U
N
I
T
1
|
Driver's Name - Last SMITH |
First JENNA |
Middle RAE |
Suffix
|
City IOWA CITY |
State IA - Iowa, US |
Zip 522400000 |
Driver's Age 20 |
Citation Charge Code 1
|
Citation Charge 1 FAILURE TO STOP WITHIN THE ASSURED CLEAR DISTANCE |
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 2 321.288 |
Citation Charge 2 FAIL TO MAINTAIN CONTROL |
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 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2001 |
Make Pontiac - PONT |
Model GRM |
Style 2D |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 88 - Other control (explain in narrative) |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 06 - Evasive action (swerve, panic braking, etc.) |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
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?
|
U
N
I
T
2
|
Driver's Name - Last CUTLER |
First JOY |
Middle KAY |
Suffix
|
City BALDWIN |
State MI - Michigan, US |
Zip 493048543 |
Driver's Age 69 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State MI - Michigan, US |
Class
|
Endorsements None |
Restrictions
C - Mechanical Aid |
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 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2007 |
Make Chevrolet - CHEV |
Model IMPALA |
Style 4DR |
Approximate Cost to Repair or Replace 4000 |
Initial Travel Direction 4 - West |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 04 |
Traffic Controls 88 - Other control (explain in narrative) |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
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 1 - On Roadway |
Weather Conditions (up to two) 01 - Clear |
Environment 7 - Previous accident |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last MUNSON |
First CONNIE |
Middle LYNN |
Suffix
|
City
|
State
|
Zip Code
|
Age 44 |
Sex Female |
Unit No. 2 |
Seating Position 07 - Rear: Left Side |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: REFUSED TREATMENT |
Transported by:
|
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
| NARRATIVE |
TRAFFIC ON I-80 WB MM 269.5 WAS SLOWING/STOPPING FOR AN ACCIDENT ON THE CEDAR RIVER BRIDGE. VEHICLE #1 BRAKED HARD TO STOP BUT IMPACTED THE REAR OF #2 WHICH WAS ALREADY STOPPED IN THE INSIDE LANE. |
|
Officer
HELTON |
Badge No. 203 |
Time Officer Notified of Accident 18:10 |
Time Officer Arrived At Scene 18:20 |
Name of Agency P12 |
Date of Report 8/1/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504