Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/15/2011		 Time of Accident
02:00 PM 		County
Winneshiek - 96		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011003302
Literal Description
TOWN LINE RD and US 0052 / US 52 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
594285.6
Y-Coordinate
4789817.
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1 		Driver's Name - Last
BLOOM		 First
TIMOTHY		 Middle
RICHARD		 Suffix
City
NEWTON		 State
IA - Iowa, US		 Zip
502080000
Driver's Age
32		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE MAINTAIN CONTROL
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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2007		 Make
Chrysler - CHRY		 Model
TOW		 Style
VN		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 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
5		 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
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
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2 		Driver's Name - Last
CURLEY		 First
MELANIE		 Middle
ANN		 Suffix
City
FAIRBANK		 State
IA - Iowa, US		 Zip
506290000
Driver's Age
35		 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
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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2007		 Make
Chrysler - CHRY		 Model
TNC		 Style
VN		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
08 - Left Front		 Most Damaged Area
06 - Left Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
4		 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
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?
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)
03 - Cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
7 - Sideswipe, opposite direction		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
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NARRATIVE

VEHICLE 1 WAS SOUTH BOUND ON HWY 52 VEHICLE 2 WAS NORTH BOUND ON HWY 52. VEHICLE 1 CROSSED THE CENTER LINE AND SIDESWIPED VEHICLE 2.
Officer
RUDE 		Badge No.
369		 Time Officer Notified of Accident
14:18		 Time Officer Arrived At Scene
14:25
Name of Agency
P10		 Date of Report
1/15/2011		 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