Aircraft Accident/Incident Report

Lake Elsinore, California 92331
Tuesady, May 28, 1991 19:55 PDT

NTSB Narrative Summary Released at Completion of Accident

THE PILOT SAID THAT HE WAS ASKED BY ONE OF THE OWNERS TO FERRY THE AIRCRAFT. WHEN HE ARRIVED TO GET IT HE FOUND THAT THE RIGHT ENGINE HAD BEEN SHUT DOWN DURING THE PREVIOUS FLIGHT. HE SAID THAT HE FOUND THE RIGHT FUEL TANK EMPTY AND ABOUT 20 GALLONS OF FUEL IN THE LEFT TANK. THE PILOT SAID HE LOADED 50 GALLONS OF FUEL IN EACH TANK, AFTER DETERMINING THAT THE FLIGHT WOULD REQUIRE ONLY 50 GALLONS. WHILE DESCENDING INTO LAKE ELSINORE ONE ENGINE QUIT FOLLOWED QUICKLY BY THE SECOND ONE AND THE PILOT LANDED IN A FIELD. FAA INSPECTORS FOUND THE RIGHT FUEL TANK CONTAINED NO FUEL AND THE LEFT TANK CONTAINED ABOUT 50 GALLONS. NO OTHER MECHANICAL MALFUNCTIONS OR FAILURES WERE IDENTIFIED DURING THE INVESTIGATION. ONE OWNER OF THE AIRCRAFT WHO WAS REPOSSESSING IT FROM A PARTNER SAID THAT AFTER THE ACCIDENT HE WAS INFORMED THAT DUE TO A PUMP FAILURE THE OTHER OWNER HAD 'SOMEHOW RIGGED THE AIRCRAFT SO THAT BOTH ENGINES WOULD BE SUPPLIED BY THE RIGHT FUEL TANK.' THE OWNER SAID THAT BOTH HE AND THE PILOT WERE UNAWARE OF THIS MODIFICATION.

NTSB Probable Cause Narrative

FUEL STARVATION DUE TO AN IMPROPER MODIFICATION OF THE FUEL SYSTEM AND THE PILOT'S FAILURE TO ENSURE THAT THE AIRCRAFT WAS AIRWORTHY PRIOR TO FLIGHT.

Event Information

Type of Event Accident
Event Date 5/28/1991
Event Day of the Week Tuesday
Time of Event 1955
Event Time Zone Pacific Daylight Time
Event City LAKE ELSINORE
Event State CALIFORNIA
Event Country --
Zipcode of the event site 92331
Event Date Year 1991
Event Date Month 5
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 0
Degrees magnetic from airport 0
Airport Elevation --
Weather Briefing Completeness Unknown
Investigator's weather source Pilot
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 Day
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) 0
Visibility (Statute Miles) 10
Air Temperature at event time (in degrees celsius) --
Dew Point at event time (in degress fahrenheit) --
Wind Direction (degrees magnetic) 0
Variable Wind Indicator Variable
Wind Speed (knots) 0
Wind Velocity Indicator Light and Variable
Wind Gust Indicator Unknown
Wind Gust (knots) 0
Altimeter Setting at event time (in. Hg) --
Density Altitude (feet) --
Intensity of Precipitation Unknown
METAR weather report --
Event Highest Injury None
On Ground, Fatal Injuries 0
On Ground, Minor Injuries 0
On Ground, Serious Injuries 0
Injury Total Fatal --
Injury Total Minor --
Injury Total None 1
Injury Total Serious --
Injury Total All --
Investigating Agency NTSB
NTSB Docket Number (internal use) 442
NTSB Notification Source --
NTSB Notification Date --
NTSB Notification Time 0
Fiche Number and/or location -used to find docket information 43728
Date of most recent change to record Dec 12 2000 10:01AM
User who most recently changed record dbo
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number N9903Z
NTSB Number LAX91LA228
Missing Aircraft Indicator N
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed None
Flight plan Was Activated? --
Damage Substantial
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name BEECH
Aircraft Model C-45H
Aircraft Series Identifier C-45H
Aircraft Serial Number AF-853
Certified Max Gross Weight 8625
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 2
Number of Engines 2
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection Unknown
Date of Last Inspection Jan 2 2000 12:00AM
Airframe hours since last inspection --
Airframe Hours --
ELT Installed No
ELT Activated Unknown
ELT Aided Location of Event Site Unknown
ELT Type --
Aircraft Owner Name STEVE MALMBORG
Aircraft Owner Street Address P.O. BOX 1368
Aircraft Owner City LAKE ELSINORE
Aircraft Owner State CA
Aircraft Owner Country
Aircraft Owner Zipcode 92331
Operator is an individual? --
Operator Name STEVE MALMBORG
Operator Same as Owner? No
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address P.O. BOX 1368
Operator City LAKE ELSINORE
Operator State CA
Operator Country
Operator Zip code 92331
Operator Code
Owner has at least one certificate None
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 No
Departure Point Same as Event No
Departure Airport Code 6CA7
Departure City ARVIN
Departure State CA
Departure Country
Departure Time 1900
Departure Time Zone PDT
Destination Same as Local Flt crash at destination city
Destination Airport Code
Destination City
Destination State
Destination Country
Specific Phase of Flight Landing
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jan 2 2001 10:35AM
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 --