even at temperatures as low as -40F.

The areas requiring special attention during a cold-weather preflight depend on the aircraft's design. FAR Part 135 and 125 certificate holders will identify these areas in the training program they are required to develop. Borrowing from what's required for that training program, general aviation pilots should pay particular attention to:

Wing leading edges, upper and lower surfaces

Vertical and horizontal stabilizing devices, leading edges, upper surfaces, lower surfaces, and side panels

Lift/drag devices (e.g., flaps)

Spoilers and speed brakes

All control surfaces and control balance bays

Propellers, spinners

Engine inlets, particle separators, and screens

Windshields and other windows necessary for visibility

Antennas

Fuselage

Exposed instrumentation devices, e.g., angle-of-attack vanes, pitot-static pressure probes, static ports

• Fuel tanks and fuel cap vents

Cooling and APU air intakes and exhausts

Landing gear If you know or suspect that the aircraft has been subjected to blowing snow, check any openings where snow can enter and freeze. In addition to and including the above, check:

Pitot tubes and static system sensing ports

Wheel wells/wheel pants

Heater intakes

Engine air intakes and carburetor intakes

Elevator and rudder controls

Fuel vents