Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
8/25/2010		 Time of Accident
09:56 PM 		County
Crawford - 24		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010050190
Literal Description
2997 350TH STREET, NORTH OF HWY 141 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
318455.4
Y-Coordinate
4643502.
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1 		Driver's Name - Last
FOREMAN		 First
THOMAS		 Middle
ELDON		 Suffix
City
MANILLA		 State
IA - Iowa, US		 Zip
51454
Driver's Age
57		 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?
2 - Blood		 Drug Test Given?
2 - Blood		 Citation Charge Code 3
 Citation Charge 3
Citation Charge Code 4
 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
1 - Fatal		 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
3 - Extricated by mechanical means
Transported to:
ST LUKE'S HOSPITAL		 Transported by:
MANILLA AMBULANCE
Insurance Co. Name
Year
1989		 Make
Buick - BUIC		 Model
SKYHAWK		 Style
2DR		 Approximate Cost to Repair or Replace
500
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
50		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
2 - Underride, compartment intrusion
Total Occupants
01		 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
06 - Hillcrest		 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?
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2 		Driver's Name - Last
LALLY		 First
JAMES		 Middle
PATRICK		 Suffix
City
VAIL		 State
IA - Iowa, US		 Zip
51465
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
 Restrictions

S - SR Required		 Citation Charge Code 2
 Citation Charge 2
Alcohol Test Given?
2 - Blood		 Drug Test Given?
 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
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:
DENISON HOSPITAL		 Transported by:
MANILLA AMBULANCE
Insurance Co. Name
Year
2009		 Make
Chevrolet - CHEV		 Model
SILVERADO		 Style
K1500		 Approximate Cost to Repair or Replace
30000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
50		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
5 - Override, moving vehicle
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
02 - Four-tire light truck (pick-up, panel)		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
6 - Under the influence of alcohol/drugs/medications		 Vision Obscured
06 - Hillcrest		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
21 - Vehicle in traffic		 Second Event
11 - Overturn/rollover		 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
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
2 - Head-on		 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?
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NARRATIVE

V1 WAS SOUTHBOUND ON 350TH STREET. V2 WAS NORTHBOUND ON 350TH STREET. THE VEHICLES MET AT THE CREST OF THE HILL AND STRUCK HEAD-ON. V2 ROLLED ONTO ITS TOP AND CAME TO REST IN THE EAST DITCH. V1 WAS FORCED REARWARD AND CAME TO REST. THE DRIVER OF V1 WAS KILLED IN THE COLLISION.
Officer
OLESEN 		Badge No.
486		 Time Officer Notified of Accident
21:17		 Time Officer Arrived At Scene
23:15
Name of Agency
P04		 Date of Report
8/26/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325