Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
4/12/2011		 Time of Accident
12:12 PM 		County
Hamilton - 40		 Accident occurred within corporate limits of (city)
Jewell - 3820		 Law Enforcement Case Number:
2011022321
Literal Description
US 0069 / LITTLE WALL LAKE RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
447264.0
Y-Coordinate
4685121.
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1 		Driver's Name - Last
BARTH		 First
NORMAN		 Middle
JOHN		 Suffix
City
KAMRAR		 State
IA - Iowa, US		 Zip
50132
Driver's Age
75		 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
None		 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
3 - Non-incapacitating		 Occupant Protection
9 - Unknown		 Airbag Deployment
2 - Deployed side of person		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
VAN DIEST MEDICAL CENTER		 Transported by:
JEWELL AMBULANCE
Insurance Co. Name
Year
2010		 Make
Toyota - TOYT		 Model
PRI		 Style
4D		 Approximate Cost to Repair or Replace
20000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
45		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
2 - Underride, compartment intrusion
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
01 - Passenger car		 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
21 - Vehicle in traffic		 Second Event
 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?
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2 		Driver's Name - Last
BEHRENDS		 First
TYLER		 Middle
SCOTT		 Suffix
City
APLINGTON		 State
IA - Iowa, US		 Zip
506040000
Driver's Age
29		 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
T - Dbl/Trpl Trlr		 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
PANAMA TRANSFER INC
Year
1997		 Make
Ford - FORD		 Model
 Style
TT		 Approximate Cost to Repair or Replace
500
Initial Travel Direction
1 - North		 Vehicle Action
03 - Turning right		 Speed Limit
45		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
07 - Truck/trailer		 Cargo Body Type
02 - Van/enclosed box		 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
21 - Vehicle in traffic		 Second Event
 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
PANAMA TRANSFER INC		 City
PANAMA		 State
IA - Iowa, US		 Zip
515626307
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 Placard #
 Hazardous Materials Released?
3 - Not applicable
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)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
04 - Business drive		 Workers Present?
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NARRATIVE

UNIT 2 WAS MAKING A LEGAL RIGHT HAND TURN IN TO HAWKEYE MINK COOP WHEN VEHICLE NUMBER 1 STRUCK THE REAR OF UNIT 2 AND CONTINUED IN TO THE GRASS ON THE RIGHT SIDE OF THE ROAD. VEHICLE NUMBER 1 SUSTAINED EXTENSIVE DAMAGE.
Officer
DEVEREAUX 		Badge No.
084		 Time Officer Notified of Accident
12:12		 Time Officer Arrived At Scene
12:19
Name of Agency
P07		 Date of Report
4/12/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218