November 5, 2019


Aviation Incident Report #16407: At 2237Z on November 05, 2019, a member of the Royal Inland Hospital Facility Management (RIHFM) team noticed that a BC Air Ambulance Summit Helicopters Ltd. Bell 412EP (C-FXEP) landed at the Kamloops (Royal Inland Hosp), BC (Heli) (CBC4) with two crew already disembarked. No hospital ambulance was in attendance and no call had been received. Standard Operating Procedure (SOP) is for BC Air Ambulance to contact the Royal Inland Hospital (RIH) Switchboard, then for the Switchboard to contact RIHFM with sufficient notice to prepare for landing. No call was received by RIHFM or the Switchboard. At 1632Z on November 06, 2019, an RIH Heliport Manager contacted the BC Air Ambulance Shift Supervisor, who investigated.

December 17, 2019


A WestJet Boeing 737-7CT (C-FUWS/WJA139) on a flight from Calgary Intl, AB (CYYC) to Vancouver Intl, BC (CYVR) initiated the missed approach.
UPDATE from National Flight Operations: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Aircraft was not stabilized at 1000’, therefore it required a go-around as per standard operating procedures (SOPs).

December 20, 2019


A WestJet Boeing 737-7CT (C-GWBN/WJA199) on a flight from Edmonton Intl, AB (CYEG) to Vancouver Intl, BC (CYVR) conducted a missed approach. The aircraft was vectored for a 2nd approach and landed without incident at 0503Z. No operational impact.
UPDATE from National Flight Operations: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. The aircraft was unstable as per the companys standard operating procedures (SOPs) and had to go around.

November 25, 2019

Incident at 5411N / 12643W (Aerodrome, runway or taxiway shutdown)

A North Cariboo Flying Service Beech 200 (NCB911) on a flight from Edmonton Intl, AB (CYEG) to Terrace, BC (CYXT) at FL220 declared a MAYDAY at 2003Z approximately 40NM SSE of Smithers, BC (CYYD). The pilot reported low oil pressure and engine surging and shutting down the engine, and requested clearance to CYYD. The aircraft had 1600 lbs of fuel and 4 souls on board (SOB). No assistance was requested and the aircraft landed safely at CYYD at 2021Z but was disabled on the runway. Runway re-opened at approximately 2040Z. (Duplicate AOR 258923-V1 deleted).
UPDATE TSB Report #A19P0169: C-FCGC, a Beech Aircraft Corporation King Air 200 aircraft operated by North Cariboo Flying Service Ltd., was conducting flight NCB911 from Edmonton Intl (CYEG), AB, to Terrace (CYXT), BC with 2 crewmembers and 2 passengers on board. During the initial approach to CYXT, the number 2 engine (Pratt & Whitney Canada PT6A-41 serial #PCE85035) fuel flow gauge indicated a drop followed by a spike and then began fluctuating. The number 2 oil pressure master warning light then illuminated followed by an oil pressure drop and fluctuation. Concurrently, the number 2 engine surged with torque fluctuations. Following SOPs and the QRH, the crew shut down the number 2 engine and initiated a diversion to Smithers (CYYD), BC. Vancouver Center was advised and the crew declared a Mayday. The crew did not request ARFF but the CYYD FSS ordered the emergency vehicles to standby. The aircraft landed safely, came to a stop, and was towed off the runway. Maintenance conducted troubleshooting and replaced the #2 engine FCU and high-pressure fuel pump prior to the test flight.

March 31, 2019


At 30/2301Z, the Kamloops (YKA) Flight Information Centre (FIC) received an Internet filed flight plan (FP) for an Elphinstone Aero Club Cessna 172M (C-GEKO) from Vancouver/Boundary Bay, BC (CZBB) to Qualicum Beach, BC (CAT4). No departure (DEP) message was received from the CZBB tower, so the FP was assumed open as per the Canadian Aviation Regulations (CARs) and standard operating procedures (SOPs). At 31/0040Z, C-GEKO entered the Information Request to Departure Station (QALQ) stage. The pilot-in-command (PIC) was contacted by the YKA FIC via cell phone at 0043Z. PIC stated they had arrived at CAT4 but that the flight had been conducted with a 1176237 BC Ltd. Cessna 182E (C-FSFD), not C-GEKO. No FP or any other information on file for C-FSFD (also no Master FP on file). PIC stated they contacted the YKA FIC via the Nanaimo (YCD) remote communications outlet (RCO) at approximately A018, in the vicinity of CAT4, to close the FP for C-FSFD. PIC was advised there was no FP on file for this aircraft. No other communication was heard from the aircraft. There was no further communication with the PIC until they were contacted by cell phone at the QALQ stage.

January 16, 2019


TSB Report #A19F0016: The Sunwest Aviation Ltd. Learjet 45, C-GVVZ, was operating as flight CNK645 from Scottsdale (KSDL), AZ to Calgary Intl (CYYC), AB. While climbing to cruising altitude, at approximately FL200, the flight crew received an AP Aileron Trim CAS message. The pilot flying disengaged the autopilot and noted that the ailerons felt frozen. The ailerons were able to be broken free with minimal effort and the autopilot was re-engaged. As per SOP’s the flight crew performed a control check every 5000 feet in the climb thereafter. During the remainder of the flight, the issue did not re-appear and CNK645 landed uneventfully. No emergency was declared.

January 26, 2019

Incident at WINNIPEG / JAMES ARMSTRONG RICHARDSON INTL MB (CYWG) (Aerodrome, runway or taxiway shutdown)

A Perimeter Aviation Swearingen SA226-TC (C-FSLZ/PAG08) from Winnipeg/Richardson International, MB (CYWG) to Winnipeg/Richardson International, MB (CYWG) returned from a maintenance flight after shutting down one engine and became disabled in the intersection of Runways 18/36 and 13/31. A Harvs Air Service Piper PA-44-180 (C-GKPY) from origin unknown to Winnipeg/Richardson International, MB (CYWG) and a West Wind Aviation aircraft of unknown make and model (WEW3212) from origin unknown to Winnipeg/Richardson International, MB (CYWG) were required to overshoot and were placed into a hold. Several arrivals and departures were delayed up to 20 minutes.
UPDATE: Correction: Aircraft information: "WEW3212" was changed to "WEN3212", and the make and model, as well as origin and destination, were added. Narrative portion updated to read as follows: "...and a WestJet Encore Ltd. de Havilland DHC-8-402 (WEN3212) from Regina International, SK (CYQR) to Winnipeg/Richardson International, MB (CYWG) were required to overshoot..."
Update TSB Report #A19C0008: C-FSLZ, a Swearingen SA226-TC aircraft operated Perimeter Aviation LP, was conducting local maintenance flight PAG08 from Winnipeg/James Armstrong Richardson Intl (CYWG), MB. The flight crew conducted an intentional shut down of the left engine (Garrett TPE331-10UA) in order to test the Negative Torque Sensing (NTS) system. During the subsequent restart of the engine, there was no torque indication, and the RPM was fluctuating. The flight crew elected to secure the left engine, and returned to CYWG. The flight crew completed the applicable checklist, SOPs and QRH items. No emergency was declared, and the subsequent landing was conducted successfully with the left engine inoperative. After the landing, the flight crew were unable to taxi the aircraft from Runway 36, and elected to shut down at the intersection of Runway 13/31 and 36. The aircraft was then towed to Apron 4.
UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Inspected rigging iaw 76-00-00, with no faults found. Inspected feather pump pressure iaw mm 61-20-10, with no faults found. Re-safetied L/H prop and set blade angles iaw FORM 045. Replaced L/E NTS press regulator iaw EMM 72-10-04 and PAL-dept-form103. Checked torque transducer to current DSC with no faults. Re-installed #1 hydraulic pump iaw MM 27-10-02. Re-installed #1 starter generator iaw MM 24-35-10. Completed ground run and symmetry check iaw form 64.2 no faults found. Aircraft released pending satisfactory NTS test flight. The aircraft passed its NTS test flight.

May 18, 2018

Incident at 2NM N LAC LA PIERRE QC (Other operational incident)

Forest fire reported by the pilot of a Cessna 172N operated by the Collège d?Enseignement Général et Professionnel Édouard-Montpetit (C-GUZC) approximately 2NM N of the town of Lac Lapierre, Rawdon area. Standard operating procedures (SOP) for fire notified.


UPDATE: TSB Report#A18P0067: C-GKFF, a Convair 580F aircraft operated by Kelowna Flightcraft, was conducting flight KFA579 from Vancouver Intl, BC (CYVR) to Kamloops, BC (CYKA). Shortly after the departure from CYVR, the number 2 engine (Allison 501-D13D, s/n CAE500841) RPM began to increase above the normal range. The flight crew contacted ATC and requested vectors back to CYVR. During the return, the RPM began to decrease. The flight crew performed a precautionary engine shutdown in accordance with the QRH and the operator?s SOPs. The aircraft landed without further incident with ARFF standing by. The operator?s maintenance replaced the propeller regulator.
A Kelowna Flightcraft Air Charter Ltd. (C-GKFF/KFA579) on a flight from Vancouver International, BC (CYVR) and landing at Vancouver International, BC (CYVR) was on final for Runway 26R and informed the Vancouver Tower on initial contact that they were shutting down an engine. The Tower initiated an emergency standby and the aircraft landed safely.

Incident at 24NM N PEMBERTON BC (CYPS)

UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Aircraft engine was inspected. It was initially noted that there appeared to be a small amount of oil on the engine and landing gear. #1 oil level checked and was close to -3. After an aircraft run up on ground, #1 oil warning light stayed on steady. The analog gauge was at the bottom of the red line at 40psi, and then dropped to Zero psi. The engine was shut down. Oil was found dripping from the engine. Inspection continued and it was found that the oil cooler was leaking badly. The oil cooler was replaced and ground runs completed to find no further leak. Oil pressures were operating normally. Oil cooler was less than 8 months out of overhaul so a Service Difficulty Report (SDR) was submitted and will be requesting breakdown analysis from overhaul company for evaluation.
A Central Mountain Air de Havilland DHC-8-102 (C-FCJE/GLR758) from Prince George, BC (CYXS) to Vancouver Int'l, BC (CYVR), 65 miles northwest of Vancouver, shut down one engine and was given priority arrival for Runway 13 at CYVR. The aircraft landed safely at 0050Z. Several arrivals and departures were delayed up to 10 minutes.
UPDATE: TSB Report#A18P0065: C-FCJE, a Bombardier DHC-8-102 aircraft operated by Central Mountain Air, was conducting flight GLR758 from Prince George, BC (CYXS) to Vancouver Intl, BC (CYVR). Approximately 24 nm North of Pemberton, BC (CYPS), the flight crew observed a Master Warning indication, and a number 1 engine Oil Pressure caution light. The flight crew confirmed the low oil pressure with the analog gauge. The QRH was consulted and power was reduced on the number 1 engine (PWC PW121, S/N 121208). Shortly after the power reduction, the oil pressure dropped further. The flight crew subsequently shut the number 1 engine down as per company SOPs and QRH, and declared an emergency. The aircraft landed at CYVR without further incident with ARFF standing by. A post flight inspection revealed a substantial amount of oil on the lower portion of the number 1 engine.

October 1, 2018

Incident at 30NM SE LONDON ON (CYXU)

TSB #A18O0137: C-FWRR, a Bombardier CL-600-2B19 (CRJ100) aircraft operated by Air Georgian, was conducting flight GGN7335 from Toronto/Lester B. Pearson Intl (CYYZ), ON to Nashville Intl (KBNA), TN. As the aircraft was climbing through FL270 in the vicinity of London (CYXU), ON, the flight crew received a CABIN ALT master caution message. The flight crew noted that the cabin altitude was at 8500 feet, and requested an immediate descent to 10 000 feet. However, the cabin altitude continued to increase to 10 000 feet, and the CABIN ALT master warning light illuminated. The flight crew donned their oxygen masks, and continued the emergency descent to 10 000 feet as per SOPs. The airspeed was reduced to 250 KIAS, and QRH procedures were followed. The decision was made to continue to destination, and the aircraft subsequently landed uneventfully at KNBA. The operator’s maintenance found the R/H pack duct blown out and deferred it as per MEL procedures. The L/H pack was checked and found to be operational. Part of the follow up actions included the replacement of the duct, as well as the duct check valve. The operator issued an SDR for the duct check valve.

October 24, 2018

Incident at NORTH BAY ON (CYYB)

A Bearskin Airlines Fairchild SA227-DC (C-GJVW/BLS1T) from North Bay, ON (CYYB) to North Bay, ON (CYYB) while conducting training at CYYB declared an emergency due to a nose gear indication. BLS1T elected to divert to Sudbury, ON (CYSB). BLS1T landed at CYSB at 1559Z without further incident.
Update TSB Report #A18O0147: C-GJVW, a Fairchild SA227-DC aircraft operated by Bearskin Airlines, was conducting training flight BLS101T 25 nm North East of North Bay (CYYB), ON. During the training exercise, the landing gear was selected to the down position, but the nose gear did not indicate down and locked. The flight crew performed troubleshooting, and completed the emergency extension as per the SOPs and AFM; however, the nose gear continued to indicate unlocked. The aircraft initially proceeded to CYYB, but then rerouted to Sudbury (CYSB), ON for operational reasons. The flight crew declared an emergency and, approximately 2 nm on final to CYSB, the nose gear indicated down and locked. The landing was uneventful with ARFF standing by. The operator’s maintenance completed landing gear swings, with no faults found. The nose gear down switch (R/H) was replaced for troubleshooting. A successful test flight was completed with no further faults.
UPDATE: Aviation Incident Report #15747: Aircraft C-GJVW showed that nose gear was not down and locked. Flyby at North Bay, ON (CYYB) could not confirm stability of nose gear. Pilots elected to fly to Sudbury, ON (CYSB) to land. Emergency crews called out for landing. Aircraft landed without incident and parked on Ramp 3.

April 5, 2018


A WestJet Encore de Havilland DHC-8-402 (WEN3464) on a flight from Toronto/Lester B. Pearson Int'l, ON (CYYZ) to Ottawa/MacDonald-Cartier Int'l, ON (CYYZ) rejected takeoff Runway 23. The aircraft returned to the gate without incident. No operational impact.
UPDATE from National Flight Operations: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. On the takeoff roll, the Pitch Trim caution light came on at 70 kts. The Captain rejected the takeoff per the Standard Operating Procedures (SOP) and vacated the runway. Crew contacted Dispatch and Maintenance Control where a decision was made to return to gate for troubleshooting.
UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Fault Isolation Manual Task was actioned and no fault found. Flight Control Electronic Control Unit (FCECU) system was reset and operationally checked serviceable. Elevator pitch trim system operationally checked serviceable

September 21, 2018


A Keewatin Air LP Learjet 35A (C-GYFB/KEW101) from Iqaluit, NU (CYFB) to Winnipeg/James Armstrong Richardson Int'l, MB (CYWG) declared an emergency due to engine fire indication. Aircraft Rescue and Fire Fighting (ARFF) was on standby. The aircraft landed safely at 2155Z. No impact to operations.
UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. During descent, #2 engine fire light, aural warning and master warning illuminated. #2 engine was shut down and fire bottle was discharged as per Standard Operating Procedures (SOP)/Emergency procedures. Initial visual inspection of #2 engine and surrounding area showed no signs of an actual fire. #2 engine cowlings, after body & thrust reversers assembly removed for inspection, showed no signs of fire damage. #2 fire detect control unit connector found unsecure and #2 engine accessory gearbox and hot section sensing element connections also found finger tight. Connections resecured. #2 engine fire detect sensing elements inspection and check completed. All resistance values within limits. No faults found. #2 engine discharged fire bottle replaced. #2 Engine fire extinguisher discharge indicator replaced. Ground runs completed with no indication of fire warning system illuminating. Aircraft released Subject to Satisfactory Test Flight. Test flight successful.

November 28, 2017

Incident at 4856N / 09017W

A Perimeter Aviation Swearingen SA227-AC (PAG591) on a flight from Thunder Bay, ON (CYQT) declared a medical emergency and returned to CYQT. The aircraft landed without incident at 2054Z. No impact to operations.
UPDATE from Flight Operations: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Shortly after takeoff, a passenger became ill. The Pilot In Command (PIC) returned to CYQT. Medical services tended to the passenger. The Chief Pilot spoke directly with crew and confirmed they operated appropriately and in accordance with the Aircraft Flight Manual (AFM) and the Standard Operative Procedures (SOP).

November 8, 2017


UPDATE from the Owner/Operator: This incident was an oversight due to a perception of urgency during a MedEvac. On takeoff position, the Pilot believed incorrectly that the aircraft had been cleared for takeoff. Because of the urgency of the situation, the Pilot did not confirm with Air Traffic Control (ATC). Subsequently, an amendment to the Standard Operating Procedures (SOP) is being considered to specify that both crew will verbally confirm the takeoff clearance and that the landing lights will be selected on only after receiving the takeoff clearance.
An Air Nunavut Dassault Falcon 10 (C-FSXX/BFF103) on a flight from Toronto/Billy Bishop, ON (CYTZ) to Windsor, ON (CYQG) departed Runway 26 without authorization. No operational impact.

November 26, 2017


At the Calgary Intl., AB (CYYC) aerodrome, a Compass Airlines Embraer EMB-170 (CPZ5711) at CYYC Gate 84 requested that 911 be called due to a passenger in distress. The airport Duty Manager was advised as per the standard operating procedure (SOP). No operational impact.

August 3, 2017

Incident at SASKATOON / JOHN G. DIEFENBAKER INTL SK (CYXE) (Aerodrome, runway or taxiway shutdown)

UPDATE: TSB Report#A17C0097: C-GYDQ, a Beech 200 aircraft operated by West Wind Aviation, was conducting a training flight from Saskatoon/John G. Diefenbaker Intl, SK (CYXE). During the final approach, the flight crew received an unsafe landing gear indication. The flight crew performed a go-around as per the SOP, carried out the appropriate checklist items and requested ARFF to be on standby. The subsequent landing was uneventful and the aircraft was brought to a stop on the runway. The aircraft then taxied to the apron approximately 15 minutes later. The operator?s maintenance personnel replaced a connector on the left landing gear down-lock safety-switch. Landing gear swings were carried out successfully and the aircraft was returned to service.
A West Wind Aviation Beech 200 (C-GYDQ/WEW220) on a local flight from Saskatoon/John G. Diefenbaker, SK (CYXE) reported an unsafe gear indication and requested Aircraft Rescue and Fire Fighting (ARFF) to be on standby. The aircraft landed safely at 1647Z. The aircraft shut down on runway. Runway 27 was unavailable for approximately 15 minutes until the aircraft was able to taxi off. No emergency declared.

May 16, 2017

Incident at IQALUIT NU (CYFB)

UPDATE from the Operator: The situation was a communication problem. The Pilot in Command realizing during the approach that the tailwinds were increasing elected to to inform the Flight Service Station (FSS) that due to severity of aforementioned winds, a circle to land was necessary in accordance with the Standard Operating Procedures (SOP) and good airmanship. In order to ensure that the communications be in accordance with the Canadian Aviation Regulations (CARs) in the future, the pilots have been instructed to notify Montreal Air Traffic Control (ATC) when a possible alternate or indirect approach is necessary. Furthermore, other options will include cancelling the IFR clearance in visual conditions.
An Air Nunavut Beech B200 (C-FGXR/BFF203) from Resolute Bay, NU (CYRB) to Iqaluit, NU (CYFB) on approach for Runway 16 circled for Runway 34 without proper clearance.

September 27, 2017


A WestJet Encore de Havilland DHC-8-402 (C-GWEU/WEN3497) on a flight from Deer Lake, NL (CYDF) to Halifax/Stanfield, NS (CYHZ) overshot Runway 14 on short final as it was landing long. The aircraft landed at 1014Z with no further issues. No impact.
UPDATE from National Flight Operations: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. Aircraft was high on final. Captain called for a go-around due to not meeting stable approach criteria. Go around carried out in accordance with the Standard Operative Procedures (SOP). Aircraft landed with no further concerns.

August 1, 2016


Update (Commercial and Business Aviation): A civil aviation safety inspector (CASI) looked into this incident. The CASI communicated with the operator to obtain more information. The incident was caused by crew inattention. The company?s standard operating procedures (SOP) will be modified. The CASI was satisfied with the information provided and indicated that no other follow-up by Transport Canada was required for the time being.
Although the crew received and read back the clearance to climb to FL200, a Propair Beech 1900C (C-GLPJ/PRO190), flying from Chibougamau (CYMT), QC, to Eleonore (CEL8), QC, was observed on the radar climbing to FL220. When questioned, the crew recognized their error and asked to remain at FL220. No loss of separation and no impact on operations.

October 26, 2016

Incident at SAULT STE. MARIE ON (CYAM) (Ground handling services)

TSB #A16O0151: C-GGBF, a de Havilland DHC-8-402 aircraft operated by Jazz Aviation LP, was conducting flight JZA8330 from Sault Ste. Marie, ON (CYAM) to Toronto/Lester B. Pearson Intl, ON (CYYZ). Prior to departure, during the turn around on the ground in CYAM, ground handling personnel did not inspect all baggage and cargo compartments as per Standard Operating Procedures (SOP) and therefore, 858 lbs of baggage was left onboard in hold number 3, and was unaccounted for. The aircraft departed for CYYZ and flew uneventfully although the MAC was 5.39% forward of the forward limit. As a new cabin crew was taking over on the following flight in CYYZ, they discovered the bags in hold number 3. The flight crew advised that they did not notice anything unusual about the behavior of the aircraft during the flight. The operator performed a review of the SOPs with the ramp personnel in CYAM and will be sending out a complete review to all employees.

May 24, 2016

Incident at Approximately 50 miles north of YNY

UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. A light came on in the cockpit and company's Standard Operating Procedures (SOP) dictated the descent. Aircraft took roughly 10-15 minutes to descend with no other issues. An Aircraft Maintenance Engineer (AME) was dispatched up to Grand Prairie immediately after the snag was reported. It turned out to be a broken wire on a 400 degree over-temp sensor which put the bleed/pressurization system into fault/emergency mode. The wire was repaired and the aircraft was returned to service.
An Air Partners Corp Cessna 560 (C-GKHD / SDE562) from Kelowna, BC (CYLW) to Grande Prairie, AB (CYQU) descended from FL380 to 14 000 feet due to a pressurization issue. SDE562 continued to destination. No impact on operations.

March 31, 2016

Incident at FORT ST. JOHN BC (CYXJ)

Approximately 4 mile final for Runway 11, a Central Mountain Air Dornier D 328 (GLR794) from Fort Nelson, BC (CYYE) to Fort St. John, BC (CYXJ) advised of a gear indication and went into the missed approach. They had previously cancelled IFR once they had the field in sight. While in the downwind for Runway 20, the crew advised that everything was okay and continued the approach and landed without incident. No impact to operations.
UPDATE from Airworthiness: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. The CASI contacted the operator involved for more information and was provided with additional details of this occurrence. Standard procedures followed. Flight crew performed bulb replacement, cleared fault and Standard Operating Procedure (SOP) followed. The aircraft had no further incident. The CASI was satisfied with the information provided and advised that no further follow-up action by Transport Canada was required at this time.

July 5, 2016

Incident at 74NM NE FORT SMITH NT (CYSM)

TSB#A16W0086: C-FIJX, the Buffalo Airways Ltd. Lockheed L-188C, was conducting fire suppression operations 74 nm NE of Fort Smith, NT (CYSM). While conducting a bombing run FIJX experienced a loss of power in the # 1 and #4 engines (Allison 501-D13). The flight crew actioned the SOP and performed the engine failure drill for both the #1 and #4 engines. The aircraft returned to CYSM and landed uneventfully. No emergency was declared and there were no injuries. The power section of engine # 1 experienced a compressor stall and engine #4 had decoupled.

June 23, 2016

Incident at HIGH LEVEL AB (CYOJ)

An Air Spray (1967) Ltd Lockheed 188A (C-GZVM/ ASB485) from Loon River, AB (CFS6) to High Level, AB (CYOJ) reported inbound for landing at 2157Z with one engine shut down. Pilot was not declaring an emergency nor did he/she require assistance. Aircraft landed without incident at 2208Z. No impact to operations.
UPDATE: TSB#A16W0073: C-GZVM, a Lockheed L-188A Electra operated by Air Spray (1967) Ltd, was operating as flight ASB485 to a forest fire in the vicinity of High Level, AB (CYOJ). While transiting to the fire, the crew noticed that the TIT, Fuel Flow and HP indications on the number 4 engine (Allison 501-D13) would not change, regardless of power lever position. The crew also tried to adjust the TD system, prop sync and phase, however nothing worked. The crew decided to jettison the load and returned to CYOJ. The Engine Failure checklist was carried out and a precautionary shutdown of the number 4 engine was executed. The aircraft landed at CYOJ without further incident.
UPDATE TSB # A16W0075: C-GZVM, a Lockheed L-188A Electra operated by Air Spray (1967) Ltd, was operating as ASB485 to a fire approximately 60 nautical miles west of Loon River, AB (CFS6). After a bombing run, the flight crew observed that the Number 4 engine (Allison 501-D13) hung at 200HP and 600 TIT. When power was applied, the RPM decreased. The flight crew shut the Number 4 engine down as per SOPs and diverted to High Level, AB (CYOJ) for an uneventful 3 engine approach and landing. The operator?s maintenance trouble shooting in ongoing; see A16W0073 for similar event.

April 27, 2016


TSB#A16W0045: C-FZCS, an Air Spray Ltd Lockheed Electra L188 aircraft, was operating as Tanker T-487 from Red Deer, AB (CYQF) on a training flight over the Rocky Mountain House, AB (CYRM) VOR at an altitude of 10 500 feet ASL. During a stall practice exercise, as the flight crew added power upon the stall recovery maneuver, the number 2 engine (Allison 501-D13) went into an under-speed condition of 13 200 rpm (normal condition is 13 820 rpm). The flight crew actioned the SOP and performed the engine failure drill. The aircraft returned to CYQF and landed without further incident. No emergency was declared and there were no injuries.

February 19, 2016

Incident at LLOYDMINSTER AB (CYLL) (Incursion - runway - vehicle)

Staff 21 (a pickup truck) proceeded onto Runway 08/26 without authorization. When queried by the Flight Service Station (FSS), the vehicle operator said they forgot to request permission. No impact to operations.
UPDATE from Aerodrome Safety: A Civil Aviation Safety Inspector (CASI) looked into this occurrence. The CASI contacted the operator involved for more information and was provided with additional details of this occurrence. Employee was pulling the urea spreader unit and stopped at hold short taxiway A 08/26, the Operator exited the truck and started the urea spreader, got back in the unit and proceeded onto runway 08/26 without requesting permission. The Operator?s intention was then queried by the Fight Service Station (FSS). Sweeper 221 was on the runway (with authorization). This occurrence is resultant of a Standard Deviation of the Airside Radio Communication - Standard Operating Procedures (SOP). The Airport is handling this occurrence through their safety management system (SMS). The CASI was satisfied with the information provided and advised that no further follow-up action by Transport Canada was required at this time.

February 7, 2016


UPDATE: TSB#A16W0019: C-FGCN, a Canadian North Boeing 737-300 operating as flight MPE4451 on behalf of Air Transat charter flight TSC4451, was on a flight from Los Cabos Intl, Mexico (MMSD) to Edmonton Intl, AB (CYEG) with a stopover at Calgary Intl, AB (CYYC). On initial approach to CYYC, the crew received a B System Hydraulic fluid depletion indication. The aircraft entered a hold, consulted their SOPs and communicated with their operations department. An emergency was declared and an uneventful approach and landing were made on Runway 29 with ARFF standing by. Emergency crews attended the aircraft and after inspection, allowed the aircraft to proceed to the terminal under its own power. The aircraft was removed from service and the flight continued to CYEG using a substitute aircraft.
At 0333Z Air Transat Boeing 737-36N (C-FGCN/TSC4451) from Baja, Mexico (MMSD) to Calgary, AB (CYYC) reported hydraulic issues inbound to CYYC. TSC4451 declared an emergency at 0346Z. TSC4451 landed safely at 0409Z and aircraft rescue and fire fighting (ARFF) was provided.

December 15, 2015


TSB #A15Q0179: A Propair Beech King Air 100 (PRO103), on an IFR flight from Rouyn-Noranda (CYUY), Quebec, to Wemindji (CYNC), Quebec, was authorized and read back the authorization for CYUY YUY AR36 CYNC. After takeoff, the aircraft reported being established on the route. When it was seen on radar, a major route deviation was noted as the aircraft was established on RR16 heading to Kenora (CYQK), Ontario. Consequently, separation with an Air Creebec Dash 8 100 (CRQ501), which was conducting a holding pattern at the SALON intersection, could not be ensured.
UPDATE: Although requested, cleared and correctly readback a clearance from Rouyn-Noranda, QC (CYUY) YUY AR36 YKQ for Wemindji, QC (CYNC), Propair Beech A100 (C-FDJX/PRO103) aircraft inadvertently entered CYQK in the navigation and reported established on AR36 whereas the aircraft was actually established on RR16, all in a non-radar environment. The Controller detected major route deviation when the aircraft appeared on radar. Impact on operations: Air Creebec de Havilland DHC-8-102 (C-GAIS/CRQ501), from Timmins, ON (CYTS) to Rouyn-Noranda, QC (CYUY) was in a hold at SALCN and not protected by the erroneous route and PRO103 entered CYYZ airspace without coordination.
Update (Commercial and Business Aviation): A civil aviation safety inspector (CASI) looked into this incident. The CASI communicated with the operator to obtain more information. There was a meeting with the pilots and a review of the method to use as part of communication procedures was conducted. The procedure was also reviewed during a meeting will all the pilots and the procedure will be integrated into the standard operating procedures (SOP) during the next review. The CASI was satisfied with the information provided and indicated that no other follow-up by Transport Canada was required for the time being.

July 20, 2015

Incident at CASTLEGAR / WEST KOOTENAY REGIONAL BC (CYCG) (Aerodrome, runway or taxiway shutdown, Aerodrome - runway or taxiway surface condition)

A Carson Air Swearingen SA226-TC (CA77) from Penticton, BC (CYYF) to Castlegar, BC (CYCG) had both tires on the right side blown out on arrival. Runway NOTAM closed due to disabled aircraft. No known operational impact. Runway unavailable from 201625Z until 201741Z.
Update from Maintenance & Manufacturing: A thunderstorm had just gone through, the runway was wet and the wind was gusting in the wake of the thunderstorm. On approach, the aircraft was flown 5kts quick as per the standard operating procedures (SOP) for gusty wind conditions. When landing, the pilot locked up the right hand (R/H) brakes on the wet runway. The pilot acknowledged that they should have held off the brakes and slowed with reverse. There was no damage to the aircraft apart from both wheels being scrap from rolling flat on the last 1000ft of the landing and for the tow back.

July 3, 2015

Incident at In the vicinity of: WATSON LAKE YT (CYQH)

TSB Report#A15W0100: The Airspray Airtankers Aero Commander 690A, C-FIIL, was on a fire fighting work near Watson Lake, YT when the left engine (Garrett TPE331-5-251K) temperature ITT climbed beyond 923 degrees Celcius while at 7000 feet in low power cruise (250 HP) and the decision was made to shut it down. All company SOPs were followed and the aircraft was flown to Watson Lake without incident. There was no indication of over temperature from engine over temp inspection. Further trouble shooting by maintenance confirms that it was a faulty ITT gauge that gave a false reading.

July 8, 2015

Incident at WABUSH NL (CYWK)

Update from Maintenance & Manufacturing: During area navigation (RNAV) approach into Wabush (CYWK), the crew lost receiver autonomous integrity monitoring (RAIM) just before the final approach fix (FAF). As per standard operating procedure (SOP) and safety the crew carried out a missed approach. RAIM was rechecked and determined to be functional. The crew conducted a second RNAV with no incident. It is to be noted that on July 6th the crew reported that the GPS was constantly showing "RAIM" not available. Maintenance found that the coax connector at the antenna was found to be corroded causing an insulation breakdown between the conductor & shield. The connector was replaced with the system testing serviceable.
An Exploits Valley Air Services Beech 1900D (C-GAAT/ EV7643) from Goose Bay, NL (CYYR) to Wabush, NL (CYWK) conducted missed approach Runway 36 due to equipment issues on board. Recleared and landed safely without further incident at 1407Z.

June 27, 2015

Incident at SAINT JOHN NB (CYSJ)

UPDATE: TSB Report#A15A0037: The Moncton Flight College Piper PA44 (registration C-FXKN) aeroplane was on a round robin cross country flight from Moncton - Halifax - St John - Moncton. On departure out of St John (CYSJ), the pilot noted an oil leak. The crew requested return to the field but were told they may have to hold for traffic. They declared an emergency and proceeded to the field for landing. The engine was not shut down on the return. Maintenance found that the oil dipstick was not properly seated and some internal threads on the dipstick assembly were damaged. Four quarts of oil remained which was well within engine operating limits , however it was one quart below Moncton Flight College?s SOPs. The oil tube and dipstick assembly were replaced and the aircraft was returned to service.
Update from Maintenance and Manufacturing: Maintenance found the left engine oil dipstick was sitting off of its seal and allowing oil for blow by the seal. The threads on the cap were allowing the assembly to only be threaded part way into the crankcase. This gave the feel to the pilot as if it was in and tight, but given the location, you could only see that the dipstick seal was not contacting the surface to provide a positive seal with the cowling off. A serviceable dip stick was installed and it screwed in perfectly. The engine and cowling was cleaned and a ground run perform to verify for leaks, non found, aircraft was released.
A Canlink Aviation Piper PA-44-180 (C-FXKN/ MFCLG01) was on a round robin training flight from Moncton, NB (CYQM) to Saint John, NB (CYSJ) to Moncton, NB (CYQM). On departure CYSJ, the pilot reported an oil leak and shortly thereafter declared an emergence at 2217Z. The flight cancelled IFR and landed CYSJ at 2221Z. No impact on Air Traffic Services (ATS) operations.

September 13, 2014

Incident at ALMA QC (CYTF)

TSB Report#A14Q0152: The Dash 8-202, registration C-GQBT, was operating IFR from CYQB Quebec/Jean Lesage Int'l airport to CYTF Alma, QC airport as a medevac flight. Approximately 3-4 nm prior to reaching waypoint UKRID to initiate the area navigation (RNAV) RWY 31 approach for landing CYTF, in visual meteorological conditions (VMC), the crew received a traffic alert and collision avoidance system (TCAS) traffic advisory (TA) traffic alert. SOP procedure was followed and the crew looked for the traffic. The TCAS resolution advisory (RA) resolution alert sounded to climb and, as per Standard Operating Procedures (SOP), the crew followed the TCAS warning instructions. Traffic was a yellow floatplane operating VFR. While responding to the TCAS RA, ATS Bagotville controller advised the crew of the floatplane's presence. TCAS message 'Clear of Traffic' was then received. The aircraft landed without incident in CYTF. The Dash 8 crew had broadcast their intentions and position on frequency 126.7 while cleared out of controlled airspace for the approach RNAV RWY 31 CYTF, approximately 3 minutes prior to reaching UKRID. The TCAS TA occurred shortly after the broadcast. The floatplane was in the training zone just north of the approach RNAV RWY 31. Air traffic service (ATS) had difficulty reaching and radar identifying the floatplane prior to it entering Class D airspace.

February 18, 2014


Update from Maintenance and Manufacturing: The company is aware of the occurrence and is following up in accordance with their approved system.
Update Commercial & Business Aviation: On departure from CYVR the alternating current (AC) generator (GEN) annunciator illuminated. The aircraft did not enter icing conditions and did not encounter airframe icing, however icing was forecast along the intended route of flight and the crew elected to return to CYVR as a precautionary measure. The crew followed standard operating procedures (SOPs) in responding to an abnormal indication.
A Pacific Coastal Airlines SAAB SF340A (C-GPCQ/ PCO585) from Vancouver, BC (CYVR) to Williams Lake, BC (CYWL) departed runway 12 at 2140Z. 10 miles south, the aircraft advised Vancouver, BC terminal that he was returning due to icing. Precautionary standby. Landed safely at 2205Z, no operational impact.
UPDATE: TSB Report#A14P0021: Pacific Coastal 585, Saab SF-340, departed R12 at Vancouver for Williams Lake, BC. At about 10 nm south of Vancouver, the crew advised ATC that they needed to return to CYVR due to airframe icing. A precautionary standby (ARFF) was initiated for an uneventful landing.

December 17, 2014

Incident at Nyala, North Sudan, Sudan

TSB Report#A14F0156: The Voyageur Airways DHC8-300, registration C-FNCU, was departing from Nyala Sudan on a flight to El Fasher Sudan. As the aircraft became airborne the crew heard a bang from the right engine (Pratt and Whitney PW123B). The crew confirmed that the engine had failed, secured it, followed the QRH and SOP procedures and returned for an uneventful landing at Nyala. The engine will be removed and shipped to Vector Aerospace for teardown and examination.

April 19, 2014

Incident at Frank Pais Intl, Hoguin (MUHG)

TSB Report#A14F0052: The Canjet Boeing 737-800 (C-FTCZ) was operating as CJ653 from Holguin, Cuba, (MUHG) to Halifax Stanfield Intl (CYHZ). During boarding of passengers the flight crew received a fire warning alert. The aft cargo fire light illuminated and the crew actioned the quick reference handbook (QRH) and activated the cargo fire suppression system in accordance with Canjet SOP. A rapid deplanement was carried out and the flight crew declared an emergency. Aircraft rescue and firefighting (ARFF) examination determined no fire had occurred. After maintenance inspection the aircraft was dispatched under minimum equipment list (MEL). Upon arrival at Halifax maintenance replaced the A2 smoke detector.

December 1, 2014

Incident at CALGARY INTL AB (CYYC) (Incursion - manoeuvring area)

A Sweeper 91+1 was cleared across Runway 17R at Calgary, AB (CYYC) by west ground controller and told to hold short of taxiway C . As they were approaching taxiway Charlie, they were told to contact East ground as per standard operating procedures (SOP). An aircraft was taxiing on Charlie and after the aircraft passed, the sweepers continued across Charlie and proceeded to apron 1. When queried the sweepers were found to be on east ground frequency.

May 29, 2014

Incident at 132 NM S YELLOWKNIFE NT (CYZF)

A Canadian North Boeing 737 200 (MPE439) enroute from Yellowknife, NT (CYZF) to Edmonton, AB (CYEG) requested a clearance to return to Yellowknife, NT because of an engine indication. No priority declared and no aircraft rescue and fire fighting (ARFF) requested. No operational impact.
Update Maintenance & Manufacturing: C-GOPW experienced #1 engine compressor stalling when the throttle levers were brought back at top of climb. Per standard operating procedures (SOP), the aircraft returned to Yellowknife, NT (CYZF). Ground runs per Pratt & Whitney (P&W) maintenance manual (MM), and could not duplicate further. Another test flight conducted and the test flight failed. The aircraft returned to CYZF for further troubleshooting. A bad PS3 line, bleed air leak, that runs to the pressure ratio bleed control (PRBC). Leak repaired and a second test flight conducted. Second Test flight failed. The company decided to replace the engine and have it shipped to a repair shop.

February 4, 2014


Update Maintenance & Manufacturing: The aircraft was 6 mile final into CYWG. The flight crew elected to start the APU through 3000. The Auxiliary power unit (APU) start was longer than normal. The draw on the battery was for so long that both inertial reference system (IRS) DC fail annunciator lights illuminated. The APU final ignited. Both IRS annunciator lights extinguished, and a temperature of between 550-600 degrees Celsius was observed on the APU exhaust gas temperature (EGT). Within seconds of the observed APU EGT, the APU fire warning light illuminated, light did extinguish prior to bottler discharge. Per Standard operating procedure (SOP), APU fire bottle was discharged. The flight crew carried out the APU fire quick reaction checklist (QRC), declared an emergency, and continued to land visually onto runway 31. The Non normal checklist was also completed. Upon landing KFL engineer inspected the APU area and found no evidence of fire. Fire loops tested serviceable. APU placed on minimum equipment list (MEL). Upon arrival into CYEG, the APU was re-inspected and the fire bottle was replaced. APU tested to be operating normal. MEL was removed.
A Canadian North Boeing 737-36Q (C-GCNZ/ MPE1525) from Moncton, NB (CYQM) to Winnipeg, MB (CYWG) was 5NM final runway 31 when the pilot reported an APU fire indication. ERS responded. At 1NM final, the pilot stated the indication went out. MPE1525 landed safely and taxied to apron without incident. A Keewatin Air Beech B200 (C-FSKN), behind MPE1525, was instructed by Tower to commence a missed approach runway 31 to facilitate response vehicles. C-FSKN remained VFR with Tower and landed safely. No other operational impact.
UPDATE: TSB Report#A14C0026: Canadian North flight MPE1525, a Boeing 737-300 aircraft, registration C-GCNZ, was on descent to runway 31 at the James Richardson International Airport in Winnipeg. During the final approach, the crew received an auxiliary power unit (APU) fire indication. The crew declared an emergency and at approximately 1 NM on final, the crew advised that the indication went out. The aircraft then landed without further incident. Another aircraft behind MPE1525 was instructed by ATC to conduct a missed approach to facilitate the response vehicles on the runway. A subsequent inspection of the aircraft revealed that no fire had occurred.

June 7, 2013

Incident at DEGVI

Update #1: According to information from the Commercial and Business Aviation Division, there was a meeting with the pilot to go over the situation. The incident was caused by an inattention error during descent. A review of the standard operating procedures (SOP) was conducted.
Even though a Max Aviation Beech 100 (MAX130), from Rouyn-Noranda (CYUY) to Montréal/St-Hubert (CYHU), had received and read back the authorization to descend to 6 000 ft, the aircraft was seen descending to 5 600 ft. No impact on operations.

March 27, 2013


MAX120, a Beech 100 operated by Max Aviation, was on an IFR flight from Québec/Jean-Lesage (CYQB) to Chibougamau/Chapais (CYMT). The crew did not follow the QUEBEC3 standard instrument departure (SID) procedure that they had received and read back on takeoff from Runway 24. No impact on ATC operations.
Update #1: According to information from the Commercial and Business Aviation Division, the company?s chief pilot met with the crew to provide an update and identify the reasons why the crew did not respect the SID procedure. The standard operating procedures (SOPs) and the calls that need to be made during takeoff were reviewed.

March 26, 2013

Incident at 20NM à l'est de Montréal/Trudeau (CYUL)

MAX130, a Beech 100 operated by Max Aviation, was on an IFR flight from Schefferville (CYKL) to Montréal/Trudeau (CYUL). At 1245Z, the aircraft was seen deviating from the OMBRE3 standard terminal arrival (STAR) procedure for Runway 06. The aircraft?s route was corrected by the controller. Shortly afterwards, MAX130 was seen descending under 8 000 ft, which was the last altitude received and read back by the crew. The altitude was corrected by the controller. No impact on ATC operations
Update #1: According to information from the Commercial and Business Aviation Division, the company manager and the chief pilot met with the crew members. The problem was caused by a lack of crew member communication and improper GPS configuration. The chief pilot and the two pilots involved in the occurrence conducted a complete review of the standard operating procedures (SOPs).

June 11, 2013

Incident at SMITHERS BC (CYYD) (Aerodrome, runway or taxiway shutdown)

Update Maintenance & Manufacturing: The cause of this incident was the left side wing tip fuel actuator having a loose ground. The pilot had allowed the left hand engine to quit on the runway. The pilot had selected the wing tip fuel at that point thinking he had run out of fuel in his main tank. The left actuator didn't respond and the pilot didn't observe the indication light signifying this failure. The aircraft is extremely difficult to taxi on one engine due to castering nose wheel so the other engine was shut down. The corrective action was to repair the ground wire on the actuator. The pilots have reviewed their SOP's to include a function check of the tip actuators prior to commencing any flight which will require selecting the tip tank fuel.
A Tsayta Aviation Britten Norman BN2 (C-GMZP) was inbound from the East of Smithers (CYYD) and landed at 0026Z. After landing, the aircraft's engines stalled and were unable to restart them. A Northern Thunderbird Air Beech 350 (NTA205), elected to depart runway 33 (00:36Z) aware of C-GMZP's position, which was approximately 200 ft North of the Intersection of runway 15/33 and Taxiway "A". A tow vehicle was escorted by Airport vehicle STAFF 30, and the aircraft was towed off the runway at 0043Z. There was no impact to operations other than the 10 minute delay to NTA205.

May 10, 2013

Incident at SLAVE LAKE AB (CYZH)

Update Maintenance & Manufacturing: The cause of the Air Spray engine shut down was due to an o-ring that had failed on a prop hub transfer tube. The required repairs were made and engine runs completed. No further discrepancies were noted.
TSB REPORT A13W0059: The Air Spray Ltd. Lockheed L188A, C-FTDH, was on climb out from a forest fire water drop when the #2 propeller (Aeroproducts A6441-606) started to wander and droop. The checklist for wandering prop was completed, and the propeller was monitored closely returning to Slave Lake, AB. Getting closer to Slave Lake, it was evident the prop was not regulated at lower power settings, so the #2 engine (Allison 501-D13) was shutdown as per the company SOP. An uneventful 1 engine inoperative landing was made at Slave Lake airport. Maintenance found that an O-ring and backup ring combination installed in an internal transfer tube assembly in the propeller hub were reversed. This caused the O-ring to chatter, wear out and leak, which allowed a drop in propeller governing pressure.

March 7, 2013


UPDATE Maintenance & Manufacturing: The company reported the aircraft was on final approach in heavy falling snow when at 1000?, the spoilers were selected to the armed position. The crew did not receive a green light indicating the spoiler?s were armed, so they elected to conduct a missed approach. The crew noticed the spoiler circuit breaker had popped and reset the breaker and landed uneventfully. The company?s Safety Manager reported that company SOP?s allow one reset of this breaker and if no further problems are detected, there is not a requirement to record this as a defect. A company investigation found company procedures were followed and maintenance could find no history of recurring problems for this type of deficiency for this aircraft.
On an IFR flight from Edmonton (CYEG) to Calgary (CYYC) an Air North Boeing 737-500 aircraft (Flight# ANT165) commenced a missed approach at 2 miles final runway 28 due to an unspecified cockpit indication. ANT165 landed safely at 0216Z. No impact on operations.

December 4, 2012

Incident at VOR de Québec (YQB)

MAX100, a Beech 100 operated by Max Aviation, was on an IFR flight from St-Hubert (CYHU) to Rimouski (CYXK). Even though the crew had received and read back route YQB V98 MODAS, the aircraft was seen heading from the Québec (YQB) VHF omnidirectional range (VOR) direct MODAS, without authorization. When asked, the crew confirmed that V98 was in their authorization. No impact on ATC operations.
Update #1: According to information from the Commercial and Business Aviation Division: The operations manager met with the pilot and the standard operating procedures (SOPs) were reviewed.

August 31, 2012

Incident at 36NM au nord ouest de Aéroport Intl Jean-Lesage (CYQB)

C-GMAG, a Beech A100 operated by Grondin Transport, was on an IFR flight from Chibougamau (CYMT) to St-Frédéric (CSZ4). While inbound, the crew was authorized at 14 000 ft. Even though the crew read back the correct altitude, the aircraft continued its descent to 13 300 ft before the controller intervened. No impact on ATC operations.
Update #1: According to information from the Commercial and Business Aviation Division: A meeting was held with the pilot on this matter, and the company?s standard operating procedures (SOPs) manual was amended.

March 9, 2012


SJ447, a Beech 200 operated by Sky Jet M.G., was on an IFR flight from Montréal/Trudeau (CYUL) to Québec/Jean-Lesage (CYQB). The crew had received and read back a clearance to climb to 7 000 ft, but the aircraft was observed at 7 400 ft at 1157Z. No impact on ATC operations.
Update #1: According to information obtained from the Commercial and Business Aviation Division: Company management held a meeting with the pilots to make them aware of the priority actions in a cockpit during takeoff and the importance of the standard operating procedures (SOPs) and required calls during IFR departures.