Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/17/2011		 Time of Accident
09:05 AM 		County
Scott - 82		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011003620
Literal Description
I-80 WB MM 296 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
703774.0
Y-Coordinate
4607669.
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1 		Driver's Name - Last
TERRY		 First
DWIGHT		 Middle
 Suffix
City
AURORA		 State
IL - Illinois, US		 Zip
60503
Driver's Age
44		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IL - Illinois, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
P - Pass		 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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2008		 Make
 Model
STANDARD		 Style
SEMI		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
09 - Tractor/semi-trailer		 Cargo Body Type
11 - Large utility (2+ axles)		 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
12 - Jackknife		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
12 - Jackknife
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)
07 - Sleet, hail, freezing rain		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
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
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT #1 WAS WEST BOUND ON I-80 AT THE 296 MILE MARKER. UNIT #1 JACKKNIFED OFF THE TRAVELED PORTION DUE TO ROAD CONDITIONS.
Officer
HANK 		Badge No.
123		 Time Officer Notified of Accident
09:15		 Time Officer Arrived At Scene
09:15
Name of Agency
P12		 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 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504