Crash Information

L O C A T I O N	Date of Accident 8/31/2010	Time of Accident 10:00 AM	County Scott - 82	Accident occurred within corporate limits of (city) Davenport - 1827	Law Enforcement Case Number: 2010051245
	Literal Description 53RD ST AT CLEAN AMERICA PARKING LOT				Legal Intervention? No	Private Property? Yes
					X-Coordinate: 702101.8
					Y-Coordinate 4605356.

U N I T 1	Driver's Name - Last ERWIN			First BENJAMIN			Middle MICHAEL		Suffix
	City STOCKTON			State IA - Iowa, US				Zip 52769
	Driver's Age 28					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 N - Tank	Restrictions N - Non-resident CDL	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 2009		Make Ford - FORD		Model CROWN VICTORIA		Style 4D		Approximate Cost to Repair or Replace 1000
	Initial Travel Direction 1 - North	Vehicle Action 09 - Backing	Speed Limit 25	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 2 - Minor 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 23 - Parked motor vehicle	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle) 23 - Parked motor vehicle
	Emergency Vehicle Type 2 - Police					Emergency Status 2 - No, not in emergency
	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			First			Middle		Suffix
	City			State				Zip
	Driver's Age					Citation Charge Code 1		Citation Charge 1
	Gender	State	Class	Endorsements None	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given?			Drug Test Given?		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position	Injury Status	Occupant Protection		Airbag Deployment	Airbag Switch Status		Ejection	Ejection Path	Trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2002		Make Ford - FORD		Model F250		Style SIL		Approximate Cost to Repair or Replace 1200
	Initial Travel Direction 9 - Unknown	Vehicle Action 12 - Legally Parked	Speed Limit 25	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	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 1 - Apparently normal	Vision Obscured 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 23 - Parked motor vehicle	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle) 23 - Parked motor vehicle
	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) 23 - Parked motor vehicle
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 04 - Business drive	Workers Present?

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NARRATIVE

UNIT 1 WAS BACKING OUT OF A PARKING SPOT GOING NORTH. UNIT 2 WAS LEGALLY PARKED IN A PARKING SPOT NORTH OF UNIT 1. AS UNIT 1 BACKED UP HEADING NORTH THE REAR OF UNIT 1 STRUCK THE REAR OF UNIT 2.

Officer VOTROUBEK	Badge No. 375	Time Officer Notified of Accident 10:05	Time Officer Arrived At Scene 10:25
Name of Agency P12	Date of Report 8/31/2010	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504