2021 Safety Recommendations

General
SR Number: 2021-05
Date Issued: 14/01/2021
Addressee: To GENEL HAVACILIK A. S.
Why this Recommendation was Developed: link_64Final Report 02/2021
Status: OPEN - Response received awaiting Assessment SR_Partially_accepted
Recommendation

SR Number:

2021-05 -- Date Issued: 14/01/2021
Why this Recommendation was Developed: link_64Final Report 02/2021
Addressee: To GENEL HAVACILIK A. S.
Status: OPEN - Response received awaiting Assessment
Recommendation: SAFETY RECOMMENDATION 2021-05: GENEL HAVACILIK A. S. must enhanced efficiency of CRM training program
Response

SR Number:

2021-05 -- Date Issued: 14/01/2021
Why this Recommendation was Developed: link_64Final Report 02/2021
Addressee: To GENEL HAVACILIK A. S.
Status: OPEN - Response received awaiting Assessment
Response: Operator’s response to AAIASB SR 2021-05 was received by email on 09/6/2021.

[Operator’s response]: “CRM training is being given in accordance with the procedure as stated in our approved Part-D Manual and our company is being inspected regularly by Turkish DGCA [Turkish Civil Aviation Authority] every year. You can find the related procedure of OM [ΟPERATIONS MANUAL] Part-D in the attachment of this e-mail.” [Attached manuals are not made publicly available by AAIASB]

[AAIASB changed status of SR 2021-05 to “Open- Response Received awaiting assessment” and will assess the Response within 60 days as per EU Reg. 996/2010.]
General
SR Number: 2021-04
Date Issued: 14/01/2021
Addressee: To GENEL HAVACILIK A. S.
Why this Recommendation was Developed: link_64Final Report 02/2021
Status: OPEN - Response received awaiting Assessment SR_Partially_accepted
Recommendation

SR Number:

2021-04 -- Date Issued: 14/01/2021
Why this Recommendation was Developed: link_64Final Report 02/2021
Addressee: To GENEL HAVACILIK A. S.
Status: OPEN - Response received awaiting Assessment
Recommendation: SAFETY RECOMMENDATION 2021-04: GENEL HAVACILIK A. S., in order to continue operating commercial flights to Mykonos (LGMK), must consider according to ICAO categorization criteria that Airport, and ascertain that all Flight Crews operating at LGMK, undergo special training taking into account the peculiarities (Airport terrain environment and weather phenomena as stated in AIP-Greece).
Response

SR Number:

2021-04 -- Date Issued: 14/01/2021
Why this Recommendation was Developed: link_64Final Report 02/2021
Addressee: To GENEL HAVACILIK A. S.
Status: OPEN - Response received awaiting Assessment
Response: Operator’s response to AAIASB SR 2021-04 was received by email on 09/6/2021.
[Operator’s response]:

“To increase the awareness of our crew about airport terrain environment and weather phenomena as stated in AIP [Aeronautical Information Publication], a safety bulletin was published within the company for future possible flights to this airport. You can find the safety bulletin published with 2021-01 number in the attachment of this email. Besides this, LGMK airport is categorised as CAT B airport on our Aerodrome Categorisation List.

According to this procedure which is explained on OM [ΟPERATIONS MANUAL] Part-A 08.01.02.03.02.01 Operations to Airport Category B is as follows; “Prior to operating to a Category B airport, the commander should be briefed…(by the contracted dispatch company)”

You can find the related procedure of OM [ΟPERATIONS MANUAL] Part-A in the attachment of this e-mail.” .” [Attached manuals are not made publicly available by AAIASB]

[AAIASB changed status of SR 2021-04 to “Open- Response Received awaiting assessment” and will assess the Response within 60 days as per EU Reg. 996/2010.]
General
SR Number: 2021-03
Date Issued: 26/11/2020
Addressee: Airworthiness Management Organization EL.MG.0037 & Maintenance Organization EL.145.0078
Why this Recommendation was Developed: link_64Final Report 01/2021
Status: OPEN - Awaiting Response SR OPEN
Recommendation

SR Number:

2021-03 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: Airworthiness Management Organization EL.MG.0037 & Maintenance Organization EL.145.0078
Status: OPEN - Awaiting Response
Recommendation: PREAMBLE:
The investigation revealed that the Aircraft was maintained based on a maintenance program prepared by the organization EL.MG.0037, was approved by the CAA but was not based on the current revision of the Aircraft service manual at the time of its issuance and approval. Also, during inspection of the maintenance works of the Aircraft, it was found that:

1. Engine components were replaced in the Maintenance Organization EL.145.0078 by others with part number which were not specified in the manufacturer's IPC.
2. The calendar restriction for carrying out the inspection of the fuel filter was not observed.
3. There was a mandatory directive which was not assessed as to whether it was applicable.
4. The inspection of the battery and cables was not carried out within the stipulated calendar deadline.
5. In the list of the remaining hours for the inspections, it appeared that there were incorrect entries in the date of execution of works but also in the number of flight hours of the Aircraft in tasks performed during the last maintenance.

SAFETY RECOMMENDATION 2021-03: It is recommended that the Airworthiness Management Organization EL.MG.0037 and the Maintenance Organization EL.145.0078 to review and possibly revise their operating procedures of those Organizations.
Response

SR Number:

2021-03 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: Airworthiness Management Organization EL.MG.0037 & Maintenance Organization EL.145.0078
Status: OPEN - Awaiting Response
Response:
General
SR Number: 2021-02
Date Issued: 26/11/2020
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Why this Recommendation was Developed: link_64Final Report 01/2021
Status: OPEN - Awaiting Response SR OPEN
Recommendation

SR Number:

2021-02 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Status: OPEN - Awaiting Response
Recommendation: PREAMBLE:
The investigation revealed that the Aircraft was maintained based on a maintenance program prepared by the organization EL.MG.0037, was approved by the CAA but was not based on the current revision of the Aircraft service manual at the time of its issuance and approval. Also, during inspection of the maintenance works of the Aircraft, it was found that:

1. Engine components were replaced in the Maintenance Organization EL.145.0078 by others with part number which were not specified in the manufacturer's IPC.
2. The calendar restriction for carrying out the inspection of the fuel filter was not observed.
3. There was a mandatory directive which was not assessed as to whether it was applicable.
4. The inspection of the battery and cables was not carried out within the stipulated calendar deadline.
5. In the list of the remaining hours for the inspections, it appeared that there were incorrect entries in the date of execution of works but also in the number of flight hours of the Aircraft in tasks performed during the last maintenance.

SAFETY RECOMMENDATION 2021-02: It is recommended that the CAA review and possibly revise the implementation of internal procedures for the control of:
- The Airworthiness Management Organization EL.MG.0037,
- The Maintenance Organization EL.145.0078 and
- The manuals to be approved.
Response

SR Number:

2021-02 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Status: OPEN - Awaiting Response
Response:
General
SR Number: 2021-01
Date Issued: 26/11/2020
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Why this Recommendation was Developed: link_64Final Report 01/2021
Status: OPEN - Awaiting Response SR OPEN
Recommendation

SR Number:

2021-01 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Status: OPEN - Awaiting Response
Recommendation: PREAMBLE:
In the No. D3/C/12041/2861 regulation of the CAA entitled “Regulation of Refueling Aircrafts at Airports”, article 19 describes, among others, the process of refueling and the possibility of supplying fuel for light and ultra-light Aircraft, while in effect is the from January 2003 decision of the CAA Director approving the use of fuel of specifications ASTM D4814 or EN 228.

The investigation revealed that in the Hellenic Territory the unleaded automotive gasoline that is available, has quality characteristics as they are mentioned in the Government Gazette 293/12.02.2016 and in the standard EN 228: 2014. Among other characteristics, the vapor pressure and the possible legal percentage of ethanol and methanol, the maximum value of which is mentioned in the above Government Gazette and in the standard EN:228, can have a direct effect on the operation of the Aircraft engines and are a latent cause of accident. For this reason it is necessary to check if the fuel meets the characteristics mentioned in the above texts and especially if it complies with the limit of zero alcohol.

Also, in the two fuel tanks the existence of a quantity of foreign bodies was observed, whose presence is not compatible with an Aircraft fuel tank. Since the fuel tanks were found closed and intact after the crash of the Aircraft, it appears that there was probably a refueling with fuel that had not previously been filtered.

SAFETY RECOMMENDATION 2021-01: It is recommended that the Civil Aviation Authority review and possibly revise the implementation of the applied procedure so that the supply and transportation of unleaded gasoline and the refueling of Aircrafts with unleaded gasoline is in accordance with applicable regulations.
Response

SR Number:

2021-01 -- Date Issued: 26/11/2020
Why this Recommendation was Developed: link_64Final Report 01/2021
Addressee: HELLENIC CIVIL AVIATION AUTHORITY (HCAA)
Status: OPEN - Awaiting Response
Response:
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