U
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I
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1
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Driver's Name - Last PINKERTON |
First TIMOTHY |
Middle RAY |
Suffix
|
City PLEASANTVILLE |
State IA - Iowa, US |
Zip 50225 |
Driver's Age 48 |
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
|
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 1 - None 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: MERCY HOSPITAL |
Transported by: SALIX FIRE AND RESCUE |
Insurance Co. Name
|
Year 1999 |
Make
|
Model
|
Style MC |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
Vehicle Config. 14 - Motorcycle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 04 - Blowout |
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 09 - Equipment failure (tires, brakes, etc.) |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 09 - Equipment failure (tires, brakes, etc.) |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
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Hazardous Materials Released?
|