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Sequence of events

On 19 June 2004, at about 1908 Coordinated Universal Time (UTC), two Australian registered Boeing Company 767-338ER aircraft were involved in a serious incident in the Ujung Pandang Flight Information Region (FIR) on air route B473, approximately 60 NM northwest of waypoint SAMGE (latitude 02o21/10//N, longitude 129 o39/00//E).

Flight number QF 83, registered VH-OGP was northbound and flight number QF 98, registered VH-OGQ was southbound on the same air route. The crew of QF 83 reported at SAMGE at 1901 UTC. The crew stated that Ujung Control cleared the crew to `Descend flight level (FL) 350, cross SADAN at FL350 and report leaving FL360'. At about 1906, while continuing to maintain FL360, the crew observed an aircraft (QF 98) on the reciprocal track. The crew of QF 98 were cruising at their cleared level of FL350. This aircraft passed 1,000 ft below QF 83 at about 1908. The crew of QF 98 asked Ujung Control to confirm their clearance. The controller then replied `Maintain FL360, report at time 1917'. If the crew of QF 83 had descended their aircraft from FL360 to FL350 there would have been an infringement of separation standards and an increased risk of collision, with QF 98.

The Australian Transport Safety Bureau (ATSB) was advised of the incident and commenced an investigation. The crews of both aircraft were interviewed and data from each aircraft's quick access recorder was analysed. A review of that data subsequently revealed that the incident occurred inside Indonesian territory. Accordingly, the Indonesian National Transportation Safety Committee (NTSC) had the responsibility to conduct an investigation in accordance with Annex 13 to the Convention on International Civil Aviation.

On 8 July 2004, the NTSC informed the ATSB that they had commenced an investigation into the incident and the ATSB appointed an accredited representative to that investigation. The NTSC, being the investigation agency of the country in which the incident occurred, will be preparing the report and has control over the public release of any investigation findings.

The ATSB will publish the NTSC report on its website www.atsb.gov.au when released by the NTSC.

 

The operator has implemented the following procedures to be followed when its aircraft are operating in the Ujung Pandang FIR:

  • Depart with an operative Traffic Alert and Collision Avoidance System (TCAS)
  • Cruise at standard levels
  • Logo lights ON at night (excluding A330 aircraft)
  • TCAS on for en route climb or descent, or for the entire climb and descent into Indonesian airports
  • If TCAS becomes unserviceable en route, flight crew must not request or accept en route climb or descent.
 
General details
Date: 19 June 2004 Investigation status: Completed 
Time: 1908 hours UTC  
Location   (show map):Samge, (IFR) Investigation type: Occurrence Investigation 
State: International Occurrence type: Loss of separation 
Release date: 15 February 2005 Occurrence class: Airspace 
Report status: Final Occurrence category: Serious Incident 
 Highest injury level: None 
 
Aircraft 1 details
Aircraft manufacturer: The Boeing Company 
Aircraft model: 767 
Aircraft registration: VH-OGP 
Serial number: 28153 
Type of operation: Air Transport High Capacity 
Damage to aircraft: Nil 
Departure point:Melbourne, VIC
Destination:Hong Kong
Aircraft 2 details
Aircraft manufacturer: The Boeing Company 
Aircraft model: 767 
Aircraft registration: VH-OGQ 
Serial number: 28154 
Type of operation: Air Transport High Capacity 
Damage to aircraft: Nil 
Departure point:Hong Kong
Destination:Brisbane, QLD
 
 
 
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Last update 13 May 2014