Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
2/14/2011		 Time of Accident
08:25 AM 		County
Scott - 82		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011011546
Literal Description
NB/EB Interstate 0080 (Milepost 287) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
688755.9
Y-Coordinate
4608583.
U
N
I
T

1 		Driver's Name - Last
CHURCH		 First
KERRY		 Middle
K		 Suffix
City
LYNDON		 State
IL - Illinois, US		 Zip
61261
Driver's Age
48		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
Gender
Male		 State
IL - Illinois, US		 Class
D - Chauffeur		 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
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
2008		 Make
Chevrolet - CHEV		 Model
COBALT		 Style
4D		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
3 - Functional 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
01 - None		 Driver Condition
5 - Asleep, fainted, fatigued, etc		 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
33 - Ditch/embankment		 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)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

UNIT 1 WAS TRAVELING WESTBOUND ON INTERSTATE 80 AT MILEPOST 287. THE DRIVER OF UNIT 1 FELL ASLEEP AND LOST CONTROL ENTERING THE MEDIAN AND THE SOUTH DITCH.
Officer
NUDD 		Badge No.
034		 Time Officer Notified of Accident
08:31		 Time Officer Arrived At Scene
08:40
Name of Agency
P12		 Date of Report
2/14/2011		 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