Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
9/27/2009		 Time of Accident
01:28 PM 		County
Winneshiek - 96		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2009056402
Literal Description
A034 / POLE LINE RD measuring 3456 Feet East from W014 / CO RD W14 and A034 / POLE LINE RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
583003.9
Y-Coordinate
4802504.
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1 		Driver's Name - Last
LATHAM		 First
MACKENZIE		 Middle
ELIZABETH		 Suffix
City
MASON CITY		 State
IA - Iowa, US		 Zip
504010000
Driver's Age
20		 Citation Charge Code 1
 Citation Charge 1
Gender
Female		 State
IA - Iowa, US		 Class
C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat		 Endorsements
None		 Restrictions

B - Cor Lenses		 Citation Charge Code 2
 Citation Charge 2
Alcohol Test Given?
1 - None		 Drug Test Given?
1 - None		 Citation Charge Code 3
 Citation Charge 3
Citation Charge Code 4
 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
5 - Uninjured		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
NA		 Transported by:
NA
Insurance Co. Name
Year
2002		 Make
Chrysler - CHRY		 Model
SEB		 Style
CV		 Approximate Cost to Repair or Replace
12000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
04 - Right Rear		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
07 - Warning sign		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
06 - Hillcrest		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
01 - Ran off road, right		 Second Event
03 - Ran off road, left		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
Emergency Vehicle Type
1 - Not applicable		 Emergency Status
3 - Not Applicable
Carrier Name
 City
 State
 Zip
Number of Axles
 Gross Vehicle Weight Rating
 Placard #
 Hazardous Materials Released?
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
4 - Roadside		 Weather Conditions (up to two)
02 - Partly cloudy		 Environment
6 - Animal in roadway		 Location
 First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
05 - Farm/residential drive		 Workers Present?
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NARRATIVE

VEHICLE 1 WAS WEST BOUND ON A-34. A DOG RAN OUT IN FRONT OF VEHICLE 1. VEHICLE 1 SWERVED TO MISS THE DOG, LOST CONTROL AND ENTERED THE SOUTH DITCH AND ROLLED OVER. VEHICLE 1 CAME TO REST ON ITS WHEELS.
Officer
RUDE 		Badge No.
369		 Time Officer Notified of Accident
13:28		 Time Officer Arrived At Scene
13:42
Name of Agency
P10		 Date of Report
9/27/2009		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046