Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/13/2011		 Time of Accident
05:00 PM 		County
Webster - 94		 Accident occurred within corporate limits of (city)
Fort Dodge - 2690		 Law Enforcement Case Number:
2011002951
Literal Description
S 25TH ST and 1ST AVE S 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
404436.9
Y-Coordinate
4706530.
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1 		Driver's Name - Last
GROSSNICKLE		 First
WILLIAM		 Middle
SHAWN		 Suffix
City
FORT DODGE		 State
IA - Iowa, US		 Zip
505010000
Driver's Age
49		 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
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
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:
HOME		 Transported by:
Insurance Co. Name
Year
2007		 Make
Chrysler - CHRY		 Model
 Style
VN		 Approximate Cost to Repair or Replace
8000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
25		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
02 - Traffic signals		 Vehicle Config.
03 - Van or mini-van		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
99 - Unknown		 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)
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
BITTNER		 First
JOHN		 Middle
PATRICK		 Suffix
City
FORT DODGE		 State
IA - Iowa, US		 Zip
50501
Driver's Age
41		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR		 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
6 - Not applicable		 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
1994		 Make
International - INTL		 Model
4700LP		 Style
FIRE TRUCK		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
2 - East		 Vehicle Action
03 - Turning right		 Speed Limit
25		 Point of Initial Impact
08 - Left Front		 Most Damaged Area
08 - Left Front		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
02 - Traffic signals		 Vehicle Config.
05 - Single-unit truck (2-axle, 6-tires)		 Cargo Body Type
09 - Other truck cargo type (explain in narrative)		 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
3 - Fire		 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
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)
21 - Vehicle in traffic
Manner of Crash/Collision
2 - Head-on		 Roadway
02 - Road surface condition		 Type
Light Conditions
2 - Dusk		 Surface Conditions
3		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
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NARRATIVE

VEHICLE #1 WAS A SOUTHBOUND MINI-VAN. VEHICLE #2 WAS AN EASTBOUND FIRE TRUCK PREPARING TO TURN RIGHT TO GO SOUTH, WITH IT'S EMERGENCY LIGHTS & SIREN OPERATING, GOING TO A CRASH SITE. THE VEHICLES COLLIDED, THE RIGHT FRONT CORNER OF THE VAN TO THE LEFT FRONT CORNER OF THE FIRE TRUCK, WITH DAMAGE PRIMARILY OCCURRING IN FRONT OF THE TIRES ON BOTH VEHICLES. DRIVER OF #1 WAS CERTAIN HE HAD A GREEN LIGHT, AND DRIVER OF #2 DID'NT KNOW WHAT COLOR HIS TRAFFIC LIGHT WAS. NO CHARGES WERE FILED DUE TO THE UNCERTAINTY OF WHICH VEHICLE HAD CONTROL OF THE INTERSECTION.
Officer
MILLS 		Badge No.
263		 Time Officer Notified of Accident
17:07		 Time Officer Arrived At Scene
17:18
Name of Agency
P07		 Date of Report
1/13/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218