U
N
I
T
1
|
Driver's Name - Last BRYAN |
First THEODORE |
Middle DAVID |
Suffix
|
City BREMERTON |
State WA - Washington, US |
Zip 98310 |
Driver's Age 64 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State WA - Washington, US |
Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat |
Endorsements None |
Restrictions
C - Mechanical Aid |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2002 |
Make Ford - FORD |
Model F250 |
Style TRUCK |
Approximate Cost to Repair or Replace 00 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 01 |
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 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 HOFFHEINS |
First KIMBERLY |
Middle M |
Suffix
|
City GLEN ROCK |
State PA - Pennsylvania, US |
Zip 17327 |
Driver's Age 20 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State PA - Pennsylvania, 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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2000 |
Make Audi - AUDI |
Model SDN |
Style 4 DR |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 06 - Left Rear |
Most Damaged Area 06 - Left Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
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
|
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 6 - Sideswipe, same direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 02 - Bridge/overpass/underpass |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
VEHICLES 1 AND 2 WERE TRAVELING WEST ON I-80 AT THE 265.7 MILE MARKER. VEHICLE 1 WAS IN THE LEFT LANE, AND VEHICLE 2 WAS IN THE RIGHT LANE. THE FRONT RIGHT FENDER OF VEHICLE 1 COLLIDED WITH THE BACK LEFT DOOR AREA OF VEHICLE 2 WHICH CAUSED VEHICLE 2 TO SPIN IN A COUNTER CLOCKWISE DIRECTION. |
|
Officer
HUFFMAN |
Badge No. 131 |
Time Officer Notified of Accident 19:43 |
Time Officer Arrived At Scene 19:52 |
Name of Agency P12 |
Date of Report 10/22/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504