U
N
I
T
1
|
Driver's Name - Last HAMMER |
First MARK |
Middle LYNN |
Suffix
|
City IOWA CITY |
State IA - Iowa, US |
Zip 52240 |
Driver's Age 47 |
Citation Charge Code 1
|
Citation Charge 1 PENDING |
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
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 2 - Blood |
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 9 - Unknown |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by: JOHNSON COUNTY AMBULANCE |
Insurance Co. Name
|
Year 2004 |
Make Chevrolet - CHEV |
Model SLV |
Style PK |
Approximate Cost to Repair or Replace 1500 |
Initial Travel Direction 2 - East |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 65 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 88 - Other control (explain in narrative) |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 6 - Under the influence of alcohol/drugs/medications |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event
|
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?
|
U
N
I
T
2
|
Driver's Name - Last HERNANDEZ |
First JESUS |
Middle DIMAS |
Suffix
|
City NORTH LIBERTY |
State IA - Iowa, US |
Zip 523170000 |
Driver's Age 46 |
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:
|
Transported by:
|
Insurance Co. Name
|
Year 2009 |
Make Ford - FORD |
Model CROWN VICTORIA |
Style 4DR |
Approximate Cost to Repair or Replace 2500 |
Initial Travel Direction 2 - East |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 65 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 88 - Other control (explain in narrative) |
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 21 - Vehicle in traffic |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
Emergency Vehicle Type 2 - Police |
Emergency Status 1 - Yes, in emergency |
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 2 - Shoulder |
Weather Conditions (up to two) 02 - Partly cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
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?
|
D I A G R A M
0 |
|
D I A G R A M
1 |
|
D I A G R A M
2 |
|
| NARRATIVE |
UNIT #1 WAS EASTBOUND ON I-80 NEAR IOWA RIVER BRIDGE, MILEMARKER 243. JOHNSON COUNTY SHERIFF DEPUTIES, EMERGENCY LIGHTS ACTIVATED, WERE FOLLOWING UNIT #1 ATTEMPTING TO BRING IT TO A STOP. UNIT #2, ALSO TRAVELING EASTBOUND WITH EMERGENCY LIGHTS ACTIVATED, CAME ALONGSIDE AND PASSED UNIT #1 IN AN ATTEMPT TO ASSIST IN BRINGING IT TO A STOP. UNIT #1 SLOWED AND BEGAN PULLING OVER ONTO THE SHOULDER. UNIT #2 ALSO PULLED OVER ONTO THE SHOULDER AHEAD OF UNIT #1 AND CAME TO A STOP. UNIT #1 FAILED TO STOP AND STRUCK UNIT #2 IN THE REAR. AFTER IMPACT, BOTH UNITS CAME TO A STOP ON THE SHOULDER. |
|
Officer
KURT |
Badge No. 327 |
Time Officer Notified of Accident 17:20 |
Time Officer Arrived At Scene 17:25 |
Name of Agency P11 |
Date of Report 12/21/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327