Misfueled Aerostar

That's a pretty egregious oversight on the part of the deceased, if the lineman's account is truthful. Maybe he was so mentally pre-occupied with the Cheyenne training he was about to oversee, he mentally blocked the fact he came in on a piston job.

Who knows, unless the line guy is lying about being told "yes" multiple times to the jet A fuel offering. The gymnastics for the line guy to fuel up the thing with the wrong nozzle kinda scream "stop!", but clearly this wasn't a hindrance to the motivated.
 
Sometime in the last two years a 421 went down for the same reason. Captain signed a fuel receipt for Jet A and either the plane didn't have the restrictor or the truck had a 'helicopter nozzle'.
 
weilke said:
Sometime in the last two years a 421 went down for the same reason. Captain signed a fuel receipt for Jet A and either the plane didn't have the restrictor or the truck had a 'helicopter nozzle'.
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There’s a helicopter nozzle? I’ve seen 4 different nozzles used in turbine helicopters but never seen one specific to helicopters.
 
hindsight2020 said:
That's a pretty egregious oversight on the part of the deceased, if the lineman's account is truthful. Maybe he was so mentally pre-occupied with the Cheyenne training he was about to oversee, he mentally blocked the fact he came in on a piston job.

Who knows, unless the line guy is lying about being told "yes" multiple times to the jet A fuel offering. The gymnastics for the line guy to fuel up the thing with the wrong nozzle kinda scream "stop!", but clearly this wasn't a hindrance to the motivated.
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I've met many great line guys, and many not so bright ones. Twice I've been asked for the keys to the inboard fuel tanks on the Cirrus which clearly say "no fuel" all over it in red letters, are locked, and say TKS on it
 
I knew Dr. Dan from our field, he was a great person who did a lot of good for the local community and to others in need. I have a hard time believing that the pilot called for the jet truck. The aircraft was placarded with 100LL on each tank, the Jet-A nozzle didn't fit the aircraft and the line guy forced the nozzle to properly fit and fuel the aircraft. Regardless, this is a tragic loss to the entire community. Dan will be extremely missed and hopefully, this accident will go on to become a teaching moment to prevent anything like this from happening again (again).
 
Velocity173 said:
There’s a helicopter nozzle? I’ve seen 4 different nozzles used in turbine helicopters but never seen one specific to helicopters.
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Whichever one fits into a 100LL tank port.
 
Just read the NTSB report, this is actually quite irritating. It's very obvious when an aircraft is jet/turbine or non.

he should have confirmed with the owner more deliberately, or trusted his gut and asked someone else what kind of fuel to put in the plane

how can you possibly work at an airport fueling airplanes and not know which type of aircraft require which type of fuel ?!
 
The whole thing seems weird. Never heard over radio on CTAF when a plane is on approach “ hey do you need Jet fuel”???
Seems odd the multiple “ sure you want JetA??” Documentations.
 
benyflyguy said:
The whole thing seems weird. Never heard over radio on CTAF when a plane is on approach “ hey do you need Jet fuel”???
Seems odd the multiple “ sure you want JetA??” Documentations.
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It is certainly possible the line guy is lying about the narrative of asking the deceased multiple times about his desire for jet A. Problem is the dead guy isn't here to refute the testimony. Do we take the line guy at face value? Does it matter? Should line people recognize a piston prop engine installation and cowling from that of a turbine powered propeller?

I don't know what the legal standing is on that question, I'm genuinely wondering what the bar is for these types of accidents from a criminal negligence burden of proof standpoint.
 
This story amazes me. How do you ignore the placard AND the fact that the fuel nozzle DOESN'T FIT?! No matter how much we idiot proof things, somebody makes a better idiot.

I paid $5.68 for avgas last time I flew, but at least our line guys have more than two brain cells to rub together.

I'm also amazed by the fatality of twins during takeoff. Seems like the risk of losing an engine and spinning it in is greater than the security of having a backup.
 
benyflyguy said:
The whole thing seems weird. Never heard over radio on CTAF when a plane is on approach “ hey do you need Jet fuel”???
Seems odd the multiple “ sure you want JetA??” Documentations.
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Note to other line people: Ask, "What kind of fuel does it take?" People in aviation can't prejudice the answers with leading questions. The PIC was a turbine CFI, had turbines on his mind and was thinking about his turbine lesson right after he lands.
 
The PIC has the final authority/responsibility for the flight. Regardless of what the line tech did, the pilot was asked at least once, the truck was in front of his aircraft, and he had to sign a receipt saying fuel type and quantity on it. I am surprised at the amount of blame going towards the line guy in this situation.

At my last FBO, I was asked to fuel a Malibu with a JetProp conversion that hadn't been fully completed yet. The fuel placards and ports were not changed over yet and still said 100LL and were too small for the duckbill Jet nozzle, but the pilot asked me to dribble it in there anyway. It felt absolutely wrong bypassing a preventative mechanism like that even though I knew there was a PT6 on the front of the plane.

A refresher for the types of fueling nozzles:

100LL / Jet-A Duckbill / Jet-A Round
WSzAU5n.png
 
FYI, he never saw nor signed a receipt--it went on a local account.
 
overdrive148 said:
At my last FBO, I was asked to fuel a Malibu with a JetProp conversion that hadn't been fully completed yet. The fuel placards and ports were not changed over yet and still said 100LL and were too small for the duckbill Jet nozzle, but the pilot asked me to dribble it in there anyway. It felt absolutely wrong bypassing a preventative mechanism like that even though I knew there was a PT6 on the front of the plane.
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I would think the Malibu would not be airworthy until the jet conversion was complete and signed off in the logbooks.
 
AKBill said:
I would think the Malibu would not be airworthy until the jet conversion was complete and signed off in the logbooks.
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I thought the same thing until it happened to me. It had flown in and wasn't based on the field. After it happened, I talked to the other line guys about it and they didn't see the "big deal". I made a chart showing piston/turbine aircraft models side by side with the proper fuel for each and how to tell (as well as to be sure to verify with the pilot especially on those types) and hung it in the line shack by our ops board. It ended up in the trash after my last day working there.

That still doesn't excuse the PIC in this case from not verifying but it is an unfortunate event on both sides. The line tech didn't know enough or push enough to make him realize what happened but he also followed orders from the pilot. The pilot should have known and picked up on the cues and evidence in front of him but didn't. I would not want to be the line tech having to live with the fact that his actions contributed directly to killing someone. Of course, knowing the aircraft type and fuel requirement I would not fuel his aircraft period, but not all line techs are trained that well...
 
overdrive148 said:
I would not want to be the line tech having to live with the fact that his actions contributed directly to killing someone. Of course, knowing the aircraft type and fuel requirement I would not fuel his aircraft period, but not all line techs are trained that well...
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Agreed... Line folks are not paid the best wage. Most of them are young and don't know the difference between a jet engine and a piston engine. As you stated it's the PIC that is responsible for the flight.

I once stopped in the FBO and asked for a fuel truck. The person behind the counter said jet A right. I asked why she thought I needed jet A. The response was that's what my computer has you listed as using. Someone typed in the wrong model for my plane. We fixed the account and I got 100LL
 
maybe it would help? ... why don't they make the PIC sign off on fuel type and quantity delivered? Almost like a wavier - I believe airline captains do something similar once an jet has been fueled.
 
kgruber said:
Watching the fueling operation is a basic pilot duty.
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That's kind of funny that you say that when looking at your avatar... maybe we made an exception for a man widely regarded as the best pilot who ever graced the air.
 
Bill Weber said:
maybe it would help? ... why don't they make the PIC sign off on fuel type and quantity delivered? Almost like a wavier - I believe airline captains do something similar once an jet has been fueled.
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Based on everything else he missed that was right in front of him, I doubt he would have read it either. His brain was in Jet-A mode.
 
overdrive148 said:
Based on everything else he missed that was right in front of him, I doubt he would have read it either. His brain was in Jet-A mode.
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Hence Mark Twain's quote: "It's not what we don't know, it's what we know that just ain't so."
 
Tantalum said:
how can you possibly work at an airport fueling airplanes and not know which type of aircraft require which type of fuel ?!
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hindsight2020 said:
It is certainly possible the line guy is lying about the narrative of asking the deceased multiple times about his desire for jet A. Problem is the dead guy isn't here to refute the testimony. Do we take the line guy at face value? Does it matter? Should line people recognize a piston prop engine installation and cowling from that of a turbine powered propeller?

I don't know what the legal standing is on that question, I'm genuinely wondering what the bar is for these types of accidents from a criminal negligence burden of proof standpoint.
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Not saying who's right and who's wrong, but although it should be verified if in doubt, think about the Jet A powered Diamonds and Cessnas out there. Everything outwards looks like they would need avgas, unless you can tell a diesel engine from a gas engine by quickly looking at a cowling. Hence the decals that should be plastered by the fuel cap. Regardless of the size of the hole or the engine.
 
KaiGywer said:
Not saying who's right and who's wrong, but although it should be verified if in doubt, think about the Jet A powered Diamonds and Cessnas out there. Everything outwards looks like they would need avgas, unless you can tell a diesel engine from a gas engine by quickly looking at a cowling. Hence the decals that should be plastered by the fuel cap. Regardless of the size of the hole or the engine.
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True, but there are very few diesel diamonds and Cessnas out there.. I'm pretty sure 90% of the aviation dorks on the site would be able to tell the difference just based in the cowling alone

I mean, if your job is to fuel airplanes, you should be pretty good at that

and not to blame the deceased in any capacity, but I always hang out with the airplane when they fuel it and double check the lettering on the truck
 
Last week, I said "top off with Avgas" the counter person responded "top off" and tried to go on to other items like how long I was staying, did I need a car.
I responded, "top off with AVGAS", she repeated it back.

Tell the line person slowly and twice.
Tell his assistant.
Tell the counter person.
Write it on a sign in sheet or ask them for some scratch paper.
See what it says on the truck or tank.
See what the fluid looks like during refueling, and in the tanks, and when sumping.
Make sure the ticket says the correct product.
(things I aspire to always do)

Oh. And don't run out of it.

and..I see (some) line people, mechanics, controllers in the same light; they can help us immeasurably....but remember they can also kill us and it's no skin off their nose.
 
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Tantalum said:
True, but there are very few diesel diamonds and Cessnas out there.. I'm pretty sure 90% of the aviation dorks on the site would be able to tell the difference just based in the cowling alone

I mean, if your job is to fuel airplanes, you should be pretty good at that

and not to blame the deceased in any capacity, but I always hang out with the airplane when they fuel it and double check the lettering on the truck
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Hanging out while fueling is nice, but many times that luxury isn't available. Not that it matters in this case. It appears the pilot was present for the fueling, if I'm reading correctly.

In my case, my plane is a leaseback, so most of the fuel goes in from the club's truck automatically after each flight, often long after I've tied up and left. My club uses the zip-tie-in-the-knot method. Granted, the club's line guys are very familiar with the aircraft, making this sort of misfueling unlikely. There's also been several times at FBOs where I ask for fuel, but it's not immediately available. I'm either asking from the front desk or from a line guy away from their truck. Often, the plane is fueled sometime between when I leave and when I arrive again at the FBO.

Again, it appears it didn't matter here, as I don't see any evidence of anyone sumping a tank in that report, but: Telling 100LL from JetA is pretty easy. Telling 100LL from a 100LL/JetA mix can be near impossible with a standard test jar. Try it some time. It will still be blue. There will be no separation line like with water. It will still smell of gasoline. Its viscosity will still be more gasoline-like than kerosene-like. It needs to be 80-90% JetA before the difference is easy to tell. If you put your fingers in it, you might feel the oiliness of kerosene, if there's enough of it. If you put your fingers into TEL regularly, though, you will have other problems! About the only way to really tell is to do a blot test on a paper towel or similar. That's annoying enough that I don't know anyone that does it regularly. Me included; I've experimented, but it's not part of my preflight.

Not sure what my point it, really, I guess. Can't eliminate all risks, maybe? But we all know that already. I wonder if there's a way to have the sample cup detect it...chemical that only reacts with JetA, detect a refraction difference, who knows.
 
Let'sgoflying! said:
See what it says on the truck or tank.
See what the fluid looks like during refueling, and in the tanks, and when sumping
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Yeah, I know, deep in my soul, there is an idiot whom has put the wrong fuel in the wrong truck. I know there is also another idiot waiting to put his name on that mistake, too. I'd like to see that color, hoping I would recognize any contamination.
 
Tantalum said:
True, but there are very few diesel diamonds and Cessnas out there.. I'm pretty sure 90% of the aviation dorks on the site would be able to tell the difference just based in the cowling alone
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Diamond, yes. 182, yes. Certain 172 use the same cowling as 100LL.
arnoha said:
Telling 100LL from a 100LL/JetA mix can be near impossible with a standard test jar. Try it some time. It will still be blue. There will be no separation line like with water. It will still smell of gasoline. Its viscosity will still be more gasoline-like than kerosene-like. It needs to be 80-90% JetA before the difference is easy to tell. If you put your fingers in it, you might feel the oiliness of kerosene, if there's enough of it. If you put your fingers into TEL regularly, though, you will have other problems! About the only way to really tell is to do a blot test on a paper towel or similar.
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There's also the evaporation test. If you blow into the sample cup screen jet-A will evaporate slower than 100LL.
 
Anytime I've gone anywhere and needed a refuel, whether I was taking a car somewhere, doesn't matter, I ALWAYS wait for the fuel truck to show up to visually verify AVGAS was being put in the tanks. Annoying because I would have much rather exited the plane, headed right into the air conditioned lobby, got a drink, handled the car situation, etc. instead of waiting around 10-20 minutes (or more) in 90+ degree weather on the field for the fuel truck to show up, however that has always given me peace of mind. Most times I sump afterwards and check the tank to make sure it was indeed AVGAS, you know, just in case someone put Jet A in an AVGAS truck by mistake (sigh). Too important of a thing to just skip or trust to someone to remember. I always sumped when I got back to the plane and visually verified the fuel in the tank.

My wife/passengers may have had to wait a bit, but I never had any complaints.

Agree that this was likely some sort of misunderstanding on the pilot's part and the failure didn't end there (square peg, round hole, etc). But man, what a horrible mistake. Fuel is just such a fundamental thing. You can't go anywhere without it, so it's baffling to me how you would not make understanding the fuel type, quantity and fuel situation overall a PRIORITY to understand.
 
asicer said:
Diamond, yes. 182, yes. Certain 172 use the same cowling as 100LL.

There's also the evaporation test. If you blow into the sample cup screen jet-A will evaporate slower than 100LL.
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Clever. I had not run into that one before. I'll give it try and add it to my tool belt.
 
dtuuri said:
Note to other line people: Ask, "What kind of fuel does it take?" People in aviation can't prejudice the answers with leading questions.
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I once had the FBO ask me, "Prist or no Prist?" Uh, no Prist, I guess. Took me a bit to figure out what they were asking me. Mind you I was flying a Cessna 177B. That could have gone south.
 
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PPC1052 said:
I once had the FBO ask me, "Prist or no Prist?" Uh, no, Prist, I guess. Took me a bit to figure out what they were asking me. Mind you I was flying a Cessna 177B. That could have gone south.
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For those that don't know, Prist is a fuel system icing inhibitor or FSII (pronounced "fizzy") that is added to jet fuel to prevent the water permanently present in the fuel from freezing at altitude. Jet-A is "negative" or "positive" prist. Some jet fuel comes pre-mixed with Prist before arriving at the FBO. Usually only small jets or jets with fuel tank algae growth take it. The larger jets have fuel line heaters to prevent the fuel from freezing without additive.
 
PPC1052 said:
It's pretty cool that Cirrus has an indicator on the outside of the plane for the line guys to easily see that those tanks have no fuel.
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This is the best picture I could find below.. but it's very obvious with a red ring around it, key lock, and text all over it telling you it is not for fuel and the type of TKS it will accept

And yet TWICE I had guys ask me "do you have the keys for the inboard fuel tanks"
.. twice I was a dick and said "the locked door that says 'not for fuel'?"
upload_2019-10-11_16-30-18.png
 
Tantalum said:
This is the best picture I could find below.. but it's very obvious with a red ring around it, key lock, and text all over it telling you it is not for fuel and the type of TKS it will accept

And yet TWICE I had guys ask me "do you have the keys for the inboard fuel tanks"
.. twice I was a dick and said "the locked door that says 'not for fuel'?"
View attachment 78594
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6FQHe5s_d.jpg
 
overdrive148 said:
For those that don't know, Prist is a fuel system icing inhibitor or FSII (pronounced "fizzy") that is added to jet fuel to prevent the water permanently present in the fuel from freezing at altitude. Jet-A is "negative" or "positive" prist. Some jet fuel comes pre-mixed with Prist before arriving at the FBO. Usually only small jets or jets with fuel tank algae growth take it. The larger jets have fuel line heaters to prevent the fuel from freezing without additive.
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Just to add, any turbine engine (prop/jet/helicopter) can be required to have Prist added. It's use will be listed in the AFM/RFM Limitations section via a straight temperature limit or through a chart and can include those aircraft with fuel heaters like a KingAir and some helicopters.
 
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