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Phase IV Completing the Technical Report

U.S. ARMY SAFETY CENTER. Phase IV Completing the Technical Report. U.S. Army. ACCI D ENT REPORT. LIMITED USE SAFETY ACIDENT INVESTIGATION REPORT OF US ARMY CLASS A ACCIDENT Equipment: Date of Accident: Location: Unit:. U.S. ARMY SAFETY CENTER. The Red Book. U.S. Army. ACCIDENT

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Phase IV Completing the Technical Report

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  1. U.S. ARMY SAFETY CENTER Phase IV Completing the Technical Report U.S. Army ACCIDENT REPORT LIMITED USE SAFETY ACIDENT INVESTIGATION REPORT OF US ARMY CLASS A ACCIDENT Equipment: Date of Accident: Location: Unit:

  2. U.S. ARMY SAFETY CENTER The Red Book U.S. Army ACCIDENT REPORT LIMITED USE SAFETY ACIDENT INVESTIGATION REPORT OF US ARMY CLASS A ACCIDENT Equipment: Date of Accident: Location: Unit:

  3. Aviation Accident ReportDA PAM 385-40 Chapter 3

  4. Aviation Accident Report 1 2 3 4 5 6 A 7 B DA Form 2397-14 Index B DA Form 2397-13 Index A 8 C 9 D 10 E 11 F 12 G 13 H 14 I 15 J 16 K 17 L 18 M

  5. General Instructions • The information on the left side of the report will aid in completing the 2397 series. • Tab items 1, 2, 4, 6, 7, and 9 of DA Form 2397–13 will be submitted with all technical reports. • Blocks 3, 5, 8, and 10 through 14 are required if necessary to substantiate other parts of the report. • Special considerations. • Legibility • Extracts • Highlighting key words and phrases

  6. Left SideSubstantiating Data DA PAM 385-40 Paragraph 3-17

  7. DA Form 2397-13 Copy of Orders Appointing Investigation Board Weather Data Certificate of Damage/ECOD Diagrams and/or Photographs Copy of Deficiencies Report Special Technical Reports and Laboratory Analysis Weight and Balance (DD Form 365-4) Copy of Directives, Regulations, Etc. Medical Data (Autopsy, Toxicology, AFIP, Etc.) Flight Planning Data Copy of Army Aviator’s Flight Record Copy of Aircraft Inspection and Maintenance Record Copy of uncorrected Fault Record Copy of Equipment Modification Record (2408-5) Other Specify Other Specify Other Specify Other Specify 1 2 3 4 Tab 1 Copy of Orders Appointing The Investigation Board 5 6 7 8 9 10 11 12 13 14 15 16 17 18

  8. 1 2 3 4 Tab 1 Copy of Orders Appointing The Investigation Board 5 6 7 Board Orders 8 9 10 11 12 13 14 15 16 17 18 (All reports)

  9. 2 3 4 Tab 2 Weather Data 5 6 7 8 9 10 11 12 13 14 15 16 17 18 (All reports)

  10. Hourly Observations 2 3 4 Tab 2 Weather Data 5 6 7 Weather Report 8 9 10 11 12 13 14 15 16 17 http://www.afccc.af.mil/ 18 (All reports)

  11. 3 4 Tab 3 Certificate of Damage/ECOD 5 6 7 ECOD Letter 8 9 10 11 12 13 14 15 16 17 18 (As necessary)

  12. 3 4 Tab 3 Certificate of Damage/ECOD TB 43-0002-3 Army Aircraft Expenditure Limits 5 6 7 ECOD Letter 8 9 10 11 12 13 14 15 16 17 18

  13. 4 Tab 4 Diagrams and/or Photographs (All reports) 5 Blade debris in trees and on ground resulting from major impact with 90’ trees 6 90 Knots AS@ entry = 152 fps 7 280’ Stabilator (Center) FAB debris from fuselage being drug through 60’ trees 8 Trail separating new And old growth Tree Tops (Old growth) 90’ 9 #1 Engine Impact 82’ Major Impact Crater 52’ 10 #1 Engine 11 49’ Flight path 60’ 63’ 12 9o Fuselage 13 402’ 454’ from main tree strike to fuselage 14 605’ from initial tree strike to fuselage 15 0’ 50’ 600’ 450’ 350’ 250’ 150’ 16 17 Profile View of Crash Path 18 (All reports)

  14. Accident Site 18 TVP 4808684083 44° 06.485 N 075° 38.981W Elevation 592’ 4 Tab 4 Diagrams and/or Photographs 5 6 7 Photo With Caption 8 Grid North 9 Magnetic North 13° 10 True North 0°25’ Wheeler Sack Army Airfield 11 12 13 14 15 Route of Flight for UH-60 16 1 2 3 4 5 Meters 17 Fort Drum Military Installation Map 18 (All reports)

  15. 4 Tab 4 Diagrams and/or Photographs 5 6 7 8 9 10 11 12 3 13 Photo #3 AH-64A, 86-09019, Poland, 9 October 2001. Picture of the left side of the fuselage taken looking east after trees were removed. The aircraft came to rest against several pines trees. The fuselage was oriented 009o, approximately 9o nose low and 36o right roll. 14 15 16 17 18 (All reports)

  16. Tab 5 Copy of Deficiency Reports 5 6 7 8 9 10 11 12 13 14 15 16 17 18 (As necessary)

  17. Tab 6 Special Technical Reports and Laboratory Analysis 6 7 8 9 10 11 12 13 14 Special Report From Boeing 15 16 17 18 (All reports)

  18. Tab 6 Special Technical Reports and Laboratory Analysis 6 7 8 9 10 11 12 13 14 Special Report From CCAD 15 16 17 18 (All reports)

  19. Tab 6 Special Technical Reports and Laboratory Analysis 6 7 8 9 10 11 12 13 14 15 16 17 Oil & Fuel Analysis 18 (All reports)

  20. Tab 7 Weight and Balance (DD Form 365-4) Crew W&B IP W&B Maintenance Chart C Confirmation 7 Weight And Balance Form 8 9 10 11 12 13 14 15 16 17 18 (All reports)

  21. Tab 8 Copies of Directives, Regulations, Etc. Any Source Stating Standards (Adequate & Inadequate AR 95-1, 385-10, DA PAM 385-90 DA PAM 738-751, Operators Manual (-10) Unit SOP, policy, procedures TC 1-210, ATMS FM 5-19, 1-300 Airworthiness, ISAQ 8 9 10 11 12 13 14 15 16 17 18 (As necessary)

  22. Tab 8 Copies of Directives, Regulations, Etc. Regulation Excerpt 8 9 10 11 12 13 14 15 16 17 18 (As necessary)

  23. Tab 9 Medical Data (Autopsy, Toxicology, AFIP, Etc.) Autopsy 9 10 11 12 13 14 15 16 17 18 (All reports)

  24. Tab 10 Flight Planning Data (FP, Msn Brief, PPC, RAW) Flight Plan 10 11 12 13 14 15 16 17 DD Form 175 18 (As necessary)

  25. RW PERFORMANCE PLANNING CARD For use of this form, see TCs 1-209, 1-215, and 1-216; the proponent agency is TRADOC. DEPARTURE PA +2276 / +2368 FAT + 20 / +37 LOAD N/A TAKEOFF GWT 4909 FUEL 650 CALIBRATION FACTOR F = 0.8 DUAL ENG SINGLE ENG CAL IND MAX TORQUE AVAILABLE CONT TORQUE AVAIL GO/NO-GO TORQUE (OGE/IGE) PREDICTED HOVER TORQUES HOVER OGE TORQUE MAX ALLOWABLE GWT (OGE/IGE) MAX R/C OR ENDURANCE IAS MAX RANGE IAS SINGLE-ENG CAPABILITY IAS (MIN/MAX) 100% 77% 72% 84% 49 KTS 92 KTS 5200 5200 VALIDATION FACTOR SAFE PEDAL MARGIN YES NO ARRIVAL DATA PA +2368 FAT +37 LANDING GWT 4460 LB DUAL ENG SINGLE ENG CAL IND MAX TORQUE AVAILABLE CRUSIE SPEED CRUISE TROQUE CRUISE FUEL FLOW 100% 65% 76% 5200 5200 SAFE PEDAL MARGIN YES NO Tab 10 Flight Planning Data (FP, Msn Brief, PPC, RAW) Crew PPC IP PPC 10 11 12 13 14 15 16 17 18 (As necessary)

  26. Tab 10 Flight Planning Data (FP, Msn Brief, PPC, RAW) Crew PPC IP PPC 10 11 12 13 14 15 16 17 Risk Assessment Worksheets 18 (As necessary)

  27. Tab 11 Copy of Army Aviator’s Flight Record (DA Form 2408-12) -12 11 12 13 14 15 16 17 18 (As necessary)

  28. Tab 12 Copy of Aircraft Inspection and Maintenance Record (DA Form 2408-13) 12 13 14 15 16 17 18 (As necessary)

  29. Tab 13 Copy of Uncorrected Fault Record (DA Form 2408-14) -14 13 14 15 16 17 18 (As necessary)

  30. Tab 14 Copy of Equipment Modification Record (DA Form 2408-5) 14 15 16 17 18 (As necessary)

  31. Radar Plot MEDEVAC Log Crash Rescue Log FDR Data Quarterly Training Brief Risk Assessment Worksheet Any type of data not covered in previous tabs that substantiates any portion of the final report. Tab 15-18 Other Specify 15 16 17 18 (As necessary)

  32. Technical Report Right SideDA Form 2397 Series

  33. DA Form 2397-14 Statement of Reviewing Official Summary of Accident Findings and Recommendations Accident Narrative Summary of Witness Interviews Wreckage Distribution Data In-Flight or Terrain Impact and Crash Damage Maintenance and Materiel Data Personal Data Injury Occupational Illness Data Personal Protection/Escape/Survival/Rescue Weather Fire Data A Right Side Tabs A-E DA Form 2397-1 & Narrative B C D E F G H I J K L M

  34. A B Tab A Statement Of Reviewing Officials (2397) C D E F G H I J K L M (Required)

  35. B Tab B Summary Of Accident (2397-1) C D E F G H I J K L M (Required)

  36. Tab C Findings And Recommendations (2397-2) C D E F G H I J K L M (Required)

  37. History of Flight • Human Factors • Materiel Factors • Analysis Tab D Accident Narrative (2397-3) D E F G H I J K L M (Required)

  38. History of Flight a. Pre-flight phase b. Flight phase c. Post-flight phase Tab D Accident Narrative (2397-3) D E F G H I J K L M (Required)

  39. Human Factors a. Personnel background info b. Personnel management c. Aircraft suitability d. Communication/Air Traffic e. Nav Aids f. Meteorological information g. Ground support services h. Crash survival i. Emergency egress j. Special investigation k. Witness investigation Tab D Accident Narrative (2397-3) D E F G H I J K L M (Required)

  40. Materiel Factors a. Aircraft airworthiness b. Flight recorders c. Airframe d. Systems e. Powerplant f. Rotor systems or props g. Transmissions/gearboxes h. Laboratory analysis i. Crash site information j. Fire Tab D Accident Narrative (2397-3) D E F G H I J K L M (Required)

  41. 4. Analysis a. Identify human errors, materiel failures, Environmental factors b. Discuss results of factors c. Identify system inadequacies d. Report preventable injuries e. Discuss command influence Tab D Accident Narrative (2397-3) D E F G H I J K L M (Required)

  42. Tab E Summary Of Witness Interviews (2397-4) E F G H I J K L M (Required)

  43. Main Fuselage 18TVP 50827471 44°01.435N 075°36.817W Elevation: 779’ Aircraft drift right and forward ~200° 1 2 3 Heading 320° N 4 5 Wind Forecast: 330/10 Observed: Calm 12 O A B 11 6 R G 7 34’ 10 9 B 8 C D 11’ Tab F Wreckage Distribution Data (2397-5) F G H I J K L M (As necessary)

  44. Tab G In-flight Or Terrain Impact And Crash Damage Data (2397-6) (1of 2) G H I J K L M (As necessary)

  45. Tab G In-flight Or Terrain Impact And Crash Damage Data (2397-6) (2 of 2) G H I J K L M (As necessary)

  46. Tab H Maintenance And Materiel Data (2397-7) H I J K L M (As necessary)

  47. Tab I Personal Data (2397-8) (1 of 2) I J K L M (Required)

  48. Tab I Personal Data (2397-8) (2 of 2) I J K L M (Required)

  49. Tab J Injury Occupational Illness Data (2397-9) J K L M (As necessary)

  50. Tab K Personal Protection/ Escape/ Survival/ Rescue Data (2397-10) K L M (Required)

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