| Type of Event | Accident |
| Event Date | 9/12/2004 |
| Event Day of the Week | Sunday |
| Time of Event | 1306 |
| Event Time Zone | Eastern Daylight Time |
| Event City | Seneca |
| Event State | NEW YORK |
| Event Country | -- |
| Zipcode of the event site | 14547 |
| Event Date Year | 2004 |
| Event Date Month | 9 |
| MidAir Collision Indicator | No |
| On Ground Collision occurred ? | No |
| Event Location Latitude | 425304N |
| Event Location Longitude | 0770408W |
| Event Location Airport | Penn Yan |
| Event Location Nearest Airport ID | PEO |
| Indicates whether the acc/inc occurred off or on an airport | Off Airport/Airstrip |
| Distance from airport in statute miles | 16 |
| Degrees magnetic from airport | 216 |
| Airport Elevation | 990 |
| Weather Briefing Completeness | Not pertinent |
| Investigator's weather source | Weather Observation Facility |
| Time of the weather observation | 1253 Eastern Daylight Time |
| Direction of event from weather observation facility (degrees) | 216 |
| Weather Observation Facility ID | POE |
| Elevation of weather observation facility | 990 |
| Distance of event from weather observation facility (units?) | 16 |
| 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) | 10 |
| Air Temperature at event time (in degrees celsius) | 23 |
| Dew Point at event time (in degress fahrenheit) | 16 |
| Wind Direction (degrees magnetic) | 250 |
| Variable Wind Indicator | Wind direction could be determined |
| Wind Speed (knots) | 7 |
| Wind Velocity Indicator | -- |
| Wind Gust Indicator | Not Gusting |
| Wind Gust (knots) | -- |
| Altimeter Setting at event time (in. Hg) | 30.18 |
| Density Altitude (feet) | 2067 |
| Intensity of Precipitation | -- |
| METAR weather report | -- |
| Event Highest Injury | Fatal |
| On Ground, Fatal Injuries | -- |
| On Ground, Minor Injuries | -- |
| On Ground, Serious Injuries | -- |
| Injury Total Fatal | 1 |
| Injury Total Minor | -- |
| Injury Total None | -- |
| Injury Total Serious | -- |
| Injury Total All | 1 |
| Investigating Agency | NTSB |
| NTSB Docket Number (internal use) | 17311 |
| NTSB Notification Source | FAA Eastern Region |
| NTSB Notification Date | Sep 12 2004 12:00AM |
| NTSB Notification Time | 1420 |
| Fiche Number and/or location -used to find docket information | DMS |
| Date of most recent change to record | Feb 24 2005 9:13AM |
| User who most recently changed record | NTSB\JOHB |
| Basic weather conditions | Visual Meteorological Cond |
| FAA District Office | Rochester, NY |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | N195CB |
| NTSB Number | IAD04LA046 |
| Missing Aircraft Indicator | -- |
| Federal Aviation Reg. Part | Part 91: General Aviation |
| Type of Flight Plan filed | None |
| Flight plan Was Activated? | No |
| Damage | Destroyed |
| Aircraft Fire | Ground |
| Aircraft Explosion | Ground |
| Aircraft Manufacturer's Full Name | Scott |
| Aircraft Model | Rans S-12 |
| Aircraft Series Identifier | -- |
| Aircraft Serial Number | 0894512 |
| Certified Max Gross Weight | 1100 |
| Aircraft Category | Airplane |
| Aircraft Registration Class | U.S. Registered/U.S. Soil |
| 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 | Annual |
| Date of Last Inspection | -- |
| Airframe hours since last inspection | -- |
| Airframe Hours | -- |
| ELT Installed | No |
| ELT Activated | No |
| ELT Aided Location of Event Site | No |
| ELT Type | -- |
| Aircraft Owner Name | Todd A. Jones |
| Aircraft Owner Street Address | -- |
| Aircraft Owner City | Clifton Springs |
| Aircraft Owner State | NY |
| Aircraft Owner Country | USA |
| Aircraft Owner Zipcode | 14432 |
| Operator is an individual? | No |
| Operator Name | -- |
| Operator Same as Owner? | Yes |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | Yes |
| Operator Street Address | -- |
| Operator City | -- |
| Operator State | -- |
| Operator Country | -- |
| Operator Zip code | -- |
| Operator Code | -- |
| Owner has at least one certificate | None |
| Other Operator of large aircraft? | -- |
| 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 | NONE |
| Departure City | Clifton Springs |
| Departure State | NY |
| Departure Country | USA |
| Departure Time | 1300 |
| Departure Time Zone | EDT |
| Destination Same as Local Flt | dest & departure same, accident can occur anywhere |
| Destination Airport Code | -- |
| Destination City | -- |
| Destination State | -- |
| Destination Country | -- |
| Specific Phase of Flight | Maneuvering |
| Report sent to ICAO? | No |
| Evacuation occurred | No |
| Date of most recent change to record | -- |
| User who most recently changed record | -- |
| Since inspection or accident | -- |
| Event Location Runway Number and Location | NA |
| Runway Length | -- |
| Runway Width | -- |
| Sight Seeing flight | No |
| Air Medical Flight | No |
| Medical Flight | -- |