U
N
I
T
1
|
Driver's Name - Last MUDRA |
First MARK |
Middle A |
Suffix JR |
City COUNCIL BLUFFS |
State IA - Iowa, US |
Zip 51501 |
Driver's Age 17 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class 0 - ID |
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 1 - None |
Drug Test Given? 3 - Urine |
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 9 - Unknown |
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 2000 |
Make Chevrolet - CHEV |
Model BLAZER |
Style SUV |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 2 - East |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 35 |
Point of Initial Impact 03 - Right Side |
Most Damaged Area 03 - Right Side |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 04 |
Traffic Controls 02 - Traffic signals |
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 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?
|
U
N
I
T
2
|
Driver's Name - Last HALEY |
First MICHELLE |
Middle LEE |
Suffix
|
City GLENWOOD |
State IA - Iowa, US |
Zip 515340000 |
Driver's Age 37 |
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 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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2007 |
Make
|
Model SOR |
Style SW |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 2 - East |
Vehicle Action 03 - Turning right |
Speed Limit 35 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 07 - Left Side |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 02 |
Traffic Controls 02 - Traffic signals |
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 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) 01 - Clear |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 11 - Four-way intersection |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
THIS OFFICER WAS ACITIVELY PURSUING (LIGHT AND SIREN ACIVATED) A 2000 MAROON CHEVY BLAZER THAT WAS STOLEN IN OMAHA. THE PURSUIT TOOK US EAST ON HIGHWAY 6 FROM NORTH BROADWAY. AS WE APPROCHED THE NORTH AVE AND HWY 6 INTERSECTION VEHICLE #1 STUCK THE DRIVERS SIDE OF VEHICLE #2. VEHICLE #1 CONTINUED EAST ON HWY 6. VEHICLE #1 THEN WENT OVER THE EMBANKMENT AND DOWN ONTO CANNING ST WHERE ALL 4 SUSPECTS WERE APPREHENDED.THERE WAS NO IMPROPER ACTION BY THE DRIVER OF VEHICLE #2 |
|
Officer
FUNK |
Badge No. 413 |
Time Officer Notified of Accident 10:58 |
Time Officer Arrived At Scene 10:58 |
Name of Agency P03 |
Date of Report 3/2/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504