Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
9/2/2010		 Time of Accident
11:07 AM 		County
Shelby - 83		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010051727
Literal Description
CO. ROAD M-16 .1 MILE SOUTH OF 2200TH ST. 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
298852.7
Y-Coordinate
4632441.
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1 		Driver's Name - Last
HELKENN		 First
TIMOTHY		 Middle
AUGUST		 Suffix
City
SCHLESWIG		 State
IA - Iowa, US		 Zip
514614045
Driver's Age
49		 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
P - Pass		 Restrictions

L - Veh w/o Airbrakes		 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
2 - Incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
3 - Deployed both front/side		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
2 - Freed by non-mechanical means
Transported to:
MYRTUE HOSPITAL - HARLAN		 Transported by:
EARLING RESCUE
Insurance Co. Name
Year
2004		 Make
Ford - FORD		 Model
F250		 Style
PU		 Approximate Cost to Repair or Replace
20000
Initial Travel Direction
1 - North		 Vehicle Action
88 - Other (explain in narrative)		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 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
5 - Asleep, fainted, fatigued, etc		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
04 - Crossed centerline/median		 Second Event
06 - Evasive action (swerve, panic braking, etc.)		 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
KAUFMAN		 First
MARCUS		 Middle
WALTER		 Suffix
City
EARLING		 State
IA - Iowa, US		 Zip
51530
Driver's Age
60		 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

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
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
MYRTUE HOSPITAL - HARLAN		 Transported by:
EARLING RESCUE
Insurance Co. Name
Year
1997		 Make
Dodge - DODG		 Model
R25		 Style
PU		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
02		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
21 - Vehicle in traffic		 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)
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
2 - Head-on		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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D 		Name- Last
KAUFMAN		 First
MARK		 Middle
ANTHONY		 Suffix
2ND
City
 State
 Zip Code
Age
36		 Sex
Male		 Unit No.
2		 Seating Position
03 - Front: Right Side		 Injury Status
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
9 - Unknown		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
MYRTUE HOSPITAL		 Transported by:
EARLING RESCUE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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NARRATIVE

VEHICLE ONE WAS TRAVELLING NORTHBOUND ON M16. PRIOR TO 2200TH STREET VEHICLE ONE ENTERED THE SOUTHBOUND LANE OF THE ROAD AND STRUCK VEHICLE 2 HEAD ON. VEHICLE 1 CAME TO REST IN THE EAST DITCH. VEHICLE 2 CAME TO REST IN THE MIDDLE OF THE ROADWAY. THE ROADWAY WAS MARKED AS A NO PASSING ZONE.
Officer
POLLARD 		Badge No.
335		 Time Officer Notified of Accident
11:07		 Time Officer Arrived At Scene
11:25
Name of Agency
P04		 Date of Report
9/2/2010		 Investigation made at scene?
 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