Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/24/2011		 Time of Accident
09:30 PM 		County
Jefferson - 51		 Accident occurred within corporate limits of (city)
Batavia - 0422		 Law Enforcement Case Number:
2010005933
Literal Description
270TH ST and ASH AVE measuring 2022 Feet South from ASH AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
569963.4
Y-Coordinate
4529569.
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1 		Driver's Name - Last
DAVIS		 First
KIRBY		 Middle
JAMES		 Suffix
City
BLOOMFIELD		 State
IA - Iowa, US		 Zip
52537
Driver's Age
27		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE 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
321.445		 Citation Charge 2
SEATBELT
Alcohol Test Given?
9 - Refused		 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
4 - Possible		 Occupant Protection
1 - None used		 Airbag Deployment
9 - Unknown		 Airbag Switch Status
9 - Unknown		 Ejection
2 - Partially ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
WAPELLO COUNTY HOSPITAL		 Transported by:
JEFFERSON COUNTY AMBULANCE
Insurance Co. Name
Year
1996		 Make
Ford - FORD		 Model
RANGER		 Style
PICK-UP		 Approximate Cost to Repair or Replace
500000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
50		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
2		 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
6 - Under the influence of alcohol/drugs/medications		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
33 - Ditch/embankment		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
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)
02 - Partly cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
4		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEHICLE #1 WAS SOUTHBOUND ON ASH AVE GRAVEL ROAD. VEHICLE #1 LOST CONTROL ENTERED INTO EASTBOUND DITCH. VEHICLE #1 CAME TO REST ON PASSENGER SIDE DOOR. DRIVER OF VEHICLE #1 WAS TRANSPORTED TO WAPELLO COUNTY HOSPITAL. TROOPER RICK DIEPHUIS #252 IS HANDLING THE OWI CHARGE OF DRIVER OF VEHICLE #1.
Officer
STEIGLEDER 		Badge No.
433		 Time Officer Notified of Accident
21:31		 Time Officer Arrived At Scene
21:57
Name of Agency
P13		 Date of Report
1/24/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743