Crash Information

L O C A T I O N	Date of Accident 10/12/2010	Time of Accident 12:40 PM	County Marion - 63	Accident occurred within corporate limits of (city) Pella - 5947	Law Enforcement Case Number: 2010058765
	Literal Description MAIN ST measuring 83 Meters South from MAIN ST and LINCOLN ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 506985.0
					Y-Coordinate 4584271.

U N I T 1	Driver's Name - Last BOONE			First JOSHUA			Middle KEITH		Suffix
	City PELLA			State IA - Iowa, US				Zip 502190000
	Driver's Age 23					Citation Charge Code 1		Citation Charge 1
	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 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 5 - Not deployed	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 2008		Make Ford - FORD		Model ECP		Style SW		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 25	Point of Initial Impact 02 - Right Front	Most Damaged Area 02 - Right Front	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 02	Traffic Controls 01 - No controls present	Vehicle Config. 04 - Sport utility vehicle	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 1 - Apparently normal	Vision Obscured 07 - Parked vehicles	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 20 - Non-motorist (see non-motorist type)	Second Event 06 - Evasive action (swerve, panic braking, etc.)	Third Event	Fourth Event	Most Harmful Event (by vehicle) 20 - Non-motorist (see non-motorist type)
	Emergency Vehicle Type 2 - Police					Emergency Status 2 - No, not in emergency
	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 4 - Pedestrian action	Location	First Harmful Event of Crash (use codes 11-42 only) 20 - Non-motorist (see non-motorist type)
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

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Name- Last
HAYES

First
MARK

Middle
W

Suffix

City

State

Zip Code

Age
70

Sex
Male

Unit No.

Seating Position
15 - Pedestrian

Injury Status
2 - Incapacitating

Occupant Protection

Airbag Deployment

Airbag Switch Status

Ejection

Ejection Path

Trapped

Transported to:
PELLA HOSPITAL

Transported by:
PELLA AMBULANCE

NON-MOTORIST

Type
1 - Pedestrian

Location
8 - Other non-intersection (explain in narrative)

Action
2 - Walking, running, jogging, playing, cycling

Condition
2 - Physical impairment

Safety Equipment
4 - None

Contributing Circumstances
02 - Darting

Unit No. of Vehicle Striking
1

D
I
A
G
R
A
M

0

NARRATIVE

VEHICLE 1 WAS TRAVELING NORTH ON MAIN ST IN PELLA AND WAS GOING AROUND 2 PARKED VANS THAT WERE DOING UTILITY WORK. AS VEHICLE 1 WAS GOING AROUND THE VANS A PEDESTRIAN SUDDENLY ATTEMPTED CROSSING THE ROAD DIRECTLY IN FRONT OF VEHICLE 1. THE DRIVER OF VEHICLE 1 WAS UNABLE TO AVOID STRIKING THE PEDESTRAIN.

Officer VANDERWIEL	Badge No. 112	Time Officer Notified of Accident 12:46	Time Officer Arrived At Scene 12:55
Name of Agency P13	Date of Report 10/12/2010	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743