U
N
I
T
1
|
Driver's Name - Last MEHMEDOVIC |
First LUTVO |
Middle
|
Suffix
|
City DES MOINES |
State IA - Iowa, US |
Zip 503100000 |
Driver's Age 42 |
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 T - Dbl/Trpl Trlr |
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 4 - Possible |
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: MERCY HOSPITAL |
Transported by: JOHNSTON EMS |
Insurance Co. Name
|
Year 1996 |
Make Mercedes - MERZ |
Model C280 |
Style 4D |
Approximate Cost to Repair or Replace 3500 |
Initial Travel Direction 2 - East |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 65 |
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 2 - Physical impairment |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
Second Event 35 - Guardrail |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 35 - Guardrail |
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?
|