Boeing Co 737-376 , VH-TAK

Local safety action

As a result of this investigation, Airservices Australia issued
a Terminal Operations - Request for Change (RFC). The RFC requested
that the following be inserted in Hamilton Island Local
Instructions, within the section titled Lateral Separation as
follows:

"Lateral Separation.

Parachuting Operations at Shute Harbour (YSHR)

Lateral separation exists between an aircraft cleared on the HM
RWY 14 VOR/DME IAL and a PJE aircraft up to A100 with a clearance
to: "OPERATE OVER THE MAINLAND WEST OF PIONEER POINT AND
SHUTEHAVEN".

The change was implemented on 23 September 1999.

The aerodrome controller did not issue a positive instruction
when the pilot of the Skylane asked for a clearance.
The pilot of the Skylane entered controlled airspace before
receiving an air traffic control clearance.
The pilot of the Skylane did not select and operate code 1200,
or any other code on the aircraft's transponder.
The non-flying pilot of the B737 did not adequately monitor the
aircraft's altitude and allowed the flying pilot to descend the
aircraft below the profile of the VOR/DME approach.
The aerodrome controller did not establish a separation
standard between the B737 and the Skylane, when the Skylane was
cleared to enter controlled airspace.
The control tower at Hamilton Island did not have a Local
Instruction or lateral separation diagrams that may have helped the
controller in working out a lateral separation standard between the
possible positions of the two aircraft.

The Skylane pilot was inside controlled airspace before the air
traffic control clearance was issued. Had the controller made a
positive instruction for the pilot to remain outside controlled
airspace, or told the pilot to standby for a clearance, the pilot
may have levelled at 1,500 ft while awaiting the clearance. Such an
action would have provided greater than the minimum separation of
500 ft that was required between an aircraft in controlled airspace
and an aircraft outside controlled airspace.

Although the Skylane was fitted with a transponder, the pilot
did not have the transponder operating. If the transponder had been
operating on code 1200 or any other code, the TCAS in the B737
would have alerted the crew to the proximity of the Skylane. Also,
the Tabletop controller, although not controlling the two aircraft,
may have received a short-term conflict alert on the radar display,
which could have been relayed to the aerodrome controller alerting
him to their close proximity.

The aerodrome controller was required to set up a separation
standard between the two aircraft before issuing the Skylane pilot
with an air traffic control clearance, unless the clearance
incorporated a requirement that ensured separation. Because
vertical separation was not available due to the B737 being on an
instrument approach, some form of lateral separation was
required.

The arc of the 5 NM radius of Shute Harbour and the inbound
radial of the runway 14 VOR/DME approach overlapped each other. As
a result, there was no form of lateral separation between the
aircraft when the clearance was issued.

The Boeing 737 (B737) was in cloud overhead Hamilton Island at
3,000 ft and the crew were cleared to track outbound on the 325
radial for a VOR/DME approach to runway 14 by the aerodrome
controller. The 325 radial was the outbound leg of a "teardrop
pattern" approach. The crew were instructed to report when
commencing the turn inbound. The co-pilot was the flying pilot and
the pilot in command was monitoring the approach and making the
radio calls.

The pilot of a Cessna 182M Skylane departed Shute Harbour (12 NM
west-north-west of Hamilton Island) and requested an air traffic
control clearance for a parachute dropping operation. The aerodrome
controller told the pilot that he would "have one for you in a
moment" but did not instruct the pilot to remain outside controlled
airspace. The controller was required to obtain an airspace release
from the Tabletop controller, who was located in the Brisbane
Centre. An airspace release was subsequently obtained from the
Tabletop controller for an area encompassing a 5 NM radius of Shute
Harbour up to and including 10,000 ft.

The B737 crew reported turning inbound and that they were
visual. The aerodrome controller told them to continue approach to
runway 14. The profile of the runway 14 VOR/DME approach restricted
the descent of aircraft to not below 2,300 ft until inside 8 NM
from Hamilton Island.

Less than 1 minute later, the Skylane pilot was issued with a
clearance by the aerodrome controller to operate within a 5 NM
radius of Shute Harbour not above 10,000 ft and to report ready for
the drop. Since first contact with the aerodrome controller, the
pilot had been steadily climbing and was established inside
controlled airspace at about 2,100 ft when the clearance was
issued. Seconds later, the pilot and parachutists in the Skylane
sighted the B737 in a left banking turn, in their relative 2
o'clock position and at the same level. The Skylane pilot estimated
the B737 passed alongside them with less than 100 m of lateral
separation.

The B737 crew were unaware of the near mid-air collision with
the Skylane. Their traffic alerting and collision avoidance system
(TCAS) did not alert them to the proximity of the Skylane because
the Skylane's transponder, although fitted, was not switched on and
operating. The pilot of the Skylane was required to have the
transponder activated and selected to code 1200 in accordance with
Aeronautical Information Publication (AIP) Australia ENR 1.6-8.

At the time of the occurrence, the Skylane was about 10 NM
north-west of Hamilton Island, where the 9-12 DME control area step
had a Class D airspace lower limit of 1,500 ft. Analysis of the
radar data showed that the B737 was below 2,300 ft beyond 8 NM of
Hamilton Island, which was below the altitude profile for the
approach. The recorded radar altitude of the B737 was consistent
with the altitude reported by the pilot of the Skylane.

The control tower did not have a Local Instruction or any
lateral separation diagrams that plotted separation points between
the final approach path of the runway 14 VOR/DME approach and the
Shute Harbour parachuting area.