| Type of Event | Accident |
| Event Date | 10/6/2012 |
| Event Day of the Week | Saturday |
| Time of Event | 839 |
| Event Time Zone | Eastern Daylight Time |
| Event City | Lyman |
| Event State | MAINE |
| Event Country | -- |
| Zipcode of the event site | 04002 |
| Event Date Year | 2012 |
| Event Date Month | 10 |
| MidAir Collision Indicator | No |
| On Ground Collision occurred ? | No |
| Event Location Latitude | 432950N |
| Event Location Longitude | 0703811W |
| Event Location Airport | -- |
| Event Location Nearest Airport ID | -- |
| Indicates whether the acc/inc occurred off or on an airport | Off Airport/Airstrip |
| Distance from airport in statute miles | -- |
| Degrees magnetic from airport | -- |
| Airport Elevation | -- |
| Weather Briefing Completeness | -- |
| Investigator's weather source | Weather Observation Facility |
| Time of the weather observation | 835 Eastern Daylight Time |
| Direction of event from weather observation facility (degrees) | 230 |
| Weather Observation Facility ID | SFM |
| Elevation of weather observation facility | 244 |
| Distance of event from weather observation facility (units?) | 6 |
| Time Zone of the weather observation | EDT |
| Lighting Conditions | Day |
| Lowest Ceiling Height | -- |
| Lowest Non-Ceiling Height | -- |
| Sky/Lowest/Cloud Conditions | Clear |
| Sky Condition for Lowest Ceiling | None |
| Visibility Runway Visual Range (Feet) | -- |
| Visibility Runway Visual Value (Statute Miles) | -- |
| Visibility (Statute Miles) | 8 |
| Air Temperature at event time (in degrees celsius) | 16 |
| Dew Point at event time (in degress fahrenheit) | 13 |
| Wind Direction (degrees magnetic) | 210 |
| Variable Wind Indicator | Wind direction could be determined |
| Wind Speed (knots) | 5 |
| Wind Velocity Indicator | -- |
| Wind Gust Indicator | Not Gusting |
| Wind Gust (knots) | -- |
| Altimeter Setting at event time (in. Hg) | 29.79 |
| Density Altitude (feet) | -- |
| Intensity of Precipitation | -- |
| METAR weather report | KSFM 061235Z AUTO 21005KT 8SM CLR 16/13 A2979 RMK |
| Event Highest Injury | Minor |
| On Ground, Fatal Injuries | -- |
| On Ground, Minor Injuries | -- |
| On Ground, Serious Injuries | -- |
| Injury Total Fatal | -- |
| Injury Total Minor | 2 |
| Injury Total None | -- |
| Injury Total Serious | -- |
| Injury Total All | 2 |
| Investigating Agency | NTSB |
| NTSB Docket Number (internal use) | 30969 |
| NTSB Notification Source | FAA NEROC |
| NTSB Notification Date | -- |
| NTSB Notification Time | -- |
| Fiche Number and/or location -used to find docket information | -- |
| Date of most recent change to record | Feb 1 2013 1:58PM |
| User who most recently changed record | gots |
| Basic weather conditions | Visual Meteorological Cond |
| FAA District Office | -- |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | N3073X |
| NTSB Number | ERA13CA010 |
| Missing Aircraft Indicator | -- |
| Federal Aviation Reg. Part | Part 91: General Aviation |
| Type of Flight Plan filed | None |
| Flight plan Was Activated? | No |
| Damage | Substantial |
| Aircraft Fire | None |
| Aircraft Explosion | None |
| Aircraft Manufacturer's Full Name | MOULTON HOWARD WELLS |
| Aircraft Model | ULTRA-PUP |
| Aircraft Series Identifier | -- |
| Aircraft Serial Number | 01 |
| Certified Max Gross Weight | 1000 |
| Aircraft Category | Airplane |
| Aircraft Registration Class | -- |
| Aircraft is a homebuilt? | Yes |
| Flight Crew Seats | -- |
| Cabin Crew Seats | -- |
| Passenger Seats | -- |
| Total number of seats on the aircraft | 2 |
| Number of Engines | 1 |
| Fixed gear or retractable gear | Fixed |
| Aircraft, Type of Last Inspection | Conditional |
| Date of Last Inspection | Nov 4 2011 12:00AM |
| Airframe hours since last inspection | -- |
| Airframe Hours | 100 |
| ELT Installed | Yes |
| ELT Activated | No |
| ELT Aided Location of Event Site | No |
| ELT Type | C91-A |
| Aircraft Owner Name | MOULTON HOWARD WELLS |
| Aircraft Owner Street Address | 282 HALEY RD |
| Aircraft Owner City | KITTERY |
| Aircraft Owner State | ME |
| Aircraft Owner Country | USA |
| Aircraft Owner Zipcode | 03904-5405 |
| Operator is an individual? | Yes |
| Operator Name | MOULTON HOWARD WELLS |
| Operator Same as Owner? | Yes |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | Yes |
| Operator Street Address | 282 HALEY RD |
| Operator City | KITTERY |
| Operator State | ME |
| Operator Country | USA |
| Operator Zip code | 03904-5405 |
| Operator Code | -- |
| Owner has at least one certificate | None |
| Other Operator of large aircraft? | No |
| Certified for Part 133 or 137 Operation | -- |
| Operator Certificate Number | -- |
| Indicates whether an air carrier operation was scheduled or not | -- |
| Indicates Domestic or International Flight | -- |
| Operator carrying Pax/Cargo/Mail | -- |
| Type of Flying (Per_Bus / Primary) | Personal |
| Second Pilot on Board | No |
| Departure Point Same as Event | No |
| Departure Airport Code | 3B4 |
| Departure City | Eliot |
| Departure State | ME |
| Departure Country | USA |
| Departure Time | 830 |
| Departure Time Zone | EDT |
| Destination Same as Local Flt | -- |
| Destination Airport Code | IWI |
| Destination City | Wiscasset |
| Destination State | ME |
| Destination Country | USA |
| Specific Phase of Flight | -- |
| Report sent to ICAO? | -- |
| Evacuation occurred | -- |
| Date of most recent change to record | Feb 1 2013 1:59PM |
| User who most recently changed record | gots |
| Since inspection or accident | Time of Accident |
| Event Location Runway Number and Location | N/A |
| Runway Length | -- |
| Runway Width | -- |
| Sight Seeing flight | No |
| Air Medical Flight | No |
| Medical Flight | -- |