Crash Information

L O C A T I O N	Date of Accident 8/18/2010	Time of Accident 11:33 PM	County Iowa - 48	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2010048779
	Literal Description SB/WB INTERSTATE 0080 AT THE 224.85				Legal Intervention? No	Private Property? No
					X-Coordinate: 590453.0
					Y-Coordinate 4615671.

U N I T 1	Driver's Name - Last MOORE			First KERI			Middle ANN		Suffix
	City GRAND RAPIDS			State MI - Michigan, US				Zip 49507
	Driver's Age 32					Citation Charge Code 1		Citation Charge 1
	Gender Female	State MI - Michigan, US	Class	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: NA					Transported by: NA
	Insurance Co. Name
	Year 2006		Make Dodge - DODG		Model MAGNUM		Style STATION WAGON		Approximate Cost to Repair or Replace 8500
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 70	Point of Initial Impact 07 - Left Side	Most Damaged Area 07 - Left Side	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 4	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 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?

U N I T 2	Driver's Name - Last MARTIN			First TROY			Middle MARTIN		Suffix
	City DANBURY			State IA - Iowa, US				Zip 510190000
	Driver's Age 38					Citation Charge Code 1 321.306		Citation Charge 1 UNSAFE LANE CHANGE
	Gender Male	State IA - Iowa, US	Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more	Endorsements	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: NA					Transported by: NA
	Insurance Co. Name CLOVERLEAF TRANSPORT CO
	Year 2001		Make		Model CONVENTIONAL		Style SEMI		Approximate Cost to Repair or Replace 3500
	Initial Travel Direction 4 - West	Vehicle Action 06 - Changing lanes	Speed Limit 70	Point of Initial Impact 02 - Right Front	Most Damaged Area 02 - Right Front	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 01 - No controls present	Vehicle Config. 09 - Tractor/semi-trailer	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 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 CLOVERLEAF TRANSPORT CO			City SIOUX CITY		State IA - Iowa, US			Zip 51111
	Number of Axles 5			Gross Vehicle Weight Rating 80000		Placard #			Hazardous Materials Released? 2 - No

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 6 - Sideswipe, same direction	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 5 - Dark, roadway not lighted	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
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S
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N

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J
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Name- Last
GILL

First
RONALD

Middle

Suffix

City

State

Zip Code

Age
46

Sex
Male

Unit No.
1

Seating Position
07 - Rear: Left Side

Injury Status
4 - Possible

Occupant Protection
1 - None 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:
MARENGO HOSPITAL

Transported by:
IOWA COUNTY PARAMEDICS

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
I
A
G
R
A
M

0

NARRATIVE

VEHICLE 1 WAS TRAVELING WEST ON I80 IN THE RIGHT LANE. THERE WAS A SEMI IN THE LEFT LANE ALSO TRAVELING WEST. THE SEMI BEGAN TO MERGE FROM THE LEFT LANE TO THE RIGHT LANE. CONTACT WAS MADE BETWEEN VEHICLE 1 AND THE SEMI VEHICLE 2. THE CONTACT WAS MADE AS THE SEMI ENTERED INTO THE ALREADY OCCUPIED RIGHT LANE.

Officer SNEDDEN	Badge No. 198	Time Officer Notified of Accident 23:35	Time Officer Arrived At Scene 23:55
Name of Agency P11	Date of Report 8/18/2010	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