Crash Information

L O C A T I O N	Date of Accident 3/24/2011	Time of Accident 08:08 PM	County Delaware - 28	Accident occurred within corporate limits of (city) Manchester - 4682	Law Enforcement Case Number: 2011019052
	Literal Description N BREWER ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 627044.2
					Y-Coordinate 4704699.

U N I T 1	Driver's Name - Last MYSAK			First KENNETH			Middle DEAN		Suffix
	City MANCHESTER			State IA - Iowa, US				Zip 520570000
	Driver's Age 49					Citation Charge Code 1 321.327		Citation Charge 1 FAIL TO YIELD TO PEDESTRIAN
	Gender Male	State IA - Iowa, US	Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more	Endorsements None	Restrictions 3 - Commercial Inst Perm	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 4 - Breath			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 1999		Make Ford - FORD		Model F15		Style PK		Approximate Cost to Repair or Replace 0
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 25	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 1 - None	Underride/Override 1 - None
	Total Occupants 01	Traffic Controls 88 - Other control (explain in narrative)	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 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 20 - Non-motorist (see non-motorist type)	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle) 20 - Non-motorist (see non-motorist type)
	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) 20 - Non-motorist (see non-motorist type)
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 4 - Dark, roadway lighted	Surface Conditions 1	Type of Roadway Junction/Feature 11 - Four-way intersection	Workers Present?

P
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Name- Last
MORRIS

First
RICHARD

Middle
ALLEN

Suffix

City

State

Zip Code

Age
66

Sex
Male

Unit No.

Seating Position
15 - Pedestrian

Injury Status
1 - Fatal

Occupant Protection

Airbag Deployment

Airbag Switch Status

Ejection

Ejection Path

Trapped

Transported to:
DEL CO HOSP/MANCHESTER

Transported by:
MANCHESTER AMBULANCE

NON-MOTORIST

Type
1 - Pedestrian

Location
1 - Marked crosswalk at intersection

Action
2 - Walking, running, jogging, playing, cycling

Condition
1 - Apparently normal

Safety Equipment
4 - None

Contributing Circumstances
88 - Other (explain in narrative)

Unit No. of Vehicle Striking
01

D
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0

NARRATIVE

VEHICLE 1 WAS EAST BOUND WHEN IT TURNED NORTH AND STRUCK A. PEDESTRIAN IN THE CROSS WALK WITH THE FRONT OF THE VEHICLE. THE PEDESTRIAN WAS WALKING EAST ON THE NORTH SIDE OF INTERSECTION.

Officer DRISCOLL	Badge No. 127	Time Officer Notified of Accident 20:37	Time Officer Arrived At Scene 20:46
Name of Agency P10	Date of Report 3/24/2011	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