Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
9/12/2010		 Time of Accident
12:35 PM 		County
Wapello - 90		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010053446
Literal Description
17405 30TH STREET 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
542604.9
Y-Coordinate
4530909.
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1 		Driver's Name - Last
HARNISCH		 First
NICOLE		 Middle
ELISE		 Suffix
City
BLAKESBURG		 State
IA - Iowa, US		 Zip
525360000
Driver's Age
16		 Citation Charge Code 1
 Citation Charge 1
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

Y - Intermediate License		 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
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:
 Transported by:
Insurance Co. Name
Year
2001		 Make
Mercury - MERC		 Model
MTN		 Style
SW		 Approximate Cost to Repair or Replace
6000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
09 - Top		 Extent of Damage
5 - Severe, vehicle totaled		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
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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Y

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If Property other than vehicles damaged explain Object Damaged
FENCE		 Estimate of Damage
200
Owner's Name - Last
BRANDT		 First
DON		 Middle
 Suffix
Owner Company Name
City
BLAKESBURG		 State
IA - Iowa, US		 Zip
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)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
04 - Ruts, holes, bumps		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEH #1 WAS EASTBOUND ON 30TH STREET WHEN IT STRUCK SOME POT HOLES IN THE ROADWAY. DRIVER VEH #1 LOST CONTROL LEAVING THE ROADWAY AND COMING TO REST IN A CREEK BED.
Officer
RUPE 		Badge No.
211		 Time Officer Notified of Accident
12:41		 Time Officer Arrived At Scene
13:21
Name of Agency
P13		 Date of Report
9/12/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743