U
N
I
T
1
|
Driver's Name - Last MOENNING |
First DERALD |
Middle E |
Suffix
|
City NORFOLK |
State NE - Nebraska, US |
Zip 68701 |
Driver's Age 53 |
Citation Charge Code 1 321.288 |
Citation Charge 1 FAIL TO MAINTAIN CONTROL |
Gender Male |
State NE - Nebraska, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
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 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 D E MOENNING & SONS |
Year 2002 |
Make
|
Model CENTURY |
Style SEMI |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 11 - Workzone signs |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
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 02 - Ran off road, straight |
Second Event 36 - Concrete barrier (median or right side) |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 36 - Concrete barrier (median or right side) |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name D E MOENNING & SONS |
City NORFOLK |
State NE - Nebraska, US |
Zip 68701 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 2 - No |
U
N
I
T
2
|
Driver's Name - Last ZOOK |
First THERESA |
Middle MICHELLE |
Suffix
|
City PAPILLION |
State NE - Nebraska, US |
Zip 68046 |
Driver's Age 31 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State MO - Missouri, US |
Class
|
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 4 - Possible |
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: JENNY EDMUNDSON |
Transported by: PACIFIC JUNCTION RESCUE |
Insurance Co. Name
|
Year 2010 |
Make Chevrolet - CHEV |
Model MALIBU |
Style 4 DOOR |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 02 |
Traffic Controls 11 - Workzone signs |
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 26 - Other non-fixed object (explain in narrative) |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 26 - Other non-fixed object (explain in narrative) |
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?
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged 3 CONCRETE BARRIERS |
Estimate of Damage 3000 |
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name ROAD SAFE |
City DES MOINES |
State IA - Iowa, US |
Zip
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged 15 SAFETY BARRELS |
Estimate of Damage 2500 |
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name ROAD SAFE |
City DES MOINES |
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) 05 - Mist |
Environment 1 - None apparent |
Location 4 - Within or adjacent to work activity |
First Harmful Event of Crash (use codes 11-42 only) 36 - Concrete barrier (median or right side) |
Manner of Crash/Collision 1 - Non-collision |
Roadway 01 - None apparent |
Type 2 - Lane shift/crossover (head-to-head traffic) |
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 2 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present? No |
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last HENDERSHOT |
First ANNA |
Middle E |
Suffix
|
City
|
State
|
Zip Code
|
Age 57 |
Sex Female |
Unit No. 02 |
Seating Position 03 - Front: Right Side |
Injury Status 4 - Possible |
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 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: JENNY EDMUNDSON |
Transported by: PACIFIC JUNCTION RESCUE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
| NARRATIVE |
VEHICLE #1 WAS TRAVELING SB ON I-29 IN THE HEAD TO HEAD CONSTRUCTION ZONE AND WAS APPROACHING THE MERGE AREA TO TAKE THE VEHICLE OUT OF THE HEAD TO HEAD TRAFFIC. VEHICLE #1 FAILED TO MERGE, RAN OFF THE ROAD, AND COLLIDED INTO 15 SAND FILLED SAFETY BARRELS AS WELL AS 3 CONCRETE BARRIERS. VEHICLE #2 WAS TRAVELING NB ON I-29 AT THE SAME LOCATION AND WAS STRUCK BY ONE OF THE BARRELS. VEHICLE #1 CAME TO A REST FACING SB AND IN THE NB LANE. VEHICLE #2 CAME TO A REST FACING NB ON THE NB SHOULDER. |
|
Officer
BEENEN |
Badge No. 066 |
Time Officer Notified of Accident 23:05 |
Time Officer Arrived At Scene 23:25 |
Name of Agency P03 |
Date of Report 10/10/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504