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NTSB Final Report: Weed, CA

Location:

Weed, California

Accident Number:

WPR21LA268

Date & Time:

July 7, 2021, 16:45 Local

Registration:

N911KW

Aircraft:

Bell 212HP

Aircraft Damage:

Substantial

Defining Event:

External load event (Rotorcraft)

Injuries:

1 None

Flight Conducted Under:

Part 133: Rotorcraft ext. load

 

 

Analysis

The flight was on an approach to a lake to retrieve water for a water bucket drop operation. During the approach, the instruments scanned normal, and the radar altimeter was set to 200 ft above ground level to provide a buffer between the bucket and terrain. When the helicopter crossed the shoreline, the pilot visually confirmed that the 100-ft long line and bucket were slightly trailing the helicopter and had not dipped in the water. Shortly afterward, he felt a “sudden onset of a significant vibration.” The pilot aborted the water retrieval and noticed that helicopter lost altitude. He applied forward cyclic and raised the collective, but the helicopter continued to descend. The pilot realized that he would not be able to fly out of the descent, so he decided to make a forced water landing. The pilot did not jettison the long line and bucket. After he leveled the helicopter and the skids touched down on the water, he made another attempt to take off, but the helicopter settled into the lake. The pilot reduced both throttle settings to idle in preparation to ditch the helicopter and applied right cyclic as the main rotors slowed. The helicopter rolled right, and the main rotor blades struck the water, which resulted in substantial damage to the fuselage, rotor, and drive systems.

Postaccident examination of the engine revealed no preimpact mechanical anomalies. The airframe examination revealed an out-of-tolerance condition of both pylon damper rod end bearings that likely caused the vibration reported by the pilot. It is likely that, after the lateral vibration, the pilot allowed the helicopter to descend while he tried to determine the source of the vibration. As the helicopter settled into the lake, the bucket filled with water. The resulting increased weight, combined with the pilot’s failure to release the water bucket, decreased the helicopter’s out-of-ground-effect performance.

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be: The pilot’s failure to maintain altitude during an approach to a lake. Contributing to the accident was the pilot’s failure to release the full water bucket as the helicopter was settling, which reduced the helicopter’s out-of-ground-effect performance.

Findings

Aircraft - Altitude - Not attained/maintained

Personnel issues - Decision making/judgment - Pilot

Personnel issues - Lack of action - Pilot

Factual Information

History of Flight

Maneuvering-low-alt flying - External load event (Rotorcraft) (Defining event)

Maneuvering-low-alt flying - Collision with terr/obj (non-CFIT)

On July 7, 2021, about 1450 Pacific daylight time, a Bell 212 helicopter, N911KW, was substantially damaged when it was involved in an accident near Weed, California. The pilot was not injured. The helicopter was operated as a Title 14 Code of Federal Regulations Part 133 external load flight.

The pilot reported that he was supporting a US Forest Service contract involving water drop operations and that the accident flight was on approach to a lake to retrieve water using a 100- ft long line and bucket. When the helicopter was about 400 ft above ground level (agl), the pilot performed an instrument scan and noted no anomalies. The pilot added that the radar altimeter was set to 200 ft agl at the time. When the helicopter crossed the shoreline, the pilot observed that the long line and bucket were “not yet in view and still out behind [him].” Shortly afterward, he felt a “sudden onset of a significant vibration,” which he also described as once- per-minute rotation. (An inspector with the US Forest Service explained that the term “indicates an imbalance in main rotor head or main rotor blades.) The pilot scanned the instrument panel and saw no annunciator lights or indications that the engines had stopped producing power.

He then glanced outside and realized that the helicopter had descended.

The pilot aborted the water retrieval, made a forward cyclic input, and raised the collective, but the helicopter continued to descend. The pilot determined that he would be unable to stop the descent, and he did not want the engines or transmission to overspeed, so he performed a forced landing on water. After he leveled the helicopter and the skids touched down on the water, the pilot made a last attempt to take off, which was unsuccessful. The pilot reduced both throttle settings to idle in preparation to ditch the helicopter and applied right cyclic as the main rotors slowed. The pilot stated that the helicopter controls responded normally and that the helicopter did not yaw significantly. The helicopter rolled right, causing the main rotor blades to strike the water, and the helicopter subsequently sank into the lake.

Automatic dependent surveillance-broadcast data showed that the bucket was about 35 ft above the water when the last data point was recorded. At that time, the helicopter's descent rate was about 768 ft per minute. The pilot did not jettison the long line and bucket because he thought that he would be able to fly away. The helicopter sustained substantial damage to the fuselage, main and tail rotor blades, and drive systems.

Training records showed that the pilot completed six recurrent long-line training flights from May 3 to 29, 2021. On May 31, 2021, the pilot completed a helicopter pilot evaluation checkride with a US Forest Service pilot inspector and was cleared for solo external-load water bucket operations.

The 240-gallon water bucket was configured to gather 90% of its total capacity, which would add an additional weight of about 1,966 pounds to the helicopter and increase its 8,150-pound gross weight to about 10,116 pounds. The bucket was recovered attached to the helicopter by a cargo hook and the long line. Postaccident examination of the bucket and engine powerpack revealed no preimpact mechanical malfunctions or failures that would have precluded normal operations.

The pylon corner mounts and pylon dampers were hydraulically tested with dynamic loads and exhibited normal operational performance. The rod end bearings for the pylon dampers had tolerances that were more than the Bell 212 Maintenance Repair and Overhaul Manual tolerance of 0.004-inch radial play: the right aft damper bearing play was 0.006 inch, and the left aft damper bearing play was 0.016 inch. According to Bell Textron, the excessive radial clearance of rod end bearings reduces the amount of damper stroking to counteract vibratory motion of the pylon. Also, a flight crew in a separate event experienced a vibration that was traced back to excessive radial wear of the pylon damper rod end bearings. The helicopter’s hover out of ground effect (OGE) performance was computed using the helicopter operator’s Rotorcraft External Load Manual, which included a performance chart from Bell Helicopter’s BHT-212-MD-1 manual. According to the performance chart, at an air temperature of 35°C, heater OFF, engine rpm at 100%, skid height of 50 ft, a 15-knot headwind, and generator values of 150 amperes, the helicopter had an OGE takeoff power gross weight limitation of about 10,250 pounds. According to the Bell 212 Rotorcraft Flight Manual: Supplement Cargo Hook, at a helicopter gross weight of 8,150 pounds, an air temperature of 35°C, heater OFF, engine rpm at 100%, skid height of 60 ft, and generator values of 150 amperes, the helicopter had an OGE takeoff power limitation at a pressure altitude of about 8,000 ft and a maximum continuous power setting limitation at a pressure altitude of about 6,600 ft. The Bell Helicopters manual also showed that, at a gross weight of about 10, 116 pounds, the helicopter had an OGE takeoff power limitation at a pressure altitude of about 3,700 ft and a maximum continuous power setting limitation of 9,300 pounds.

Pilot Information

Certificate:

Commercial; Flight instructor

Age:

35,Male

Airplane Rating(s):

Single-engine land

Seat Occupied:

Left

Other Aircraft Rating(s):

Helicopter

Restraint Used:

Lap only

Instrument Rating(s):

Helicopter

Second Pilot Present:

No

Instructor Rating(s):

Helicopter

Toxicology Performed:

 

Medical Certification:

Class 1 None

Last FAA Medical Exam:

December 3, 2020

Occupational Pilot:

Yes

Last Flight Review or Equivalent:

May 5, 2021

Flight Time:

4636 hours (Total, all aircraft), 239 hours (Total, this make and model), 4407 hours (Pilot In Command, all aircraft), 19 hours (Last 90 days, all aircraft), 8 hours (Last 30 days, all aircraft)

Aircraft and Owner/Operator Information

Aircraft Make:

Bell

Registration:

N911KW

Model/Series:

212HP

Aircraft Category:

Helicopter

Year of Manufacture:

1973

Amateur Built:

 

Airworthiness Certificate:

Utility

Serial Number:

30592

Landing Gear Type:

None; Skid

Seats:

11

Date/Type of Last Inspection:

June 29, 2021 Continuous airworthiness

Certified Max Gross Wt.:

11200 lbs

Time Since Last Inspection:

 

Engines:

2 Turbo shaft

Airframe Total Time:

14543.5 Hrs as of last inspection

Engine Manufacturer:

Pratt & Whitney

ELT:

Installed, not activated

Engine Model/Series:

PT6T-3B

Registered Owner:

 

Rated Power:

 

Operator:

 

Operating Certificate(s) Held:

Rotorcraft external load (133)

Meteorological Information and Flight Plan

Conditions at Accident Site:

Visual (VMC)

Condition of Light:

Day

Observation Facility, Elevation:

KSIY,2651 ft msl

Distance from Accident Site:

16 Nautical Miles

Observation Time:

14:53 Local

Direction from Accident Site:

345°

Lowest Cloud Condition:

Clear

Visibility

10 miles

Lowest Ceiling:

None

Visibility (RVR):

 

Wind Speed/Gusts:

15 knots / 20 knots

Turbulence Type Forecast/Actual:

None / None

Wind Direction:

20°

Turbulence Severity Forecast/Actual:

N/A / N/A

Altimeter Setting:

29.96 inches Hg

Temperature/Dew Point:

34°C / -4°C

Precipitation and Obscuration:

No Obscuration; No Precipitation

 

Departure Point:

Dunsmuir, CA (1O6)

Type of Flight Plan Filed:

None

Destination:

Weed , CA

Type of Clearance:

None

Departure Time:

Type of Airspace:

Class G

Wreckage and Impact Information

Crew Injuries:

1 None

Aircraft Damage:

Substantial

Passenger Injuries:

 

Aircraft Fire:

None

Ground Injuries:

 

Aircraft Explosion:

None

Total Injuries:

1 None

Latitude, Longitude:

41.537,-122.378(est)

Administrative Information

Investigator In Charge (IIC):

Nepomuceno, Eleazar

 

Additional Participating Persons:

Michael Lenard; FAA; Sacramento, CA

Gary Howe; Bell Helicopters Inc; Fort Worth, TX Mark Stutzner; Bell Helicopters Inc; Fort Worth, TX Nora Vallee; TSB

André Doyon; Pratt & Whitney

Eric Shambora; USFS; Sacramento, CA

 

Original Publish Date:

June 28, 2023                                                                              Investigation Class:

3

Note:

The NTSB did not travel to the scene of this accident.

 

Investigation Docket:

https://data.ntsb.gov/Docket?ProjectID=103465

 

The National Transportation Safety Board (NTSB), established in 1967, is an independent federal agency mandated by Congress through the Independent Safety Board Act of 1974 to investigate transportation accidents, determine the probable causes of the accidents, issue safety recommendations, study transportation safety issues, and evaluate the safety effectiveness of government agencies involved in transportation. The NTSB makes public its actions and decisions through accident reports, safety studies, special investigation reports, safety recommendations, and statistical reviews.

The Independent Safety Board Act, as codified at 49 U.S.C. Section 1154(b), precludes the admission into evidence or use of any part of an NTSB report related to an incident or accident in a civil action for damages resulting from a matter mentioned in the report. A factual report that may be admissible under 49 U.S.C. § 1154(b) is available here.

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