Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
8/15/2010		 Time of Accident
03:05 PM 		County
Hamilton - 40		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010048143
Literal Description
SB/WB Interstate 0035 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
453075.8
Y-Coordinate
4696330.
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1 		Driver's Name - Last
PAULSEN		 First
DARREL		 Middle
LEE		 Suffix
City
CHEROKEE		 State
IA - Iowa, US		 Zip
510120000
Driver's Age
66		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
Gender
Male		 State
IA - Iowa, US		 Class
D - Chauffeur		 Endorsements
1 - Trk - Trctr Semi-Trailer Comb		 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
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
1990		 Make
Ford - FORD		 Model
F25		 Style
PK		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
3 - South		 Vehicle Action
10 - Slowing/stopping		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
11 - Workzone signs		 Vehicle Config.
07 - Truck/trailer		 Cargo Body Type
09 - Other truck cargo type (explain in narrative)		 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
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2 		Driver's Name - Last
GAYDO		 First
JENNIFER		 Middle
JO		 Suffix
City
CHEROKEE		 State
IA - Iowa, US		 Zip
510120000
Driver's Age
43		 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
 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
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2005		 Make
Cadillac - CADI		 Model
ESC		 Style
SW		 Approximate Cost to Repair or Replace
7000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
3		 Traffic Controls
11 - Workzone signs		 Vehicle Config.
04 - Sport utility vehicle		 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
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3 		Driver's Name - Last
TATE		 First
GREGORY		 Middle
JOHN PAUL		 Suffix
City
AMES		 State
IA - Iowa, US		 Zip
50014
Driver's Age
31		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 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
3 - Non-incapacitating		 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:
HAMILTON CO HOSPITAL		 Transported by:
AMBULANCE
Insurance Co. Name
Year
2006		 Make
Chrysler - CHRY		 Model
SEB		 Style
4D		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
11 - Workzone signs		 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?
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
3 - Within transition area for lane shift		 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end		 Roadway
05 - Work Zone (construction, maintenance, utility)		 Type
1 - Lane Closure
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
22 - Other intersection		 Workers Present?
No
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D 		Name- Last
PAULSEN		 First
SUSAN		 Middle
ANN		 Suffix
City
 State
 Zip Code
Age
66		 Sex
Female		 Unit No.
1		 Seating Position
03 - Front: Right Side		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
 Transported by:
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
GAYDO		 First
TIMOTHY		 Middle
PAUL		 Suffix
City
 State
 Zip Code
Age
51		 Sex
Male		 Unit No.
2		 Seating Position
03 - Front: Right Side		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 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:
 Transported by:
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
GAYDO		 First
BAILEY		 Middle
PATRICIA		 Suffix
City
 State
 Zip Code
Age
12		 Sex
Female		 Unit No.
2		 Seating Position
08 - Rear: Center		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
 Transported by:
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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NARRATIVE

VEHICLE ONE REAR ENDED VEHICLE TWO. VEHICLE TWO TOOK EVASIVE ACTION AND MOVED LEFT. VEHICLE ONE CONTINUED ON TO REAR END VEHICLE 3 BEFORE COMING TO A STOP. VEHICLE ONE WAS PULLING A LIFE STOCK DUAL AX IL TRAILER
Officer
SALDIVAR 		Badge No.
281		 Time Officer Notified of Accident
15:13		 Time Officer Arrived At Scene
15:21
Name of Agency
P07		 Date of Report
8/15/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218