Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
5/29/2011		 Time of Accident
04:55 PM 		County
Keokuk - 54		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011031155
Literal Description
Iowa 0022 / IOWA 22 measuring 0.19 Miles East from 312TH AVE and Iowa 0022 / IOWA 22 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
583876.4
Y-Coordinate
4590404.
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1 		Driver's Name - Last
WAGLER		 First
ALLEN		 Middle
RICHARD		 Suffix
City
SIGOURNEY		 State
IA - Iowa, US		 Zip
525910000
Driver's Age
82		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
D - Chauffeur		 Endorsements
1 - Trk - Trctr Semi-Trailer Comb		 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
3 - Deployed both front/side		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2010		 Make
Ford - FORD		 Model
FOC		 Style
4D		 Approximate Cost to Repair or Replace
20000
Initial Travel Direction
4 - West		 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
02		 Traffic Controls
01 - No controls present		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
04 - Blowout		 Driver Condition
1 - Apparently normal		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
13 - Other non-collision		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
03 - Ran off road, left
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)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
13 - Other non-collision
Manner of Crash/Collision
1 - Non-collision		 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

VEHICLE #1 WAS TRAVELING WEST ON HIGHWAY 22 WEST OF KINROSS WHEN IT CROSSED THE CENTER LINE AND ENTERED THE DITCH ON THE SOUTH SIDE OF THE ROAD. VEHICLE #1 CONTINUED TO TRAVEL WEST IN THE DITCH BEFORE COMING TO A FINAL REST IN THE DITCH. A WITNESS TO THE ACCIDENT STATED THAT IT APPEARED A TIRE BLEW OR SOMETHING BROKE ON THE FRONT OF THE CAR PRIOR TO ENTERING THE DITCH. THE DRIVER AND PASSANGER OF VEHICLE #1 WERE NOT INJURED AND RELEASED FROM THE SCENE. VEHICLE #1 WAS TOWED BY DICKS TOWING BACK TO SIGOURNEY.
Officer
HENNINGSEN 		Badge No.
194		 Time Officer Notified of Accident
17:05		 Time Officer Arrived At Scene
17:16
Name of Agency
P13		 Date of Report
5/29/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743