U
N
I
T
1
|
Driver's Name - Last CUMMINS |
First RICHARD |
Middle P |
Suffix
|
City SAN DIEGO |
State CA - California, US |
Zip 92104 |
Driver's Age 67 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State CA - California, US |
Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat |
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:
|
Transported by:
|
Insurance Co. Name
|
Year 2010 |
Make Chevrolet - CHEV |
Model COBALT |
Style 4D |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 3 - South |
Vehicle Action 05 - Overtaking/passing |
Speed Limit 55 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
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 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 EVANS |
First DOUGLAS |
Middle ROBERT |
Suffix
|
City NUNICA |
State MI - Michigan, US |
Zip 494489676 |
Driver's Age 41 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MI - Michigan, 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 6 - Not applicable |
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 BIG DOUG DELIVERY LLC |
Year 2000 |
Make Volvo - VOLV |
Model CONV |
Style TT |
Approximate Cost to Repair or Replace 0 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 01 |
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 BIG DOUG DELIVERY LLC |
City NUNICA |
State MI - Michigan, US |
Zip 49448 |
Number of Axles 5 |
Gross Vehicle Weight Rating 117827 |
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) 02 - Partly cloudy |
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 |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
VEHICLE 1 WAS TRAVELING SOUTHBOUND AND BEGAN TO PASS VEHICLE #2, WHICH WAS ALSO SOUTHBOUND ON HWY 38. DRIVER #1 DECIDED NOT TO PASS AND ATTEMPTED TO GET BACK BEHIND VEHICLE #2. AS DRIVER #1 WAS CHANGING LANES, VEHICLE #1 STRUCK VEHICLE #2. VEHICLE #1 CAME TO REST ON THE EAST SHOULDER AND VEHICLE #2 CAME TO REST ON THE WEST SHOULDER. |
|
Officer
ENGSTLER |
Badge No. 306 |
Time Officer Notified of Accident 14:19 |
Time Officer Arrived At Scene 14:21 |
Name of Agency P15 |
Date of Report 9/2/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 15 Office
5912 NW 2nd Ave
Des Moines,IA 50313-
Phone: (515) 281-6176
Fax: (515) 289-1066