Crash Information

L O C A T I O N	Date of Accident 4/18/2011	Time of Accident 01:48 PM	County Chickasaw - 19	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011023282
	Literal Description US 18 AND 63 AT INTERSECTION WITH 235TH STREET				Legal Intervention? No	Private Property? No
					X-Coordinate: 555361.9
					Y-Coordinate 4762778.

U N I T 1	Driver's Name - Last WAHL			First WENDELL			Middle JAMES		Suffix
	City NEW HAMPTON			State IA - Iowa, US				Zip 506599596
	Driver's Age 87					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 1 - Fatal	Occupant Protection 1 - None used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 3 - No ON/OFF switch present		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: CONWAY FUNERAL HOME					Transported by: CONWAY FUNERAL HOME
	Insurance Co. Name
	Year 1997		Make Chevrolet - CHEV		Model LUMINA		Style 4DR		Approximate Cost to Repair or Replace 4000
	Initial Travel Direction 2 - East	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 02 - Right Front	Most Damaged Area 02 - Right Front	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 1 - None
	Total Occupants 01	Traffic Controls 05 - Yield signs	Vehicle Config. 01 - Passenger car	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 9 - Unknown	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?

U N I T 2	Driver's Name - Last GRISWOLD			First BRANDON			Middle M		Suffix
	City FREMONT			State WI - Wisconsin, US				Zip 549400000
	Driver's Age 23					Citation Charge Code 1		Citation Charge 1
	Gender Male	State WI - Wisconsin, 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 3 - Non-incapacitating	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 3 - No ON/OFF switch present		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: MERCY HOSPITAL NEW HAMPTON					Transported by: CHICKASAW AMBULANCE
	Insurance Co. Name
	Year 2007		Make Ford - FORD		Model ECONOLINE E350		Style VAN		Approximate Cost to Repair or Replace 7000
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 65	Point of Initial Impact 08 - Left Front	Most Damaged Area 08 - Left Front	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 1 - None
	Total Occupants 02	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 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?

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) 03 - Cloudy	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 5 - Broadside	Weather Conditions (up to two) 03 - Cloudy	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 11 - Four-way intersection	Workers Present?

P
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N

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J
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Name- Last
STALKER

First
ERIC

Middle
S

Suffix

City

State

Zip Code

Age
28

Sex
Male

Unit No.
02

Seating Position
03 - Front: Right Side

Injury Status
3 - Non-incapacitating

Occupant Protection
2 - Shoulder and lap belt used

Airbag Deployment
1 - Deployed front of person

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:
MERCY HOSPITAL NEW HAMPTON

Transported by:
CHICKASAW AMBULANCE

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
I
A
G
R
A
M

0

NARRATIVE

UNIT #1 WAS EASTBOUND ON 235TH STREET. UNIT #2 WAS NORTHBOUND ON HWY 63. UNIT #1 FAILED TO YIELD FROM YIELD SIGN IN THE CROSSOVER AND DROVE INTO THE NORTHBOUND LANES OF HWY 63. THE VEHICLE COLLIDED AND UNIT #1 SPUN AND CAME TO REST ON THE ROADWAY. UNIT #2 ENTERED THE EAST DITCH.

Officer McNALLY	Badge No. 477	Time Officer Notified of Accident 13:52	Time Officer Arrived At Scene 14:13
Name of Agency P08	Date of Report 4/18/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381