Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
1/18/2011		 Time of Accident
09:18 AM 		County
Black Hawk - 07		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011003873
Literal Description
NB/EB US 0020 / US 20 measuring 821 Feet East from US 0020 / US 20 and V062 / JESUP RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
574005.5
Y-Coordinate
4700074.
U
N
I
T

1 		Driver's Name - Last
ALDERSON		 First
DANNY		 Middle
JOE		 Suffix
City
NORTH LIBERTY		 State
IA - Iowa, US		 Zip
523170000
Driver's Age
48		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 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
2011		 Make
 Model
TK		 Style
TK		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
2 - East		 Vehicle Action
05 - Overtaking/passing		 Speed Limit
65		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right 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
02 - Van/enclosed box		 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
I
T

2 		Driver's Name - Last
MANGRICH		 First
JAMIE ALLEN		 Middle
 Suffix
City
WATERLOO		 State
IA - Iowa, US		 Zip
507010000
Driver's Age
30		 Citation Charge Code 1
321.306		 Citation Charge 1
IMPROPER USE OF LANES
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:
 Transported by:
Insurance Co. Name
Year
2004		 Make
Chevrolet - CHEV		 Model
TRAILBLAZER		 Style
SUV		 Approximate Cost to Repair or Replace
4500
Initial Travel Direction
2 - East		 Vehicle Action
06 - Changing lanes		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 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
6 - Sideswipe, same direction		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
2		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

UNIT ONE WAS OVER TAKING UNIT TWO WHEN UNIT TWO ATTEMPTED TO CHANGE LANES AND STRUCK UNIT ONE
Officer
HAHN 		Badge No.
039		 Time Officer Notified of Accident
09:18		 Time Officer Arrived At Scene
09:32
Name of Agency
P10		 Date of Report
1/18/2011		 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