Crash Information

L O C A T I O N	Date of Accident 4/11/2011	Time of Accident 08:59 AM	County Pottawattamie - 78	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011022063
	Literal Description I 80 W.B. @ 17.65MM				Legal Intervention? No	Private Property? No
					X-Coordinate: 276290.1
					Y-Coordinate 4584027.

U N I T 1	Driver's Name - Last BOGLOEWA			First LUDMILA			Middle		Suffix
	City WHEELING			State IL - Illinois, US				Zip 60090
	Driver's Age 62					Citation Charge Code 1 321.314		Citation Charge 1 UNSAFE LANE CHANGE
	Gender Male	State IL - Illinois, US	Class D - Chauffeur	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 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 2003		Make		Model ALTIMA		Style 4D		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 4 - West	Vehicle Action 06 - Changing lanes	Speed Limit 70	Point of Initial Impact 08 - Left Front	Most Damaged Area 08 - Left Front	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 03	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 04 - Crossed centerline/median	Second Event 21 - Vehicle in traffic	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?

U N I T 2	Driver's Name - Last KETELSEN			First ARLEN			Middle THOMAS		Suffix
	City WEST DES MOINES			State IA - Iowa, US				Zip 502650000
	Driver's Age 59					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 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 2010		Make Dodge - DODG		Model CHARGER		Style 4D		Approximate Cost to Repair or Replace 8000
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 70	Point of Initial Impact 04 - Right Rear	Most Damaged Area 04 - Right Rear	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	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 01 - Ran off road, right	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?

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 6 - Sideswipe, same direction	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

D
I
A
G
R
A
M

0

NARRATIVE

BOTH VEHICLES WERE TRAVELING WEST ON I 80. VEHICLE # 1 STARTED TO CHANGE LANES INTO THE LEFT LANE AND STRUCK VEHICLE #2 IN THE RIGHT REAR BUMPER AREA. AS A RESULT OF THE CONTACT VEHICLE #1 SPUN INTO THE MEDIAN AND VEHICLE #2 SPUN OFF INTO THE WEST DITCH.

Officer FUNK	Badge No. 413	Time Officer Notified of Accident 08:59	Time Officer Arrived At Scene 09:19
Name of Agency P03	Date of Report 4/11/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504