Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
10/25/2010		 Time of Accident
11:10 PM 		County
Dubuque - 31		 Accident occurred within corporate limits of (city)
Farley - 2497		 Law Enforcement Case Number:
2010061152
Literal Description
1ST ST N 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
663995.1
Y-Coordinate
4701537.
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1 		Driver's Name - Last
SMITH		 First
ROBERT		 Middle
LEO		 Suffix
City
FARLEY		 State
IA - Iowa, US		 Zip
520460000
Driver's Age
58		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE TO MAINTAIN CONTROL
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?
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
2 - Deployed side of person		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
2 - Freed by non-mechanical means
Transported to:
MERCY HOSPITAL DUBUQUE		 Transported by:
AMBULANCE
Insurance Co. Name
Year
2009		 Make
 Model
A5S		 Style
4D		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
25		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 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
05 - Animal or object in roadway		 Second Event
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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)
06 - Rain		 Environment
6 - Animal in roadway		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
2		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEHICLE #1 WAS SOUTH BOUND ON 1ST ST NORTH COMING INTO FARLEY. #1 SWERVED TO MISS A DEER IN THE ROADWAY AND LOST CONTROL,. #1 WENT INTO THE WEST DITCH AND ROLLED OVER.
Officer
DAUSENER 		Badge No.
144		 Time Officer Notified of Accident
23:13		 Time Officer Arrived At Scene
23:23
Name of Agency
P10		 Date of Report
10/25/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046