Crash Information

L O C A T I O N	Date of Accident 10/26/2010	Time of Accident 05:17 PM	County Lucas - 59	Accident occurred within corporate limits of (city) Derby - 1942	Law Enforcement Case Number: 2010061377
	Literal Description FRONT ST and CENTER ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 461606.5
					Y-Coordinate 4531251.

U N I T 1	Driver's Name - Last CONLEY			First TIMOTHY			Middle STEPHAN		Suffix
	City HUMESTON			State IA - Iowa, US				Zip 501230000
	Driver's Age 20					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	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 3 - No ON/OFF switch present		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: N/A					Transported by: N/A
	Insurance Co. Name
	Year 1994		Make Chevrolet - CHEV		Model S10		Style PK		Approximate Cost to Repair or Replace 3000
	Initial Travel Direction 4 - West	Vehicle Action 05 - Overtaking/passing	Speed Limit 25	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. 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 06 - Evasive action (swerve, panic braking, etc.)	Second Event 20 - Non-motorist (see non-motorist type)	Third Event	Fourth Event	Most Harmful Event (by vehicle) 20 - Non-motorist (see non-motorist type)
	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) 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 12 - T - intersection	Workers Present?

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Name- Last
JAHNKE

First
CURTIS

Middle
DEAN

Suffix

City

State

Zip Code

Age
17

Sex
Male

Unit No.

Seating Position
15 - Pedestrian

Injury Status
4 - Possible

Occupant Protection

Airbag Deployment

Airbag Switch Status

Ejection

Ejection Path

Trapped

Transported to:
N/A

Transported by:
N/A

NON-MOTORIST

Type
2 - Pedalcyclist (bicycle, tricycle, unicycle, pedal car)

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

Action
1 - Entering or crossing roadway

Condition
1 - Apparently normal

Safety Equipment
4 - None

Contributing Circumstances
06 - Inattentive (talking, eating, etc.)

Unit No. of Vehicle Striking
1

D
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A
G
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M

0

NARRATIVE

BICYCLE RIDER WAS TRAVELING WESTBOUND ON FRONT STREET WHEN UNIT 1 ATTEMPTED TO PASS BICYCLE. AS DRIVER OF UNIT 1 WAS ATTEMPTING TO PASS THE BICYCLIST, THE BICYCLE RIDER TURNED IN FRONT OF UNIT 1. THE BICYCLE RIDER WAS WEARING HEADPHONES AT TIME OF COLLISION.

Officer SPENCER	Badge No. 387	Time Officer Notified of Accident 17:17	Time Officer Arrived At Scene 17:36
Name of Agency P02	Date of Report 10/26/2010	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653