U
N
I
T
1
|
Driver's Name - Last ROBERTS |
First GEORGE |
Middle FRANKS |
Suffix 4TH |
City MOORESVILLE |
State MO - Missouri, US |
Zip 64664 |
Driver's Age 46 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MO - Missouri, US |
Class
|
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 1988 |
Make
|
Model TK |
Style DS |
Approximate Cost to Repair or Replace 0 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 99 - Unknown |
Most Damaged Area 99 - Unknown |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 07 - Truck/trailer |
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 42 - Other fixed object (explain in narrative) |
Second Event
|
Third Event
|
Fourth Event 42 - Other fixed object (explain in narrative) |
Most Harmful Event (by vehicle) 42 - Other fixed object (explain in narrative) |
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 KAUFFMAN |
First JASON |
Middle CRAWFORD |
Suffix
|
City WEBSTER CITY |
State IA - Iowa, US |
Zip 505950000 |
Driver's Age 42 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
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 1993 |
Make Honda - HOND |
Model CIV |
Style 4D |
Approximate Cost to Repair or Replace 1500 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 10 - Under Carriage |
Most Damaged Area 10 - Under Carriage |
Extent of Damage 4 - Disabling damage |
Underride/Override 2 - Underride, compartment intrusion |
Total Occupants 2 |
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 42 - Other fixed object (explain in narrative) |
Second Event
|
Third Event
|
Fourth Event 42 - Other fixed object (explain in narrative) |
Most Harmful Event (by vehicle) 42 - Other fixed object (explain in narrative) |
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) 42 - Other fixed object (explain in narrative) |
Manner of Crash/Collision 1 - Non-collision |
Roadway 03 - Debris |
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 WESTBOUND ON HWY 20 WHEN IT LOST ITS BATTERY COVER. VEHICLE #2 WAS WESTBOUND AND STRUCK THE BATTERY COVER OFF OF VEHICLE #1. THE BATTERY COVER CAUSED DAMAGE TO THE UNDERCARRIAGE OF VEHICLE #2. |
|
Officer
IRWIN |
Badge No. 276 |
Time Officer Notified of Accident 18:45 |
Time Officer Arrived At Scene 18:55 |
Name of Agency P07 |
Date of Report 9/7/2010 |
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