Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/12/2011		 Time of Accident
07:24 AM 		County
Mills - 65		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011011062
Literal Description
221ST ST AND ASHTON RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
267116.8
Y-Coordinate
4557908.
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1 		Driver's Name - Last
BEIER		 First
BLAKE		 Middle
MICHAEL		 Suffix
City
GLENWOOD		 State
IA - Iowa, US		 Zip
515340000
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

Y - Intermediate License		 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:
REFUSED		 Transported by:
GLENWOOD RESCUE
Insurance Co. Name
Year
2000		 Make
Pontiac - PONT		 Model
GRAND PRIX		 Style
4DR		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 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
01		 Traffic Controls
01 - No controls present		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
03 - Ran off road, left		 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?
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
2 - Shoulder		 Weather Conditions (up to two)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
3 - Dawn		 Surface Conditions
3		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

Vehicle #1 was traveling NB on 221st St. in Mills County. Vehicle #1 lost control on the icy roads and entered the west ditch. Vehicle #1 then rolled onto its roof and came to rest in that location. Driver #1 exited vehicle under own power and refused rescue treatment. Father of driver was on location.
Officer
BARDSLEY 		Badge No.
037		 Time Officer Notified of Accident
07:29		 Time Officer Arrived At Scene
07:39
Name of Agency
P03		 Date of Report
2/12/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504