U
N
I
T
1
|
Driver's Name - Last DARNALL |
First JAY |
Middle A |
Suffix
|
City EUSTIS |
State NE - Nebraska, US |
Zip 69028 |
Driver's Age 52 |
Citation Charge Code 1 321.297 |
Citation Charge 1 DRIVING ON WRONG SIDE OF TWO WAY HIGHWAY/OVER CENTERLIN |
Gender Male |
State NE - Nebraska, US |
Class
|
Endorsements
|
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 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: REFUSED |
Transported by: REFUSED |
Insurance Co. Name
|
Year 2008 |
Make Dodge - DODG |
Model SPRINTER |
Style VAN |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 05 - Single-unit truck (2-axle, 6-tires) |
Cargo Body Type 02 - Van/enclosed box |
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 04 - Crossed centerline/median |
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 MURILLO |
First STACY |
Middle ANN |
Suffix
|
City TOLEDO |
State IA - Iowa, US |
Zip 523420000 |
Driver's Age 33 |
Citation Charge Code 1 321.20B-B |
Citation Charge 1 VIOLATION - FINANCIAL LIABILITY - ACCIDENT |
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
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 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: GUTHRIE CENTER HOSPITAL ER |
Transported by: GUTHRIE CENTER AMBULANCE |
Insurance Co. Name
|
Year 2001 |
Make Dodge - DODG |
Model INT |
Style 4D |
Approximate Cost to Repair or Replace 4000 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 04 |
Traffic Controls 01 - No controls present |
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 04 - Crossed centerline/median |
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?
|
| 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 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 7 - Sideswipe, opposite direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 12 - T - intersection |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last MURILLO |
First DIEGO |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 13 |
Sex Male |
Unit No. 02 |
Seating Position 09 - Rear: Right Side |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 4 - Other deployment (explain in narrative) |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: GUTHRIE CENTER HOSPITAL ER |
Transported by: GUTHRIE CENTER RESCUE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
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Name- Last MURILLO |
First SOPHIA |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 7 |
Sex Female |
Unit No. 02 |
Seating Position 07 - Rear: Left Side |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 4 - Other deployment (explain in narrative) |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: GUTHRIE CENTER HOSPITAL ER |
Transported by: GUTHRIE CENTER RESCUE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last ALVAREZ |
First JOSE |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 22 |
Sex Male |
Unit No. 02 |
Seating Position 03 - Front: Right Side |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: GUTHRIE CENTER HOSPITAL ER |
Transported by: GUTHRIE CENTER RESCUE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
| NARRATIVE |
Unit 1 westbound Highway 44 approaching Poplar Avenue. Unit 1 crossed centerline after looking at incoming cell phone call. Unit 2 took evasive action due to unit 1 in her lane. Unit 2 traveled into westbound lane. Unit 1 took evasive action traveling back into westbound lane. Unit 1 and Unit 2 collided in westbound lane. Unit 2 was struck in right rear door area. Unit 2 spun, entering ditch backward. Unit 1 traveled back into eastbound lane, then came to rest on westbound shoulder. Unit 1 and Unit 2 sustained disabling damage. |
|
Officer
PAULSEN |
Badge No. 148 |
Time Officer Notified of Accident 12:09 |
Time Officer Arrived At Scene 12:10 |
Name of Agency P04 |
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 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325