Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/13/2010		 Time of Accident
06:25 PM 		County
Mills - 65		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010070480
Literal Description
NB INTERSTATE 29 35.50MM 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
263011.5
Y-Coordinate
4547644.
U
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1 		Driver's Name - Last
BOTTER		 First
THOMAS		 Middle
J		 Suffix
City
TOPEKA		 State
KS - Kansas, US		 Zip
66606
Driver's Age
60		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
KS - Kansas, 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
1 - Fatal		 Occupant Protection
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
3 - Totally ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
FUNERAL HOME		 Transported by:
Insurance Co. Name
Year
2004		 Make
Chevrolet - CHEV		 Model
TRLBLZR		 Style
SUV		 Approximate Cost to Repair or Replace
8000
Initial Travel Direction
1 - North		 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
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
9 - Unknown		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
01 - Ran off road, right		 Second Event
11 - Overturn/rollover		 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)
01 - Clear		 Environment
1 - None apparent		 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
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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0
NARRATIVE

UNIT 1 WAS NORTHBOUND ON I-29 IN THE RIGHT LANE. AT APPROXIMATELY 1825 HRS UNIT 1 WENT INTO THE EAST DITCH AT THE 35.50MM, ROLLED, AND CAME TO REST ON ITS WHEELS FACING SOUTHBOUND IN THE EAST DITCH. THE DRIVER WAS EJECTED FROM THE VEHICLE AND CAME TO REST BETWEEN UNIT 1 AND THE TREE.
Officer
KINSER 		Badge No.
425		 Time Officer Notified of Accident
18:31		 Time Officer Arrived At Scene
18:41
Name of Agency
P03		 Date of Report
12/13/2010		 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