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Inspector did not notice the blocker doors attach bolts were installed incorrectly; after the #2 engine inboard thrust reverser sleeve was installed on a B737-500.
| Attributes | |
| ACN | 782742 |
| Time | |
| Date | 200803 |
| Place | |
| Locale Reference | airport : zzz.airport |
| State Reference | US |
| Altitude | agl single value : 0 |
| Aircraft 1 | |
| Operator | common carrier : air carrier |
| Make Model Name | B737-500 |
| Operating Under FAR Part | Part 121 |
| Person 1 | |
| Affiliation | company : air carrier |
| Function | maintenance : inspector |
| ASRS Report | 782742 |
| Events | |
| Anomaly | maintenance problem : improper maintenance non adherence : published procedure non adherence : far |
| Independent Detector | other other : 1 |
| Resolutory Action | none taken : detected after the fact |
| Consequence | other |
| Factors | |
| Maintenance | performance deficiency : installation performance deficiency : scheduled maintenance performance deficiency : inspection |
| Supplementary | |
| Problem Areas | Maintenance Human Performance |
| Primary Problem | Maintenance Human Performance |
Narrative:
#2 engine inboard thrust reverser sleeve was installed. When blocker doors were installed; attach bolts were installed incorrectly. I did look at the bolts; saw they were installed and secured to arm and door. Operated thrust reverser with power on. Checked for hydraulic leaks -- none. Operation of thrust reverser: thrust reverser operated smooth; no grinding or jerking. Lights in cockpit -- normal. Lower slider was out of track. When I looked; latches were locked; thrust reverser was flush and smooth with outer thrust reverser; did not notice a difference. On the date this occurred; I was 1 of 4 inspectors covering planes and numerous mechanics. The aircraft at the time was not airworthy -- an out of service aircraft.
Original NASA ASRS Text
Title: INSPECTOR DID NOT NOTICE THE BLOCKER DOORS ATTACH BOLTS WERE INSTALLED INCORRECTLY; AFTER THE #2 ENG INBOARD THRUST REVERSER SLEEVE WAS INSTALLED ON A B737-500.
Narrative: #2 ENG INBOARD THRUST REVERSER SLEEVE WAS INSTALLED. WHEN BLOCKER DOORS WERE INSTALLED; ATTACH BOLTS WERE INSTALLED INCORRECTLY. I DID LOOK AT THE BOLTS; SAW THEY WERE INSTALLED AND SECURED TO ARM AND DOOR. OPERATED THRUST REVERSER WITH PWR ON. CHKED FOR HYD LEAKS -- NONE. OP OF THRUST REVERSER: THRUST REVERSER OPERATED SMOOTH; NO GRINDING OR JERKING. LIGHTS IN COCKPIT -- NORMAL. LOWER SLIDER WAS OUT OF TRACK. WHEN I LOOKED; LATCHES WERE LOCKED; THRUST REVERSER WAS FLUSH AND SMOOTH WITH OUTER THRUST REVERSER; DID NOT NOTICE A DIFFERENCE. ON THE DATE THIS OCCURRED; I WAS 1 OF 4 INSPECTORS COVERING PLANES AND NUMEROUS MECHS. THE ACFT AT THE TIME WAS NOT AIRWORTHY -- AN OUT OF SERVICE ACFT.
Data retrieved from NASA's ASRS site as of May 2009 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.