Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
10/22/2010		 Time of Accident
07:30 PM 		County
Buena Vista - 11		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010060715
Literal Description
HWY 10 E OF 240TH 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
342419.2
Y-Coordinate
4746059.
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1 		Driver's Name - Last
DOERKSEN		 First
JACOB		 Middle
LOEWEN		 Suffix
City
ALBERT CITY		 State
IA - Iowa, US		 Zip
505100000
Driver's Age
50		 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

B - Cor Lenses		 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
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
DEYOUNG FARMS
Year
1995		 Make
 Model
 Style
UN		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
2 - East		 Vehicle Action
02 - Turning left		 Speed Limit
55		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
07 - Truck/trailer		 Cargo Body Type
03 - Dump truck (grain, gravel)		 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
22 - Vehicle in/from other roadway		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
22 - Vehicle in/from other roadway
Emergency Vehicle Type
1 - Not applicable		 Emergency Status
3 - Not Applicable
Carrier Name
DEYOUNG FARMS		 City
LAURENS		 State
IA - Iowa, US		 Zip
50554
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 Placard #
 Hazardous Materials Released?
2 - No
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2 		Driver's Name - Last
HALE		 First
RAYMOND		 Middle
MICHAEL		 Suffix
City
SIOUX RAPIDS		 State
IA - Iowa, US		 Zip
505850000
Driver's Age
50		 Citation Charge Code 1
321J.2		 Citation Charge 1
OPERATING WHILE INTOXICATED
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

B - Cor Lenses		 Citation Charge Code 2
 Citation Charge 2
Alcohol Test Given?
3 - Urine		 Drug Test Given?
 Citation Charge Code 3
 Citation Charge 3
Citation Charge Code 4
 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
3 - Non-incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
BV HOSPITAL		 Transported by:
LAURENS AMBULANCE
Insurance Co. Name
Year
1998		 Make
Ford - FORD		 Model
RNG		 Style
PK		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 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
1		 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
6 - Under the influence of alcohol/drugs/medications		 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?
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
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
1		 Type of Roadway Junction/Feature
05 - Farm/residential drive		 Workers Present?
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NARRATIVE

VEH 1 PULLED OUT OF FARM DRIVE TO TURN EAST. VEH 2 WAS EB AT A HIGH RATE OF SPEED. VEH 2 RAN INTO BACK OF VEH 1. DRIVER OF VEH 2 WAS UNDER THE INFLUENCE OF ALCOHOL.
Officer
ERDMANN 		Badge No.
041		 Time Officer Notified of Accident
19:34		 Time Officer Arrived At Scene
19:47
Name of Agency
P06		 Date of Report
10/23/2010		 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