# STC SA04621NY

- Type: Supplemental type certificate
- Status: Current, Issued
- Holder: Lake Central Air Services, Canada
- Description: Installation of the LCA01917 Exhaust System
- Applied: March 30, 2021
- Status date: April 8, 2021
- Product: Aircraft, Small Airplane
- Certification basis: Part 21, Part 23
- Data sheets: [TCDS 1A13](https://openairdocs.org/tcds/1A13)
- Certificate PDF: https://openairdocs.org/files/sha256/a2/2b/a22b1fbcabf8c7c6df14f43ad37f1b8f04149dcc7cedd6c0f4cac1b7582ba956
- FAA DRS: https://drs.faa.gov/browse/excelExternalWindow/2D5699DEAD7536BB862586BE007C3A07.0001
- DRS record last changed: December 6, 2025
- Page: https://openairdocs.org/stc/SA04621NY

## ADs that name it (0)

None.

## Approved models (1)

- REVO Incorporated Lake Model 250 ([TCDS 1A13](https://openairdocs.org/tcds/1A13))

## What the certificate says

Read from the PDF's text layer, without the form's printed wording; the layout is lost and the order can differ. The PDF is the record.

FAA Form 8110-2 (11/20) SUPERSEDES PREVIOUS EDITION Page 1 of ___ United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate Number:

IMPORT SA04621NY Lake Central Air Services Muskoka Airport R.R. 1 Gravenhurst, Ontario Canada P1P 1R1 Part 23 Title 14 Code of Federal Regulations 1A13 Revo, Incorporated LAKE MODEL 250

1. Installation of the LCA01917 Exhaust System must be in accordance with Lake Central Air Service Installation Instruction LCA01917-CD-2 R-0, Rev. 0, Transport Canada Civil Aviation (TCCA) approved June 24, 2014, or later TCCA approved revisions.

(See Description of Type Design Change Continued on Page 3 of 3)

1. If the holder agrees to permit another person to use this certificate to alter a product, the holder must give the other person written evidence of that permission.

(See Limitations and Conditions Continued on Page 3 of 3) March 30, 2021 April 8, 2021 Timothy J. Hadsall Acting Manager, New York ACO Branch Compliance & Airworthiness Division Aircraft Certification Service 3

FAA Form 8110-2 (11/20) SUPERSEDES PREVIOUS EDITION Page 2 of ___ United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate Number:

**IMPORT SA04621NY SA04621NY 3**

FAA Form 8110-2 (11/20) SUPERSEDES PREVIOUS EDITION Page ___ of ___ United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number:

IMPORT SA04621NY Date of Issuance: April 8, 2021

Description of Type Design Change (continued):

2. Maintenance must be in accordance with Lake Central Air Service Maintenance Manual Supplement LCA01917-CD R-0, Rev. 0, TCCA accepted June 26, 2014, or later TCCA accepted revisions.

2. The installer must determine whether this design change is compatible with previously approved modifications.

3. This STC is applicable to all serial numbers for this Make-Model.

----------END---------- 3 3

## Every issue (1)

- April 8, 2021: Issued, Current. [certificate](https://openairdocs.org/files/sha256/a2/2b/a22b1fbcabf8c7c6df14f43ad37f1b8f04149dcc7cedd6c0f4cac1b7582ba956)

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