STATE OF WASHINGTON UNIFORM INCIDENT REPORT

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1 TATE OF WAHINGTON UNIFORM INCIDENT REPORT 7 { j DRIVENAWAY ( ) TOWED( I I T LOCKED KEY IN DELINQ. VICTIM THEFT DRIVE- DAMAGE TO PECIM DAMAGE BY VEHICLE PAYMENT CONENT IN. ABLE VEHICLE HADING DAMAGED AREA Y N Y N Y N Y N Y N Y N Y N ( ) TOP ( ) UNDERIDE DAMAGE ET. $ MAKING FALE REPORT TO PUBLIC OFFICER (1) A PERON COMMIT THE CRIME OF MAKING A FALE RE" IF HE/HE WILLFULLY MAKE ANY UNTRUE. MILEADING OR EXAGGERATED TATEMENT IN ANY REPORT TO A POLICE OR FIRE DEPT. (2) MAKING A FALE REPORT I A MIDEMEANOR. IF PROPERlY CRIME I DID NOT GIVE ANYONE PERMIION TO ENTER MY PREMIE AND/OR TAKYREMOVE MY PROPERTY/VEHICLE. IF FOUND PROPERTY. I HAVE BEEN ADVIED OF CHAPTER 63 OF THE R C W AND ( ) I Do ( ) I M) NOT WIH TO CLAIM THE PflOPEflW IF,, THE TRUE OWNER CANNOT BE FOUNO I I HAVE READ. UNDERTAND AND AGREE TO THE ABOVE. f ( ) RELEAED PROPERTY TO J ( ) I ACCEPT LIABILITY FOR TOWING AND TORAGE P ( ) THE NAMED JUVENILE I PREENTLY A RUNAWAY E ( ) THE NAMED PERON I PREENTLY MIING IGNATURE OF PERON DATE c AREA OFFICER NAME / NUMBER ADMlN CLEARANCE DITRIBUTION ( ) HD OTHER' ( ) WARRANT ( ) C A ( ) JUV ( ) DET j ()ARR/J ( ) EXC/J ()UNF ( ) UPENDED ( ) PA 1 Eg; ( ) MH ( ) PAT Fftpt DATA ENTRY - z 0 n

2 - - P E R 0 N I B U I N E E - AGENCYNAME , Rnnton ~ _. Cauntv heriff's Office ADDITIONAL P ERONNE H I CLE PAGE OF INCIDENT CLAIFICATION (INC. RCW NUMBER) ADDL ( ) PERON CODE: V-VICTIM E-VICT. BUINE &DECEAED TYPE I-INDIVIOUAL G-GOVERNMENT P-POLICE ON ( ) VEHICLE W-WITNE C-COMPLAINANT RO-REG, OWNER VICTIM B-BUINE R-RELIG#XI O-OTHER supp. ( 1 NARRATIVE O-OTHER G-PARENT I GUARDIAN CODE: F-FINANCIAL -OCIETY I PUBLIC U-UNKNOWN TNAME (LAT, FIRT, MIDDLE) 1 I l l 1 ALIA NAME() IDENTIFIER IRACE/ ETH 1 EX I D.O.B. I AGE I HGT I WGT 1 HAIR I EYE U P E C T I U B J E C T TREET ADDRE APT. X CITY TATE ZIP RE. REIDENCE PHONE TATU FPNO EMPLOYMENT I OCCUPATION I CHOOL BUINE PHONE OC. EC. NUMBER DRIVER LIC. I ID CARD NO. I I I I IBR ARRET BOOKED I WHERE BOOKING # CHARGE CITATION I WARRANT X BAIL OFFENE NO., 1. M F ARRET DATE LOCATION OF ARRET 2. M F I ( ) GANG ( ) TRIBE ( ) AFFILIATION ON VIEW CITED TATEMENT CHARGE IDENTIFICATION NUMBER MULTI ARRET ( ) ORAL ( ) ADMITTED CLEAR 0 ( ) WRTN. ( ) DENIED 0 JUV. PARENTI NAME I RELATIONHIP OF PERON NOTIFIED I DATMIME NOTIFIED NOTIFIED BY DIPOITION OF JUVENlLl GON. NOTIFIED I I Y N I I I I NUMBER OF UPECT /ARRETED UPECT CODE: A-ARRET -UPECT I-INTiTUTIONAL X-OTHER PERON IN THI INCIDENT: %RUNAWAY M-MIING (MENTAL. MTOV NO. NAME (LAT, FIRT, MIDDLE) IRACEJ ALIA NAME() I IDENTIFIER ETH 1 EX 1 D.O.B. 1 AGE I HGT I WGT [HAIR 1 TREET ADDRE APT. X CITY TATE ZIP RE. TATU REIDENCE PHONE FPNO EMPLOYMENT I OCCUPATION I CHOOL BUINE PHONE OC. EC. NUMBER DRIVER LIC. I ID CARD NO. TATE IBR ARRET BOOKED I WHERE BOOKING # CHARGE CITATION I WARRANT # BAIL OFFENE NO. I 1. M F ARRET DATE LOCATION OF ARRET 2. M F I ( ) GANG ( ) TRIBE ( ) AFFILIATION ON VIEW CITED TATEMENT CHARGE IDENTIFICATION NUMBER MULTI ARRET ( ) ORAL ( ) ADMITTED CLEAR 0 ( ) WRTN. ( ) DENIED 0 NAME I RELATIONHIP OF PERON NOTIFIED OATUTIME NOTIFIED NOTIFIED BY DIPOITION OF JUVENILE,! ' A P ~ ~ ~ ~ T ~, "V,.. I.", Ir PLY Y N I 1 I I VEHICLE ( ) TOLEN ( ) LOCATED ( ) EIZED ( ) DAMAGEDNANDALIZED ( ) VICTIM VEH. ( ) HOLD -FOR: CODE: ( ) RECOVERED# ( ) TOWED ( ) ABANDONED ( ) OTHER: ( ) UPECT VEH. 1 I I NO, LICENE NUMBER TATE VIN I HULL NO. YEAR MAKE MODEL TYLE TATE EYE R ZOLOR PECIAL FEATURE I DECRIPTION VALUE t DRIVER I: REGITERED OWNER NAME JEHICLE DIPOITION TOW COMPANY I ADDRE I PHONE TATE TOW NO. REGITERED OWNER ADDRE ) LEFT AT CENE,- I DRIVENAWAY l. \. TOWED I I LOCKED KEY IN DELINP. VICTIM THEFT DRIVE- DAMAGE TO PECIFY DAMAGE BY DAMAGE ET. VEHICLE PAYMENT CONENT IN. ABLE 1 VEHICLE 1 HADING DAMAGED AREA - 1 Y N Y N Y N Y N Y N Y N Y N ( ) TOP ( ) UNDERIDE 1 1

3 NARRATIVE ON AT APPROX HR I REPONDED TO A REPORT OF A HELICOPTER THAT HAD GONE DOWN IN THE AREA OF 45TH AND OLMPIA. DIPATCH ADVIED THAT KENNEWICK POLICE WA OUT WITH THE PILOT AND THERE WERE NO INJURIE. I ARRIVED ON THE CENE AT APPROX HR. I CONTACTED THE PILOT OF THE HELICOPTER, TRENT MAIE, AT THE CENE OF THE CRAH IN AN ORCHARD JUT EAT OF OLYMPIA ON 45TH. MAIE ADVIED THAT THE OWNER OF THE ORCHARD HAD HIRED HIM TO FLY OVER THE CHERRY TREE TO DRY THEM OFF FROM A RECENT RAIN. HE AID THAT AT ABOUT 1330 HR HE WA HOVERING AROUND THE MIDDLE OF THE ORCHARD WHEN THE HELICOPTER UDDENLY TARTED TO LOE POWER. MAIE AID THAT THE CHOPPER ENGINE DID NOT QUIT, BUT THAT IT JUT TARTED TO LOE POWER. MAIE THEN TRIED TO FLY THE CHOPPER TO AN OPEN FIELD JUT TO THE EAT OF ORCHARD TO LAND BUT JUT A HE WA REACHING THE END OF THE TREE HE REALIZED THAT THE AIRCRAFT WA NOT GOING TO MAKE IT. HE THEN DECIDED TO TRY TO LAND THE CHOPPER BETWEEN THE ROW. MAIE AID THE HELICOPTER CAME DOWN VERY FAT. HE AID THAT HE WA ONLY ABOUT FIVE FEET ABOVE THE TOP OF THE TREE WHEN IT CAME DOWN. MAIE AID THAT HE CAN ONLY GUE WHAT THE PROBLEM WA, THAT MAYBE A PROBLEM WITH THE MAGNITO OR TUFU30. HE AID THAT HE HAD JUT FILLED UP WITH FUEL AT VITA AIRFIELD APPROX. 45 MINUTE PRIOR TO THE ACCIDENT. MAIE AID THAT HOVERING OVER THE TREE REQUIRE THE HELICOPTER TO UE ALL OF IT POWER DUE TO THE TREE DEFLECTING AIR O THERE I VERY LITTLE LIFT GENERATED. ALO THERE I NO LIFT FROM AIR PEED. MAE ADVIED THAT NEITHER HE NOR HI PAENGER JAME BULERA WERE INJURED. I THEN POKE WITH JAME BULERA. JAME ALO AID THAT THEY WERE DRYING TREE IN THE ORCHARD AROUND 1330 HR WHEN MAE NOTICED A LO OF POWER. JAME AID THAT THEY WERE IN THE ORCHARD N D 7-8 ROW WHEN THE POWER LO OCCURRED AND MAIE TRIED TO TURN OUT TO GAIN PEED. HE AID MAIE WA TRYING TO MAKE IT TO THE VACANT FIELD JUT TO THE EAT OF THE ORCHARD BUT WA LOING POWER TO QUICKLY. JAME AID MAE THEN LANDED THE AIRCRAFT BETWEEN THE LAT TWO ROW OF TREE. I OBERVED THE AIRCRAFT BETWEEN THE ECOND AND THIRD ROW ON THE East ide OF THE ORCHARD. THE LANDING POD APPEARED TO BE CRUHED. ALO THE TAIL ECTION APPEARED TO BE BENT OR BROKEN, A WA THE REAR ROTOR ECTION. THE AIRCRAFT ROTOR HIT 7-8 TREE ON IT WAY DOWN, TEARING OFF LIMB AND LARGE BRANCHE. THERE DID NOT APPEAR TO BE ANY FUEL OR OIL LEAKING FROM THE AIRCRAFT. I THEN CONTACTED JOHN PRINGLE THE OWNER OF THE ORCHARD. PRINGLE ADVIED THAT MAIE AND HI AIRCRAFT HAD BEEN HIRED TO DRY OFF THE CHERRY TREE. HE AID THAT HE HAD BEEN RIDING IN THE AIRCRAFT APPROX. TWO HOUR BEFORE THE ACCIDENT AND DID NOT NOTICE ANY PROBLEM WITH IT. HE AID THAT HE OBERVED MAIE FUEL THE AIRCRAFT UP AT VITA FIELD APPROX. 45 MINUTE BEFORE THE ACCIDENT. THE NUMBER ON THE HELICOPTER I N AND MAIE ADVIED THAT IT I L ENTROM, MODEL F28C. THE ERIAL NUMBER I 366. MAIE DOT, FAA LICENE NUMBER I , IUED

4 GT. MOREY CONTACTED THE FAA AND ADVIED THEM OF THE ACCIDENT. EE ALO TATEMENT. END OF REPORT.

5 BENTON COUNTY HERIFF OFFICE TATEMENT FORM \ THE FOLLOWING TATEMENT I GIVEN TO THE BENTON COUNTY HERIFF OFFICE, WITHOUT ANY THREAT OR PROMIE AND I TRUE AND CORRECT TO THE BET OF MY KNOWLEDGE. CAE#

6 BENTON COUNTY HERIFF OFFICE TATEMENT FORM \. THE FOLLOWING TATEMENT I GIVEN TO THE BENTON COUNTY HERIFF OFFICE, WITHOUT ANY THREAT OR P ~ I EAND I TRUE AND CORRECT TO THE BET OF MY KNOWLEDGE. PAGE OF CAE#

7 AGENCY NAME NAME OF VICTIM() TYPE OF ORIGINAL REPORT ADDITIONAL NARRATIVE FOLLOW-UP Benton County heriff's Office b,wmf INCIDENT CLAIFICATION ADDL IBR CODE DATE PAGE / OF 3 INCIDENT NUMBER i A C A C A C A C A C RECLAIFY TO CONNECTING REPORT NUMBER TOTAL IF OVER 10 d?q$z*v?352z IR CLEARANCE I o/ FFICER NAME / NUMBER AREA OFFICER NAME / NUMBER ADMIN CLEARANCE DITRIBUTION ) ARR/A ( ) EXClA ( ) WARRANT ( ) CA ( ) CP ) ARR/J ( ) EXClJ ( ) UNF ( ) UPENDED ( ) P A ( ) DH ( ) 0 AREA ( ) H D EXCEPTIONAL: APPROVED BY DATA ENTRY

8 ADDITIONAL NARRATIVE / FOLLOW-UP PAGE OF 3 AGENCY NAME Benton County heriff s Office NAME OF VICTIM() TYPE OF ORIGINAL REPORT INCIDENT CLAIFICATION A;/xcwT /& c1-t INCIDENT NUMBER a9-/cu/ ADDL TOTAL IF IBR OVER 10 CODE A C A C A C A C A C DATE RECLAIFY TO CONNECTING REPORT NUMBER PROPERTY CHANGE: ACTION ADDITIONAL LO ACTION ADDITIONAL RECOVERED TOTAL RECOVERY ( ) COMPUTER UED REPORT DATE ( ) DRUG RELATED IFFICE NAME NUMBER a3zz- AREA OFFICER NAME / NUMBER AREA APPROVED BY o/ IR CLEARANCE ADMIN CLEARANCE ) ARR/A ( ) EXClA ( ) WARRANT ) ARR/J ( ) EXC/J ( ) UNF ( ) UPENDED DITRIBUTION ( ) H D ( CA ( ) CP ( ) JUV ( ) DET ()PA ( ) DH ( ) MH ( ) PAT EXCEPTIONAL: DATA ENTRY

9 ADDITIONAL NARRATIVE / FOLLOW-UP PAGE 3 OF 3. AGENCY NAME Benton County heriff s Office NAME OF VICTIM() TYPE OF ORIGINAL REPORT 4- INCIDE T CLAIFICATION INCIDENT NUMBER Go- 7a3/ ADDL TOTAL IF IBR OVER 10 CODE A C A C A C A C A C DATE RECLAIFY TO CONNECTING REPORT NUMBER PROPERTY CHANGE: ACTION ADDITIONAL LO ACTION ADDITIONAL RECOVERED TOTAL RECOVERY ( ) COMPUTER UED REPORT DATE ( ) DRUG RELATED s 9 V U I I ALCOHOLRELATED AREA OFFICER NAME / NUMBER AREA (7/ IBR CLEARANCE ADMIN CLEARANCE DITRIBUTION ( ) H D EXCEPTIONAL: ( ) ARR/A ( ) EXC/A ( ) WARRANT ( ) CA ( ) CP ( ) JUV ( ) ; ( ) ARR/J ( ) EXC/J ( ) UNF ( ) UPENDED ()PA ( ) DH ( ) MH ( ) APPROVED BY DATA ENTRY

10 BENTON COUNTY HERIFF OFFICE TATEMENT FORM THE FOLLOWING TATEMENT I GIVEN TO THE BENTON COUNTY HERIFF OFFICE, WITHOUT ANY THREAT OR PROMIE AND I TRUE AND CORRECT TO THE BET OF MY KNOWLEDGE. - / IGNE PAC E UI OF CAE# 0@-703/

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