NTSB Identification: LAX93LA088.
The docket is stored on NTSB microfiche number 47673.
Accident occurred Saturday, January 02, 1993 in CONCORD, CA
Probable Cause Approval Date: 11/15/1993
Aircraft: PIPER PA-28R-201T, registration: N2008M
Injuries: 1 Minor.

NTSB investigators may not have traveled in support of this investigation and used data provided by various sources to prepare this aircraft accident report.

DURING AN IFR FLIGHT AT ABOUT 11,000 FEET MSL, THE AIRPLANE'S ENGINE BEGAN TO RUN ROUGH AND THE ENGINE OIL PRESSURE DROPPED TO ZERO. THE PILOT ALSO SAID HE SMELLED SOMETHING THAT WAS BURNING. THE PILOT ENTERED A DESCENT AND REQUESTED VECTORS TO THE NEAREST AIRPORT. WHILE ON THE VECTOR, THE ENGINE BEGAN TO RUN ROUGHER AND THE BURNING SMELL BECAME STRONGER. THE PILOT SHUT DOWN THE ENGINE AND ENTERED A POWER OFF FORCED LANDING. HE BROKE OUT OF THE CLOUDS AND DETERMINED THAT HE COULD NOT GLIDE TO THE AIRPORT. HE PERFORMED A LANDING TO THE ONLY AVAILABLE AREA. DURING TOUCHDOWN, THE AIRPLANE COLLIDED WITH POSTS. AN FAA SAFETY INSPECTOR EXAMINED THE ENGINE. HE DETERMINED THAT 1 OF THE 4 BOLTS USED TO BOLT THE ENGINE OIL PUMP COVER TO THE CRANKCASE WAS MISSING. A DAMAGED BOLT WAS FOUND IN THE ENGINE'S CAMSHAFT GEAR. THE TAB WASHERS USED TO LOCK THE OIL PUMP COVER BOLTS HAD THEIR SINGLE TAB BENT DOWNWARD. THE TAB WASHERS' TWIN TABS ON THE 3 REMAINING BOLTS WERE POINTED STRAIGHT OUT. THEY APPEARED TO HAVE NEVER BEEN BENT INTO PLACE AFTER THE BOLTS WERE TIGHTENED. IMPROPER INSTALLATION OF THE WASHERS RESULTED IN ONE BOLT FALLING OFF AND BEING INGESTED THROUGH VARIOUS DRIVE GEARS. THE ENGINE WAS OVERHAULED BY THE MANUFACTURER 515 HOURS PRIOR TO THE ACCIDENT.

The National Transportation Safety Board determines the probable cause(s) of this accident to be:

THE ENGINE MANUFACTURER FAILING TO PROPERLY INSTALL TAB WASHERS DURING OVERHAUL WHICH RESULTED IN ONE BOLT BECOMING LOOSE AND BEING INGESTED THROUGH VARIOUS ENGINE GEAR DRIVES. THE INGESTION AND LOOSE OIL PUMP COVER RESULTED IN THE ENGINE RUNNING ROUGH AND A BURNING SMELL WHICH CAUSED THE PILOT TO HAVE TO SHUT DOWN THE ENGINE.

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