U
N
I
T
3
|
Driver's Name - Last
KNOX |
First
CAROL |
Middle
ROSE |
Suffix
|
City
HAWKEYE |
State
IA - Iowa, US |
Zip
52147 |
Driver's Age
46 |
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
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
2011 |
Make
Ford - FORD |
Model
FOCUS |
Style
4D |
Approximate Cost to Repair or Replace
1000 |
Initial Travel Direction
2 - East |
Vehicle Action
01 - Movement essentially straight |
Speed Limit
55 |
Point of Initial Impact
05 - Rear |
Most Damaged Area
05 - Rear |
Extent of Damage
2 - Minor 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
13 - Fog/smoke/dust |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event
06 - Evasive action (swerve, panic braking, etc.) |
Second Event
21 - Vehicle in traffic |
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
4
|
Driver's Name - Last
DAVIS |
First
LISA |
Middle
ANN |
Suffix
|
City
CASTALIA |
State
IA - Iowa, US |
Zip
52133 |
Driver's Age
49 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender
Female |
State
IA - Iowa, US |
Class
D - Chauffeur |
Endorsements
3 - Pass Veh less than 16 Pass Design |
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
3 - No ON/OFF switch present |
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
4D |
Approximate Cost to Repair or Replace
2500 |
Initial Travel Direction
2 - East |
Vehicle Action
01 - Movement essentially straight |
Speed Limit
55 |
Point of Initial Impact
01 - Front |
Most Damaged Area
01 - Front |
Extent of Damage
4 - Disabling 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
13 - Fog/smoke/dust |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event
06 - Evasive action (swerve, panic braking, etc.) |
Second Event
21 - Vehicle in traffic |
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)
04 - Fog, smoke |
Environment
2 - Weather condition |
Location
|
First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic |
Manner of Crash/Collision
5 - Broadside |
Roadway
01 - None apparent |
Type
|
Light Conditions
1 - Daylight |
Surface Conditions
2 |
Type of Roadway Junction/Feature
11 - Four-way intersection |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last
JOHNSON |
First
HOPE |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age
14 |
Sex
Female |
Unit No.
1 |
Seating Position
88 - Other (explain in narrative) |
Injury Status
3 - Non-incapacitating |
Occupant Protection
8 - Other (explain in narrative) |
Airbag Deployment
6 - Not applicable |
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:
VETERANS MEMORIAL HOSP |
Transported by:
AMBULANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last
JOHNSON |
First
ANDREA |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age
|
Sex
Female |
Unit No.
1 |
Seating Position
88 - Other (explain in narrative) |
Injury Status
3 - Non-incapacitating |
Occupant Protection
8 - Other (explain in narrative) |
Airbag Deployment
6 - Not applicable |
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:
VETERANS MEMORIAL HOSP |
Transported by:
AMBUANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last
WHITE |
First
EMILY |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age
16 |
Sex
Female |
Unit No.
1 |
Seating Position
88 - Other (explain in narrative) |
Injury Status
3 - Non-incapacitating |
Occupant Protection
8 - Other (explain in narrative) |
Airbag Deployment
6 - Not applicable |
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:
CENTRAL COMM HOSP |
Transported by:
AMBULANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last
IHDE |
First
MORGAN |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age
16 |
Sex
Female |
Unit No.
1 |
Seating Position
88 - Other (explain in narrative) |
Injury Status
3 - Non-incapacitating |
Occupant Protection
8 - Other (explain in narrative) |
Airbag Deployment
6 - Not applicable |
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:
PRAIRIE DU CHIEN HOSP |
Transported by:
AMBULANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D
I
A
G
R
A
M
0 |
 |
D
I
A
G
R
A
M
1 |
 |
| NARRATIVE |
UNIT #1 A SCHOOL BUS WAS SOUTHBOUND ON ECHO AVENUE AND STOPPED AT THE STOP SIGN FOR HWY #18. DUE TO DENSE FOG, THE DRIVER OF UNIT #1 OPENED WINDOWS AND THE DOOR TO LISTEN FOR CROSS OR OTHER TRAFFIC. UNIT #1 PULLED OUT ONTO HWY #18, MAKING A LEFT TURN TO GO EASTBOUND ON HWY #18. UNIT #2 WAS WESTBOUND ON HWY #18 APPROACHING ECHO AVENUE, THE DRIVER NOTICED UNIT #1 PULLING ONTO THE ROADWAY AND ATTEMPTED EVASIVE/SEVERE BRAKING. UNIT #2 WAS UNABLE TO STOP AND STRUCK THE LEFT SIDE OF UNIT #1. DUE TO THE IMPACT UNIT #1 ROTATED COUNTER CLOCKWISE, COMING TO REST FACING THE NORTH WITHIN THE INTERSECTION ON THE ROADWAY. UNIT #2 CAME TO REST FACING WEST ON THE ROADWAY WITHIN THE INTERSECTION. UNIT #3 WAS EASTBOUND ON HWY #18 AND WAS STOPPED ON THE ROADWAY DUE TO THE COLLISION BLOCKING HWY #18. UNIT #4 WAS ALSO EASTBOUND ON HWY #18, BUT WAS UNABLE TO STOP BEHIND UNIT #3 STRIKING IT IN THE REAR. BOTH VEHICLES CAME TO REST ON THE ROADWAY |
|
Officer
MOMMER |
Badge No.
189 |
Time Officer Notified of Accident
07:49 |
Time Officer Arrived At Scene
08:03 |
Name of Agency
P10 |
Date of Report
2/16/2011 |
Investigation made at scene?
Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046