Crash Information

L O C A T I O N	Date of Accident 1/17/2011	Time of Accident 01:00 PM	County Woodbury - 97	Accident occurred within corporate limits of (city) Sioux City - 7057	Law Enforcement Case Number: 2011003698
	Literal Description NB/EB Interstate 0129				Legal Intervention? No	Private Property? No
					X-Coordinate: 222161.0
					Y-Coordinate 4704900.

U N I T 1	Driver's Name - Last PAULSEN			First JOSEPH			Middle BARY		Suffix
	City SIOUX CITY			State IA - Iowa, US				Zip 511060000
	Driver's Age 56					Citation Charge Code 1 321.288		Citation Charge 1 FAIL TO 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 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 9 - Unknown	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2007		Make General Motors - GMC		Model SRA		Style PK		Approximate Cost to Repair or Replace 8000
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 65	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 01 - No controls present	Vehicle Config. 02 - Four-tire light truck (pick-up, panel)	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 03 - Ran off road, left	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 AMEZCUA			First MARTIN			Middle		Suffix JR
	City SIOUX CITY			State IA - Iowa, US				Zip 511080000
	Driver's Age 21					Citation Charge Code 1 321.20B-B		Citation Charge 1 NO VEHICLE INSURANCE - ACCIDENT
	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 S - SR Required	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 9 - Unknown	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2003		Make Chevrolet - CHEV		Model IMPALA		Style 4DR		Approximate Cost to Repair or Replace 8000
	Initial Travel Direction 4 - West	Vehicle Action 88 - Other (explain in narrative)	Speed Limit 65	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 01 - No controls present	Vehicle Config. 01 - Passenger car	Cargo Body Type 01 - Not applicable	Vehicle Defect 88 - Other (explain in narrative)	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 23 - Parked motor vehicle	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) 05 - Mist	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	Weather Conditions (up to two) 05 - Mist	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 2	Type of Roadway Junction/Feature 02 - Bridge/overpass/underpass	Workers Present?

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NARRATIVE

ON 01-17-2011 I, TROOPER ALBRECHT, WAS ON PATROL. I WAS CALLED TO A TWO VEHICLE PROPERTY DAMAGE ONLY ACCIDENT WESTBOUND ON HWY 20 AND MM 1. I ARRIVED ON SCENE. UNIT 1 WAS WESTBOUND ON HWY 20 NEAR MM 1 IN THE LEFT LANE/INSIDE LANE. UNIT 2 WAS PARKED IN THE LEFT LANE/INSIDE LANE WITH HIS 4 WAYS ON. UNIT 2 WAS HAVING UNKNOWN MECHANICAL PROBLEMS AND HAD CALLED 911 FOR HELP. UNIT 1 REAR ENDED UNIT 2. BOTH UNIT 1 AND UNIT 2 CAME TO REST ON THE LEFT SHOULD/INSIDE SHOULDER. BOTH VEHICLES WERE REMOVED FROM THE SCENE BY SOUTH SIOUX TOWING. ROAD AND WEATHER CONDITIONS: ROADS WERE WET WITH LIGHT RAIN/MIST COMING DOWN. **** EXPLAIN THE VEHICLE ACTION FOR UNIT 002 **** Explain the Vehicle Action for Unit 002

Officer ALBRECHT	Badge No. 071	Time Officer Notified of Accident 13:03	Time Officer Arrived At Scene 13:06
Name of Agency P04	Date of Report 1/17/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325