NATIONAl TRANSPORTATION SAFETY BOARD PILOT/OPERATOR AIRCRAFT ACCIDENTnNCIDENT REPORT

This fonn to be used for reporting civil and public use aircraft accidents and Incidents BASIC INFORMATION A«i<mttllncident UJa:tion

""""'c;ty/Pia""' Oq k ..... :t""s,.,./'!'':.;A;-d ______ smooo::U:_ ZWo 2 fti 6 } _ Cooottyo JS A l..atiluOOoN3'ii}J G 0 (ddomnnsNJS) L<>ng;wrl<iJJ (dd<l'""'"' )'.IW)

AIRCRAFT INFORMATION Maaufadurer. R 0 b {.-, S ;-; ~ Modek {Z, 2.. 2..

: Mos G...,. W.;g&t: /3 7 0 "" ~NIN~:. }O~S~1~.~nr-------------------

Weigbtat Time of Accldea.tllnddat: ------'"'

Registration Nnmb<t: .JJ10 ji5 "f N Loc:ation of Center of Gravity at Time Gf Acddefltllncldent~

_____ inches. from Doom ur Odatum

Ca~ of Ain:nft I Type of Airworthines:sCertifieate D Aitplane : (Cited ail tlwl Cl{JPiy) D Balloon ' Stantlard Sptcial 0 Blimp/Dirigible O Norm11! O R.estticted B Glider .B UtJ1ity 0 Limited

Cabin Crew:

Percent Mean.Mrodyrlamic Cord (%MAC}

Landing Gur 0 Retractable

Cheek any additioaai landing gear Cm'liigttratioo lhat appllt:s:

0 TaiT\\'h«:l

r:n ~ 0 Acrobatic 0 Provi~iMIBl [j Puw~-jift D Tnmsptn1 D ~me~ 0 Ul!rnligltt I 0 s~ Fhght

P""""t"" _I_!_ __ _

0Trieyde

D-ian 0-P!oot l!!JFloot

DH ... Skid OSkirl 0Ski 0~1 0 Unknown 0 Ltgbt Sport

Last Jospettlou Tyl~C

~ 100 Hour D C011tinuous Ai!WOrtbines$ 0 AAIP 0 Conditiunai li11lJB.:I.ion 0 Annual 0 Unknown

Stall Warning Sysl~m lll$t2lled

DYes ~No Oun;:nown

Ol!uii 0Unkmwn

Airlnm<Tot•IT;.,., 7Zp;3, i "" hours: measured at (eked:. une) ~Last lnspc:ction 0 rune of AlXidentilm::ident

Tyl" of Fire Ellthlp!slllng Sys-

~~--------------ELT lastaDed ELT AetMtcd. El,1' Mantrfacturer. -------------

~[]~Y~~~~~NO=---~O~Y~~~KJ~N~o-------4~~----------------------------­EL T Aided in Loeatiag Acc:identllllcident

ov~ lii!No EngineTYP" jgReciprocaling 0 TumoSimft 0 TurOOProp

[]T-Ier OTurboFan Ounknmw

~riaiNomltu't ______________ _

llattf:l')l l'ype~

I

3

OWNER/OPERA TOR INFORMATION Registered Aircraft Ow•er I Owoer Address

Name: W0, fe r(r'1£ f PitQk. }I e fico 2te r L t, C Ci!yo Oc ec,.., 1r ! e w

0Yos il!lNo 7 S!aleo !2€:: Z!Po~ l't"/70 Fmctionat Qwn(!l"Ship Aireraft: Cmmtryo f..! ~tJ. Ope-rator of Airc~ft ~ Ssme As RegistEred Owner I Opentor Address llQ "'""'A' ""''i>!£red "'-'

Name: ·-···-·- ' City~ Dning Bvsi~ As: I State: ZIP: ··-·····-····-Air~~(4 CharaderCode): ' Country:

ll<jJulafi"" Flip< Coadoctod Uader -ue~gF!ighl

!lliFAR9l 0fAR 129 0FAR9!-FI;ght D l'ublic !),. 1-"«Uype) DYes i1il No 0 FAR 10:3 0FAR133 0 Non-US. Conun=ial 0 F- D State 0 """' A.ir Medical Flight 0FAR!21 QFAR.B5 0Non-US,N~ D~wn ov .. I!!JNc 0FARI25 0FAR !37 0 Anned Fcrees

PurpMe of Flight n.-.. Op.ntlon Ty~ of Commercial Opentiillg Certitinkt Held l'i;;r FAR 91, 1113, U:J-137 (SelecJ.one) t(lr FAR. l21. llS. tl9, 135 {&lectont-) (Check llll !hat opply)

!ill Persooal 0 Sdleduled or Commuter ONono 0Business D Non~Scheduledor AlrTmd 0 Flag Carrier Operating Certifictie{l21) 0 Ex<X,utivefCMpm;:rte OS"""'"""'"" 0 Other Work Use OAirCargo 0 Iostructiooal Domtatie or IJ:ltfrutioul 0 Foreign Air Carriers (129) QFony 0Domel>tie: 0 lntematiooal 0 Commuter Air Carrier (135) 0 Positioning 0 On-Demand Air T!W (135) 0 Aerial Application 0 Large HeHcopter {127)

0 Aerial Observation c.,..()p<mlou 0 Ro!orc!al1 External: Load-{133) OAirDrop 0"""'-IC- -oc-0Ai! Rm:c/Show o"""'-··· Huw m.an:Y1' 0 Agricultural Aircraft(JJ7) D Flight T t:St Ocargu lbs 8 Public Use 0Mail D """'"""""" of LMgo Aimaft

Unknown

OTHERAIRCRAFT-COWSION !lfakw--n-lhls_for __ ,

AlnndtRegu-Number Manufadu.-er: Damage to Otlwr Aircraft

M- D """""""' DMloor

D....,...,. 0None

~tcml Owner of Other Aim-aft

First Name: Cilyo_ .... Middle Initial: s- ZIP' Last Name: Country:

Pilot or Otber Ain:raft

First Name: Cily'· Middle s- ZIP: ... Lust Name: Coonny,

MECHANICAL MALFUNCTION/FAILURE (It t'nOtG' ~ lfl needed, continue on -$8JKV'Bie eheet)

Was there Metbaaical Malfuaetioa/Failure? 0 Yes illl No 0 UnlmOWJl 'fotal Time!Cydes (JfyM, li!lt the name Q{dw part, m(llflifacatrer, ptul M., aerltJJ tw~ hfld des~·ribe lhttfoHwe) On Part

"""" <;ycles

Time Sinu This Part .laspct:tedtOverbauled

"""" DAMAGE TO AIRCRAFT AND OTHER PROPERTY Air....rt J)amsgo Al......rtFire I Al"""lt E>plo<ioa DN<ruc ~ Substantial ~~gtlt 0-Ground""' !n-fl;ght l9 Nore D Bmh Groutld and fu-Fl;ght OM...,. """'•""' 0 liHkoown Origin In-Flight 0 Unlrnown Origin

0 On-Ground • 0 On-Ground

4

O~ripi:Wil IJ'f Damage ta Ain:nft and Other Pmpeny (ase uddttionol Wet ifne.;e.rsary)

5 h-v c /-v-r"' I d c, r-;_y e f d " irfr <7tMe

AIRPORT INFORMATION llfU!e""'"""_..,..,.., oo Ai~&rti~rer. ____________________________ __

Ai~N~-----------------------------------Prmrimny to Airport ll!l Off AioponiAnwip

Approoch Segment -Me} oo.-...-- o"""'""' 0 C....Wind 0 Downwind

IFR Approach (Ch£cl: an that apply)

Distanee From Airport Center: , .. ____________ ~SM

Dindin From Airport degrees MAG

Airport Elevation: ft. MSL

0Fmal 0GoAmuoo 0Aborted~(•ftennuci><l<>wll)

; VFRApproadl {CluaaJttbDtappl)l)

J& NoM 0 PAR 0 MLS 0 """""" 0 Non< 0 Sfop and& [JADFmoo os-., OLilA OGPS OTmtl'ioPattern ~T<>ll<h>n<~Go 0 SDF 0 ILS 0 ASR 0 l.Qran : 0 Straigbt-ln Simulated f-otml Landing 0 VOR!fVOR 0 Localizer Only 0 Viswit 0 Unknown : 0 Valleyffemtin Following Forced Landing 0 VORIDM:E 0 WC-bacl: ~ D Contact : D GQ Around 0 Pfecautionazy Wdiog

'

f-'O=cTccACAN=----'0"' RNAV;__ ______ .....:;O:.Ci<cl.:;"=""'"'----- _ : 0 Frul S!Qp 0 U»koown Runway Information ------r-C;;n"n:-'d;';-iti;'; •• =."".~r:;;R:-.-• .,=ayc;1L;-an.,-:d;:-;ng-;S;-u-rf;'a=e•:.=I;:Ch:=.,",;:.a-;fl:-ma:--, ---:-~:----1 R 1D (UIVC) L ......_ t't Wtdtb: ft 0 Dry 0 Snow-Compacted 0 Water-Cairn

un'Wa'{ · ·· en,.. ... ,: 0 Holes 0 Snow-Crusted 0 Water-ChnWY 0 Ice Covered D Snow-Dry D Water-Glassy Runw•y/Landing Surface (Ciw:kall rlw apply)

0 Asphalt 0 Grass/Turf 0 Macadam 0 Concrete 0 Gravel D Moial/WQcd

0 Water 0 U»koown

0 Rough 0 Snow~Wet 0 Wet 0 Rubber Deposilll 0 Soft 0 Unknown 0 Stusb Covered 0 Vegetatit.ln 0 Dbt D Ice 0 Soow

FUGHT mNERARY INFORMATION: Destination A«prutiD ;"V!YF< a., M y r-Ife f5e Pte ~ s-. si: Coanlty• VS A

I Ttpe FtiPt Plan Filed .5I. None 0 VF1UIFR D ""'""""VFR 0 ,,..

: 0 Mili<myVFR 0 U­i OVFR

I Adivated? 0 Yes tJ Nl)

0 Speciai!FR 0VFROnTop

D VFR Flight Following D Traffic Advisory

Oeru;,e 0 t.1nkoo'l'tn INA

Ail'$pa£e wbere the aecitknfrmcldtm:t ~ {Cludoll""" apply} 0 Clas!> A 0 Class E OclassB filetasso 0 Class C 0 Demo Area 0 CI<IS$ D D Warning AWl

Airtntft Load »~ription (Checkt1ll rhatapp/JI} 0 NQne 0 T-owing Glider f.i.PassengC1! 0 Towing Banner 0 Cargo 0 Other External

FUEL & SERVICES INFORMATION Fuel on Bond at Last Takeoff (t:OI'ft'ert .from {IOU17Ih. os ~)

Fu~tiTyPf! 0 81)/&7

0 Pn:!htrnmd Arel:t

o""""'"".voa D Mi1illlty Opei>liom- {MOA) 0 Airpon Advisory Area

0 Panld!utists 0 Wat« D Cbemieai/Fertilizer/Seeds

3 0 Gallons lEI too Luw Lead 01001!3(1

D 1151145 OJetA 0 Alltomotkre

0JP3 0JP4 ows

Other Servitu,. if Aay. Prior tf) Dep•rtureJ ,

Fl.?> ttr j-Je,, "5

5

0 JetTmining Area OTRSA 0 fAR93

0Livestock: OUntnown

OSP"W D Air Traffic Cont:ro! Area 0Unkllown

0 Other, spedt}o --------------

EVACUATION OF AIRCRAFT Was an emerge1u~y evaWJ~tion of tile airenft performed? I5!J Yes 0No

Method of .Exit-Describe bQW the ;;~cwpants exited and hm\• many oocupants evacuated eadl ~tioo

Cc..b : .... ex;! ~ ( i?<~tV,J: Re,..qveJj

WEATHER INFORMATION AT THE ACCIDENT/INCIDENT SITE Weather Observatio• F;acllity Soutc:t' ofWuthtr htfMlllatioa Method ofBriefing

Facilicy ID: svT (Cher:lt ()/f that apply) (Check ufl Jlmt apply)

Obscrvati()n Time: . lb:U 0 Nati<mal Weather Service Ocompany Ornt>~ ~flight SeN!ce Station OMilitey 0Teletype

Time Zone: "(;J7r 0TVJRadiQ D imemet 0 Tciepbooe!Compurer

Dist.Mce from Accident Site: NM 0 A""'""'ted Repon OUnJmown 0 Airaaft R&dio 0 Cvmmercial Weather Servlce(DUATS) OTV/Radio

Direction from Accideot Site; degrees MAG .ll'JUnlrnowo

Briefing Type/Cemplemless: Liaht C:oud:lthm Vililibility 0Ful! 0Abbrevial:ed 0Dawn ODasi< 0Delk:Night

_JQ_nril" 0 Partial I Limited By Piict 00nt:Mwn fii!!nay QNigbt 0 llrigl« Night 0 Partial f Limited By Briefi.:r liJ Nut Penineut 0 Not Reported

Sky/Low .. t Cluod Coadilioa CeiUng ~n to Visibility (Ched:nllt!Wcpply)

Oc"tear 0Thin- 0 "-<cl-) o- ~N<>m: OF .. 0Few 0 Thin OVercast o"""""' 0 lndeflnlte Blowing Dust 0GroundFOJ! 0 Patti&! Obscutaliun Ounknown ! D OVercast o- 0-S...d o...,. 181,- D Biow!ng &xrw 0l<r.€1F¢g

Lowest CWad Cosditicm Height ; CeiHagHelgltt 0 BIQwing Spray Osmoke

7: sOil !tAGL ftAGt o""" 0Unlmown

Wind Direction Wiod Speed ~ WindGiil!IID Type ofTurbu&enee (Checkalltlwtapply)

0 1')!110"" Vel.ncity:~_KTS Vclooily' ~KTS [lj.N<>ne Din Clouds

Q!Q___deti<=MAG -- 0 Clear Air 0 Vicinity ofThut'lder'stonn

OCalm O<Jmtill!l Sc:v~ of Turbulence Ovariable , 0 Light and Variable 0NotOU$ting 0 Extreme 0 Moderntc 0 Light

I Osever~ 0 Moderate Cbop

NOTAMs (D, L and FDC), AIRMETs, SIGMETs, I'IREI's in effect at tbe dme of the acddentllncident

N/1'

leirtg For«ast Type <>fl'=ipil>tio• {Ciuxkaf/1/ud •PfiiYJ Temperatu~ {C) -· rr ..

l!!:l """' 0Drittle «~{F) B. Non< o ......... 0Rime OlWn DicePclkm

Alti- Seiling: JO, 0 '/ in. HG or .... o- OCle~tr 0Snow 0 Snow Pellets 0Ugbt OMi""" O~~a• D Sni:Jw Orail'ls ., MB D Rain Sbowers 0 Ire Crystals

D-ty A!Piude; _I 2 2 I'$ • ldngAdual 0 Fn=ing Rain 0 fcc Pellets Shower ........ ~ne 0 Soow Shower 0 freezing Drinle

DewPoldt' ±(C) {3.Nllrn!: o-.... or (FJ OT!ao;: D Severe 0 Clt:m lnkaslty of Precipitation

0Light OMExed 0 Light 0 Moderate o-,

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PILOT .. A" INFORMATION Pilot "A., Rcspo11sibilitial at the Time of Accident!IJJcicle•t

0 Pilot 0 Co-Pilot 0 Student Pilot 0 Flight Instructor 0 Check Pilot 0 Flight Engineer D Other Flight Crew

Pilot "A" lf:fification .@-a . First Name ARI ( r '" t j' • City: Q5A~ Middle Initial: kAJ[H07o State: ZIP:

JtH~fJ Last Name: Country:

Age at time of Accident/Incident: z.._6 Date of Birth: :ertificate Number: - -,.,;;;

Degne of lajury Scat Oceapied Seat Belt Shoulder Haroe55 f1 None 0 Falal 0 Left 0 Front 0 UnknDwn Used lhl Yes 0No Used ~Yes 0No 0 Minor 0 Unlrnown Ga_Right ORear AWiiJable t(!Yes 0No Available ~ Yes 0No 0 Serious 0 Cen~N 0 Single

Pilot Certif~Cate(s) (Ch«lc all thcJ apply)

0None 0Student 0 Recreational 0 Commercial D Flight Engineer 0 Foreig11 IRJ PrivaliO 0 Flight Jn>tructor Qsport 0 AirlincTnwport 0 U.S. Militay

Principal Occupatio• Med.ic:al Certif"tcate Medial Certitkate Validity Date of Last Medial

0 Pilot 0 None 0 CIISS3 0 Without limitations/waivers

12!1 Other 0 Class I 0 Driver'sLicense(SportPilotooly) 0 With limitlrionslwalvers 0 Unlrnown IKJ Class2 0 Unknown 0Unlmown - fddlyyyy

Medieal Certificate Limitations

fV/A

Medical Certifletlte W•iven

N/11 Date of Last FiiKht Review Flight Review Aircraft or Equiv•leut. lncludio;

~/11/1 z Make: ~(J~ /'t£ ,,~ FAR 121/135 Checks: mml~ Mookl: 1:. 2.?.

Airpl .. e RaliJ~~(s) Otlw!r Airuaft Ra .. s) lnstnuneot Ratillg(s) Instnctor Ratillx(s) (Ch«k all tltDJ apply) (Check an dtDI apply) (Check ali t/tat opp/)1) (CMrlr Dll lhot opp/)1} 11g None K! None 0 None 1i None 0 lnSUUJne~~t Airplane B Single-Engine Land 0Ainhip 0Airplanc 0 Airplane Singlc-IOngine ~ Insuument Helicopter

Single-Engine Sea 0 Fn:c Balloon ~Helicopter 0 Airplane Multi-Engine Helicopter 0 Muftiengine Land 0 Glider 0 Po._-ed Lift 0Gyroplane O Giider 0 Multicngine Sea 0 0yroplane 0 Powered Lift 0 Sport

0 Helicopter O PoweredLift

Type Ratiags Studeat Eaclorsemeats (Include dDJes)

IJ/~

Fligbt Tillie (elffer ap,-oprlate Alrp!Aa< 1,...,._,

All TllisM .... Siol&le Alrplon< 141*• mmrber of ltaurs in Melt box) .AIR,.ft &Modo! Eoqp.e Mallit..pe N~t AA:lUI ~ Roro....-.ft c- ~Air

Total Time ?- z. 5. "{ ~.b 0 v Pi!()( in Conmand (PIC) l~O,i lClO ?; Time as Instructor

This Mllke/Modd

last90Days i?.Pb.~ Last30 Days b.Cl Last24Houn 0

7

. ...=...:~ -.. -:,.. •.

PILOT"B" Pilot ' 1B" Reapomibilities at tfte rune of A«ideatllllcideat

D Pilot 0 {',.o..-Pilot 0 Student Pilot 0 Flight Jnsttnctor 0 Chock Pilot 0Fiigbt- 0 Otber fliWlt Crew

Pilot ~'B" Jdentifieatift:

FrrstName: City; Middle Initial: ~ ZIP: - ··--Last Name: -··· C.umry:

Age at time of Accidentllncident __ Date of Birth! Certificate Number.

Degn:e -oflnjury Seat Oecupied j Seat Belt Shoolder Hames, 0None OF ... 0Left 0Froot 0 Unlm<>wn U•ed OY" ON• u"" DYes 0No 0Minor ou.-... D Right o- i Available OY" ONe Avuilable DYes 0No OSerious D Center 0Slngle

Pilot CertifieaU(s)

0None q;>_';'~; 8~' 0 COIDJ11M.';ia1 0Fiight£otin"' 0Foretgn 0 Privm D 0 Airline T.runspart D u.s. M>1itruy

! Medleal' ~-:;::,_:,:~lly Date•

0Pilot ! 0None OC'-3 00ther OOI.ISSl 0 Driver" s License (Spon Pilot only) 0 With limituti®slwaivern

-"~ OuoJmown i 0CJa.s2 0Unknown 0Uokoown

Medical Limitatioos

Medical Certifictte Waivers

~~~F~:R.~ Ainmft

FAR M-

:M-1:

Airplane RatiMg(s:) otilter i ,...,._.., Ratlug(•) Iustructer Rathtg(s) (Check nil thot apply) (C"-'ka/1 'hat apply) (Ch<ck «<I thotopply) (Ched; alf thtlt apply)

0"'- """"' D ><o•" DNone 0 lnsuume:ut Airplane B Singl~e LawJ. Airship : 0Airptane 0 Atrphme Single-Engine 0 blsttument Helicopter Singfe-Engim~ Sea Free Balloon : 0 Helicopter D Airpllme Multi-Engine D Iieliwpter

0 Multier!gine Land Gl- : 0 Powered Lrft 0Gy- Druoo , 0 MWtiengine Sea Gy- D ''""''"' Lift

0SJ1f>rt ! ""''-' P~Lift

Type Ratings (Include dates)

-:= E _:'"<'_ .... _.. ::::::·.:;::· - ..-... A""'" ·- -- """"" ....;.M, ... "

Pdoti i

L"t3oo.y,

Lost24 """'' I

8

AOOITIONAL FLIGHT CREW MEMBERS of----tile -· Pilot Name and Addns$ Degree oflnjury

F~tName: ;: .. 0None 0Faml Middle Initial: Zl:P: OMioo• 0Urtbtowo

Last Name: c...nti;;• D SeriO\!S

Pilot Cert:ilieate(s) (Cher:k afllhm apply) , Seat Owopi<d 0None o- g~- 0 Commcr1:iial 0 Fright Engineer 0Foreign : D Left D Front ~te 0 flight[~ 0 Aidiue Tramport 0 U.S. Miiiiarv ·o- B~gle Type htiug/Endonemm.t for [ 'f ot;;J Fiight Time m the Time Oc.nwr ~idmlflocident Aituaft? OY" 0No of tbis AttidentiJRcidt.C hrn 0 Unknown

Pilot Name ami Addreu Degree oflojury

Fm:tName: Cily 0None 0F.W Middle tnrtiat: """' Zl~

0Minor DUn""'""' .. ·~ 0 Serious Last Ntm'ie: O.mm1"

Pilot Certifieate(s) ~k all that apply} 1 S..t Oe<upied 0Nooe os..- o- Ocommercia:I 0 Flight EDg:ineer 0Foreign :OLea 0Froot 0 Private 0 Ri&bt fnstrut:'lor Ospcn OAirlineT~ 0 U.S. Militaty : 0 Rlli}U 0 Rear

Type Rating/Endtmlemeal for : TotaJ FlightTHnf: •I 1M Time Dam"' 0Single

Acddeatflodd-ent Aircraft? 0Yos 0No of this Acridatti11J(ideat: br$ OUn.known .

PUut N~ and Addrrss I Degn:e «flujury

Fim.Nam&Y ""'" 0None 0 Fatal

Middle lnifiai: 0 Minor OUnknown

Us! N""' Osonoos Pilot C-te(s) iCh«k <>II""' opplyJ Seat OecupiW 0None 0Student o- OCOflll'llefcial 0 Htgln Engineer 0Fm-eign OLetl OF""" 0 Private 0 fliglrt lUllti'OOIOt 0 Sport QAirlioo Tmmport Ou.s Militny QRight OR£>, Type Ratidg/Eed~at for- I Total Fligbt Ttme at tire 1'ilm D""""" 0 Single

AccidtD:tlladdeat Aireraft? ov ... 0No oftbis AttideatiJ~t~ Jus 0Unkoown

PASSENGERISJIOTHER PERSONNEL -fliOht-·-.. --!!neeoosaNI

~~~DIIAtldn:l& l ! J • i~d ;I~ :dm! i

If ~EX:S ~ ~

FirstName:~!J... __ o"" r~ k:! ~., o l.lll o o oio o om o Middle fnitiai: /VI f.. 2-7G• t; !::..!: La:~tName: 7Vf!I7· p=(l •

"""" Ri ..::7 ZIP I COUlttfl': _J,.L':.

Fim.Name: Cily I

~.:,.Initial: ZIP: 0000000000

FirnName: City:

"""''"'" "''"" z'" DOD DO 00000 --------Last Name: -···· ~

First Name: Middle initial; sw"- DDDDD DO DOD

'

FlutName: CiiYI. I Middle Initial: 00000 00000 ...

FimNarne: Ci'!y: D 0 0 0 olo D D 0 0 Mlddlelrntia!: Sla1e: ZiP:

COOnlly: -····

Fi:tst:N,ame: Cily. Middle lnifia!- ·- ZlPc 00000 00000 Last Name: ~ ---. ......

..~~-

First Name: Cily1 Middle Initial: State: Zl~ 00000 00000 tan Name: ------ Country:

9

~-

----·······-----···· ·----

NARRATIVE HISTORY OF FLIGHT IP-..,. or'"'"'"'""'' Describe what ooet~rred in cluunologt<:al order, including cir~ leading to and nature of accidentrmcident Describe twain and include wreckage distribution sketch if pertinent. Attacli extJa sheets if needed. State time and point of departure. intended destination, and services obtained.

See

17, 2-rl I~

RECOMMENDATION {How.....,_....,...,nc--booo-nlad?)

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ADDITIONAL INFORMATION (Pioose lype or print in ink} Use this space if additional space is needed iOr any answers.

I HEREBY CERTIFYlliATTHI!ABOYE INFOIWATIONIS COMPlETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE D• of this Report Signal:ve and Name of P'ilot/()penlror

r, Lt7 {l.o!Z. Signature: ""''"' , ...... ,\ ·= ,J

-~ Type orPr:intNome:

Sigaature- ad Name of PerJon Flliog Repwt if Olliedhaa Jlilot/Operator g;_,

"' - .. Type or Print Name

Title:

FOR NTSB USE ONLY NTSIIAt~fac~~ I RoriewT?~~~Office I N•ptE'9hnv,.ligato<<;_/ /. cR"fl. Lll N1 6 , >VIL,. ..,.,-utrv. 1~~'7..-~

11 I

····--~-········~-·-· ·-··-·-····· --

Carrol A. Smith Senior Air Safety Investigator Eastern Region Aatlt .JHae l'k; 1012

RECORD OF CONVERSATION

Person Contacted: William M. Mistrot, Raleigh NC 27609, Mari Kajimoto, Japan Number• ERA! 2l "399, N!089N

Narrative: Mr. Mistrot stated he is a commercial pilot with ratings for airplane single engine land and instrument

airplane. In addition he holds a private pilot certificate with ratings for helicopter and instrument

helicopter. He stated he has 347 total aircraft hours with 180 hours in the R22 and 163.5 hours in

airplane single engine land. He has flown 191 hours as pilot in command in all aircraft and 102.8 hours in

the R22 and 89 hours in airplane single engine land. He has flown 17.2 hours in all aircraft in the last 90

and 30 days. All hours were flown in the R22. He flew 2.5 hours in the R22, 24 hours before the accident.

The airplane is registered to Watercraft Photo Helicopter LLC and he is undergoing training for a

certified flight instructor rating and photo training. On June 14, 2012, Mari Kajimoto, was going to fly a

Part 91 cross country flight from Wilmington, North carolina {ILM) to Myrtle Beach, South Carolina

(MYR). Ms. Kajimoto did not file a flight plan; however she obtained weather on a computer. Marl

Kajimoto was the pilot·in command and Mr. Mistrot was a passenger. Ms. Kajimoto flight instructor was

sick and could not go on the flight so Mr. Mistrot asked Ms. Kajimoto, on June 13, 2012, if she would like

to fly up to Beaufort, North Carolina (MRH). Ms. Kajimoto accepted and they flew up and spent the

night. A preflight inspection was conducted and no anomalies were noted. Mr. Mistrot was located In

the left front seat with all restraint systems fastened and Ms. Kajimoto was located in the right front

seat with all restraint systems msteoed. They departed MRH at about 1530 en route to ILM. They

landed at ILM and topped off both fuel tanks and departed ILM at 1630 en route to MYR. Mr. Mistrot

stated that he and Ms. Kajimoto had been swapping qff on flying; however when they departed ILM Ms.

Kajimoto was flying the helicopter and he was handling the radios for the entire flight. When they

arrived in the vicinity of the pier at Oak Island, North Carolina, Ms. Kajimoto stated she wanted to do an

autorotation. Mr. Mistrot Informed Ms. Kajimoto that he did not feel comfortable with her doing an

autorotation because he did not have that many hours in the left seat. Mr. Mistrot stated neither one of

them were sure if they could do an autorotation without an instructor on board the helicopter. No one

at Watercraft Photo Helicopter LLC had told them they could not do them and it is not written anywhere

stating they cannot do them. Mr. Mistrot stated the last time he did an autorotation was on June 2,

2012, and he did one autorotation with a power recovery. Ms. Kajimoto intended to make a power

recovery and did not intend to go to the water. She entered the maneuver at 600 feet and at 75 knots.

With a manffold pressure of 21 inches. She lowered the collective and rolled the throttle to the off

position, and then she immediately raised the collective pitch. The main rotor low warning hom

sounded. Ms. Kajimoto rolled on the throttle and increased collective and the main rotor rpm continued

to decrease. The helicopter continued to descend until it impacted the water. The helicopter rolled over

inverted. They released their restraints after the main rotor stopped, exited the helicopter, came to the

surface, and were rescued by a boat. There was nothing mechanically wrong with the helicopter. It was

an improper use of the flight controls during an autorotation.