Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
3/10/2011		 Time of Accident
09:25 PM 		County
Warren - 91		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011016544
Literal Description
HWY 65, .2 MILES W OF 150TH AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
456162.9
Y-Coordinate
4570491.
U
N
I
T

1 		Driver's Name - Last
TAIT		 First
GERALDINE		 Middle
LEE		 Suffix
City
HUMESTON		 State
IA - Iowa, US		 Zip
501230000
Driver's Age
71		 Citation Charge Code 1
 Citation Charge 1
Gender
Female		 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
 Injury Status
 Occupant Protection
 Airbag Deployment
 Airbag Switch Status
 Ejection
 Ejection Path
 Trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2000		 Make
Chevrolet - CHEV		 Model
SUB		 Style
SW		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
 Vehicle Action
 Speed Limit
 Point of Initial Impact
 Most Damaged Area
 Extent of Damage
 Underride/Override
Total Occupants
 Traffic Controls
 Vehicle Config.
 Cargo Body Type
 Vehicle Defect
 Driver Condition
 Vision Obscured
 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
Emergency Vehicle Type
 Emergency Status
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
 Weather Conditions (up to two)
 Environment
 Location
 First Harmful Event of Crash (use codes 11-42 only)
25 - Animal
Manner of Crash/Collision
 Roadway
 Type
Light Conditions
 Surface Conditions
 Type of Roadway Junction/Feature
 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

UNIT 1 WAS EAST BOUND ON HWY 65, APPROXIMATELY .2 MILES WEST OF 150TH AVENUE WHEN IT STRUCK A DEER.
Officer
SCHMIDT 		Badge No.
336		 Time Officer Notified of Accident
21:25		 Time Officer Arrived At Scene
21:35
Name of Agency
P02		 Date of Report
3/10/2011		 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