Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
9/14/2010		 Time of Accident
10:57 AM 		County
Jasper - 50		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010053866
Literal Description
NB/EB INTERSTATE 0080 @177.05 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
513706.8
Y-Coordinate
4615945.
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1 		Driver's Name - Last
HINSHAW		 First
TERRY		 Middle
LAWRENCE		 Suffix
City
KELLOGG		 State
IA - Iowa, US		 Zip
50135
Driver's Age
55		 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
5 - Uninjured		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
Year
2000		 Make
Ford - FORD		 Model
F15		 Style
PK		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
3 - Functional 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
13 - Other non-collision		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
13 - Other non-collision
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
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2 		Driver's Name - Last
HOFER		 First
CHARLES		 Middle
NICHOLAS		 Suffix
City
BAXTER		 State
IA - Iowa, US		 Zip
500280000
Driver's Age
79		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
N - Tank		 Restrictions

B - Cor Lenses		 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
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
Year
1998		 Make
 Model
T/T		 Style
SEMI		 Approximate Cost to Repair or Replace
300
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
99 - Unknown		 Most Damaged Area
07 - Left Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
09 - Tractor/semi-trailer		 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
09 - Equipment failure (tires, brakes, etc.)		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
09 - Equipment failure (tires, brakes, etc.)
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)
13 - Other non-collision
Manner of Crash/Collision
1 - Non-collision		 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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0
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1
NARRATIVE

VEHICLE #2 WAS TRAVELING WEST BOUND IN THE OUT SIDE LANE. THE REAR LEFT TRAILER TIRE CAME LOOSE AND ENTERED THE MEDIAN. VEHICLE #1 WAS TRAVELING EAST BOUND IN THE OUT SIDE LANE. VEHICLE #1 ATTEMPTED TO VEAR TO THE RIGHT, BUT WAS STRUCK BY THE TRAILER TIRE.
Officer
AARHUS 		Badge No.
058		 Time Officer Notified of Accident
10:58		 Time Officer Arrived At Scene
11:20
Name of Agency
P01		 Date of Report
9/14/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011