****Report of the PRESIDENTIAL COMMISSIONon the Space Shuttle Challenger Accident****
**** ****
****Appendix A: CommissionActivities.****

 

 

[**206**] **An Overview**

President Reagan, seeking to ensure a thoroughand unbiased investigation of the Challenger accident, announced theformation of the Commission on February 3, 1986. The mandate given bythe President, contained in Executive Order12546, required Commission membersto:

> 
(1) Review the circumstancessurrounding the accident to establish the probable cause or causes ofthe accident; and

(2) Develop recommendations for corrective orother action based upon the Commission's findings anddeterminations.

Following their swearing in by Chairman Rogerson February 6th, Commission members immediately began a series ofhearings during which NASA officials outlined agency procedurescovering the Shuttle program and the status of NASA's investigationof the accident.

Shortly thereafter, on February 10th, Dr.Alton G. Keel, Jr., Associate Director of the Office of' Managementand Budget, was appointed Executive Director. Dr. Keel begangathering a staff of 15 experienced investigators from variousgovernment agencies and the military services, and administrativepersonnel to support Commission activities.

During a closed session on February 10, 1986,the Commission began to learn of the troubled history of the SolidRocket Motor joint and seals. Moreover, it discovered the firstindication that the contractor, Morton Thiokol, initially recommendedagainst launch on January 27, 1986, the night before the launch of51-L, because of concerns regarding low temperature effects on thejoint and seal. To investigate this disturbing development,additional closed sessions were scheduled for February 13th and 14that Kennedy. The February 13, 1986, session was an extensivepresentation of film, video and telemetry data relating to theChallenger accident. It provided the Commission the first evidencethat the Solid Rocket Motor joint and seal may have malfunctioned,initiating the accident.

The session on February 14th included NASA andcontractor participants involved in the discussion on January 27,1986, not to launch 51-L. After testimony was received, an executivesession of the Commission was convened. The following statement wassubsequently issued by the Chairman on February 15, 1986, reflectingthe conclusion and view of the Commission:

> 
"In recent days, the Commissionhas been investigating all aspects of the decision making processleading up to the launch of the Challenger and has found that theprocess may have been flawed. The President has been soadvised.

"Dr. William Graham, Acting Administrator ofNASA, has been asked not to include on the internal investigatingteams at NASA, persons involved in that process.

"The Commission will, of course, continue itsinvestigation and will make a full report to the President within 120days."

The role of the Commissioners thus changedfrom that of overseers to that of active investigators and analystsof data presented by NASA and its contractors.

[**207**] The Commissionitself divided into four investigative panels:

> 
1. Development and Production,responsible for investigating the acquisition and test and evaluationprocesses for the Space Shuttle elements;

2. Pre-Launch Activities, responsible forassessing the Shuttle system processing, launch readiness process andpre-launch security;

3. Mission Planning and Operations,responsible for investigating mission planning and operations,schedule pressures and crew safety areas; and

4. Accident Analysis, charged with analyzingthe accident data and developing both an anomaly tree and accidentscenarios.

By February 17th, the panel organization hadbeen finalized and, on February 18th, Chairman Rogers described theCommission's new approach before Congress. Working groups were sentto Marshall, Kennedy and Thiokol to analyze data relating to theaccident and to redirect efforts. NASA's investigation was alsoreorganized to reflect the structure of the Commission'spanels.

A series of public hearings were planned onFebruary 25th, 26th and 27th to assure an orderly and fairpresentation of all the facts that the Commission had discoveredconcerning the launch decision making process for flight 51-L. Atthese hearings, additional information about the launch decision wasobtained from the testimony of Thiokol, Rockwell and NASA officials.Details about the history of problems with the then suspect SolidRocket Motor joints and seals also began emerging and served to focusthe Commission's attention on a need to document fully the extent ofknowledge and awareness about the problems within both Thiokol andNASA.

Following these hearings, a substantialportion of the investigative efforts of the Commission was conductedby the separate panels in parallel with full Commissionhearings.

The Accident Analysis Panel, chaired by MajorGeneral Donald Kutyna, made several trips to both Kennedy andMarshall and traveled to Thiokol facilities in Utah to reviewphotographic and telemetric evidence as well as the results of thesalvage operation and to oversee the tests being conducted by NASAand Thiokol engineers.

The Accident Analysis Panel followed standardinvestigative procedures. An extensive effort was needed to establishthe design, manufacturing and processing baseline configuration ofthe Shuttle vehicle for STS 51-L. A data base was established for theexamination and analysis of information related to all flightelements and segments. From these data and a compilation of possibleand observed deviations from the norm, scenarios that might have ledto the accident were developed. Tests and analyses were thenperformed to determine the specific scenarios most likely to havecaused loss of Challenger.

Early in March, at the request of theChairman, this group assembled and directed the Commission'sindependent team of technical observers with extensive experience inSolid Rocket Motor technology and accident investigation to validateand interpret the tests and analyses performed on the Thiokol motorby NASA and Thiokol.

The Development and Production Panel, chairedby Joseph Sutter, centered its investigation on the production andtesting activities of the Shuttle element contractors. Starting atJohnson, the panel and staff investigators looked at how thesecontractors and their NASA counterparts interact.

They next traveled to the Wasatch plant ofThiokol in Promontory, Utah. Thiokol personnel briefed the group onthe details of the design, manufacturing, verification andcertification of the Solid Rocket Motors. Similar sessions took placein April in Downey, California, at the headquarters of Rocketdyne,Inc., the Shuttle main engine contractor; in Canoga Park, California,at the facilities of Rockwell International, the Orbiter contractor;in Michoud, Louisiana, at the plant of Martin Marietta, the ExternalTank contractor; and in Berea, Kentucky, at the facilities of ParkerSeal Company, the manufacturers of the O-ring seals of the ThiokolSolid Rocket Motors.

In addition, the panel traveled to Marshall tolearn about Marshall's interaction with Thiokol and to discuss issuesthat had been raised during the visits to the contractors'plants.

The Pre-Launch Activities Panel, chaired byDavid Acheson, centered its investigation at Kennedy where theShuttle elements are assembled and all other final launchpreparations are completed. This panel, in conjunction with theMission Planning and Operations Panel, chaired by Dr. Sally Ride, metwith its NASA counterparts in early March. This series of meetingsidentified for the Commission the various aspects of the pre[**208**]launch process that required thorough review, not only for thepurpose of the Challenger accident investigation but also to increasesafety margins for the future.

Later in March the Pre-Launch Panel again metat Kennedy to receive the NASA Team's preliminary reports and tofocus on the spare parts issue and Solid Rocket Booster assemblyoperations. Panel members also met with contractor personnel involvedin Shuttle processing and Kennedy security work.

After the joint meeting at Kennedy with thePre-Launch Activities Panel, the Mission Planning and OperationsPanel traveled to Johnson to begin working with its NASA counterpartsand to initiate its own investigative efforts. A specific focus ofits work was the mission planning and crew preparation for STS 51-Land details of NASA's safety, reliability and quality assuranceprograms. Later meetings at both Johnson and Marshall dealt withrange safety, weather criteria for launch, flight delays and hardwaretesting.

While the work of the individual panels andtheir investigative staffs was ongoing, a general investigative staffbegan a series of individual interviews to document fully the factualbackground of various areas of the Commission's interest, includingthe telecon between NASA and Thiokol officials the night before thelaunch; the history of joint design and O-ring problems; NASA safety,reliability and quality assurance functions; and the assembly of theright Solid Rocket Booster for STS 51-L. Subsequent investigativeefforts by this group were directed in the area of the effectivenessof NASA's organizational structure, particularly the Shuttle programstructure, and allegations that there had been external pressure onNASA to launch on January 28th.

More than 160 individuals were interviewed andmore than 35 formal panel investigative sessions were held generatingalmost 12,000 pages of transcript (Table 1 and Table 2). Almost 6,300documents, totaling more than 122,000 pages, and hundreds ofphotographs were examined and made a part of the Commission'spermanent data base and archives. These sessions and all the datagathered added to the 2,800 pages of hearing transcript generated bythe Commission in both closed and open sessions.

In addition to the work of the Commission andthe Commission staff, NASA personnel expended a vast effort in theinvestigation. More than 1,300 employees from all NASA facilitieswere involved and were supported by more than 1,600 people from othergovernment agencies and over 3,100 from NASA's contractororganizations. Particularly significant were the activities of themilitary, the Coast Guard and the NTSB in the salvage and analysis ofthe Shuttle wreckage.

** **

**Table 1**

**Commission         Investigative Interviews**

.

**Interviews of January         27, 1986 Teleconference (8:15 PM EST)         Participants**

.

Ben Powers

John Schell

William Macbeth

Jerry E Mason

Frank Adams

Keith Coates

Brian Russell 

Robert Lund

Larry Wear 

George Hardy

Jack Kapp

Joseph Kilminster

James Smith

Jud Lovingood

Ron Ebeling

Roger Boisjoly

Boyd Brinton

Jack Buchanan

Calvin Wiggins

Arnold Thompson

Robert Schwinghamer

Allan McDonald

Larry Sayer

Jerry Peoples

William Reihl

Carver Kennedy

Joel Maw

James Kingsbury

Wayne Littles

Cecil Houston

Kyle Speas

John Q Miller

Lawrence Mulloy

Jerry Burn

John McCarty 

Stanley Reinartz

Don Ketner

[**209**]**Interviews of         Personnel Involved in Stacking of Right SRB for Flight         51-L**

.

Howard Fichtl

Ed O'Neal

Mike Sestile

Jim Gardner

Jack Roberts

Leslie Lake

Granville Goad

John Taris

Curtis J. Newsome

Buddy Rogers

David Mumpower

Kenneth Koby

Mark Vigil

Mario Duran

Robin Nix

Allen R. Hyde

Bob Heinbaugh

Jim St. John

Glenn Charron

Jerry Wilkerson

Howard Christy

Billy Massey

Stewart Dalton

Alex McCool

Jackie Walden

Mike Sieglitz

Sharron Whitaker

Charles D. Newman

Alvie Hicks

Jim Jordan

**Interviews on Ice on Pad**

- Thomas Moser     John Peller

** **

**Interviews on Security**

- Marvin Jones     Herbert Weisner

 

**Interviews on History         of SRB Joint Design and Problem**

.

Leon Ray

Robert Lindstrom

James Kingsbury

Ben Powers

Alex McCool

James Brier

Sam Lowry

Michael Mann

Jerry Peoples

Jesse Moore

Stanley Reinartz

Richard Kohrs

Glenn Eudy

Joseph Kilminster

Calvin Wiggins

Maurice Parker

Ben Powers

Arnold Thompson

Mark Salita

Keith Coates

John Miller

Irving Davids

Joe Pelham

John Schell

Bill Rice

Arnold Aldrich

Phillip Dykstera

James W. J homes

Bill Horton

Hans Mark

Ed Dorsey

Boyd Brinton

Jerry Cox

Glynn Lunney

Roger Boisjoly

James Abrahamson

Bill Bush

Walt C. Williams

Brian Russel

Jerry Mason

Paul Wetzel

George Hardy

Jack Kemp

Jack Kapp

David Winterhalter

Larry Mulloy

Robert Lund

Ronald Ebeling

William Hamby

Fred Uptagrafft

Howard McIntosh

Arnold Aldrich

Michael Weeks

Richard Cook

Glenn Eudy 

Hazel Saunders

Paul Herr

Walter Dankhoff

Robert Gaffin

** **

**Interview on Launch Coverage CameraFailures**

Charles Alsworth

 

**Interviews on Outside         Pressure To Launch**

.

Michael Weeks

Phil Culbertson

Jerry E. Mason

Karen Ehlers

Jesse Moore 

George Hardy

Arnold Aldrich

George Johnson

Charles Kupperman

Larry Mulloy

Lawrence Wear

James Beggs

Shirley Green

Joseph Kilminster

John Q. Miller

William R. Graham

Vera Herschberg 

Stanley Reinartz

James Smith

Richard Cook

Richard Smith

Robert Lund 

Norman Terrell

Ben Powers

 

[**210**]**Interviews on         Safety, Reliability and Quality Assurance**

.

David Brown

Jackie C. Walker

Howard Gittens

Wayne Frazier

Richard M. Henritze

Benny Nunnelly

Brian Russell

Norman R. Schulze

James 0. Batte

George Butler

Haggai Cohen 

Stanley Reinartz

Arthur M. Carr

Henry P. Smith

Harry Quong 

Milton Silveira

Wiley C. Bunn

Wesley Hawkins

Dallas N. Vickers

David Austin

John Maxson

 

**Interviews on         Management Structure**

.

Dick Kohrs

James Smith

Jerry Cox 

Richard A. Colonna

Jesse Moore

Arnold Aldrich

Jerry Griffin 

Walt C. Williams 

Dr. Hans Mark

John J. McCarty

Stanley Reinartz 

George Bridwell

William Hamby

Scott Simpkinson

James Kingsbury 

George Johnson

Michael Weeks

James Brier

Thomas J. Lee

Richard Cook

Lawrence Wear

Jud A. Lovingood

William F. Taylor

Michael Mann

John Q. Miller

Bill Bush

William Lucas

 

**Interviews on Human         Factors**

.

Louis E. Toole

Jenny Howard

Ray Hallard

Gregory Haywood Williams

James B. Hill

Greg Oliver

Ken McCrary

Robert L. Brayant

Leonard J. Riche

Robert Yackovetsky

Joe Kenneth Patterson

Keith Coates

Heather M. Mitchell

Morton O'Hare

** **

**Interview on WreckageReconstruction**

Terry Armentrout

** **

**Interview on Crew Activities**

George Abbey

 

** **

[**211**]         Table 2. **Commission         Panel Sessions**

.
DateLocationSubject
.

**Accident         Analysis Panel**

.

March 3, 4, 5 

Marshall

Accident Data Review, Fault         Tree Analysis

March 6, 7

Kennedy

Film & Wreckage         Review

March 11

Kennedy

Coordination with NASA Task         Force

March 12, 13

Marshall

Accident Data Review, Fault         Tree Analysis, Test Requirements

March 19

Thiokol-Utah

Test Coordination

March 26

Marshall

Test Review

April 10, 11

Marshall

Test Review

April 14, 15, 16, 17

Marshall

Final Review

.

**Design,         Development and Production Panel**

.

March 5 

Johnson

Preliminary Briefing

March 17

Thiokol-Utah

Fact-Finding Session

March 18

Thiokol-Utah

Design-Production

April 2

Rocketdyne-California

Main Engines

April 3

Rocketdyne &         Rockwell-California

Development-Orbiter

April 4

Rockwell-California

Orbiter

April 7

Marshall

Development and         Production

April 8,9

Martin         Marietta-Louisiana

Development-External         Tank

April 11

Parker Seal-Kentucky

O-rings

.

**Pre-Launch         Activities Panel**

.

March 4, 5, 6

Kennedy

Training, Workload,         Schedule, Spares, Pre-launch Investigation Update,         Security

March 17, 18, l9

Kennedy

Manpower, Spare Parts,         Shuttle Processing, Security, Hold-down Post Spring 51-L,         Booster Flow, Salvage Status, SRB Recovery, Launch Readiness         Process

.

**Mission         Planning and Operations Panel**

.

March 4, 5

Kennedy

Preliminary Briefing

March 11, 12

Johnson

Crew Activity Planning,         Training, Abort Modes, Safety, Manifesting

March 20

Johnson

Objectives Review

March 24, 25

Johnson

Range Safety, Mission         Operations, Landing Operations, Weather, Tile Damage, Main         Engines, Safety, Reliability and Quality Assurance

March 31, April 1

Johnson

Payload Safety, Hardware         Testing, Training, 51-L Flight Design

April 7 

Marshall

Safety, Reliability and         Quality Assurance

April 8, 9

Johnson

Workload, Software,         Manifesting, Landing Considerations

April 14, 15

Johnson

Ascent/Entry Envelope,         Abort Option History, Safety, Reliability and Quality         Assurance

 

[**212-213**]Executive Order 12546, dated February 3, 1986, which established thePresidential Commission on the Space Shuttle ChallengerAccident.

 

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