U
N
I
T
1
|
Driver's Name - Last VANG |
First BEE |
Middle
|
Suffix
|
City SOUTH SIOUX CITY |
State NE - Nebraska, US |
Zip 687760000 |
Driver's Age 21 |
Citation Charge Code 1 321.285-J |
Citation Charge 1 SPEEDING > 55 93F |
Gender Male |
State NE - Nebraska, US |
Class
|
Endorsements None |
Restrictions
None |
Citation Charge Code 2 321.384 |
Citation Charge 2 FAIL TO USE HEADLAMPS WHEN REQUIRED |
Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3 321.277 |
Citation Charge 3 RECKLESS DRIVING |
Citation Charge Code 4 321.288 |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: BURGESS ONAWA |
Transported by: BURGESS RESCUE |
Insurance Co. Name
|
Year 2005 |
Make
|
Model RL |
Style 4DR |
Approximate Cost to Repair or Replace 10000 |
Initial Travel Direction 2 - East |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 25 |
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. 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 01 - Ran off road, right |
Second Event 23 - Parked motor vehicle |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 23 - Parked motor vehicle |
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
|
First
|
Middle
|
Suffix
|
City
|
State
|
Zip
|
Driver's Age
|
Citation Charge Code 1
|
Citation Charge 1
|
Gender
|
State
|
Class
|
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given?
|
Drug Test Given?
|
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position
|
Injury Status
|
Occupant Protection
|
Airbag Deployment
|
Airbag Switch Status
|
Ejection
|
Ejection Path
|
Trapped
|
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 1997 |
Make Ford - FORD |
Model F15 |
Style 4DR |
Approximate Cost to Repair or Replace 10000 |
Initial Travel Direction
|
Vehicle Action 12 - Legally Parked |
Speed Limit
|
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 0 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 8 - Other (explain in narrative) |
Vision Obscured 88 - Other (explain in narrative) |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 23 - Parked motor vehicle |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle)
|
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?
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged HOUSE AND A/C UNIT 156 MAIN |
Estimate of Damage 8000 |
Owner's Name - Last STEVENS |
First BRAD |
Middle
|
Suffix
|
Owner Company Name
|
City BLENCOE |
State IA - Iowa, US |
Zip
|
| ACCIDENT ENVIRONMENT |
ROADWAY CHARACTERISTICS Major Contributing Circumstances: |
WORKZONE RELATED? |
SEQUENCE OF EVENTS |
Location of First Harmful Event 6 - Outside Trafficway |
Weather Conditions (up to two) 01 - Clear |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 23 - Parked motor vehicle |
Manner of Crash/Collision 1 - Non-collision |
Roadway 01 - None apparent |
Type
|
Light Conditions 4 - Dark, roadway lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
Vehicle #1's speed was checked at 93 mph in a 70 mph zone on I-29 near mile marker 102. Vehicle #1 exitted I-29 at exit 105. At the top of the off-ramp the driver turned his lights off and continued east toward Blencoe. I lost contact with the vehicle. I attempted to locate the vehicle around Blencoe. I located the vehicle east of K45. The vehicle had continued east onto Main St. in Blencoe. The driver lost control and left the roadway to the right. It drove through several yards before striking a parked vehicle and then a tree. Both vehicles were totaled and a residence was damaged by flying debris from the parked vehicle. The subject was transported to Burgess in Onawa and later released with a broken nose. The driver was arrested and taken to the Monona County Jail. |
|
Officer
MELBY |
Badge No. 481 |
Time Officer Notified of Accident 01:46 |
Time Officer Arrived At Scene 01:46 |
Name of Agency P04 |
Date of Report 4/21/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325