Iowa State Patrol: Department of Public Safety

Crash Information

L
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C
A
T
I
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N 		Date of Accident
8/24/2010		 Time of Accident
07:50 AM 		County
Black Hawk - 07		 Accident occurred within corporate limits of (city)
Cedar Falls - 1185		 Law Enforcement Case Number:
2010049814
Literal Description
US 0020 / NE RAMP and HUDSON RD and Iowa 0058 and US 0020 / NW RAMP 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
543946.7
Y-Coordinate
4701712.
U
N
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T

1 		Driver's Name - Last
SILJKOVIC		 First
HASUDIN		 Middle
 Suffix
City
WATERLOO		 State
IA - Iowa, US		 Zip
507020000
Driver's Age
20		 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

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
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
2007		 Make
 Model
MAX		 Style
4D		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
4 - West		 Vehicle Action
10 - Slowing/stopping		 Speed Limit
45		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
04 - Stop 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
SIGWARTH		 First
PAUL JOSEPH		 Middle
 Suffix
City
DUBUQUE		 State
IA - Iowa, US		 Zip
520010000
Driver's Age
38		 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

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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2001		 Make
Lincoln - LINC		 Model
LS		 Style
4D		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
4 - West		 Vehicle Action
11 - Stopped for stop sign/signal		 Speed Limit
45		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
04 - Stop 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?
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)
03 - Cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
20 - Off-ramp		 Workers Present?
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NARRATIVE

VEHICLE 1 WAS COMING TO A STOP ON THE HWY 20 WESTBOUND EXIT RAMP, WHEN IT COLLIDED WITH THE REAR OF VEHICLE 2. V2 WAS STOPPED AT THE STOP SIGN ON THE EXIT RAMP WAITING TO TURN NORTHBOUND ONTO HUDSON ROAD.
Officer
FORSYTH 		Badge No.
116		 Time Officer Notified of Accident
08:10		 Time Officer Arrived At Scene
08:10
Name of Agency
P09		 Date of Report
8/24/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 09 Office
1510 W 1st St
Cedar Falls,IA 50613-1799
Phone: (319) 266-2677
Fax: (319) 266-2228