Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
10/10/2010		 Time of Accident
03:36 PM 		County
Winneshiek - 96		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010058510
Literal Description
A052 / OLD STAGE RD and 138TH AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
607681.3
Y-Coordinate
4793995.
U
N
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1 		Driver's Name - Last
SAYSIRISANH		 First
PASAMITH		 Middle
 Suffix
City
MASON CITY		 State
IA - Iowa, US		 Zip
504010000
Driver's Age
30		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE TO HAVE CONTROL
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?
4 - Breath		 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
6 - Helmet 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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2007		 Make
 Model
 Style
MC		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
07 - Warning sign		 Vehicle Config.
14 - Motorcycle		 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
03 - Ran off road, left		 Second Event
33 - Ditch/embankment		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
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
4 - Roadside		 Weather Conditions (up to two)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
12 - T - intersection		 Workers Present?
D
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M

0
NARRATIVE

VEHICLE 1 WAS EAST BOUND ON COUNTY ROAD A-52. VEHICLE 1 FAILED TO MAKE THE CURVE AND ENTERED THE NORTH DITCH. VEHICLE 1 CAME TO REST IN THE NORTH DITCH.
Officer
RUDE 		Badge No.
369		 Time Officer Notified of Accident
15:36		 Time Officer Arrived At Scene
15:47
Name of Agency
P10		 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 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046