Andrews Air Force Base Airport
Aircraft Accident/Incident Report

Camp Springs, Maryland 20746
Wednesday, May 13, 2009 11:47 EDT

NTSB Narrative Summary Released at Completion of Accident

The Andrews Air Force Base (ADW), Camp Springs, Maryland, ground controller, who was working the ground control (GC), clearance delivery (CD), and flight data (FD) positions combined, authorized four vehicles to cross runway 19R without the local controller’s (LC's) approval while VM206, a BE-20, was departing runway 19R. At the time of the incursion, the LC was also the front line manager (FLM). VM206 was holding short of runway 19R at the midfield taxiway C waiting to back-taxi toward the approach end of the runway for departure. One of four vehicles was holding behind VM206 on taxiway C waiting to cross the runway from west to east, and three other vehicles were on taxiway S waiting to cross the departure end from east to west. After landing traffic cleared runway 19R, the LC/FLM cleared VM206 for takeoff from runway 19R at taxiway C, permitting the use of the full runway for takeoff. VM206 entered runway 19R at taxiway C, turned left and taxied approximately 500 feet toward the approach end of the runway, turned, and commenced the takeoff roll. As VM206 was turning and beginning its takeoff roll, the GC asked the LC, “am I crossing?”. The request was not made on a recorded landline as required by local air traffic control directives. The LC responded to the GC on the recorded land line, “You’re not crossing.” The GC then instructed the vehicles to cross the departure end of the runway. The vehicle operator who was holding behind VM206 again requested clearance to cross. The GC, performing tasks associated with CD, stated in her interview that she cleared the vehicle to cross runway 19R without visually scanning the runway. According to the controllers interviewed, the Airport Movement Area Safety System did not alarm. The LC noticed the vehicle cross the departure end and directed the GC to stop the vehicle. However, the vehicle was nearly across the runway by the time the GC instructed them to stop. The vehicle operator continued across the runway until clear of runway 19R. FAA Order 7110.65, “Air Traffic Control” states that the LC has primary responsibility for operations conducted on the active runway and must control the use of those runways. The GC is required to obtain approval from the local controller before authorizing an aircraft or a vehicle to cross or use any portion of an active runway and advise the local controller when the coordinated runway operation is complete.

NTSB Probable Cause Narrative

The failure of the ground controller to coordinate the runway crossings with the local controller and her failure to scan the runway prior to issuing the crossing instructions. Contributing to the incident was the combination of the front line manager/tower supervisor and the local control position, which prevented diligent oversight of the tower cab operations.

Event Information

Type of Event Incident
Event Date 5/13/2009
Event Day of the Week Wednesday
Time of Event 1147
Event Time Zone Eastern Daylight Time
Event City Camp Springs
Event State MARYLAND
Event Country --
Zipcode of the event site 20746
Event Date Year 2009
Event Date Month 5
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude 384839N
Event Location Longitude 0765201W
Event Location Airport Andrews Air Force Base
Event Location Nearest Airport ID KADW
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 280
Weather Briefing Completeness --
Investigator's weather source Weather Observation Facility
Time of the weather observation 1155 Eastern Daylight Time
Direction of event from weather observation facility (degrees) --
Weather Observation Facility ID KADW
Elevation of weather observation facility --
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) 20
Dew Point at event time (in degress fahrenheit) 6
Wind Direction (degrees magnetic) 170
Variable Wind Indicator Wind direction could be determined
Wind Speed (knots) 8
Wind Velocity Indicator --
Wind Gust Indicator Not Gusting
Wind Gust (knots) --
Altimeter Setting at event time (in. Hg) --
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) 25562
NTSB Notification Source FAA
NTSB Notification Date --
NTSB Notification Time --
Fiche Number and/or location -used to find docket information --
Date of most recent change to record Jun 15 2009 12:11PM
User who most recently changed record rows
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number --
NTSB Number OPS09IA004
Missing Aircraft Indicator --
Federal Aviation Reg. Part --
Type of Flight Plan filed Unknown
Flight plan Was Activated? --
Damage None
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name --
Aircraft Model BE20
Aircraft Series Identifier --
Aircraft Serial Number --
Certified Max Gross Weight --
Aircraft Category --
Aircraft Registration Class --
Aircraft is a homebuilt? --
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 Unknown
ELT Activated Unknown
ELT Aided Location of Event Site Unknown
ELT Type --
Aircraft Owner Name --
Aircraft Owner Street Address --
Aircraft Owner City --
Aircraft Owner State --
Aircraft Owner Country USA
Aircraft Owner Zipcode --
Operator is an individual? No
Operator Name --
Operator Same as Owner? No
Operator Is Doing Business As --
Operator Address Same as Owner? No
Operator Street Address --
Operator City --
Operator State --
Operator Country USA
Operator Zip code --
Operator Code --
Owner has at least one certificate None
Other Operator of large aircraft? No
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) --
Second Pilot on Board --
Departure Point Same as Event Yes
Departure Airport Code ADW
Departure City Camp Springs
Departure State MD
Departure Country USA
Departure Time --
Departure Time Zone EDT
Destination Same as Local Flt --
Destination Airport Code --
Destination City --
Destination State --
Destination Country USA
Specific Phase of Flight --
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jun 8 2009 9:41AM
User who most recently changed record rows
Since inspection or accident --
Event Location Runway Number and Location 19R
Runway Length 9300
Runway Width 200
Sight Seeing flight No
Air Medical Flight No
Medical Flight --