Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
11/3/2010		 Time of Accident
10:26 AM 		County
Buena Vista - 11		 Accident occurred within corporate limits of (city)
Rembrandt - 6405		 Law Enforcement Case Number:
2010062811
Literal Description
US 0071 / 130TH AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
324137.7
Y-Coordinate
4742537.
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1 		Driver's Name - Last
ROEMMICH		 First
ARLENE		 Middle
MARIE		 Suffix
City
SUTHERLAND		 State
IA - Iowa, US		 Zip
510580000
Driver's Age
73		 Citation Charge Code 1
321.256		 Citation Charge 1
FAIL TO OBEY TRAFFIC CONTROL DEVICE
Gender
Female		 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
3 - Deployed both front/side		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
B.V. CO HOSPITAL		 Transported by:
B.V. AMBULANCE
Insurance Co. Name
Year
2005		 Make
Chevrolet - CHEV		 Model
IMPALA		 Style
4DR		 Approximate Cost to Repair or Replace
3500
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
4 - Disabling damage		 Underride/Override
9 - Unknown
Total Occupants
1		 Traffic Controls
11 - Workzone signs		 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
26 - Other non-fixed object (explain in narrative)		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
26 - Other non-fixed object (explain in narrative)
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
4 - Within or adjacent to work activity		 First Harmful Event of Crash (use codes 11-42 only)
42 - Other fixed object (explain in narrative)
Manner of Crash/Collision
1 - Non-collision		 Roadway
05 - Work Zone (construction, maintenance, utility)		 Type
1 - Lane Closure
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
Yes
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NARRATIVE

VEHICLE #1 HAD STOPPED AT CONSTRUCTION ZONE WITH MANNED STOP SIGNS ON THE NORTH AND SOUTH OF THE ZONE. VEH. WAS WAVED TO GO ON THROUGH, STOP SIGN WAS TURNED TO SLOW. VEH. STARTED OUT AROUND TRAFFIC CONE THEN TURNED BACK INTO CONSTRUCTION AREA AND ENTERED A LARGE SECTION WHERE CONCRETE HAD BEEN REMOVED.
Officer
BRECHWALD 		Badge No.
025		 Time Officer Notified of Accident
10:32		 Time Officer Arrived At Scene
10:43
Name of Agency
P06		 Date of Report
11/3/2010		 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