Iowa State Patrol: Department of Public Safety

Crash Information

L
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C
A
T
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N 		Date of Accident
1/22/2011		 Time of Accident
03:11 PM 		County
Tama - 86		 Accident occurred within corporate limits of (city)
Traer - 7710		 Law Enforcement Case Number:
2011005445
Literal Description
2ND ST and US 0063 / S MAIN ST and Iowa 0008 / 2ND ST 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
544135.4
Y-Coordinate
4671385.
U
N
I
T

1 		Driver's Name - Last
VANHOVE		 First
BRADY		 Middle
MICHAEL		 Suffix
City
TRAER		 State
IA - Iowa, US		 Zip
506750000
Driver's Age
17		 Citation Charge Code 1
 Citation Charge 1
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
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
Chrysler - CHRY		 Model
SEB		 Style
2D		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
3 - South		 Vehicle Action
02 - Turning left		 Speed Limit
20		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
02 - Traffic signals		 Vehicle Config.
01 - Passenger car		 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
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?
U
N
I
T

2 		Driver's Name - Last
ZERBA		 First
PATRICIA		 Middle
ANN		 Suffix
City
INDEPENDENCE		 State
IA - Iowa, US		 Zip
506440000
Driver's Age
75		 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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2004		 Make
Lincoln - LINC		 Model
TOW		 Style
4D		 Approximate Cost to Repair or Replace
6000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
20		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
02 - Traffic signals		 Vehicle Config.
01 - Passenger car		 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
4 - Angle, oncoming left turn		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
D
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NARRATIVE

UNIT #1 WAS SB ON HWY 63. UNIT #2 WAS NB ON HWY 63. UNIT #1 ATTEMPTED TO TURN LEFT ONTO HWY 8. UNITS #1 AND #2 MADE CONTACT WITHIN THE INTERSECTION. UNIT #1 PARKED ON HWY 8. UNIT #2 CAME TO REST FACING NORTH IN THE RIGHT LANE OF HWY 63.
Officer
MILLER 		Badge No.
366		 Time Officer Notified of Accident
15:14		 Time Officer Arrived At Scene
15:22
Name of Agency
P11		 Date of Report
1/22/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327