Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
4/3/2011		 Time of Accident
02:38 PM 		County
Story - 85		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011020729
Literal Description
SB/WB INTERSTATE 0035 SOUTH OF STORY CITY MM 123.5 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
452860.6
Y-Coordinate
4668915.
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1 		Driver's Name - Last
GERHOLDT		 First
DEBRA		 Middle
KAY		 Suffix
City
AMES		 State
IA - Iowa, US		 Zip
50010
Driver's Age
47		 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
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
3 - Extricated by mechanical means
Transported to:
MARY GREELEY HOSPITAL		 Transported by:
STORY CITY RESCUE
Insurance Co. Name
Year
1991		 Make
 Model
TRK		 Style
UT		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
09 - Top		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
3		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
05 - Other tire defect (explain in narrative)		 Driver Condition
1 - Apparently normal		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
09 - Equipment failure (tires, brakes, etc.)		 Second Event
03 - Ran off road, left		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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D 		Name- Last
GERHOLDT		 First
GARRETT		 Middle
 Suffix
City
 State
 Zip Code
Age
10		 Sex
Male		 Unit No.
1		 Seating Position
03 - Front: Right Side		 Injury Status
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
MARY GREELEY HOSPITAL		 Transported by:
STORY CITY RESCUE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
BROSDAHL		 First
TANNER		 Middle
 Suffix
City
 State
 Zip Code
Age
9		 Sex
Male		 Unit No.
1		 Seating Position
07 - Rear: Left Side		 Injury Status
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
3 - Extricated by mechanical means
Transported to:
MARY GREELEY HOSPITAL		 Transported by:
STORY CITY RESCUE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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NARRATIVE

VEHICLE 31 WAS GOING NORTH ON INTERSTATE 35 WHEN THE REAR PASSENGER TIRE'S TREAD SEPARATED FROM THE TIRE CAUSING THE DRIVER TO LOSE CONTROL. THE VEHICLE CROSSED BOTH NORTHBOUND LANES, ENTERED THE MEDIAN, AND ROLLED OVER.
Officer
TJEPKES 		Badge No.
074		 Time Officer Notified of Accident
14:38		 Time Officer Arrived At Scene
14:39
Name of Agency
P01		 Date of Report
4/3/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011