Aircraft Accident Investigation Report

4 1.17 Organizational and Management Information ....................................................... 38 1.17.1 Jamaica Civil Aviation Authority ................................................................... 38 1.17.1.1 Safety Oversight......................................................................................... 38 1.17.1.2 Air Navigation Services ............................................................................. 44 1.17.1.3 Aircraft Accident Investigation.................................................................. 46 1.17.2 Caribbean Aviation Training Center ............................................................... 46 1.17.3 Tinson Pen Aerodrome ................................................................................... 49 1.17.4 Jamaica Fire Brigade........................................................................................... 50 2.0 ANALYSIS ................................................................................................................ 51 2.1 Pilot Decision Making.............................................................................................. 51 2.2 Aircraft Performance................................................................................................ 51 2.3 Human Factors ......................................................................................................... 51 2.4 Jamaica Civil Aviation Authority Safety Oversight ................................................ 51 2.5 Jamaica Civil Aviation Authority Air Traffic Services ........................................... 52 2.6 Jamaica Civil Aviation Authority Aircraft Accident Investigation ......................... 52 2.7 Caribbean Aviation Training Center ........................................................................ 52 2.8 Tinson Pen Aerodrome............................................................................................. 53 2.9 Jamaica Fire Brigade ................................................................................................ 53 3.0 CONCLUSION ......................................................................................................... 53 3.1 Findings as to Causes and Contributing Factors....................................................... 53 3.2 Findings as to Risk.................................................................................................... 54 4.0 SAFETY RECOMMENDATIONS ........................................................................ 56 4.1 Safety Action Taken ................................................................................................. 56 4.2 Safety Action Required............................................................................................. 56 Exhibit 1 ............................................................................................................................ 60 Exhibit 2 ............................................................................................................................ 61