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126.9 megahertz. At this time, ACA870 was approximately 9 nm from AFR033 and converging on
a track of 116° magnetic. No action was taken by the radar controller. Approximately one minute
and thirty seconds later, at 0212:33, while the radar controller was communicating with another
aircraft, ACA870 received a TCAS RA and attempted to make radio contact with the radar
controller, but was cut off by another transmission. Seven seconds later, at 0212:40, ACA870
declared Pan, Pan, Pan. The radar controller issued a clearance to descend to FL 360. ACA870
replied that they were climbing as a result of the RA and that they were on a collision course.
The radar controller advised ACA870 to follow the advisory.
- 2 -
Immediately thereafter, AFR033 declared Pan, Pan, Pan and advised the controller that the
aircraft was descending as a result of a TCAS RA (see Appendix A, Figure 2). AFR033 received an
initial TCAS traffic advisory (TA) at 0211:34 and an RA to descend at 0212:47. Recorded radar
data of the occurrence shows AFR033's altitude to have been 36,900 feet at 0212:49, 36,700 feet at
0212:54, 36,700 feet at 0212:59, and 36,400 feet at 0213:03. (Valid recorded radar data may differ
from aircraft-reported altitude by plus or minus 200 feet.) Aircraft data provided by Air France
show the altitude of AFR033 as 36,788 feet at 0212:59 with a downward velocity of 1,790 feet per
minute, and 36,384 feet at 0213:30. The time between the onset of the RA and initiation of
descent with the autopilot off was two seconds.
On receiving the TCAS RA, ACA870 began an immediate climb to FL 380 and reached that
altitude approximately 50 seconds after commencement of the climb. Seventeen seconds after
the end of the AFR033 Pan, Pan, Pan transmission, ACA870 advised that they were directly
overhead the Air France aircraft and that the two aircraft would have collided.
1.2 Injuries to Persons
There were no injuries.
1.3 Damage to Aircraft
There was no damage to either aircraft.
1.4 Other Damage
There was no other damage as a result of this occurrence.
1.5 Personnel Information
1.5.1 Air Traffic Controllers
Controller Position Radar Controller
Age 36
Licence ATC
Experience
- as a Controller
- as an IFR Controller
- in Present Unit
8 years
8 years
8 years
Hours on Duty Prior to Occurrence 6
Hours off Duty Prior to Work Period 58
- 3 -
Controller Position Data Controller
Age 34
Licence ATC
Experience
- as a Controller
- as an IFR Controller
- in Present Unit
9 years
9 years
9 years
Hours on Duty Prior to Occurrence 3.75
Hours off Duty Prior to Work Period 38
1.5.1.1 Air Traffic Controllers’ Experience
The sector in which the loss of separation occurred, BANCS, was staffed by a data controller and
a radar controller in accordance with unit staffing requirements. The team supervisor, in
keeping with normal practice, was working at another sector providing a relief break for a
controller. The radar controller had eight years’, and the data controller nine years’, experience
in air traffic control. Both controllers were appropriately licenced and qualified. The radar
controller had been on duty for six hours, and the data controller three and three quarters hours,
since the beginning of their shifts. The radar controller was on the first shift of his work cycle,
having completed two days off. The data controller had been off the previous day but had
reportedly worked 16 shifts in the previous 18 days, 7 of which had been overtime shifts. Such a
schedule is within the terms of the collective agreement provided one day off is provided after
nine consecutive days of work. The traffic volume at the time of the occurrence was described as
moderate to heavy. All necessary equipment was serviceable and being used.
1.6 Aircraft Information
1.6.1 Air Canada Boeing 747 C-GAGN
Manufacturer Boeing
Type and Model 747-400
Year of Manufacture Not applicable
Serial Number Not applicable
Engine Type (number of) 4
- 4 -
1.6.2 Air France Airbus A340 F-GLZL
Manufacturer Airbus Industrie
Type and Model A340
Year of Manufacture Not applicable
Serial Number Not applicable
Engine Type (number of) 4
1.7 Meteorological Information
The weather was clear in the vicinity of the occurrence.
1.8 Aids to Navigation
All navigation aids were reported to be operating normally.
1.9 Communications
Normal means of communication were serviceable.
1.10 Control Procedures - General
1.10.1 Flight Progress Strip Manipulation
Flight progress strips are maintained by controllers and contain written information on the
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