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A shop technician reports installing incorrect oil hole plugs in the #1 bearing front support on a P&west 2037 engine. Correct plugs required 'J' thread, not standard thread, as installed.
| Attributes | |
| ACN | 550899 |
| Time | |
| Date | 200206 |
| Day | Tue |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| Altitude | agl single value : 0 |
| Aircraft 1 | |
| Controlling Facilities | tower : mco.tower |
| Flight Phase | ground : parked |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : technician |
| Qualification | technician : fcc technician : powerplant technician : airframe |
| ASRS Report | 550899 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | maintenance : lead technician |
| Events | |
| Anomaly | aircraft equipment problem : less severe maintenance problem : improper maintenance maintenance problem : improper documentation non adherence : published procedure |
| Independent Detector | other other : gnd 1 |
| Resolutory Action | none taken : detected after the fact |
| Consequence | other other |
| Factors | |
| Maintenance | contributing factor : engineering procedure contributing factor : manuals contributing factor : work cards performance deficiency : installation performance deficiency : non compliance with legal requirements performance deficiency : inspection performance deficiency : fault isolation |
| Supplementary | |
| Problem Areas | Chart Or Publication Maintenance Human Performance |
| Primary Problem | Maintenance Human Performance |
Narrative:
My job on the #1 brg front support (part #1b2702) is to install plugs on the oil holes, per 72-32-04 revision 01 notes 1D, 1E, 1F, 1G. I am to install plug part #1b2808. Yrs ago, I was installing plugs I acquired from my lead. My lead acquired the plugs from the engineer. There were oil leaks and a second repair was written by the engineer. The new repair called for florescent particle inspection. During this time I have heard from another engineer that the plugs I was installing 2 yrs ago were standard plugs, not j-thread as required.
Original NASA ASRS Text
Title: A SHOP TECHNICIAN RPTS INSTALLING INCORRECT OIL HOLE PLUGS IN THE #1 BEARING FRONT SUPPORT ON A P&W 2037 ENG. CORRECT PLUGS REQUIRED 'J' THREAD, NOT STANDARD THREAD, AS INSTALLED.
Narrative: MY JOB ON THE #1 BRG FRONT SUPPORT (PART #1B2702) IS TO INSTALL PLUGS ON THE OIL HOLES, PER 72-32-04 REVISION 01 NOTES 1D, 1E, 1F, 1G. I AM TO INSTALL PLUG PART #1B2808. YRS AGO, I WAS INSTALLING PLUGS I ACQUIRED FROM MY LEAD. MY LEAD ACQUIRED THE PLUGS FROM THE ENGINEER. THERE WERE OIL LEAKS AND A SECOND REPAIR WAS WRITTEN BY THE ENGINEER. THE NEW REPAIR CALLED FOR FLORESCENT PARTICLE INSPECTION. DURING THIS TIME I HAVE HEARD FROM ANOTHER ENGINEER THAT THE PLUGS I WAS INSTALLING 2 YRS AGO WERE STANDARD PLUGS, NOT J-THREAD AS REQUIRED.
Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.