Crash Information

L O C A T I O N	Date of Accident 2/26/2011	Time of Accident 02:10 PM	County Clinton - 23	Accident occurred within corporate limits of (city) Welton - 8235	Law Enforcement Case Number: 2011014034
	Literal Description 146MM HWY 61 NB				Legal Intervention? No	Private Property? No
					X-Coordinate: 699576.5
					Y-Coordinate 4642693.

U N I T 1	Driver's Name - Last JEWELL			First JEFFREY			Middle ORVILLE		Suffix II
	City DUBUQUE			State IA - Iowa, US				Zip 520010000
	Driver's Age 27					Citation Charge Code 1 N/A		Citation Charge 1 N/A
	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 S - SR Required	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 6 - Not applicable	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		Model GCH		Style SW		Approximate Cost to Repair or Replace 9500
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 65	Point of Initial Impact 04 - Right Rear	Most Damaged Area 09 - Top	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 1 - None
	Total Occupants 02	Traffic Controls 01 - No controls present	Vehicle Config. 04 - Sport utility vehicle	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 03 - Ran off road, left	Second Event 06 - Evasive action (swerve, panic braking, etc.)	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 1 - On Roadway	Weather Conditions (up to two) 07 - Sleet, hail, freezing rain	Environment 2 - Weather condition	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 1 - Daylight	Surface Conditions 3	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

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Name- Last
CANNON

First
KEELY

Middle
MARIE

Suffix

City

State

Zip Code

Age
26

Sex
Female

Unit No.
01

Seating Position
03 - Front: Right Side

Injury Status
5 - Uninjured

Occupant Protection
2 - Shoulder and lap belt used

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:

Transported by:

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
I
A
G
R
A
M

0

NARRATIVE

UNIT 1 WAS NORTHBOUND ON HWY 61. UNIT 1 LOST CONTROL, ENTERED THE MEDIAN ROLLING ONCE, COMING TO REST ON IT'S WHEELS.

Officer GRIEM	Badge No. 311	Time Officer Notified of Accident 16:10	Time Officer Arrived At Scene 16:14
Name of Agency P12	Date of Report 2/26/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504