Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
5/30/2011		 Time of Accident
08:09 PM 		County
Jones - 53		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011031398
Literal Description
NB/EB US 0151 / US 151 AND D065 / RICHLAND RD 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
651704.9
Y-Coordinate
4679212.
U
N
I
T

1 		Driver's Name - Last
GRANT		 First
MADILYN		 Middle
JO		 Suffix
City
SHERRILL		 State
IA - Iowa, US		 Zip
520730000
Driver's Age
17		 Citation Charge Code 1
UNDER INVESTIGATION		 Citation Charge 1
Gender
Female		 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

Y - Intermediate License		 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
01 - Front: Left Side / Motorcycle Driver		 Injury Status
2 - Incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
2 - Freed by non-mechanical means
Transported to:
U OF I HOSPITAL / IA CITY		 Transported by:
HELICOPTER
Insurance Co. Name
Year
1995		 Make
Toyota - TOYT		 Model
CAM		 Style
4D		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
02		 Traffic Controls
05 - Yield signs		 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
21 - Vehicle in traffic		 Second Event
03 - Ran off road, left		 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?
U
N
I
T

2 		Driver's Name - Last
KAEFRING		 First
DAVID		 Middle
L		 Suffix
City
CEDAR RPAIDS		 State
IA - Iowa, US		 Zip
52402
Driver's Age
23		 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?
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
1 - Deployed front of person		 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
Year
2003		 Make
Toyota - TOYT		 Model
AVALON		 Style
4DR		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
02		 Traffic Controls
07 - Warning sign		 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
21 - Vehicle in traffic		 Second Event
01 - Ran off road, right		 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?
P
R
O
P
E
R
T
Y

D
A
M
A
G
E
If Property other than vehicles damaged explain Object Damaged
STOP SIGN		 Estimate of Damage
250
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
STATE OF IOWA
City
ANAMOSA		 State
IA - Iowa, US		 Zip
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
5 - Broadside		 Roadway
01 - None apparent		 Type
Light Conditions
2 - Dusk		 Surface Conditions
1		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
P
E
R
S
O
N 		I
N
J
U
R
E
D 		Name- Last
SMITH		 First
KATRINA		 Middle
LEE-ANN		 Suffix
City
 State
 Zip Code
Age
15		 Sex
Female		 Unit No.
01		 Seating Position
03 - Front: Right Side		 Injury Status
2 - Incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
3 - Extricated by mechanical means
Transported to:
U OF I HOSPITAL / IA CITY		 Transported by:
HELICOPTER
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
D
I
A
G
R
A
M

0
NARRATIVE

VEHICLE 1 EAST BOUND FAILED TO YIELD TO VEHICLE 2 NORTH BOUND. 2 STRUCK 1 IN THE PASSENGER SIDE DOOR CAUSING BOTH VEHICLES TO SPIN AND COME TO REST ON THE NORTH EAST SIDE OF THE INTERSECTION FACING SOUTH.
Officer
DRISCOLL 		Badge No.
127		 Time Officer Notified of Accident
20:18		 Time Officer Arrived At Scene
20:30
Name of Agency
P10		 Date of Report
5/30/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046