Crash Information

L O C A T I O N	Date of Accident 8/19/2010	Time of Accident 01:20 PM	County Webster - 94	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2010048895
	Literal Description US 0169 / US 169 N OF C66				Legal Intervention? No	Private Property? No
					X-Coordinate: 399126.7
					Y-Coordinate 4715952.

U N I T 1	Driver's Name - Last BOERTJE			First RODGER			Middle RAYMOND		Suffix
	City PRAIRIE CITY			State IA - Iowa, US				Zip 502280000
	Driver's Age 84					Citation Charge Code 1 321.288		Citation Charge 1 FAIL TO MAINTAIN CONTROL
	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 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 1 - Deployed front of person	Airbag Switch Status 3 - No ON/OFF switch present		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: TRINITY REGIONAL					Transported by: TRH AMBULANCE
	Insurance Co. Name
	Year 1998		Make Buick - BUIC		Model PRK		Style 4D		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 3 - Underride, no compartment intrusion
	Total Occupants 02	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	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 MOORE			First JOHNN			Middle		Suffix
	City FORT DODGE			State IA - Iowa, US				Zip 505010000
	Driver's Age 41					Citation Charge Code 1		Citation Charge 1
	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 3 - No ON/OFF switch present		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2011		Make		Model SOR		Style 4D		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 1 - North	Vehicle Action 10 - Slowing/stopping	Speed Limit 55	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 4 - Disabling damage	Underride/Override 5 - Override, moving vehicle
	Total Occupants 01	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	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 4 - Within or adjacent to work activity	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 01 - Clear	Roadway 05 - Work Zone (construction, maintenance, utility)	Type 1 - Lane Closure
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present? Yes

P
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J
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Name- Last
BOERTJE

First
THELMA

Middle
LORIETTA

Suffix

City

State

Zip Code

Age
83

Sex
Female

Unit No.
01

Seating Position
03 - Front: Right Side

Injury Status
2 - Incapacitating

Occupant Protection
2 - Shoulder and lap belt used

Airbag Deployment
1 - Deployed front of person

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:
TRINITY REGIONAL

Transported by:
CLARE AMBULANCE

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 2 NORTHBOUND SLOWED, AND STOPPED BEHIND STOPPED CAR FOR ROAD CONSTRUCTION LANE CLOSURE. UNIT 1 NORTHBOUND FAILS TO SLOW AND STOP AND COLLIDED INTO REAR END OF UNIT 2 PUSHING IT FORWARD. NO CONTACT MADE WITH NON CONTACT VEHICLE.

Officer MORENZ	Badge No. 230	Time Officer Notified of Accident 13:25	Time Officer Arrived At Scene 13:29
Name of Agency P07	Date of Report 8/13/2010	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