Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
4/29/2011		 Time of Accident
10:45 AM 		County
Black Hawk - 07		 Accident occurred within corporate limits of (city)
Waterloo - 8155		 Law Enforcement Case Number:
2011025429
Literal Description
SB/WB US 0063 / SERGEANT RD and GREYHOUND DR and US 0020 / RAMP 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
549037.3
Y-Coordinate
4701029.
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1 		Driver's Name - Last
YATES		 First
MICHAEL		 Middle
SCOTT		 Suffix
City
WATERLOO		 State
IA - Iowa, US		 Zip
507010000
Driver's Age
44		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
T - Dbl/Trpl Trlr		 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
6 - Not applicable		 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
CORKERY INDUSTRIES INC
Year
1996		 Make
Mack - MACK		 Model
 Style
TT		 Approximate Cost to Repair or Replace
22000
Initial Travel Direction
3 - South		 Vehicle Action
02 - Turning left		 Speed Limit
55		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
02 - Traffic signals		 Vehicle Config.
09 - Tractor/semi-trailer		 Cargo Body Type
04 - Cargo tank		 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
11 - Overturn/rollover		 Second Event
 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
CORKERY INDUSTRIES INC		 City
WATERLOO		 State
IA - Iowa, US		 Zip
50701
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 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)
01 - Clear		 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		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
19 - On-ramp		 Workers Present?
NARRATIVE

Officer
VALENTINE 		Badge No.
267		 Time Officer Notified of Accident
 Time Officer Arrived At Scene
Name of Agency
P15		 Date of Report
4/29/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 15 Office
5912 NW 2nd Ave
Des Moines,IA 50313-
Phone: (515) 281-6176
Fax: (515) 289-1066