Report on the serious incident at Bergen Airport Flesland (ENBR) on 24 March 2003, involving SAS329, MD-81, LN-RMO, operated by Scanidnavian Airlines
Luftfart rapport 2005/48 eng
Innflyging i dårlig sikt til bane 35. I ca. 100 ft førte autopilot flyet ut på høyre side. Fartøysjef koplet ut autopilot og korrigerte til venstre. En overkorrigering førte flyet for langt ut til venstre, og resultatet ble kollisjon med banelys på venstre banekant under utrulling etter landing.
Sikkerhetstilråding
Safety recommendation SL no. 2005/55T
SAS Commanders’ policy is not to use landing lights in darkness and reduced visibility in drifting fog or precipitation. SAS should consider to re-evaluate the wording in OM Part A to clarify when use of landing lights are not recommended and when it may be beneficial.
Safety recommendation SL no. 2005/54T
Scandinavian Airlines has experienced four landing incidents at ENBR involving the use of AP down to the MUH. SAS should consider to re-evaluate the procedure of using the autopilot below CAT 1 minimum at ENBR.
Safety recommendation SL no. 2005/53T
Norway is the only country in the world using yellow runway markings. AIBN has not seen any scientific evidence supporting the Norwegian policy of using yellow runway markings. CAA-N should consider to evaluate the requirement for adhering to ICAO standard white runway surface markings in Norway.
Safety recommendation SL no. 2005/52T
Based on investigations of four landing incidents at ENBR, AIBN considers that the installation of centre line lighting systems will improve the flight safety level during landings at ENBR. CAA-N should consider to evaluate the requirement for RWY centre line lighting system at ENBR.
Safety recommendation SL no. 2005/51T
Based on the present NOTAM at ENBR regarding not using autopilot inside 3 NM on ILS 35, Avinor should consider to publish in AIP Norway any restrictions on automatic approaches and landings by use of the ILS equipment at Bergen airport Flesland.
Safety recommendation SL no. 2005/50T
Simultaneous operation of RWY 17/35 LLZ transmitters may be causing interference from the opposite LLZ signal. CAA-N should consider to review the Norwegian requirements for ILS equipment and use of interlock.
Fakta
Sted | Bergen lufthavn Flesland (ENBR) |
Hendelsesdato | 24.03.2003 |
ICAO flyplassindikator | ENBR |
Luftfartøy | McDonnell Douglas DC-9 |
Operatør | SAS |
Reg. merke | LN-RMO |
Flygeforhold | IMC |
Fylke | Hordaland |
Type hendelse | Alvorlig luftfartshendelse |
Type flyging | Ervervsmessig, ruteflyging |
Kategori luftfart | Tung, fly (> 10 000kg) |
Flykategori | Landfly, Multi-engine, Turbofan/Turbojet |
FIR/AOR | ENSV (Stavanger ATCC) |