U
N
I
T
1
|
Driver's Name - Last TREWIN |
First GARY |
Middle VIRGIL |
Suffix
|
City INDEPENDENCE |
State IA - Iowa, US |
Zip 506440000 |
Driver's Age 57 |
Citation Charge Code 1 321.218 |
Citation Charge 1 DRIVING WHILE SUSPENDED (NON-PYMT OF CHILD SUPPORT) |
Gender Male |
State IA - Iowa, US |
Class 0 - ID |
Endorsements None |
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 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2001 |
Make Dodge - DODG |
Model R25 |
Style PK |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 6 - Override, parked/stationary vehicle |
Total Occupants 4 |
Traffic Controls 01 - No controls present |
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 23 - Parked motor vehicle |
Second Event 03 - Ran off road, left |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 23 - Parked motor vehicle |
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?
|
U
N
I
T
2
|
Driver's Name - Last
|
First
|
Middle
|
Suffix
|
City
|
State
|
Zip
|
Driver's Age
|
Citation Charge Code 1
|
Citation Charge 1
|
Gender
|
State
|
Class
|
Endorsements None |
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
|
Injury Status
|
Occupant Protection
|
Airbag Deployment
|
Airbag Switch Status
|
Ejection
|
Ejection Path
|
Trapped
|
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2000 |
Make Honda - HOND |
Model CIVIC |
Style 2D |
Approximate Cost to Repair or Replace 6500 |
Initial Travel Direction 3 - South |
Vehicle Action 13 - Illegally Parked/unattended |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 2 - Underride, compartment intrusion |
Total Occupants 0 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 88 - Other (explain in narrative) |
Driver Condition 8 - Other (explain in narrative) |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 03 - Ran off road, left |
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) 01 - Clear |
Environment 7 - Previous accident |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 23 - Parked motor vehicle |
Manner of Crash/Collision 3 - Rear-end |
Roadway 07 - Obstruction in roadway |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last PARKS |
First JASON |
Middle LYNN |
Suffix
|
City
|
State
|
Zip Code
|
Age 22 |
Sex Male |
Unit No. 01 |
Seating Position 07 - Rear: Left Side |
Injury Status 3 - Non-incapacitating |
Occupant Protection 1 - None used |
Airbag Deployment 6 - Not applicable |
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:
|
Transported by:
|
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last LOVELL |
First BENJAMIN |
Middle RICHARD |
Suffix
|
City
|
State
|
Zip Code
|
Age 22 |
Sex Male |
Unit No. 1 |
Seating Position 03 - Front: Right Side |
Injury Status 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last BRIMMER |
First CHARLES |
Middle ELLIOTT |
Suffix
|
City
|
State
|
Zip Code
|
Age 24 |
Sex Male |
Unit No. 1 |
Seating Position 09 - Rear: Right Side |
Injury Status 3 - Non-incapacitating |
Occupant Protection 1 - None used |
Airbag Deployment 6 - Not applicable |
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: MERCY NORTH IOWA |
Transported by: FOREST CITY AMBULANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
| NARRATIVE |
UNTI 1 WAS SOUTHBOUND ON INTERSTATE 35. A VEHICLE WAS PARKED IN THE MIDDLE OF THE OUTSIDE LANE OF TRAFFIC DUE TO A PREVIOUS CAR VS. DEER ACCIDENT. THE OCCUPANTS OF THE PARKED CAR HAD EXITED THE VEHICLE AND WERE STANDING ON THE WEST SHOULDER. THERE WERE NO LIGHTS ON THE PARKED CAR. THE DRIVER OF UNIT 1 WAS UNABLE TO SEE THE VEHICLE AND REAR-ENDED IT. UNIT 1 RODE UP ON TOP OF THE VEHICLE, THEN PUSHED IT ACROSS THE SOUTHBOUND LANES AND ACROSS THE MEDIAN. THE VEHICLES CAME TO REST PARTIALLY IN THE OUTSIDE NORTHBOUND LANE, FACING EAST. THE FRONT END OF UNIT 1 WAS ON TOP OF THE OTHER VEHICLE. |
|
Officer
ALBRIGHT |
Badge No. 026 |
Time Officer Notified of Accident 01:25 |
Time Officer Arrived At Scene 01:34 |
Name of Agency P08 |
Date of Report 10/16/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381