FACTUAL REPORT AVIATION

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1 Aircraft Registration Number: N25787 Occurrence Date: Occurrence Type: 09/25/2003 Accident Most Critical Injury: Fatal Investigated By: NTSB Location/Time Nearest City/Place Three Oaks Zip Code Local Time Time Zone MI EDT Airport Proximity: Off Airport/Airstrip Aircraft Information Summary Aircraft Manufacturer Cessna Distance From Landing Facility: 0.25 Model/Series 52 Direction From Airport: 45 Type of Aircraft Airplane Sightseeing Flight: No Air Medical Transport Flight: Narrative Brief narrative statement of facts, conditions and circumstances pertinent to the accident/incident: HISTORY OF FLIGHT No On September 25, 2003, about 645 eastern daylight time, a Cessna 52, N25787, piloted by a private pilot, was destroyed when it impacted trees and terrain after takeoff from a private airstrip near Three Oaks, Michigan. The personal flight was operating under 4 CFR Part 9. Visual meteorological conditions prevailed at the time of the accident. No flight plan was on file. The flight was originating at the time of the accident. A witness stated: My brother, [the pilot], took off from the airstrip in the back of his property for a short flight to "buzz" us and fly over the house. The day was beautiful, sunny, scattered clouds, but gusty. We had attempted an outdoor lunch a few hours previously but went inside due to the wind and the chill when the sun went behind the clouds. The take-off appeared and sounded normal to my other brother and I standing at the house end of the airstrip watching him go. The plane banked to the right and approximately halfway into the turn the nose of the plane pointed straight down so that for /2 a second the entire plane was visible just above the far treeline with top (roof) of the plane and the wingspan facing us squarely. It fell straight down disappearing into the neighboring cornfield followed immediately by a small crash sound and then silence. PERSONNEL INFORMATION The pilot held a private pilot certificate for single engine land airplanes. He reported 600 hours of total flight experience on his most recent application for an FAA third class medical certificate, which was issued on September 23, He reported that he accumulated 0 hours of flight time in the six months prior to that application. That medical certificate had a limitation that the pilot "must wear corrective lenses." The pilot recorded hours of total flight time in his logbook. The pilot reported on his insurance renewal application that his last flight review was on January 5, AIRCRAFT INFORMATION N25787, a 978-model Cessna 52, serial number , was a high wing, propeller-driven, fixed landing gear, semi-monocoque design, two-seat airplane. The airplane was powered by a four cylinder, air cooled, horizontally opposed, normally aspirated, 0 horsepower, serial number L-560-5, Lycoming O-235-L2C engine. The airplane was equipped with a McCauley, 2-blade, - Page

2 Occurrence Date: Occurrence Type: 09/25/2003 Accident Narrative (Continued) all-metal, fixed pitch propeller, model number A03/TCM6958M, serial number TA020. The last annual inspection recorded in the airplane's maintenance logbooks was dated July 9, That entry showed the airplane had 4,83 hours of total time. METEOROLOGICAL INFORMATION At 654, the recorded South Bend Regional Airport, near South Bend, Indiana, located about 5 miles and 5 degrees from the accident site, weather was: Wind 290 degrees at 9 knots, variable between 250 and 30 degrees; visibility 0 statute miles; sky condition few 3,800 feet; temperature 3 degrees C; dew point 4 degrees C; altimeter inches of mercury. At 653, the recorded Southwest Michigan Regional Airport, near Benton Harbor, Michigan, located about 8 miles and 030 degrees from the accident site, weather was: Wind variable at 6 knots; visibility 0 statute miles; sky condition few 3,200 feet; temperature 3 degrees C; dew point 6 degrees C; altimeter inches of mercury. At 653, the recorded Porter County Municipal Airport, near Valparaiso, Indiana, located about 30 miles and 25 degrees from the accident site weather was: Wind 220 degrees at 5 knots; visibility 0 statute miles; sky condition clear; temperature 5 degrees C; dew point 4 degrees C; altimeter inches of mercury. WRECKAGE AND IMPACT INFORMATION The airplane was found about 200 feet east of a northbound runway at a private airstrip. The wreckage was located at the base of a tree at latitude 4 degrees minutes N and longitude 86 degrees W. The tree's bark revealed scrapes above the wreckage. A section of the right wing's lower skin was found wrapped around the tree. The aileron bell crank was found in that section of skin with its cabling intact. The left wing's leading edge exhibited a semicircular shaped crush rearward. The apex of that crush was about the inboard section of the left wing. Both wing flaps were found retracted and the flap selector was at zero degrees. The empennage was deformed and displaced to the left and was found with the left wing resting on it. The propeller was found detached from the engine's crankshaft flange. Fuel was found in the left wing fuel tank. The right tank was found ruptured. An on-scene investigation was conducted. Control continuity was established from the cockpit controls to each flight control surface. Control continuity was established from the cockpit controls to the engine. The engine's crankshaft could be rotated by hand and the engine produced a thumb compression at each cylinder. Both magnetos produced a spark at the end of each spark plug lead as the engine's crankshaft was rotated. The propeller exhibited chordwise scratches on the outboard section of one of its blades. The other blade was found with a forward bend. The carburetor's drain plug was removed and a blue colored liquid that smelled like avgas exited the drain. No contamination was observed in the blue liquid. No anomalies were detected with the airplane and engine. MEDICAL AND PATHOLOGICAL INFORMATION An autopsy was performed on the pilot by the Berrien County Medical Examiners Office. The FAA Civil Aeromedical Institute prepared a Final Forensic Toxicology Accident Report. The report was negative for the tests performed. - Page a

3 Narrative (Continued) ADDITIONAL INFORMATION The parties to the investigation included the FAA and Cessna Aircraft Company. The aircraft wreckage was released to a representative of the insurance company. - Page b

4 Landing Facility/Approach Information Airport Name Airport ID: Airport Elevation Runway Used Runway Length Runway Width 628 Ft. MSL NA Runway Surface Type: Grass/turf Runway Surface Condition: Dry Type Instrument Approach: NONE VFR Approach/Landing: Aircraft Information Aircraft Manufacturer Cessna Model/Series 52 Serial Number Airworthiness Certificate(s): Normal Landing Gear Type: Tricycle Homebuilt Aircraft? No Number of Seats: 2 Certified Max Gross Wt. 670 LBS Number of Engines: Engine Type: Reciprocating Engine Manufacturer: Lycoming Model/Series: O-235-L2C Rated Power: 0 HP - Aircraft Inspection Information Type of Last Inspection Date of Last Inspection Time Since Last Inspection Airframe Total Time Annual 07/2003 Hours 483 Hours - Emergency Locator Transmitter (ELT) Information ELT Installed? Yes ELT Operated? No ELT Aided in Locating Accident Site? No Owner/Operator Information Registered Aircraft Owner Peter W. Souchuk Operator of Aircraft Same as Reg'd Aircraft Owner Street Address 2200 W. North Avenue City Chicago Street Address Same as Reg'd Aircraft Owner City IL Zip Code 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 2

5 First Pilot Information Name City Date of Birth Age 49 Sex: M Seat Occupied: Left Principal Profession: Unknown Certificate Number: Certificate(s): Private Airplane Rating(s): Single-engine Land Rotorcraft/Glider/LTA: Instrument Rating(s): Instructor Rating(s): Type Rating/Endorsement for Accident/Incident Aircraft? Current Biennial Flight Review? 0/2002 Medical Cert.: Class 3 Medical Cert. Status: Valid Medical--w/ waivers/lim. Date of Last Medical Exam: 09/ Flight Time Matrix All A/C This Make and Model Airplane Single Engine Airplane Mult-Engine Night Actual Instrument Simulated Rotorcraft Glider Lighter Than Air Total Time 600 Pilot In Command(PIC) Instructor Last 90 Days Last 30 Days Last 24 Hours Seatbelt Used? Yes Shoulder Harness Used? Yes Toxicology Performed? Yes Second Pilot? No Flight Plan/Itinerary Type of Flight Plan Filed: Departure Point Airport Identifier Departure Time Time Zone Same as Accident/Incident Location 645 Destination Airport Identifier Local Flight Type of Clearance: Type of Airspace: Class G Weather Information Source of Briefing: No record of briefing Method of Briefing: Unknown - Page 3

6 Weather Information WOF ID Observation Time Time Zone WOF Elevation WOF Distance From Accident Site Direction From Accident Site SBN 654 EDT 799 Ft. MSL 5 NM 5 Deg. Mag. Sky/Lowest Cloud Condition: Clear Ft. AGL Condition of Light: Day Lowest Ceiling: Ft. AGL Visibility: 0 SM Altimeter: "Hg Temperature: 3 C Dew Point: 4 C Wind Direction: 290 Density Altitude: Ft. Wind Speed: 9 Gusts: Weather Condtions at Accident Site: Visual Conditions Visibility (RVR): Ft. Visibility (RVV) SM Intensity of Precipitation: Restrictions to Visibility: Type of Precipitation: Accident Information Aircraft Damage: Destroyed 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 Passengers - TOTAL ABOARD - Other Ground - GRAND TOTAL - Fatal Serious Minor TOTAL - Page 4

7 Administrative Information Investigator-In-Charge (IIC) Edward F. Malinowski Additional Persons Participating in This Accident/Incident Investigation: Robert Helbing Inspector Federal Aviation Administration 843 Commerce Drive, Suite 200 South Bend, IN Emile Lohman Air Safety Investigator Cessna Aircraft Company P.O. Box 7704 Wichita, KS Gregory Erikson Air Safety Investigator Textron Lycoming 6N038 Chambellan, Box 783 Wayne, IL Page 5

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