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Factual Information

Summary

On 15 September 2005, the crew of a Boeing Company 767-300 (767) aircraft, registered OE-LAZ, was cleared by air traffic control to fly the ARBEY TWO Standard Arrival Route (STAR) procedures for an approach to runway 27 at Melbourne International Airport. As the aircraft flew the STAR procedure, the controllers observed it overfly the PAULA airspace fix and continue on the downwind leg instead of turning right onto the base leg for runway 27, as required. The controllers provided the crew with radar vectors to position the aircraft onto the runway 27 localiser, and the aircraft landed without further incident. When subsequently queried about the STAR non-compliance, the crew stated that they had been unsure about how to complete the procedure after overflying PAULA.

The procedure for the ARBEY TWO STAR for runway 27 specified that a right turn be made at PAULA to track to the Epping non directional radio beacon and intercept the localiser of the runway 27 instrument landing system. On 9 September 2005, another of the operators 767 aircraft was involved in a similar non-compliance with the ARBEY TWO STAR at Melbourne. On that occasion, the crew did not follow the published transition onto the STAR from the APPLE airspace fix to the north-west of Melbourne. On 17 September 2005, and again on 3 November 2005, controllers at Melbourne observed the operators 767 aircraft overfly the PAULA airspace fix and continue on the downwind leg instead of turning right and tracking to Epping as required.

On 16 September 2005, the Australian Transport Safety Bureau (ATSB) provided the Air Accident Investigation Branch, Flugunfalluntersuchungsstelle, of the Republic of Austria with details of the 15 September air safety incident at Melbourne, and copies of radar plots and air traffic control voice recordings relating to the occurrence. The ATSB also provided the Flugunfalluntersuchungsstelle with details of the 9 September, 17 September, and 3 November ARBEY TWO STAR occurrences involving the operators 767 aircraft.

On 23 December 2005, the Flugunfalluntersuchungsstelle advised the ATSB that it had held meetings with the operator to discuss the 767 STAR non-compliances at Melbourne. The ATSB has received no other reports of STAR non-compliances at Melbourne involving the operators 767 aircraft subsequent to the 3 November 2005 occurrence.

 
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