U
N
I
T
1
|
Driver's Name - Last STROUD |
First CLEO |
Middle EUGENE |
Suffix
|
City INDIANOLA |
State IA - Iowa, US |
Zip 501250000 |
Driver's Age 48 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class D - Chauffeur |
Endorsements 2 - Veh w/16001 GVWR or more, Not Vid for Trk-Trctr Semitrailer Comb |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: N-A |
Transported by: N-A |
Insurance Co. Name
|
Year 2004 |
Make Ford - FORD |
Model F-250 |
Style PICKUP |
Approximate Cost to Repair or Replace 7000 |
Initial Travel Direction 2 - East |
Vehicle Action 07 - Entering traffic lane (merging) |
Speed Limit 65 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 09 - Top |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 07 - Warning sign |
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 01 - Ran off road, right |
Second Event 11 - Overturn/rollover |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 11 - Overturn/rollover |
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?
|