Crash Information

L O C A T I O N	Date of Accident 2/20/2011	Time of Accident 02:00 PM	County Woodbury - 97	Accident occurred within corporate limits of (city) Salix - 6770	Law Enforcement Case Number: 2011012626
	Literal Description NB/EB Interstate 0029 (Milepost 133)				Legal Intervention? No	Private Property? No
					X-Coordinate: 228575.7
					Y-Coordinate 4687868.

U N I T 1	Driver's Name - Last SCHAFFER			First NICKOLAS			Middle ANDREW		Suffix
	City VERMILLION			State SD - South Dakota, US				Zip 570691204
	Driver's Age 21					Citation Charge Code 1		Citation Charge 1
	Gender Male	State SD - South Dakota, US	Class	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 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 1999		Make Ford - FORD		Model TAURUS		Style 4DR		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 70	Point of Initial Impact 01 - Front	Most Damaged Area 01 - 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 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 09 - Equipment failure (tires, brakes, etc.)	Third Event	Fourth Event 34 - Curb/island/raised median	Most Harmful Event (by vehicle) 09 - Equipment failure (tires, brakes, etc.)
	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) 06 - Rain	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	Weather Conditions (up to two) 06 - Rain	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 2	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

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NARRATIVE

ON 02-20-11 AT APPROXIMATELY 1400 HRS VEHICLE ONE TRAVELING I29NB AT MM 133. VEHICLE ONE PASSED A SEMI TRUCK THE FRONT HOOD CAME UNATTACHED AND HIT THE FRONT WINDSHIELD. FUNCTIONAL DAMAGE. NO INJURIES AND NO CITATIONS ISSUED.

Officer YANEFF	Badge No. 177	Time Officer Notified of Accident 14:00	Time Officer Arrived At Scene 14:15
Name of Agency P04	Date of Report 2/20/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325