Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
5/23/2011		 Time of Accident
10:02 AM 		County
Hamilton - 40		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011029784
Literal Description
Iowa 0017 / STAGE COACH RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
425073.5
Y-Coordinate
4708675.
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1 		Driver's Name - Last
FLOWERDAY		 First
LYNN		 Middle
 Suffix
City
WEBSTER CITY		 State
IA - Iowa, US		 Zip
505950000
Driver's Age
71		 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?
2 - Blood		 Drug Test Given?
 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
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
3 - Extricated by mechanical means
Transported to:
STATE MEDICAL EXAMINER		 Transported by:
FUNERAL HOME
Insurance Co. Name
Year
1997		 Make
Chrysler - CHRY		 Model
TOW		 Style
VN		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 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.
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
04 - Crossed centerline/median		 Second Event
21 - Vehicle in traffic		 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?
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2 		Driver's Name - Last
GAMBILL		 First
BRYAN		 Middle
WAYNE		 Suffix
City
FORT DODGE		 State
IA - Iowa, US		 Zip
505010000
Driver's Age
32		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
None		 Restrictions

None		 Citation Charge Code 2
 Citation Charge 2
Alcohol Test Given?
4 - Breath		 Drug Test Given?
 Citation Charge Code 3
 Citation Charge 3
Citation Charge Code 4
 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
4 - Possible		 Occupant Protection
9 - Unknown		 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:
WEBSTER CITY MED		 Transported by:
PVT VEH
Insurance Co. Name
PEPSI COLA GENERAL BOTTLERS INC
Year
2000		 Make
International - INTL		 Model
 Style
DS		 Approximate Cost to Repair or Replace
15000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 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.
07 - Truck/trailer		 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
PEPSI COLA GENERAL BOTTLERS INC		 City
URBANDALE		 State
IA - Iowa, US		 Zip
50322
Number of Axles
5		 Gross Vehicle Weight Rating
52000		 Placard #
 Hazardous Materials Released?
1 - Yes
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)
21 - Vehicle in traffic
Manner of Crash/Collision
2 - Head-on		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT 1 SOUTHBOUND ON HWY 17. UNIT 2 NORTHBOUND ON HWY 17. UNIT 1 CROSSED CENTER LINE AND COLLIDED HEAD ON INTO UNIT 2. UNIT 1 CROSSED BACK OVER CENTER LINE AND ENTERED WEST DITCH FOLLOWING IMPACT. UNIT 2 CROSSED CENTER LINE AND ENTERED WEST DITCH FOLLOWING IMPACT.
Officer
MORENZ 		Badge No.
230		 Time Officer Notified of Accident
10:10		 Time Officer Arrived At Scene
10:46
Name of Agency
P07		 Date of Report
5/3/2011		 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