U
N
I
T
1
|
Driver's Name - Last BUEHLOW |
First RAYMOND |
Middle J |
Suffix
|
City KINCARDINE |
State ON - Ontario, CA |
Zip N2Z1Y1 |
Driver's Age 58 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State ON - Ontario, CA |
Class D - Chauffeur |
Endorsements None |
Restrictions
None |
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 4 - Possible |
Occupant Protection 6 - Helmet used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 4 - Not applicable (motorcycle, bicycle, etc.) |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2010 |
Make
|
Model FLH |
Style M/C |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 14 - Motorcycle |
Cargo Body Type 10 - Small utility (one axle) |
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 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 21 - Vehicle in traffic |
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 ONSRUD |
First PAUL |
Middle O |
Suffix
|
City LA CROSSE |
State WI - Wisconsin, US |
Zip 54601 |
Driver's Age 78 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State WI - Wisconsin, US |
Class D - Chauffeur |
Endorsements None |
Restrictions
None |
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 2003 |
Make Dodge - DODG |
Model
|
Style P-U |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 2 - East |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 12 - Boat |
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) 02 - Partly cloudy |
Environment 1 - None apparent |
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?
|
D I A G R A M
0 |
|
| NARRATIVE |
UNIT 1 WAS TRAVELING IN THE LEFT EB LANE ON I-80. UNIT 2 WAS TRAVELING IN THE LEFT EB LANE AHEAD OF UNIT 1. UNIT 2'S DRIVER APPLIED HIS BRAKES FOR STOPPED TRAFFIC AHEAD. UNIT 1'S DRIVER APPLIED HIS BRAKES TO AVOID UNIT 2. UNIT 1 SLID INTO UNIT 2'S BACK END. |
|
Officer
HICKS |
Badge No. 207 |
Time Officer Notified of Accident 14:03 |
Time Officer Arrived At Scene 14:10 |
Name of Agency P11 |
Date of Report 8/5/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327