U
N
I
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2
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Driver's Name - Last THORNGREN |
First ETHAN |
Middle
|
Suffix
|
City ROCKFORD |
State IA - Iowa, US |
Zip 50468 |
Driver's Age 19 |
Citation Charge Code 1 321.279 |
Citation Charge 1 ELUDING |
Gender Male |
State IA - Iowa, US |
Class 0 - ID |
Endorsements None |
Restrictions
None |
Citation Charge Code 2 321.277 |
Citation Charge 2 RECKLESS DRIVING |
Alcohol Test Given? 2 - Blood |
Drug Test Given?
|
Citation Charge Code 3 321J.2 |
Citation Charge 3 DRIVING WHILE REVOKED |
Citation Charge Code 4 321J.2 |
Citation Charge 4
|
Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 5 - Uninjured |
Occupant Protection 9 - Unknown |
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: MERCY |
Transported by: MASON CITY FIRE DEPT |
Insurance Co. Name
|
Year 2009 |
Make Chevrolet - CHEV |
Model EXPRESS G1500 |
Style VAN |
Approximate Cost to Repair or Replace 4000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 45 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 11 - Workzone signs |
Vehicle Config. 03 - Van or mini-van |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 2 - Physical impairment |
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
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State
|
Zip
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Number of Axles
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Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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