Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/31/2010		 Time of Accident
10:15 AM 		County
Cass - 15		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010074297
Literal Description
EB INTERSTATE 0080 56.5 MM. 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
331217.7
Y-Coordinate
4595925.
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1 		Driver's Name - Last
DIAZ		 First
DAVID		 Middle
J		 Suffix
City
OMAHA		 State
NE - Nebraska, US		 Zip
68107
Driver's Age
45		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
NE - Nebraska, US		 Class
 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
4 - Possible		 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:
NONE		 Transported by:
NONE
Insurance Co. Name
Year
2010		 Make
Chevrolet - CHEV		 Model
G2500		 Style
VAN		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
09 - Top		 Most Damaged Area
09 - Top		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
01 - No controls present		 Vehicle Config.
03 - Van or mini-van		 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
03 - Ran off road, left		 Second Event
01 - Ran off road, right		 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?
P
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P
E
R
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Y

D
A
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A
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E
If Property other than vehicles damaged explain Object Damaged
FENCE		 Estimate of Damage
100
Owner's Name - Last
LAMBERTSEN		 First
TERRY		 Middle
 Suffix
Owner Company Name
City
ATLANTIC		 State
IA - Iowa, US		 Zip
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
4 - Roadside		 Weather Conditions (up to two)
03 - Cloudy		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
3		 Type of Roadway Junction/Feature
02 - Bridge/overpass/underpass		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

VEHICLE NO. 1 WAS EAST BOUND ON I-80 AT 56.5 MM. THERE WAS FREEZING MOISTURE AT THE TIME. THE BRIDGE SURFACE WAS SLICK AT THE TIME CAUSING THE VEHICLE TO GO OUT OF CONTROL. THE VEHICLE WENT OFF THE LEFT SHOULDER FIRST THEN ACROSS TO THE RIGHT SHOULDER AND SLIDE INTO THE SOUTH DITCH AND ROLLED. COMING TO REST IN CORN FIELD NEXT TO INTERSTATE.
Officer
PIGSLEY 		Badge No.
234		 Time Officer Notified of Accident
10:27		 Time Officer Arrived At Scene
10:29
Name of Agency
P03		 Date of Report
12/31/2010		 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