Crash Information

L O C A T I O N	Date of Accident 11/29/2010	Time of Accident 01:45 PM	County Cass - 15	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2010067612
	Literal Description 52.50MM WB I-80				Legal Intervention? No	Private Property? No
					X-Coordinate: 324688.2
					Y-Coordinate 4596185.

U N I T 1	Driver's Name - Last SISKA			First CASSI			Middle M		Suffix
	City HIGHLAND			State IN - Indiana, US				Zip 463220000
	Driver's Age 24					Citation Charge Code 1 321.288		Citation Charge 1 FAIL TO MAINTAIN CONTROL
	Gender Female	State IN - Indiana, US	Class	Endorsements None	Restrictions	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 1 - Switch in ON position		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2003		Make Chevrolet - CHEV		Model MALIBU		Style 4DR		Approximate Cost to Repair or Replace 2500
	Initial Travel Direction 4 - West	Vehicle Action 05 - Overtaking/passing	Speed Limit 70	Point of Initial Impact 02 - Right Front	Most Damaged Area 06 - Left Rear	Extent of Damage 3 - Functional damage	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 01 - Ran off road, right	Second Event 21 - Vehicle in traffic	Third Event	Fourth Event	Most Harmful Event (by vehicle) 01 - Ran off road, right
	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 HEATH			First DERRICK			Middle LIONEL		Suffix
	City COLO SPRGS			State CO - Colorado, US				Zip 80915
	Driver's Age 28					Citation Charge Code 1		Citation Charge 1
	Gender Male	State CO - Colorado, US	Class	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 1 - Switch in ON position		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2005		Make Ford - FORD		Model EXPEDITION		Style 4DR		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 07 - Left Side	Most Damaged Area 07 - Left Side	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 2	Traffic Controls 01 - No controls present	Vehicle Config. 04 - Sport utility vehicle	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 01 - Ran off road, right	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) 06 - Rain	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	Weather Conditions (up to two) 06 - Rain	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 2	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

D
I
A
G
R
A
M

0

NARRATIVE

Vehicle #1 and #2 were both travelling west on I-80 at the 52.50mm. Vehicle #2 was in the right lane. Vehicle #1 was in the right lane attempting to pass vehicle #2 when this vehicle lost control and struck vehicle #2. Both vehicles came to rest upright in the north ditch.

Officer BROSAM	Badge No. 078	Time Officer Notified of Accident 13:47	Time Officer Arrived At Scene 14:10
Name of Agency P03	Date of Report 11/29/2010	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504