U
N
I
T
2
|
Driver's Name - Last REEN |
First TIMOTHY |
Middle PAUL |
Suffix
|
City GOOSE LAKE |
State IA - Iowa, US |
Zip 527500000 |
Driver's Age 47 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements
|
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name REEN CONSTRUCTION |
Year 2006 |
Make Ford - FORD |
Model F550 DIES |
Style CB |
Approximate Cost to Repair or Replace 500 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 05 - Single-unit truck (2-axle, 6-tires) |
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 REEN CONSTRUCTION |
City GOOSE LAKE |
State IA - Iowa, US |
Zip 52750 |
Number of Axles 2 |
Gross Vehicle Weight Rating 32000 |
Placard #
|
Hazardous Materials Released? 2 - No |
U
N
I
T
3
|
Driver's Name - Last SKOFF |
First RACHEL |
Middle ANN |
Suffix
|
City DEWITT |
State IA - Iowa, US |
Zip 52742 |
Driver's Age 24 |
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 N - Tank |
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 3 - Non-incapacitating |
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 2004 |
Make Ford - FORD |
Model TAURUS |
Style 4D |
Approximate Cost to Repair or Replace 6000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
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 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?
|
| 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) 05 - Mist |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
Roadway 02 - Road surface condition |
Type
|
Light Conditions 2 - Dusk |
Surface Conditions 3 |
Type of Roadway Junction/Feature 02 - Bridge/overpass/underpass |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last MARKS |
First TALAN |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 0 |
Sex Male |
Unit No. 01 |
Seating Position 08 - Rear: Center |
Injury Status 4 - Possible |
Occupant Protection 5 - Child safety seat used |
Airbag Deployment 5 - Not deployed |
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: DEWITT HOSPITAL |
Transported by: DEWITT 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 MARKS |
First TALIA |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 6 |
Sex Female |
Unit No. 01 |
Seating Position 07 - Rear: Left Side |
Injury Status 3 - Non-incapacitating |
Occupant Protection 5 - Child safety seat used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: DEWITT HOSPITAL |
Transported by: DEWITT 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 MARKS |
First CAIMYN |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age 4 |
Sex Male |
Unit No. 01 |
Seating Position 09 - Rear: Right Side |
Injury Status 4 - Possible |
Occupant Protection 5 - Child safety seat used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: DEWITT HOSPITAL |
Transported by: MEDIC |
| 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 ON WAPSI RIVER BRIDGE WHEN IT LOST CONTROL DUE TO ICY CONDITIONS. THE LEFT FRONT OF UNIT 1 STRUCK THE BRIDGE CAUSING IT TO BLOCK TRAFFIC. UNIT 2 WAS NORTHBOUND ON HWY 61 BEHIND UNIT 1 AND SLOWED DOWN DUE TO THE ROAD BEING BLOCKED. UNIT 3 WAS NORTHBOUND ON THE BRIDGE BEHIND UNIT 2. UNIT 3 LOST CONTROL AT THE BEGINNING OF THE BRIDGE DUE TO ICY ROAD CONDITIONS. THE FRONT OF UNIT 3 STRUCK THE REAR OF UNIT 2. |
|
Officer
VOTROUBEK |
Badge No. 375 |
Time Officer Notified of Accident 17:29 |
Time Officer Arrived At Scene 17:37 |
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