Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/30/2010		 Time of Accident
03:30 PM 		County
Clayton - 22		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010074164
Literal Description
X026 / FALCON AVE and US 0018 / US 18 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
631117.0
Y-Coordinate
4766574.
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1 		Driver's Name - Last
PERLETH		 First
RAENA		 Middle
LYNN		 Suffix
City
DUBUQUE		 State
IA - Iowa, US		 Zip
52003
Driver's Age
22		 Citation Charge Code 1
 Citation Charge 1
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
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
ELKADER HOSPITAL		 Transported by:
MONONA EMS
Insurance Co. Name
Year
2001		 Make
Ford - FORD		 Model
TAU		 Style
4D		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
06 - No Passing Zone (marked)		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
13 - Fog/smoke/dust		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
22 - Vehicle in/from other roadway		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
22 - Vehicle in/from other roadway
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?
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2 		Driver's Name - Last
WALECH-ROTH		 First
LAURA		 Middle
LEE		 Suffix
City
ROCHESTER		 State
MN - Minnesota, US		 Zip
55901
Driver's Age
51		 Citation Charge Code 1
 Citation Charge 1
Gender
Female		 State
MN - Minnesota, US		 Class
D - Chauffeur		 Endorsements
None		 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
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
PRAIRIE DU CHIEN HOSPITAL		 Transported by:
MONONA EMS
Insurance Co. Name
Year
2002		 Make
Toyota - TOYT		 Model
SIENNA		 Style
VAN		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
3 - South		 Vehicle Action
03 - Turning right		 Speed Limit
55		 Point of Initial Impact
08 - Left Front		 Most Damaged Area
08 - Left Front		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
3		 Traffic Controls
04 - Stop signs		 Vehicle Config.
03 - Van or mini-van		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
13 - Fog/smoke/dust		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
22 - Vehicle in/from other roadway		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
22 - Vehicle in/from other roadway
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)
04 - Fog, smoke		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
22 - Vehicle in/from other roadway
Manner of Crash/Collision
5 - Broadside		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
2		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
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NARRATIVE

VEHICLE 1 WAS TRAVELING WESTBOUND ON HWY 18. VEHICLE 2 WAS STOPPED AT THE STOP SIGN AT THE INTERSECTION OF HWY 18 AND FALCON AVENUE FACING SOUTHBOUND. VEHICLE 2 STARTED TO TURN RIGHT (WESTBOUND) ONTO HWY 18 AND DID NOT SEE VEHICLE 1 DUE TO THE FOGGY CONDITIONS. AS VEHICLE 2 PULLED OUT SHE PULLED INTO THE PATH OF VEHICLE 1 CAUSING THE COLLISION. VEHICLE 1 STRUCK VEHICLE 2 IN THE DRIVERS SIDE FRONT QUARTER PANEL. VEHICLE 1 CAME TO REST IN THE SOUTHWEST DITCH OF THE INTERSECTION. VEHICLE 2 CAME TO REST IN THE WESTBOUND LANE OF HWY 18 FACING TO THE WEST.
Officer
DRISCOLL 		Badge No.
298		 Time Officer Notified of Accident
15:35		 Time Officer Arrived At Scene
15:40
Name of Agency
P10		 Date of Report
12/30/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046