Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/26/2011		 Time of Accident
05:00 PM 		County
Dubuque - 31		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011014051
Literal Description
Y021 / SUNDOWN RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
676990.5
Y-Coordinate
4696335.
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1 		Driver's Name - Last
KLOSTER		 First
ALEXANDER		 Middle
LUVERNE		 Suffix
III
City
KEOKUK		 State
IA - Iowa, US		 Zip
526320000
Driver's Age
39		 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

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
2003		 Make
Dodge - DODG		 Model
GRAND CARAVAN		 Style
VAN		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
04 - Right Rear		 Most Damaged Area
03 - Right Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
03 - Van or mini-van		 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
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
06 - Evasive action (swerve, panic braking, etc.)
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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Y

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If Property other than vehicles damaged explain Object Damaged
COUNTY ROAD SIGN		 Estimate of Damage
200
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
COUNTY OF DUBUQUE
City
DUBUQUE		 State
IA - Iowa, US		 Zip
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)
13 - Other non-collision
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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0
NARRATIVE

VEHICLE 1 WAS TRAVELING SOUTH ON Y-21 WHEN IT BEGAN TO SLIDE, LEFT THE ROAD, STRUCK A COUNTY ROAD SIGN AND CAME TO FINAL REST IN THE DITCH.
Officer
JONES 		Badge No.
389		 Time Officer Notified of Accident
17:20		 Time Officer Arrived At Scene
17:20
Name of Agency
P10		 Date of Report
2/27/2011		 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