Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/15/2011		 Time of Accident
09:50 PM 		County
Dallas - 25		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011011842
Literal Description
195TH ST AT S AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
422564.7
Y-Coordinate
4622880.
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1 		Driver's Name - Last
LANG		 First
JEFFREY		 Middle
GARIS		 Suffix
City
DES MOINES		 State
IA - Iowa, US		 Zip
503170000
Driver's Age
48		 Citation Charge Code 1
321.20B-B		 Citation Charge 1
VIOLATION - FINANCIAL LIABILITY - ACCIDENT
Gender
Male		 State
IA - Iowa, US		 Class
0 - ID		 Endorsements
None		 Restrictions

None		 Citation Charge Code 2
321J.2		 Citation Charge 2
OWI 1ST
Alcohol Test Given?
9 - Refused		 Drug Test Given?
1 - None		 Citation Charge Code 3
321.218		 Citation Charge 3
DRIVE WHILE REVOKED
Citation Charge Code 4
321.288		 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
2 - Incapacitating		 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
3 - Extricated by mechanical means
Transported to:
DSM METHODIST		 Transported by:
LIFEFLIGHT
Insurance Co. Name
Year
2001		 Make
Ford - FORD		 Model
TAURUS		 Style
SEDAN		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
07 - Left Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
03		 Traffic Controls
07 - Warning sign		 Vehicle Config.
01 - Passenger car		 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
02 - Ran off road, straight		 Second Event
11 - Overturn/rollover		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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?
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If Property other than vehicles damaged explain Object Damaged
STREET NAME/CHEVRON SIGNS		 Estimate of Damage
500
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
DALLAS COUNTY SECONDARY ROADS
City
ADEL		 State
IA - Iowa, US		 Zip
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)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
1		 Type of Roadway Junction/Feature
12 - T - intersection		 Workers Present?
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D 		Name- Last
JOHNSON		 First
RICK		 Middle
ALLEN		 Suffix
City
 State
 Zip Code
Age
44		 Sex
Male		 Unit No.
01		 Seating Position
03 - Front: Right Side		 Injury Status
2 - Incapacitating		 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
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
DSM METHODIST		 Transported by:
DALLAS CO EMS
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
TUCKER		 First
DAVID		 Middle
BOYD		 Suffix
City
 State
 Zip Code
Age
48		 Sex
Male		 Unit No.
01		 Seating Position
09 - Rear: Right Side		 Injury Status
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
DSM METHODIST		 Transported by:
DALLAS COUNTY EMS
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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NARRATIVE

UNIT 1 WAS EASTBOUND ON F-31 WHEN LANG LOST CONTROL ON THE CURVE, STRUCK SEVERAL SIGNS AND ENTERED THE EAST DITCH WHERE THE VEHICLE ROLLED ONTO ITS TOP. ALSO FILED CHARGE OF NO PROOF OF INSURANCE.
Officer
EHLER 		Badge No.
212		 Time Officer Notified of Accident
22:00		 Time Officer Arrived At Scene
22:20
Name of Agency
P01		 Date of Report
2/15/2011		 Investigation made at scene?
 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011