Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
9/25/2010		 Time of Accident
02:59 PM 		County
Poweshiek - 79		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010055838
Literal Description
SB/WB Interstate 0080 measuring 843 Feet West from US 0063 / US 63 and Interstate 0080 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
536996.5
Y-Coordinate
4616183.
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1 		Driver's Name - Last
CARHOFF		 First
NATHAN		 Middle
EDWARD		 Suffix
City
ANKENY		 State
IA - Iowa, US		 Zip
500230000
Driver's Age
28		 Citation Charge Code 1
321.314		 Citation Charge 1
UNSAFE TURN OR FAIL TO GIVE SIGNAL
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
 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
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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2008		 Make
Chevrolet - CHEV		 Model
MAL		 Style
4D		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
4 - West		 Vehicle Action
06 - Changing lanes		 Speed Limit
70		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
02		 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
88 - Other (explain in narrative)		 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?
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2 		Driver's Name - Last
GEURTS		 First
TRENT		 Middle
LEE		 Suffix
City
KNOXVILLE		 State
IA - Iowa, US		 Zip
501380000
Driver's Age
21		 Citation Charge Code 1
321.20B-B		 Citation Charge 1
VIOLATION - FINANCIAL LIABILITY - ACCIDENT
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

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
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
NA		 Transported by:
NA
Insurance Co. Name
Year
2001		 Make
Chrysler - CHRY		 Model
SEB		 Style
2D		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 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
02		 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
21 - Vehicle in traffic		 Second Event
 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)
06 - Rain		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
6 - Sideswipe, same direction		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
2		 Type of Roadway Junction/Feature
02 - Bridge/overpass/underpass		 Workers Present?
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NARRATIVE

UNIT 1TRAVELING WESTBOUND I-80 IN THE LEFT LANE. UNIT 2 TRAVELING WESTBOUND I-80 IN THE RIGHT LANE. UNIT 1TOOK EVASIVE ACTION TO AVOID SLOWER TRAFFIC IN THE LEFT LANE AND ATTEMPTED TO CHANGE LANES. UNIT 1 STRUCK UNIT 2 WHILE ATTEMPTING TO CHANGE LANES.
Officer
WILLIAMS 		Badge No.
206		 Time Officer Notified of Accident
15:03		 Time Officer Arrived At Scene
15:08
Name of Agency
P11		 Date of Report
9/25/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327