Iowa State Patrol: Department of Public Safety
Minimal Crash Report:

 Case Number:  2018029260  Type:  Personal Injury  County:  17
 Crash Date:  20181113  Time:  1155
 Location:  14833 GROUSE AVE
 
 Vehicle 1 Year:  2004  Make:  FORD  Type:  EXPEDITION
 Towed By:  HAPPY TRAILS
 Driver Name:  SHAFFER,KEVIN WALTER  Age:  47
 City & State of Residence:  MASON CITY IOWA
 
 Vehicle 2 Year:  2015  Make:  CHEV  Type:  EQUINOX
 Towed By:  HAPPY TRAILS
 Driver Name:  TRACY,TIMOTHY JOSEPH  Age:  64
 City & State of Residence:  SWALEDALE IOWA
 
 Vehicle 3 Year:     Make:     Type:   
 Towed By:   
 Driver Name:     Age:   
 City & State of Residence:   
 
 Injury 1 Type:  Injured
 Name:  SHAFFER,KEVIN WALTER  Age:  47
 City & State of Residence:  MASON CITY IOWA
 Seatbelt Use:     Life saved by Seatbelt:   
 Transported To:  MERCY MEDICAL  Transported By:  NORTH IOWA
 
 Injury 2 Type:  Injured
 Name:  TRACY,TIMOTHY JOSEPH  Age:  64
 City & State of Residence:  SWALEDALE IOWA
 Seatbelt Use:  Yes  Life saved by Seatbelt:   
 Transported To:  MERCY MEDICAL  Transported By:  NORTH IOWA
 
 Injury 3 Type:  Injured
 Name:  PEUVION,DENNIS  Age:  56
 City & State of Residence:  CLEAR LAKE IOWA
 Seatbelt Use:  Yes  Life saved by Seatbelt:   
 Transported To:  MERCY MEDICAL  Transported By:  NORTH IOWA
 
 Injury 4 Type:   
 Name:     Age:   
 City & State of Residence:   
 Seatbelt Use:     Life saved by Seatbelt:   
 Transported To:     Transported By:   
 
 Injury 5 Type:   
 Name:     Age:   
 City & State of Residence:   
 Seatbelt Use:     Life saved by Seatbelt:   
 Transported To:     Transported By:   
 
 Injury 6 Type:   
 Name:     Age:   
 City & State of Residence:   
 Seatbelt Use:     Life saved by Seatbelt:   
 Transported To:     Transported By:   
 
 Motor Carrier Info (IF Large truck is involved)
 Name of Carrier:   
 DOT or MCC #:   
 City & State of Carrier:     Hazmat Involved?:   
 
 Summary:  
    VEH NUMBER ONE WAS TRAVELING NORTH ON GROUSE AVE CROSSED THE CENTER LINE
AND STRUCK VEH NUMBER TWO THAT WAS SOUTH BOUND ON GROUSE AVE ASSISTED BY
CERRO GORDO SHERIFF OFFICE CLEAR LAKE POLICE DEPT CLEAR LAKE FIRE DEPT
MASON CITY FIRE DEPT MERCY AIR MED AND HAPPY TRAILS TOWING
OFFICER NAME: IOWA STATE PATROL TROOPER EMORY OCHOA 249 . POST: 08
 
 Officer Name:  IOWA STATE PATROL TROOPER EMORY OCHOA 249  Post:  08
 Assisted By:  SEE SUMMARY


Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381