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Significant Factors


  1. The supervisor of the trainee, the aerodrome controller, had a lapse in concentration at a critical stage of the departure sequence, having been operating at the position in excess of 3 hours.
  2. The trainee was unfamiliar with terminal area operations/procedures and was unaware of the increase in complexity during runway transition.
  3. Tower training publications' critical safety section and other references did not include potential standard instrument departure or arrival areas of conflict.
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