U
N
I
T
1
|
Driver's Name - Last REED |
First DORIS |
Middle EFFIE |
Suffix
|
City DAVIS CITY |
State IA - Iowa, US |
Zip 500650000 |
Driver's Age 36 |
Citation Charge Code 1 321.98 |
Citation Charge 1 IMPROPER REGISTRATION |
Gender Female |
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 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
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2003 |
Make Ford - FORD |
Model EPD |
Style SW |
Approximate Cost to Repair or Replace 500 |
Initial Travel Direction 1 - North |
Vehicle Action 09 - Backing |
Speed Limit 5 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
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?
|
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 2008 |
Make Ford - FORD |
Model CVC |
Style 4D |
Approximate Cost to Repair or Replace 1155 |
Initial Travel Direction 3 - South |
Vehicle Action 12 - Legally Parked |
Speed Limit 5 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right 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?
|
| ACCIDENT ENVIRONMENT |
ROADWAY CHARACTERISTICS Major Contributing Circumstances: |
WORKZONE RELATED? |
SEQUENCE OF EVENTS |
Location of First Harmful Event 6 - Outside Trafficway |
Weather Conditions (up to two) 02 - Partly cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 23 - Parked motor vehicle |
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 04 - Business drive |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
**** EXPLAIN THE VEHICLE ACTION FOR UNIT 002 UNIT TWO WAS LEGALLY PARKED IN THE KUM AND GO PARKING LOT AT LAMONI. UNIT ONE CONDUCTING A BACKING MANEUVER FROM HER SPOT IN THE PARKING LOT SIDE SWIPED UNIT TWO. UNIT TWO SUSTAINED DAMAGE TO THE BACK PASSENGER SIDE DOOR AND THE RIGHT REAR QUARTER PANEL RESULTING IN MINOR DAMAGE. UNIT ONE SUSTAINED MINOR DAMAGE TO THE DRIVERS FRONT BUMPER. |
|
Officer
WILLIAMS |
Badge No. 464 |
Time Officer Notified of Accident 14:04 |
Time Officer Arrived At Scene 14:04 |
Name of Agency P02 |
Date of Report 9/13/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653