Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/25/2011		 Time of Accident
04:00 PM 		County
Humboldt - 46		 Accident occurred within corporate limits of (city)
Gilmore City - 2922		 Law Enforcement Case Number:
2011013656
Literal Description
N GILMORE ST and S GILMORE ST and Iowa 0003 / E IOWA AVE and Iowa 0003 / W IOWA AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
381859.2
Y-Coordinate
4732110.
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1 		Driver's Name - Last
GAGEN		 First
SARAH		 Middle
ANN		 Suffix
City
WEST BEND		 State
IA - Iowa, US		 Zip
505970000
Driver's Age
16		 Citation Charge Code 1
321.322		 Citation Charge 1
FAIL TO YIELD FROM STOP SIGN
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

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
4 - Possible		 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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2001		 Make
Ford - FORD		 Model
FOC		 Style
4D		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
25		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
04 - Stop signs		 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
 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?
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2 		Driver's Name - Last
DEVEREAUX		 First
SCOTT		 Middle
FITZGERALD		 Suffix
City
POMEROY		 State
IA - Iowa, US		 Zip
505750000
Driver's Age
41		 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

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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2009		 Make
Ford - FORD		 Model
CVC		 Style
4D		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
35		 Point of Initial Impact
08 - Left Front		 Most Damaged Area
08 - Left Front		 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
22 - Vehicle in/from other roadway		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
22 - Vehicle in/from other roadway
Emergency Vehicle Type
2 - Police		 Emergency Status
2 - No, not in emergency
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)
03 - Cloudy		 Environment
1 - None apparent		 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
1		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
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NARRATIVE

VEHICLE #1 WAS SOUTHBOUND ON P-19. VEHICLE #2 WAS EASTBOUND ON HWY 3. VEHICLE #1 FAILED TO YIELD FROM THE STOP SIGN AT HWY 3, STRIKING VEHICLE #2 IN THE LEFT FRONT.
Officer
RINARD 		Badge No.
095		 Time Officer Notified of Accident
16:00		 Time Officer Arrived At Scene
16:15
Name of Agency
P07		 Date of Report
2/25/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218