Crash Information

L O C A T I O N	Date of Accident 4/19/2011	Time of Accident 07:50 AM	County Sioux - 84	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011023418
	Literal Description L22, 1/2 MILE SOUTH 420TH STREET				Legal Intervention? No	Private Property? No
					X-Coordinate: 263765.7
					Y-Coordinate 4768199.

U N I T 1	Driver's Name - Last MEYER			First TRAVIS			Middle JAMES		Suffix
	City BERN			State KS - Kansas, US				Zip 66408
	Driver's Age 18					Citation Charge Code 1 321.288		Citation Charge 1 FAIL TO MAINTAIN CONTROL
	Gender Male	State KS - Kansas, US	Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat	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 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: NA					Transported by: NA
	Insurance Co. Name
	Year 2003		Make Buick - BUIC		Model RENDEZVOUS		Style VAN		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 3 - South	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 08 - Left Front	Most Damaged Area 01 - Front	Extent of Damage 4 - Disabling damage	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 05 - Other tire defect (explain in narrative)	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 01 - Ran off road, right	Third Event	Fourth Event	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?

ACCIDENT ENVIRONMENT		ROADWAY CHARACTERISTICS Major Contributing Circumstances:	WORKZONE RELATED?	SEQUENCE OF EVENTS
Location of First Harmful Event 2 - Shoulder	Weather Conditions (up to two) 08 - Snow	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 11 - Overturn/rollover
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 08 - Snow	Roadway 02 - Road surface condition	Type
Light Conditions 1 - Daylight	Surface Conditions 5	Type of Roadway Junction/Feature 05 - Farm/residential drive	Workers Present?

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NARRATIVE

ON 4-19-11 AT APPROXIMATELY 7:50AM A VEHICLE WAS TRAVELLING SOUTHBOUND ON COUNTY ROAD L22 WHEN THE DRIVER LOST CONTROL IN THE SLUSH ON THE ROAD. THE VEHICLE THEN WENT INTO THE EAST DITCH WHERE IT STRUCK A FARM DRIVE AND ROLLED. THE TIRES ON THE VEHICLE WERE WORN BELOW THE WEAR BARS TO THE POINT THEY WERE ALMOST BALD.

Officer SKAAR	Badge No. 323	Time Officer Notified of Accident 07:50	Time Officer Arrived At Scene 08:43
Name of Agency P06	Date of Report 4/19/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 06 Office
503 W 44th St
Spencer,IA 51301-2089
Phone: (712) 262-1424
Fax: (712) 262-3222