| Type of Event | Incident |
| Event Date | 8/10/2004 |
| Event Day of the Week | Tuesday |
| Time of Event | 1435 |
| Event Time Zone | Coordinated Universal Time? Same as GMT |
| Event City | Melbourne |
| Event State | -- |
| Event Country | AMERICAN SAMOA |
| Zipcode of the event site | -- |
| Event Date Year | 2004 |
| Event Date Month | 8 |
| 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 | -- |
| Distance from airport in statute miles | -- |
| Degrees magnetic from airport | -- |
| Airport Elevation | -- |
| Weather Briefing Completeness | -- |
| Investigator's weather source | -- |
| Time of the weather observation | |
| Direction of event from weather observation facility (degrees) | -- |
| Weather Observation Facility ID | -- |
| Elevation of weather observation facility | -- |
| Distance of event from weather observation facility (units?) | -- |
| Time Zone of the weather observation | -- |
| Lighting Conditions | -- |
| Lowest Ceiling Height | -- |
| Lowest Non-Ceiling Height | -- |
| Sky/Lowest/Cloud Conditions | -- |
| Sky Condition for Lowest Ceiling | -- |
| Visibility Runway Visual Range (Feet) | -- |
| Visibility Runway Visual Value (Statute Miles) | -- |
| Visibility (Statute Miles) | -- |
| Air Temperature at event time (in degrees celsius) | -- |
| Dew Point at event time (in degress fahrenheit) | -- |
| Wind Direction (degrees magnetic) | -- |
| Variable Wind Indicator | -- |
| Wind Speed (knots) | -- |
| Wind Velocity Indicator | -- |
| Wind Gust Indicator | -- |
| Wind Gust (knots) | -- |
| Altimeter Setting at event time (in. Hg) | -- |
| Density Altitude (feet) | -- |
| Intensity of Precipitation | -- |
| METAR weather report | -- |
| Event Highest Injury | -- |
| On Ground, Fatal Injuries | -- |
| On Ground, Minor Injuries | -- |
| On Ground, Serious Injuries | -- |
| Injury Total Fatal | -- |
| Injury Total Minor | -- |
| Injury Total None | -- |
| Injury Total Serious | -- |
| Injury Total All | -- |
| Investigating Agency | Foreign |
| NTSB Docket Number (internal use) | -- |
| NTSB Notification Source | ATSB |
| NTSB Notification Date | Aug 25 2004 12:00AM |
| NTSB Notification Time | 2047 |
| Fiche Number and/or location -used to find docket information | -- |
| Date of most recent change to record | Aug 30 2004 10:48AM |
| User who most recently changed record | HAUT |
| Basic weather conditions | -- |
| FAA District Office | -- |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | -- |
| NTSB Number | DCA04WA073 |
| Missing Aircraft Indicator | -- |
| Federal Aviation Reg. Part | Non-U.S., Commercial |
| Type of Flight Plan filed | -- |
| Flight plan Was Activated? | No |
| Damage | None |
| Aircraft Fire | -- |
| Aircraft Explosion | -- |
| Aircraft Manufacturer's Full Name | Boeing |
| Aircraft Model | 717-200 |
| Aircraft Series Identifier | -- |
| Aircraft Serial Number | -- |
| Certified Max Gross Weight | -- |
| Aircraft Category | Airplane |
| Aircraft Registration Class | -- |
| Aircraft is a homebuilt? | No |
| Flight Crew Seats | -- |
| Cabin Crew Seats | -- |
| Passenger Seats | -- |
| Total number of seats on the aircraft | -- |
| Number of Engines | -- |
| Fixed gear or retractable gear | Fixed |
| Aircraft, Type of Last Inspection | -- |
| Date of Last Inspection | -- |
| Airframe hours since last inspection | -- |
| Airframe Hours | -- |
| ELT Installed | -- |
| ELT Activated | -- |
| ELT Aided Location of Event Site | -- |
| ELT Type | -- |
| Aircraft Owner Name | -- |
| Aircraft Owner Street Address | -- |
| Aircraft Owner City | -- |
| Aircraft Owner State | -- |
| Aircraft Owner Country | -- |
| Aircraft Owner Zipcode | -- |
| Operator is an individual? | -- |
| Operator Name | -- |
| Operator Same as Owner? | -- |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | -- |
| Operator Street Address | -- |
| Operator City | -- |
| Operator State | -- |
| Operator Country | -- |
| Operator Zip code | -- |
| Operator Code | -- |
| Owner has at least one certificate | None |
| 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 | Scheduled |
| Indicates Domestic or International Flight | Domestic |
| Operator carrying Pax/Cargo/Mail | Passenger Only |
| Type of Flying (Per_Bus / Primary) | -- |
| Second Pilot on Board | -- |
| Departure Point Same as Event | Yes |
| Departure Airport Code | -- |
| Departure City | Melbourne |
| Departure State | -- |
| Departure Country | AS |
| Departure Time | -- |
| Departure Time Zone | UTC |
| Destination Same as Local Flt | -- |
| Destination Airport Code | -- |
| Destination City | -- |
| Destination State | -- |
| Destination Country | -- |
| Specific Phase of Flight | Climb - to cruise |
| Report sent to ICAO? | -- |
| Evacuation occurred | No |
| Date of most recent change to record | Aug 30 2004 10:48AM |
| User who most recently changed record | HAUT |
| Since inspection or accident | -- |
| Event Location Runway Number and Location | -- |
| Runway Length | -- |
| Runway Width | -- |
| Sight Seeing flight | No |
| Air Medical Flight | No |
| Medical Flight | -- |