FACTUAL REPORT AVIATION

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This space for binding 04/24/1990. Occurrence Date: Accident. Occurrence Type: Off Airport/Airstrip. Model/Series. Air Medical Transport Flight:

FACTUAL REPORT AVIATION

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FACTUAL REPORT AVIATION. Location/Time. Aircraft Information Summary. Revenue Sightseeing Flight: No Narrative. Air Medical Transport Flight:

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FACTUAL REPORT AVIATION

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FACTUAL REPORT AVIATION

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FACTUAL REPORT AVIATION

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Aircraft Registration Number: N38DM Occurrence Date: Occurrence Type: 4/6/ Accident Most Critical Injury: Serious Investigated By: NTSB Location/Time Nearest /Place IMMOKALEE Zip Code Local Time Time Zone FL 344 Airport Proximity: On Airport Aircraft Information Summary Aircraft Manufacturer Bellanca Distance From Landing Facility: Model/Series 8KCAB Direction From Airport: Type of Aircraft Sightseeing Flight: No Narrative Brief narrative statement of facts, conditions and circumstances pertinent to the accident/incident: Air Medical Transport Flight: On April 6,, about eastern daylight time, a Bellanca 8KCAB, N38DM, owned by a private individual, impacted with the ground while landing at the Immokalee Airport, Immokalee, Florida. Visual meteorological conditions prevailed at the time, and no flight plan was filed for the 4 CFR Part 9 personal flight. The airplane was substantially damaged. The commercial-rated pilot and one passenger reported serious injuries. The flight had departed from the same airport, at. The flight was landing on runway 8. According to the airport manager, the pilot was doing spot landings, and landed short of the runway. The airplane came to rest on runway 8. According to the pilot, he had stayed in the local traffic pattern, and was doing some landings, when he elected to depart the traffic pattern to do some local flying. Upon return to the airport he said, "...I made a normal approach and normal speed. About 5 to 5 feet [above the ground], the bottom dropped out coming down hard on [the] landing gear 6 feet short of [the] runway. Ground was soft, pitching the plane on its nose." According to the FAA inspector's statement the pilot "...did not report any mechanical problems." No - Page

Landing Facility/Approach Information Airport Name Airport ID: Airport Elevation Runway Used Runway Length Runway Width IMMOKALEE REGIONAL IMM 38 Ft. MSL 8 5 5 Runway Surface Type: Asphalt Runway Surface Condition: Dry Type Instrument Approach: NONE VFR Approach/Landing: Full Stop Aircraft Information Aircraft Manufacturer Bellanca Model/Series 8KCAB Serial Number 9-7 Airworthiness Certificate(s): Acrobatic; Normal Landing Gear Type: Tailwheel Homebuilt Aircraft? No Number of Seats: Certified Max Gross Wt. 8 LBS Number of Engines: Engine Type: Reciprocating Engine Manufacturer: Lycoming Model/Series: IO-3-EA Rated Power: 5 LBS - Aircraft Inspection Information Type of Last Inspection Date of Last Inspection Time Since Last Inspection Airframe Total Time Annual 9/999 Hours 54 Hours - Emergency Locator Transmitter (ELT) Information ELT Installed? Yes ELT Operated? No ELT Aided in Locating Accident Site? Owner/Operator Information Registered Aircraft Owner RONALD A. SMITH Operator of Aircraft Same as Reg'd Aircraft Owner Street Address 3 N. ALPINE DR. LAKE HOPATCONG Street Address Same as Reg'd Aircraft Owner NJ Zip Code 7849 Zip Code Operator Does Business As: Operator Designator Code: - Type of U.S. Certificate(s) Held: Air Carrier Operating Certificate(s): Operating Certificate: Operator Certificate: Regulation Flight Conducted Under: Part 9: General Aviation Type of Flight Operation Conducted: Personal - Page

First Pilot Information Name Date of Birth Age 79 Sex: M Seat Occupied: Rear Principal Profession: Unknown Certificate Number: Certificate(s): Commercial Rating(s): Single-engine Land Rotorcraft/Glider/LTA: Instrument Rating(s): Instructor Rating(s): Type Rating/Endorsement for Accident/Incident Aircraft? No Current Biennial Flight Review? Medical Cert.: Class Medical Cert. Status: Valid Medical--w/ waivers/lim. Date of Last Medical Exam: /999 - Flight Time Matrix All A/C This Make and Model Single Engine Mult-Engine Night Actual Instrument Simulated Rotorcraft Glider Lighter Than Air Total Time 796 399 796 Pilot In Command(PIC) Instructor Last 9 Days Last 3 Days Last 4 Hours Seatbelt Used? Yes Shoulder Harness Used? No Toxicology Performed? No Second Pilot? No Flight Plan/Itinerary Type of Flight Plan Filed: Departure Point Airport Identifier Departure Time Time Zone Same as Accident/Incident Location Destination Airport Identifier Local Flight Type of Clearance: Type of Airspace: Weather Information Source of Briefing: No record of briefing Method of Briefing: - Page 3

Weather Information WOF ID Observation Time Time Zone WOF Elevation WOF Distance From Accident Site Direction From Accident Site RSW 5 3 Ft. MSL 5 NM 8 Deg. Mag. Sky/Lowest Cloud Condition: Clear Ft. AGL Condition of Light: Day Lowest Ceiling: Broken 8 Ft. AGL Visibility: SM Altimeter: 3. "Hg Temperature: 3 C Dew Point: C Wind Direction: 7 Density Altitude: Ft. Wind Speed: 3 Gusts: Weather Condtions at Accident Site: Visual Conditions Visibility (RVR): Ft. Visibility (RVV) SM Intensity of Precipitation: Unknown Restrictions to Visibility: Type of Precipitation: Accident Information Aircraft Damage: Substantial Aircraft Fire: Aircraft Explosion Classification: U.S. Registered/U.S. Soil - Injury Summary Matrix First Pilot Second Pilot Student Pilot Flight Instructor Check Pilot Flight Engineer Cabin Attendants Other Crew Fatal Serious Minor TOTAL Passengers - TOTAL ABOARD - Other Ground - GRAND TOTAL - - Page 4

Administrative Information Investigator-In-Charge (IIC) ALAN J. YURMAN Additional Persons Participating in This Accident/Incident Investigation: WALTER WILSON MIAMI FSDO MIAMI, FL 3366 - Page 5