BOMBARDIER INC CL-600-2C10PSA Airlines

TO THE FEDERAL AVIATION ADMINISTRATION: Prohibit operations on Helicopter Route 4 between Hains Point and the Wilson Bridge when runways 15 and 33 are being used for departures and arrivals, respectively, at Ronald Reagan Washington National Airport (DCA). (Urgent)

TO THE FEDERAL AVIATION ADMINISTRATION: Designate an alternative helicopter route that can be used to facilitate travel between Hains Point and the Wilson Bridge when that segment of Route 4 is closed. (Urgent)

TO THE FEDERAL AVIATION ADMINISTRATION: Develop and implement time-on-position limitations for supervisory air traffic control personnel, including guidance for district and facility level management to adapt these limitations to account for their own staffing and local standard operating procedures.

TO THE FEDERAL AVIATION ADMINISTRATION: Develop instructor-led, scenario-based training on threat and error management that trains controllers to continuously monitor their environment to more quickly and accurately identify threats; promote team communication to ensure that communications are clear, timely, and assertive; emphasize effective scanning habits; recognize patterns in the development of adverse events; and enhance decision-making under stress by developing habits that balance procedural compliance with problem solving to mitigate the risks of threats and errors, and provide this training to all air traffic controllers annually.

TO THE FEDERAL AVIATION ADMINISTRATION: Develop and implement a risk assessment tool for supervisors that incorporates the principles of threat and error management to assist in risk identification, mitigation, and operational decision making.

TO THE FEDERAL AVIATION ADMINISTRATION: Initiate rulemaking in 14 Code of Federal Regulations Part 93 Subpart K, High Density Traffic Airports, that prescribes air carrier operation limitations at DCA in 30-minute periods, similar to those imposed at LaGuardia Airport, to ensure that the airport does not exceed capacity and to mitigate inconsistent air carrier scheduling practices.

TO THE FEDERAL AVIATION ADMINISTRATION: Fully implement operational use of the time-based flow management system at Potomac Consolidated Terminal Radar Approach Control and its associated air traffic control towers.

TO THE FEDERAL AVIATION ADMINISTRATION: Reassess the Ronald Reagan Washington National Airport’s airport arrival rate with special consideration to its airspace complexity, airfield limitations, mixed fleet operations, and traffic volume.

TO THE FEDERAL AVIATION ADMINISTRATION: Require each Class B or Class C air traffic control tower facility to evaluate its existing miles-in-trail procedures or agreements to ensure that the spacing provided is appropriate for operational safety, and make the results publicly available.

TO THE FEDERAL AVIATION ADMINISTRATION: Define objective criteria for the determination of air traffic facility levels considering traffic and airspace volume, operational factors unique to each facility, and cost of living.

TO THE FEDERAL AVIATION ADMINISTRATION: Using the criteria established by Safety Recommendation A-26-15, determine whether the classification of the Ronald Reagan Washington National Airport’s air traffic control tower as a level 9 facility appropriately reflects the complexity of its operations.

TO THE FEDERAL AVIATION ADMINISTRATION: Develop a new and comprehensive instructor-led, scenario-based training on the proper use of visual separation, both tower- and pilot-applied. This training should include information on the inherent limitations of see and avoid, responsibilities when applying visual separation, and guidance for controllers on factors, such as current traffic volume, workload, weather or environmental factors, experience, and staffing, that should be considered when applying visual separation. Require this training for all controllers and include on a recurrent basis thereafter in annual simulator refresher training.

TO FEDERAL AVIATION ADMINISTRATION: Conduct a comprehensive evaluation, in conjunction with local operators, to determine the overall safety benefits and risks to requiring all aircraft to use the same frequency when the helicopter and local positions are combined in the Ronald Reagan Washington National Airport air traffic control tower.

TO THE FEDERAL AVIATION ADMINISTRATION: Implement anti-blocking technology that will alert controllers and/or flight crews to potentially blocked transmissions when simultaneous broadcasting occurs.

TO THE FEDERAL AVIATION ADMINISTRATION: Develop and implement improvements to the conflict alert system to provide more salient and meaningful alerts to controllers based on the severity of the conflict triggering the alert.

TO THE FEDERAL AVIATION ADMINISTRATION: Once the improvements to the conflict alert system discussed in Safety Recommendation A-26-20 are implemented, provide training to controllers on its use.

TO THE FEDERAL AVIATION ADMINISTRATION: Revise the Air Traffic Organization’s initial event response procedures so that an appropriate on-site supervisor makes each postaccident and postincident drug and alcohol testing determination, based on their assessment of whether the event meets testing criteria and which controllers had duties pertaining to the involved aircraft, without needing to wait for investigation or approval.

TO THE FEDERAL AVIATION ADMINISTRATION: At least annually, provide training on the revised postaccident and postincident drug and alcohol testing determination procedure discussed in Safety Recommendation A-26-22 to all staff who have responsibilities under that procedure; this training should include a post-learning knowledge assessment.

TO THE FEDERAL AVIATION ADMINISTRATION: Ensure that annual reviews of helicopter route charts are being conducted throughout the National Airspace System as required by Federal Aviation Administration Order.

TO THE FEDERAL AVIATION ADMINISTRATION: Conduct a safety risk management process to evaluate whether modifications to the remaining helicopter route structure in the vicinity of Ronald Reagan Washington National Airport are necessary to safely deconflict helicopter and fixed-wing traffic and provide the results to the National Transportation Safety Board.

TO THE FEDERAL AVIATION ADMINISTRATION: Amend your helicopter route design criteria and approval process to ensure that current and future route designs or design changes provide vertical separation from airport approach and departure paths.

TO THE FEDERAL AVIATION ADMINISTRATION: Based on the criteria and approval process established by Safety Recommendation A-26-26, review all existing helicopter routes to ensure alignment with these updated criteria.

TO THE FEDERAL AVIATION ADMINISTRATION: Incorporate the lateral location and published altitudes of helicopter routes onto all instrument and visual approach and departure procedures to provide necessary situation awareness to fixed-wing operators of the risk of helicopter traffic operating in their vicinity.

TO THE FEDERAL AVIATION ADMINISTRATION: Modify airborne collision avoidance system traffic advisory aural alerts to include clock position, relative altitude, range, and vertical tendency.

TO THE FEDERAL AVIATION ADMINISTRATION: Require existing and new traffic alerting and collision avoidance system (TCAS) I, TCAS II, and airborne collision avoidance system X installations to integrate directional traffic symbols.

TO THE FEDERAL AVIATION ADMINISTRATION: Require all aircraft operating in airspace where Automatic Dependent Surveillance–Broadcast (ADS-B) Out is required to also be equipped with ADS B In with a cockpit display of traffic information that is configured to provide alerting audible to the pilot and/or flight crew.

TO THE FEDERAL AVIATION ADMINISTRATION: Require the use of the appropriate variant of airborne collision avoidance system X on new production aircraft that are subject to traffic alert and collision avoidance system equipage regulations.

TO THE FEDERAL AVIATION ADMINISTRATION: Require existing aircraft that are subject to traffic alert and collision avoidance system equipage regulations be retrofitted with the appropriate variant of airborne collision avoidance system X.

TO THE FEDERAL AVIATION ADMINISTRATION: Evaluate the feasibility of decreasing the traffic advisory and resolution advisory inhibit altitudes in airborne collision avoidance system Xa to enable improved alerting throughout more of the flight envelope.

TO THE FEDERAL AVIATION ADMINISTRATION: If the evaluation resulting from Safety Recommendation A-26-34 finds that the inhibit altitudes can be safely decreased, require retrofitting of the applicable airborne collision avoidance system X variant incorporating the reduced traffic advisory and resolution advisory inhibit altitudes on all aircraft that are subject to traffic alert and collision avoidance system and equipage regulations.

TO THE FEDERAL AVIATION ADMINISTRATION: Require that all rotorcraft operating in Class B airspace be equipped with airborne collision avoidance system (ACAS) Xr technology once the ACAS Xr standard has been published.

TO FEDERAL AVIATION ADMINISTRATION: Create an objective definition of close proximity encounter and a public database of those encounters and their locations that can be used to monitor their prevalence and identify areas of potential traffic conflict for safety assurance and safety risk management.

TO THE FEDERAL AVIATION ADMINISTRATION: Develop and implement a process that will, in a timely manner, notify involved parties after events such as near midair collisions or traffic alert and collision avoidance system resolution advisory activations, such that notification occurs while relevant data remain available and before meaningful safety analysis, reporting, or corrective action is no longer practicable.

TO THE FEDERAL AVIATION ADMINISTRATION: Based on the results of the audit completed in accordance with Safety Recommendation A-26-56, ensure that all safety management system functions and data sharing activities at all air traffic control facilities are conducted in collaboration with all relevant external stakeholders.

TO THE FEDERAL AVIATION ADMINISTRATION: Establish a requirement across all air traffic control tower standard operating procedures that the operations supervisor (OS) or controller-in-charge (CIC) document in the daily facility log when any control position is combined with the local control position, or when the OS/CIC position is combined with a control position, along with a rationale for doing so.

TO THE UNITED STATES ARMY: Revise training procedures for flight crews assigned to operate in the Washington, DC, area to ensure that they receive initial and recurrent training on fixed-wing operations at Ronald Reagan Washington National Airport, including approach and departure paths, runway configurations, and the interaction of those traffic flows with published helicopter routes.

TO THE UNITED STATES ARMY: Develop and implement a recurring procedure, at an interval not to exceed 18 months, to verify the continued accuracy of recorded flight data.

TO THE UNITED STATES ARMY: Incorporate information within the appropriate operator’s manual for all applicable aircraft on the potential total error allowed by design that could occur in flight on an otherwise airworthy barometric altimeter, including the increased position error associated with the external stores support system configuration.

TO THE UNITED STATES ARMY: Develop and implement a transponder inspection procedure on all aircraft with transponders capable of transmitting Mode S and automatic dependent surveillance—broadcast (ADS-B) and operated in the National Airspace System (NAS), at least annually and upon each aircraft’s entry into service in the NAS, that ensures 1) the transponder ADS-B settings are correct, 2) the transponder is transmitting ADS-B, and 3) the transponder is transmitting the correctly assigned address.

TO THE UNITED STATES ARMY: Establish a flight data monitoring program for rotary-wing aircraft the US Army operates in the National Airspace System.

TO THE UNITED STATES ARMY: Survey US Army helicopter pilots to identify barriers to the utilization of flight safety reporting systems, develop a plan to address the identified barriers, and implement that plan across Army aviation units.

TO THE UNITED STATES ARMY: Revise the method for allocating resources to ensure the development of a robust safety management system that will, at a minimum, identify and monitor the potential for midair collisions between Army aircraft and civil air traffic operating in the National Airspace System.

TO THE UNITED STATES ARMY: Develop and maintain a flight safety management capability that is independently resourced and functionally separate from its occupational and environmental health management system, and ensure that this capability is both culturally and functionally integrated with units conducting sustained flight operations in the National Airspace System.

TO THE UNITED STATES DEPARTMENT OF WAR, POLICY BOARD ON FEDERAL AVIATION: Conduct a study to evaluate the quality of radio transmissions and reception for those aircraft operated within the National Airspace System to identify factors that degrade communications equipment performance and adversely affect the safety of civilian and military flight operations.

TO THE UNITED STATES DEPARTMENT OF WAR, POLICY BOARD ON FEDERAL AVIATION: Implement appropriate enhancements, based on the findings of the study recommended in Safety Recommendation A-26-49, to remediate identified deficiencies in air–ground radio communications performance.

TO THE UNITED STATES DEPARTMENT OF WAR, POLICY BOARD ON FEDERAL AVIATION: Require the Department of War to verify on all aircraft with transponders capable of transmitting Mode S and automatic dependent surveillance—broadcast (ADS-B) and operated in the National Airspace System (NAS), at least annually and upon each aircraft’s entry into service in the NAS, that 1) the transponder ADS-B settings are correct, 2) the transponder is transmitting ADS B, and 3) the transponder is transmitting the correctly assigned address.

TO THE UNITED STATES DEPARTMENT OF WAR, POLICY BOARD ON FEDERAL AVIATION: Require armed services to amend their operational procedures to allow flight crews to enable Automatic Dependent Surveillance—Broadcast Out while in flight.

TO THE UNITED STATES DEPARTMENT OF WAR, POLICY BOARD ON FEDERAL AVIATION: Require all military aircraft operating in the National Airspace System (NAS) be equipped with Automatic Dependent Surveillance-Broadcast (ADS-B) In with a cockpit display of traffic information that is configured to provide alerting audible to the pilot and/or flight crew, and that such requirement apply wherever in the NAS the Federal Aviation Administration requires any aircraft to operate with ADS-B Out.

TO THE UNITED STATES DEPARTMENT OF TRANSPORTATION: Require the Federal Aviation Administration to demonstrate at least annually that each air traffic control facility it operates has the routine capability to accomplish required postaccident and postincident drug and alcohol testing within the US Department of Transportation’s specified timeframes of 2 hours for alcohol and 4 hours for drugs, and implement a process to ensure that any facility without such capability will demonstrate timely remediation.

TO THE UNITED STATES DEPARTMENT OF TRANSPORTATION: Work with the Federal Aviation Administration (FAA) Administrator to convene an independent panel to conduct a comprehensive review of the safety culture within the FAA’s Air Traffic Organization (ATO), and use the findings to enhance the ATO’s existing safety management system and integrate it into all levels of the organization.

UNITED STATES DEPARTMENT OF TRANSPORTATION, OFFICE OF THE INSPECTOR GENERAL: Complete an audit of the Federal Aviation Administration (FAA) Air Traffic Organization safety management system functions and data sharing activities at all air traffic control facilities and determine whether these activities are conducted in collaboration with all relevant external stakeholders, ensuring that the audit’s results are documented, reported to the Secretary of Transportation and the FAA Administrator, and made available to the public.

TO THE RTCA PROGRAM MANAGEMENT COMMITTEE: Finalize and publish the minimum operational performance standards for airborne collision avoidance system Xr for rotorcraft.