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Air Transat Flight TS 236 of August 24, 2001 - Air Transat welcomes investigation findings and recommendations
Air Transat welcomes the findings of the investigation conducted by Portuguese authorities into the emergency landing in the Azores of Flight TS 236 on August 24, 2001. Air Transat supports the recommendations included in the report, all of which apply to the industry as a whole. Air Transat President and Chief Executive Officer Allen B. Graham said: "Since the occurrence we have reviewed our training programs and enhanced our processes, in terms of both maintenance and flight operations. Passenger safety has always been and continues to be our top priority; this event is unique in our history."
The occurrence resulted from a fuel leak and a complex combination of events and risk factors, including human errors, all of which are analyzed at great length in the report.
Among other things, the report recommends the mandatory installation of a new warning system for detecting fuel leaks, as recommended by Airbus to all operators in 2002. The report acknowledges that it had been difficult for the crew of Flight TS 236 to identify and subsequently isolate the fuel leak. Other recommendations aim at improving maintenance and training processes. Also recommended is a review of checklists.
The investigation was led by Portuguese authorities. Canada, France, the United Kingdom, Air Transat, Airbus and Rolls-Royce also participated.
"On behalf of the entire Air Transat team, I would like to reiterate our sincere regrets to the passengers, for whom it was undoubtedly a very difficult experience. Also, I would like to underline the professionalism shown by our crew on that occasion. Every one of them did their very best to perform their duty and put the safety of everyone on board first," said Mr. Graham.
Following the occurrence, Air Transat developed and implemented a comprehensive action plan that was submitted to Transport Canada, and took additional precautionary initiatives. Among others:
· A comprehensive review of its maintenance and operations program that led to an improvement of the performance of its quality assurance activity.
· The introduction of human factors training for all technical personnel.
· Fuel leak scenarios have been integrated into simulator training programs.
· The introduction of a new Safety Management System.
· The introduction of the new fuel leak detection system on Airbus A330 aircraft.
About Air Transat
Air Transat offers departures from Canada to some 90 destinations in 25 countries. With a fleet of 13 aircraft, the airline is Canada's leading vacation charter carrier. Air Transat is a member of Transat A.T. Inc., an integrated company specializing in the organization, marketing, and distribution of holiday travel.
The following backgrounder has been prepared by Air Transat for people unfamiliar with the story of Flight TS 236. Journalists and all other interested parties are encouraged to refer to the investigation report, which is available on the Internet at www.GPIAA-portugal-report.com and remains the only official reference.
1. Flight TS 236 took off from Toronto at 8.52 pm (EST) on Thursday, August 23, 2001; it made an emergency landing at 6.45 am (UTC, or Coordinated Universal Time) on August 24, 2001, at Lajes Airport, Terceira, Azores, Portugal.
2. There were 293 passengers and 13 crew members onboard. Sixteen passengers and two crew members were injured during the evacuation of the aircraft. All injuries were minor or very minor, except for two passengers who suffered serious, but non life-threatening, injuries.
3. The aircraft was an Airbus A330 manufactured in 1999, configured with 362 seats and put into service by Air Transat in April of 1999.
4. Leaving the gate in Toronto, the aircraft had 47.9 tonnes of fuel on board; 5.5 tonnes over and above the fuel required by regulations.
5. It has been estimated that a fuel leak started at 4.38 am (UTC), approximately four hours into the flight.
6. At 5.45 am (UTC, or Coordinated Universal Time) the pilots made a decision to divert the flight to the Azores.
7. At 6.13 am (UTC) the right engine flamed out.
8. At 6.26 am (UTC) the left engine flamed out. What followed is a 19-minute glide, over a distance of 65 nautical miles (approximately 120 km).
9. At 6.45 am (UTC) or 2.45 am (EST) the aircraft landed at Lajes Airport, on the island of Terceira, at an estimated speed of 200 knots (370 km/h). An emergency evacuation of the aircraft was ordered and took place in 90 seconds.
10. Following the occurrence, Air Transat made sure resources were made available to meet the immediate needs of the passengers.
11. The investigation was conducted by the Aviation Accidents Prevention and Investigation Department of Portugal, Portugal being the state of occurrence, in accordance with Annex 13 of the Convention on International Civil Aviation (ICAO).
12. Other participants in the investigation included the Transportation Safety Board and Transport Canada (Canada), the Bureau d'Enquêtes et d'Analyses pour la Sécurité de l'Aviation Civile and Direction Générale de l'Aviation Civile (France), the Air Accidents Investigation Branch (United Kingdom), Air Transat, Airbus and Rolls-Royce.
13. In accordance with section 3.1 of the aforementioned Annex 13, "the sole objective of the investigation of an accident or incident shall be the prevention of accidents and incidents. It is not the purpose of this activity to apportion blame or liability". Report: The investigation report is available at www.GPIAA-portugal-report.com