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N
I
T
1
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Driver's Name - Last LOPEZ |
First CILAS |
Middle N |
Suffix
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City OMAHA |
State NE - Nebraska, US |
Zip 68107 |
Driver's Age 33 |
Citation Charge Code 1 321.288 |
Citation Charge 1 FAIL TO MAINTAIN CONTROL |
Gender Male |
State OT - Other, OT |
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 2 321.174 |
Citation Charge 2 FAILURE TO HAVE VALID LICENSE/PERMIT WHILE OPER. MOTOR |
Alcohol Test Given? 4 - Breath |
Drug Test Given? 1 - None |
Citation Charge Code 3
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Citation Charge 3
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Citation Charge Code 4
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Citation Charge 4
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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
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Trapped 1 - Not trapped |
Transported to:
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Transported by:
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Insurance Co. Name
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Year 1992 |
Make Honda - HOND |
Model ACCORD |
Style 4DR |
Approximate Cost to Repair or Replace 1500 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
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 02 |
Traffic Controls 06 - No Passing Zone (marked) |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 5 - Asleep, fainted, fatigued, etc |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
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| SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
Second Event 33 - Ditch/embankment |
Third Event
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Fourth Event
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Most Harmful Event (by vehicle) 33 - Ditch/embankment |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
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City
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State
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Zip
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Number of Axles
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Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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