Da Form 2397-1 - Technical Report Of U.s. Army Aircraft Accident

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TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT
REQUIREMENTS CONTROL SYMBOL
PART II - SUMMARY
CSOCS-309
For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.
C
2. TYPE EVENTS
a.
b.
c.
1. CLASSIFICATION
a. Type
A
B
b. Category
Flight
Flight Related
Dawn
Day
Dusk
Night
4. a. On Post
Yes
No
b. On Airfield
Yes
No
3. PERIOD OF DAY
5. NEAREST MIL INSTALLATION
6. NO. OF ACFT INVOLVED
7. LOCATION
a. City:
b. State:
c. Country:
d. Grid or Lat./Long.:
8.
a. Acft MTDS:
b. (1) Orgn Acft Asgd:
(2) UIC:
c. Instal Acft Asgd:
9.
ORGN/CHAIN OF CMD INVOLVED AND ACCOUNTABLE
a.
Orgn Involved
Chain of Cmd
Chain of Cmd
Chain of Cmd
Chain of Cmd
Army HQ
ORGN/Chain
(1) Unit
of Cmd
Involved
(2) UIC
b.
Orgn Accountable
Chain of Cmd
Chain of Cmd
Chain of Cmd
Chain of Cmd
Army HQ
ORGN/Chain
(1) Unit
of Cmd
Accountable
(2) UIC
10. a. Estimated Cost
Total Loss
11. SURVIVABILITY
12. IN-FLT ESCAPE
13. FIRE
14.
POSTCRASH
ESCAPE
$
(1) Acft Damage Cost
Owner
Survivable
Ejection
None
DIFFICULTIES
$
(2) Repair M/Hrs Cost
No. M/Hrs
Partially
Bailout
Inflight
Yes
Survivable
Not
Post-
$
(3) Other Damage Mil
Owner
No
Nonsurvivable
Accomplished
crash
$
(4) Other Damage Civ
Owner
Acft Missing
NA
Other
NA
$
(5) Injury Cost
$
15. USABLE FUEL
lbs.
(6) Total Cost This Acft
a. At Takeoff:
lbs.
b. At Time of Emerg:
ABOARD
b. Total Cost Multiple Acft
$
c. At Acdt or Term:
lbs.
d. Type Fuel:
ACFT
Not
Disabling
Nondisabling
18. MISSION
19. INJURIES
16.
GENERAL DATA
Yes No
17.
FLIGHT
Fatal
Missing
injured
(Number)
a. Type
PLAN
a. Fluid Spillage
(A)
(B - E)
(F-G)
(H)
(I)
b. (1) Night Visual Aids Used
a. Occupants Military
VFR
(2) Specify Type
b. Occupants Other
b. Operations
c. (1) Digital Source Collector Installed
c. Non-Occupants Mil
IFR
(2) Specify Type
d. Non-Occupants
Single-
ship
None
d. Field Training Exercise Involved
e. Total This Acft
Multi-
e. Heads-Up Display In Use
f. Multiple Acft Event
NA
ship
f. Emergency Locator Transmitter
Installed
TERRAIN OF CRASH SITE (More than one may apply)
20.
a. General Characteristics
b. Surface at Crash Site
Mountain
Desert
Rolling
Flat
Water
Prepared
Ice
Sod
Snow
Soggy
Water
c. Crash Site Grade
Level
Slope
d. Obstacles at Crash Site
Stumps
Trees
Bldg
Wires
Rocks/Boulders
Degrees
Other
21. FLIGHT DATA
Altitude
Phase of
Airspeed
Heading
Overgross
Flight Duration
Aircraft Weight
(Compass)
Yes
No
Operation
TAS
AGL
MSL
a. Planned Data
Hr
Tns
b. When Emergency Occurred
Hr
Tns
c. Accident or Termination
Hr
Tns
22. ACCIDENT CAUSE FACTORS (Enter a D, S, or U in appropriate blocks to identify definite, suspected, or undetermined causes)
a. Personnel
Personnel
(Continued)
D, S, or U
D, S, or U
(1) Flight Crew:
(3) Supervisory
Duty
Duty
Duty
Duty
Duty
(4) Other
Duty
(2) Ground Crew:
Duty
b. Materiel Failure/Malfunction
Duty
c. Environmental
23. SEQUENCE (Factual accident sequence from onset of emergency through termination of flight. Use additional sheet if required.)
24. AVN SAFETY
b. Signature
a. Name, Rank, and Orgn
OFFICER
25. CASE NO.
a. Date
(YYYYMMDD)
b. Time
c. Acft Serial No.
26. OTHER ACFT SERIAL NO.
APD PE v1.00
PREVIOUS EDITION IS OBSOLETE.
DA FORM 2397-1, FEB 2009

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