U
N
I
T
1
|
Driver's Name - Last SIEREN |
First ALFRED |
Middle JOHN |
Suffix
|
City NORWALK |
State IA - Iowa, US |
Zip 502110000 |
Driver's Age 59 |
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
|
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
|
Year 1998 |
Make Ford - FORD |
Model F15 |
Style 3D |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 1 - North |
Vehicle Action 09 - Backing |
Speed Limit 55 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 06 - Hillcrest |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 13 - Other non-collision |
Second Event 21 - Vehicle in traffic |
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 HOBART |
First MICHAEL |
Middle EUGENE |
Suffix
|
City PROLE |
State IA - Iowa, US |
Zip 502290000 |
Driver's Age 48 |
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 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 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 1994 |
Make Chevrolet - CHEV |
Model C15 |
Style PK |
Approximate Cost to Repair or Replace 20000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 07 - Left Side |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 06 - Hillcrest |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 21 - Vehicle in traffic |
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?
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged NONE |
Estimate of Damage
|
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name
|
City
|
State
|
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) 03 - Cloudy |
Environment 7 - Previous accident |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 02 - Road surface condition |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 5 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
UPON MY ARRIVAL AT THE ACCIDENT SCENE I OBSERVED A WHITE 4DR VEHICLE ON THE EAST SHOULDER WITH A ONE SINGLE OCCUPANT. A FEMALE DRIVER. THERE WAS ALSO A PICKUP TRUCK AT THE CREST OF THE HILL PROVIDING TRAFFIC CONTROL. NEITHER VEHICLE WERE INVOLVED IN THE SECOND ACCIDENT. I ALSO OBSERVED VEHICLE LABLED AS VEHICLE ONE IN THE WEST DITCH WITH DAMAGE TO THE PASSENGER SIDE REAR QUARTER PANEL. THE NEXT VEHICLE THAT I OBSERVED WAS A VEHICLE I LABELED VEHICLE NUMBER TWO. IT HAD DAMAGE TO THE ENTIRE DRIVER SIDE. FROM STATEMENT MADE BY ALL PARTY'S AT THE SCENE THE NON CONTACT VEHICLE HAD SPUN OUT ON THE ICE ROADS AND ENDED UP IN THE EAST DITCH WITH THE REAR END PARTIALLY ON THE TRAVEL PORTION OF THE ROADWAY. VEHICLE ONE HAD STOPPED ON THE ROADWAY AND WAS IN THE PROCESS OF BACKING UP TO THE NON CONTACT VEHICLE WHEN VEHICLE TWO CAME OVER THE HILL CREST. VEHICLE TWO ATTEMPTED TO STOP. VEHICLE TWO WAS TRAVELING TO FAST FOR CONDITIONS AND WAS UN ABLE TO STOP SO THE DRIVER ATTEMPTED TO PASS BETWEEN THE NON-CONTACT VEHICLE AND VEHICLE ONE. CONTACT WAS MADE BETWEEN VEHICLE ONE AND VEHICLE TWO. VEHICLE ONE ENDED UP IN THE WEST DITCH WHILE VEHICLE TWO WAS ABLE TO DRIVE ONTO THE SHOULDER BEFORE COMING TO A STOP. BOTH VEHICLES WERE IN VIOLATION. VEHICLE ONE WAS IN VIOLATION OF UNSAFE BACKING WHILE VEHICLE TWO FAILED TO MAINTAIN CONTROL OF HIS VEHICLE. |
|
Officer
EYBERG |
Badge No. 024 |
Time Officer Notified of Accident 06:55 |
Time Officer Arrived At Scene 07:30 |
Name of Agency P02 |
Date of Report 3/9/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653