U
N
I
T
1
|
Driver's Name - Last WHITE |
First DOUGLAS |
Middle STEVEN |
Suffix
|
City NEWELL |
State IA - Iowa, US |
Zip 505680000 |
Driver's Age 26 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
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 1 - None 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: UNINJURED |
Transported by:
|
Insurance Co. Name
|
Year 2005 |
Make
|
Model TM155 |
Style FARM TRACTOR |
Approximate Cost to Repair or Replace 13000 |
Initial Travel Direction 4 - West |
Vehicle Action 02 - Turning left |
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 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 20 - Farm vehicle/equipment |
Cargo Body Type 18 - Other trailer type (explain in narrative) |
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 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
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
U
N
I
T
2
|
Driver's Name - Last REHDER |
First ROBERT |
Middle WAYNE |
Suffix
|
City NEWELL |
State IA - Iowa, US |
Zip 50568 |
Driver's Age 66 |
Citation Charge Code 1 321.303 |
Citation Charge 1 UNSAFE PASSING |
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
Endorsements P - Pass |
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 4 - Possible |
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 2006 |
Make Dodge - DODG |
Model CVN |
Style VN |
Approximate Cost to Repair or Replace 12000 |
Initial Travel Direction 4 - West |
Vehicle Action 05 - Overtaking/passing |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 03 |
Traffic Controls 01 - No controls present |
Vehicle Config. 03 - Van or mini-van |
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 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?
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged MAIL BOX |
Estimate of Damage 100 |
Owner's Name - Last DIRKX |
First RICHARD |
Middle
|
Suffix
|
Owner Company Name
|
City STORM LAKE |
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) 03 - Cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
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 REHDER |
First JULIE |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 65 |
Sex Female |
Unit No. 02 |
Seating Position 03 - Front: Right Side |
Injury Status 2 - Incapacitating |
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: BUENA VISTA COUNTY HOSPITAL |
Transported by: B.V COUNTY AMBULANCE |
| 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 REHDER |
First RYAN |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 32 |
Sex Male |
Unit No. 02 |
Seating Position 04 - Center: Left Side / Motorcycle Passenger |
Injury Status 4 - Possible |
Occupant Protection 3 - Lap belt only used |
Airbag Deployment 2 - Deployed side of person |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 2 - Freed by non-mechanical means |
Transported to: BUENA VISTA COUNTY HOSPITAL |
Transported by: NEWELL 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 |
VEHICLE #1 A 2005 NEW HOLLAND FARM TRACTOR WITH A ROUND BALER WAS WESTBOUND ON HWY 7. VEHICLE #2 A 2006 DODGE GRAND CARAVAN WAS ALSO WESTBOUND ON HWY 7. VEHICLE #1 SIGNALED TO TURN LEFT INTO THE RICHARD DIRKX FARM RESIDENCE AND BEGAN HIS TURN AS VEHICLE #2 BEGAN TO PASS. VEHICLE #2 STRUCK THE LOADER ON THE FRONT OF THE TRACTOR CAUSING VEHICLE #2 TO TRAVEL ONTO THE SOUTH SHOULDER STRIKING THE MAIL BOX AND THAN CONTINUING WEST THRU THE DITCH INTO A CREEK. |
|
Officer
MAIER |
Badge No. 215 |
Time Officer Notified of Accident 17:30 |
Time Officer Arrived At Scene 17:36 |
Name of Agency P06 |
Date of Report 10/17/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 06 Office
503 W 44th St
Spencer,IA 51301-2089
Phone: (712) 262-1424
Fax: (712) 262-3222