St Augustine Airport
Aircraft Accident/Incident Report

St. Augustine, Florida 32095
Monday, August 18, 2003 7:08 EDT

NTSB Narrative Summary Released at Completion of Accident

The copilot who had 60.4 hours total time in make and model, was seated in the left seat and was flying pilot for the part 91 positioning flight. An intersection departure was performed which provided 6,300 feet of usable runway for takeoff. The copilot was unsure how to release the parking brake before the flight was cleared for takeoff; the PIC had to instruct him how to do so. During the takeoff roll on runway 31 with a 4-knot wind from 240 degrees, the CVR recorded the PIC to state "V1", followed one second later by "rotate." Approximately 1 second later, the CVR recorded the copilot to state "whoa", followed by the cockpit area microphone recording an unidentified squealing sound. The PIC stated that the airplane turned abruptly 30 degrees to the left, and he initiated the aborted takeoff. He applied the brakes, reduced thrust, and applied both thrust reversers. In an attempt to maintain directional control, he and the copilot applied right rudder input and pumped the right brake, but the airplane departed the left side of the runway about 2,000 feet from the departure end of the runway. One of the main landing gears contacted an arresting cable, and the airplane continued onto grass. The anti-skid system tested OK before takeoff; and was on for takeoff. The PIC further stated the left main landing gear tire had good tread remaining prior to the flight. The left main landing gear tire was flat spotted. A 2,000 foot-long skid mark to the left of the runway centerline began approximately 1,850 feet from the point where the takeoff roll began. Examination of the left brake, both brake mixing valves, left and right wheelspeed transducers, power brake valve, control unit, and both parking brake valves revealed no evidence of preimpact failure or malfunction that would have resulted in left brake application. The company pilots are trained to utilize challenge/response to checklist items. Review of the CVR and the procedures listed in the airplane's "Before Starting Engines", "Starting Engines", "Before Taxi", "Taxi", and "Before Takeoff" checklists revealed none of the 5 checklists were verbally completed, and none of the checklists were completed at all with respect to challenge/response. Approximately 8 seconds elapsed from the time a squealing sound was heard on the CVR to the time when the copilot advised the PIC to "power off", which clarified his previous comment "hit it, hit it."

NTSB Probable Cause Narrative

The inadvertent left brake application by the copilot during the takeoff roll and the delay by the pilot-in-command to abort the takeoff resulting in a loss of directional control, and on-ground encounter with terrain.

Event Information

Type of Event Accident
Event Date 8/18/2003
Event Day of the Week Monday
Time of Event 708
Event Time Zone Eastern Daylight Time
Event City St. Augustine
Event State FLORIDA
Event Country --
Zipcode of the event site 32095
Event Date Year 2003
Event Date Month 8
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude 295735N
Event Location Longitude 0812026W
Event Location Airport St Augustine Airport
Event Location Nearest Airport ID KSGJ
Indicates whether the acc/inc occurred off or on an airport On Airport
Distance from airport in statute miles --
Degrees magnetic from airport --
Airport Elevation 10
Weather Briefing Completeness Not pertinent
Investigator's weather source Weather Observation Facility
Time of the weather observation 715 Eastern Daylight Time
Direction of event from weather observation facility (degrees) --
Weather Observation Facility ID KSGJ
Elevation of weather observation facility 10
Distance of event from weather observation facility (units?) --
Time Zone of the weather observation EDT
Lighting Conditions Day
Lowest Ceiling Height --
Lowest Non-Ceiling Height --
Sky/Lowest/Cloud Conditions Clear
Sky Condition for Lowest Ceiling None
Visibility Runway Visual Range (Feet) --
Visibility Runway Visual Value (Statute Miles) --
Visibility (Statute Miles) 10
Air Temperature at event time (in degrees celsius) 23
Dew Point at event time (in degress fahrenheit) 22
Wind Direction (degrees magnetic) 240
Variable Wind Indicator Wind direction could be determined
Wind Speed (knots) 4
Wind Velocity Indicator --
Wind Gust Indicator Not Gusting
Wind Gust (knots) --
Altimeter Setting at event time (in. Hg) 30.05
Density Altitude (feet) --
Intensity of Precipitation --
METAR weather report --
Event Highest Injury None
On Ground, Fatal Injuries --
On Ground, Minor Injuries --
On Ground, Serious Injuries --
Injury Total Fatal --
Injury Total Minor --
Injury Total None 2
Injury Total Serious --
Injury Total All --
Investigating Agency NTSB
NTSB Docket Number (internal use) 18501
NTSB Notification Source FAA Comm Center
NTSB Notification Date Aug 18 2003 12:00AM
NTSB Notification Time 810
Fiche Number and/or location -used to find docket information DMS
Date of most recent change to record Oct 27 2005 6:51AM
User who most recently changed record NTSB\JOHB
Basic weather conditions Visual Meteorological Cond
FAA District Office Orlando, Florida

Aircraft Involved

Aircraft #1

Aircraft Registration Number N51NP
NTSB Number MIA03LA163
Missing Aircraft Indicator --
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed IFR
Flight plan Was Activated? Yes
Damage Substantial
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name Beech
Aircraft Model 400A
Aircraft Series Identifier --
Aircraft Serial Number RK-224
Certified Max Gross Weight 16300
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 10
Number of Engines 2
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection AAIP
Date of Last Inspection Jan 16 2003 12:00AM
Airframe hours since last inspection 90.2
Airframe Hours 1087.3
ELT Installed Unknown
ELT Activated Unknown
ELT Aided Location of Event Site No
ELT Type --
Aircraft Owner Name AC Expeditions LLC
Aircraft Owner Street Address 9995 Gate Parkway North, Suite 200
Aircraft Owner City Jacksonville
Aircraft Owner State FL
Aircraft Owner Country USA
Aircraft Owner Zipcode 32246
Operator is an individual? No
Operator Name Executive Beechcraft, Inc.
Operator Same as Owner? No
Operator Is Doing Business As --
Operator Address Same as Owner? No
Operator Street Address 10 Richards Road
Operator City Kansas City
Operator State MO
Operator Country USA
Operator Zip code 64116
Operator Code --
Owner has at least one certificate --
Other Operator of large aircraft? --
Certified for Part 133 or 137 Operation --
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 Yes
Departure Airport Code KSGJ
Departure City St. Augustine
Departure State FL
Departure Country USA
Departure Time 708
Departure Time Zone EDT
Destination Same as Local Flt --
Destination Airport Code KHKY
Destination City Hickory
Destination State NC
Destination Country USA
Specific Phase of Flight Takeoff - aborted
Report sent to ICAO? Yes
Evacuation occurred Yes
Date of most recent change to record Jul 28 2005 9:56AM
User who most recently changed record KENJ
Since inspection or accident Time of Accident
Event Location Runway Number and Location 31
Runway Length 6300
Runway Width 150
Sight Seeing flight No
Air Medical Flight No
Medical Flight --