U
N
I
T
1
|
Driver's Name - Last WILSON |
First BRIAN |
Middle JAMES |
Suffix
|
City MUSCATINE |
State IA - Iowa, US |
Zip 52761 |
Driver's Age 28 |
Citation Charge Code 1 321.288 |
Citation Charge 1 FAIL TO MAINTAIN CONTROL |
Gender Male |
State IA - Iowa, US |
Class 0 - ID |
Endorsements None |
Restrictions
None |
Citation Charge Code 2 321A.32 |
Citation Charge 2 DRIVING UNDER SUSPENSION SR22 RELATED |
Alcohol Test Given? 2 - Blood |
Drug Test Given? 1 - None |
Citation Charge Code 3 321J.2 |
Citation Charge 3 OWI 2ND |
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 5 - Not deployed |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: GENESIS EAST |
Transported by: DURANT AMBULANCE |
Insurance Co. Name
|
Year 2006 |
Make Dodge - DODG |
Model GRAND CARAVAN |
Style VAN |
Approximate Cost to Repair or Replace 15000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 03 - Van or mini-van |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 6 - Under the influence of alcohol/drugs/medications |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
Second Event 33 - Ditch/embankment |
Third Event
|
Fourth Event 11 - Overturn/rollover |
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?
|