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時間:2010-09-29 17:04來源:藍天飛行翻譯 作者:admin
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The F/O did not maintain any credit accounts in Singapore. At the time of the accident,
the F/O maintained his savings in a savings account. His parents reported that he owed
them an amount for initial flight training expenses which was less than the savings at that
time. There were no specified repayment terms. He was reported to be saving money to
further his flight training to qualify for an ATPL. There were no reports of any other
loans or debts. The F/O had a life insurance policy bought in 1992 and a standard SilkAir
policy11.
1.18.4.3 Recent Behaviour
The F/O last flew on 16 December 1997. The F/O’s associates and friends reported no
changes or anything unusual in the F/O’s behaviour in the weeks prior to the accident. He
was reported to have eaten and slept normally in the days prior to the accident.
On the morning of 19 December 1997, two engineers who knew the F/O socially talked
with him when the aircraft was being prepared for departure from Singapore. They made
plans to meet that night. They reported that the F/O appeared to be normal and in good
spirits.
The F/O planned to return to New Zealand in February 1998 to acquire additional pilotin-
command hours and obtain his ATPL.
1.18.5 Relationship Between the PIC and the F/O
From December 1996 through December 1997, the PIC and the F/O flew 18 sectors
together across seven days (including the accident flight). The investigation found no
evidence to indicate that there had ever been any difficulties in the relationship between
the PIC and the F/O.
On the two hours of CVR information, there were no indications of any difficulties in the
relationship between the two pilots. There were several cordial discussions not related to
their work tasks at the time.
11 Amended based on information in Appendix M.
28
2 ANALYSIS
2.1 Introduction
The investigation was conducted in accordance with the standards and recommended
practices of Annex 13 to the Convention on International Civil Aviation. In accordance
with Annex 13, the sole objective of the investigation of an accident or incident shall be
the prevention of accidents and incidents. It is not the purpose of this activity to apportion
blame or liability.
This was an extremely difficult and challenging investigation due to the degree of
destruction of the wreckage, the difficulties presented by the accident site and the lack of
information from the flight recorders during the final moments of the accident sequence.
The analysis is drawn from facts compiled in the engineering and systems, operations,
and human factor aspects of the investigations.
Analysis on the engineering and systems aspect starts with the aircraft structural and
systems integrity including trajectory and flutter analysis studies. The results of tear down
and examination of the actuators are analyzed to determine the positions and conditions
of the control surfaces, engines, and other related systems. Special attention is also given
to the issues arising from previous B737 accidents, e.g. the Colorado Springs and
Pittsburgh accidents, especially on the issue of the rudder power control unit (PCU). The
stoppage of the flight recorders is analyzed based on the electrical wiring diagrams, as
well as on-ground and in-flight tests performed in the USA and in Singapore. The
maintenance aspect is analyzed in the last part of the engineering and systems section.
The investigation of the operations aspect covers general factors of the operation of the
flight such as flight crew, air traffic control, weather, navigation, communication, flight
trajectory and conditions based on CVR, FDR as well as radar data, and flight simulation
exercises. The analysis focuses on the possible system failures and its effect to the aircraft
descent trajectory as suggested from radar data points. The descent technique that arises
from emergency situation and recovery from such extreme descent is also discussed.
The investigation of the human factor aspect of the accident took into consideration all
available background data of the flight crew, and the results of the analysis in the other
areas (e.g. engineering and systems, operations, etc). The analysis covers general human
performance issues (such as medical, professional qualification, training, fatigue,
impairment, improper in-flight management, etc), the human factor aspects of the CVR
and ATC recordings, as well as specific human factor issues.
In accordance with Annex 13, a report was made to the relevant aviation security
authorities in late 1999. While the technical investigation continued, aviation security
authorities conducted a separate investigation, which is not covered in this report.
 
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