Aircraft Accident/Incident Report

Telluride, Colorado 81435
Thursday, April 29, 1993 4:15 MDT

NTSB Narrative Summary Released at Completion of Accident

THE AIRLINE TRANSPORT-RATED PILOTS DEPARTED GRAND JUNCTION, CO, AT APPROXIMATELY 0345 MDT EN ROUTE TO FARMINGTON, NM, THEIR HOME BASE. AT 0351, THE FLIGHT LEVELED OFF AT 11,600 FEET ON A GROUND TRACK OF 135 DEGREES, AND MAINTAINED THAT HEADING AND ALTITUDE UNTIL RECORDED RADAR DATA ENDED AT 0407. ABOUT 0415, THE AIRPLANE IMPACTED A 14,246 FOOT MOUNTAIN AT THE 11,600 FOOT LEVEL. NO EVIDENCE OF PREIMPACT AIRFRAME, ENGINE, PROPELLER, OR FLIGHT CONTROL FAILURE OR MALFUNCTION WAS FOUND. AUTOPSY AND TOXICOLOGY PROTOCOLS CONDUCTED ON BOTH PILOTS FAILED TO DISCLOSE ANY PHYSICAL IMPAIRMENT. RECORDS SHOWED THAT BOTH PILOTS HAD BEEN ACTIVE SINCE 0800 THE PREVIOUS MORNING.

NTSB Probable Cause Narrative

FAILURE OF THE PILOT-IN-COMMAND TO PLAN AND/OR ASSURE SELECTION OF AN ALTITUDE/COURSE COMBINATION THAT WOULD PROVIDE TERRAIN CLEARANCE, AND FAILURE OF THE OTHER (SECOND) PILOT TO ADEQUATELY MONITOR THE SITUATION. DARKNESS, HIGH (MOUNTAINOUS) TERRAIN, AND PILOT/CREW FATIGUE WERE RELATED FACTORS.

Event Information

Type of Event Accident
Event Date 4/29/1993
Event Day of the Week Thursday
Time of Event 415
Event Time Zone Mountain Daylight Time
Event City TELLURIDE
Event State COLORADO
Event Country --
Zipcode of the event site 81435
Event Date Year 1993
Event Date Month 4
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude
Event Location Longitude
Event Location Airport
Event Location Nearest Airport ID
Indicates whether the acc/inc occurred off or on an airport Off Airport/Airstrip
Distance from airport in statute miles --
Degrees magnetic from airport --
Airport Elevation --
Weather Briefing Completeness Unknown
Investigator's weather source Witness
Time of the weather observation 0
Direction of event from weather observation facility (degrees) 0
Weather Observation Facility ID
Elevation of weather observation facility 0
Distance of event from weather observation facility (units?) 0
Time Zone of the weather observation
Lighting Conditions Night/Dark
Lowest Ceiling Height 0
Lowest Non-Ceiling Height 0
Sky/Lowest/Cloud Conditions Clear
Sky Condition for Lowest Ceiling None
Visibility Runway Visual Range (Feet) 0
Visibility Runway Visual Value (Statute Miles) --
Visibility (Statute Miles) 15
Air Temperature at event time (in degrees celsius) 4
Dew Point at event time (in degress fahrenheit) -6
Wind Direction (degrees magnetic) 0
Variable Wind Indicator Unknown
Wind Speed (knots) 0
Wind Velocity Indicator Calm
Wind Gust Indicator Not Gusting
Wind Gust (knots) 0
Altimeter Setting at event time (in. Hg) 30
Density Altitude (feet) 11762
Intensity of Precipitation Unknown
METAR weather report --
Event Highest Injury Fatal
On Ground, Fatal Injuries 0
On Ground, Minor Injuries 0
On Ground, Serious Injuries 0
Injury Total Fatal 2
Injury Total Minor --
Injury Total None --
Injury Total Serious --
Injury Total All 2
Investigating Agency NTSB
NTSB Docket Number (internal use) 769
NTSB Notification Source --
NTSB Notification Date Apr 30 1993 12:00AM
NTSB Notification Time 1000
Fiche Number and/or location -used to find docket information IMAGE
Date of most recent change to record Dec 11 2000 1:14PM
User who most recently changed record dbo
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number N5650N
NTSB Number DEN93FA052
Missing Aircraft Indicator N
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed None
Flight plan Was Activated? --
Damage Destroyed
Aircraft Fire Ground
Aircraft Explosion Ground
Aircraft Manufacturer's Full Name BEECH
Aircraft Model 58
Aircraft Series Identifier 58
Aircraft Serial Number TH-1638
Certified Max Gross Weight 5500
Aircraft Category Airplane
Aircraft Registration Class U.S. Registered/U.S. Soil
Aircraft is a homebuilt? No
Flight Crew Seats --
Cabin Crew Seats --
Passenger Seats --
Total number of seats on the aircraft 6
Number of Engines 2
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection 100 Hour
Date of Last Inspection Apr 12 1993 12:00AM
Airframe hours since last inspection 49
Airframe Hours 779
ELT Installed Yes
ELT Activated No
ELT Aided Location of Event Site Unknown
ELT Type --
Aircraft Owner Name SAN JUAN PILOT TRAINING, INC.
Aircraft Owner Street Address 2325 EAST 30TH STREET
Aircraft Owner City FARMINGTON
Aircraft Owner State NM
Aircraft Owner Country
Aircraft Owner Zipcode 87401
Operator is an individual? --
Operator Name
Operator Same as Owner? Yes
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address
Operator City
Operator State
Operator Country
Operator Zip code
Operator Code MASV
Owner has at least one certificate Yes - certificate holder
Other Operator of large aircraft? No
Certified for Part 133 or 137 Operation Unknown
Operator Certificate Number --
Indicates whether an air carrier operation was scheduled or not --
Indicates Domestic or International Flight --
Operator carrying Pax/Cargo/Mail --
Type of Flying (Per_Bus / Primary) Positioning
Second Pilot on Board Yes
Departure Point Same as Event No
Departure Airport Code GJT
Departure City GRAND JUNCTION
Departure State CO
Departure Country
Departure Time 340
Departure Time Zone MDT
Destination Same as Local Flt --
Destination Airport Code FMN
Destination City FARMINGTON
Destination State NM
Destination Country
Specific Phase of Flight Cruise
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jan 2 2001 10:30AM
User who most recently changed record dbo
Since inspection or accident --
Event Location Runway Number and Location 0
Runway Length --
Runway Width --
Sight Seeing flight No
Air Medical Flight No
Medical Flight --