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A B757-200 was dispatched in non compliance with incorrect engine fire extinguisher bottles installed. Caused by publication deficiency.
| Attributes | |
| ACN | 571274 |
| Time | |
| Date | 200301 |
| Day | Sun |
| Local Time Of Day | 0001 To 0600 |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| Altitude | agl single value : 0 |
| Environment | |
| Light | Night |
| Aircraft 1 | |
| Operator | common carrier : air carrier |
| Make Model Name | B757-200 |
| Operating Under FAR Part | Part 121 |
| Flight Phase | ground : maintenance |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : technician |
| Qualification | technician : airframe technician : powerplant |
| Experience | maintenance technician : 9.5 |
| ASRS Report | 571274 |
| Person 2 | |
| Affiliation | company : air carrier |
| Function | maintenance : technician |
| Events | |
| Anomaly | aircraft equipment problem : critical maintenance problem : improper maintenance maintenance problem : improper documentation non adherence : published procedure non adherence : far |
| Resolutory Action | none taken : detected after the fact |
| Consequence | other other |
| Factors | |
| Maintenance | contributing factor : manuals contributing factor : work cards performance deficiency : logbook entry performance deficiency : installation performance deficiency : non compliance with legal requirements |
| Supplementary | |
| Problem Areas | Chart Or Publication Maintenance Human Performance Aircraft |
| Primary Problem | Chart Or Publication |
| Situations | |
| Publication | Illustrated Parts Catalog |
Narrative:
While replacing 2 depleted engine fire bottles, wrong part number bottles were inadvertently installed. Due to misinterp of ipc. Manufacturer's part #24600013-21 from removed fire bottle where searched for in ipc and search revealed a match. Part #24600013-21 was found in section 26-21-00-05 of ipc, item 140. When xrefed for effectivity of aircraft, part number was found to be superseded by part #34600013-9DL and the effectivity was good. Parts were ordered and subsequently installed. After discrepancy was noted at shop level and myself informed, further research revealed that if part #34600013-9DL had been xrefed for effectivity, it would not have matched. Aircraft was rted to ZZZ and discrepancy corrected.
Original NASA ASRS Text
Title: A B757-200 WAS DISPATCHED IN NON COMPLIANCE WITH INCORRECT ENG FIRE EXTINGUISHER BOTTLES INSTALLED. CAUSED BY PUB DEFICIENCY.
Narrative: WHILE REPLACING 2 DEPLETED ENG FIRE BOTTLES, WRONG PART NUMBER BOTTLES WERE INADVERTENTLY INSTALLED. DUE TO MISINTERP OF IPC. MANUFACTURER'S PART #24600013-21 FROM REMOVED FIRE BOTTLE WHERE SEARCHED FOR IN IPC AND SEARCH REVEALED A MATCH. PART #24600013-21 WAS FOUND IN SECTION 26-21-00-05 OF IPC, ITEM 140. WHEN XREFED FOR EFFECTIVITY OF ACFT, PART NUMBER WAS FOUND TO BE SUPERSEDED BY PART #34600013-9DL AND THE EFFECTIVITY WAS GOOD. PARTS WERE ORDERED AND SUBSEQUENTLY INSTALLED. AFTER DISCREPANCY WAS NOTED AT SHOP LEVEL AND MYSELF INFORMED, FURTHER RESEARCH REVEALED THAT IF PART #34600013-9DL HAD BEEN XREFED FOR EFFECTIVITY, IT WOULD NOT HAVE MATCHED. ACFT WAS RTED TO ZZZ AND DISCREPANCY CORRECTED.
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.