Crash Information

L O C A T I O N	Date of Accident 4/24/2011	Time of Accident 12:11 AM	County Webster - 94	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011024564
	Literal Description D020 / 220TH ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 420923.1
					Y-Coordinate 4702634.

U N I T 1	Driver's Name - Last PERGANDE			First CHRISTOPHER			Middle DALE		Suffix
	City WEBSTER CITY			State IA - Iowa, US				Zip 50595
	Driver's Age 16					Citation Charge Code 1 321.174		Citation Charge 1 FAILURE TO HAVE VALID LICENSE/ PERMIT WHILE OPERATING M
	Gender Male	State NO - None, US	Class	Endorsements None	Restrictions None	Citation Charge Code 2 321.288		Citation Charge 2 FAIL TO MAINTAIN CONTROL
	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: VAN DIEST					Transported by: DUNCOMBE
	Insurance Co. Name
	Year 2000		Make		Model LEG		Style 4D		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 2 - East	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 4	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 33 - Ditch/embankment	Third Event	Fourth Event	Most Harmful Event (by vehicle) 33 - Ditch/embankment
	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) 33 - Ditch/embankment
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 5 - Dark, roadway not lighted	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
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Name- Last
FISHBURN

First
NATHAN

Middle
AARON

Suffix

City

State

Zip Code

Age
19

Sex
Male

Unit No.
1

Seating Position
03 - Front: Right Side

Injury Status
2 - Incapacitating

Occupant Protection
9 - Unknown

Airbag Deployment
5 - Not deployed

Airbag Switch Status
9 - Unknown

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
1 - Not trapped

Transported to:
VAN DIEST

Transported by:
DUNCOMBE

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
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A
G
R
A
M

0

NARRATIVE

UNIT 1 WAS TRAVELING EASTBOUND ON COUNTRY ROAD D20 IN WEBSTER COUNTY WHEN IT LOST CONTROL AND ENTERED THE SOUTH DITCH.

Officer BURNS	Badge No. 028	Time Officer Notified of Accident 00:11	Time Officer Arrived At Scene 00:29
Name of Agency P07	Date of Report 4/24/2011	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