Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
5/28/2011		 Time of Accident
12:07 AM 		County
Scott - 82		 Accident occurred within corporate limits of (city)
Davenport - 1827		 Law Enforcement Case Number:
2011030892
Literal Description
SB/WB Interstate 0080 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
703711.3
Y-Coordinate
4607661.
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1 		Driver's Name - Last
THAI		 First
TRUNG		 Middle
MINH		 Suffix
City
DAVENPORT		 State
IA - Iowa, US		 Zip
52802
Driver's Age
48		 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

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
4 - Possible		 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:
GENESIS EAST		 Transported by:
AMBULANCE
Insurance Co. Name
Year
2003		 Make
Oldsmobile - OLDS		 Model
 Style
VAN		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
4		 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
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
 City
 State
 Zip
Number of Axles
 Gross Vehicle Weight Rating
 Placard #
 Hazardous Materials Released?
U
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2 		Driver's Name - Last
HICKMAN		 First
DEMARIO		 Middle
QUINN		 Suffix
City
MOLINE		 State
IL - Illinois, US		 Zip
61255
Driver's Age
24		 Citation Charge Code 1
321J.2(2)(a)		 Citation Charge 1
OPER VEH WH INT (OWI) / 1ST OFF
Gender
Male		 State
IL - Illinois, US		 Class
C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat		 Endorsements
None		 Restrictions

None		 Citation Charge Code 2
321.285		 Citation Charge 2
FAILURE TO STOP WITHIN THE ASSURED CLEAR DISTANCE
Alcohol Test Given?
4 - Breath		 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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2004		 Make
Ford - FORD		 Model
ESCAPE		 Style
SUV		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
6 - Under the influence of alcohol/drugs/medications		 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
 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)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end		 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?
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D 		Name- Last
PHAM		 First
SUM		 Middle
 Suffix
City
 State
 Zip Code
Age
66		 Sex
Male		 Unit No.
1		 Seating Position
03 - Front: Right Side		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 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:
GENESIS EAST		 Transported by:
AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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N 		I
N
J
U
R
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D 		Name- Last
HO		 First
MY		 Middle
TIEN		 Suffix
City
 State
 Zip Code
Age
38		 Sex
Female		 Unit No.
1		 Seating Position
06 - Center: Right Side		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 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:
GENESIS EAST		 Transported by:
AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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N
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D 		Name- Last
TRAN		 First
MEE		 Middle
RAN		 Suffix
City
 State
 Zip Code
Age
37		 Sex
Female		 Unit No.
1		 Seating Position
04 - Center: Left Side / Motorcycle Passenger		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 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:
GENESIS EAST		 Transported by:
AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
D
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NARRATIVE

VEHICLE #1 AND #2 WERE BOTH HEADING WEST BOUND ON I-80. VEHICLE #2 HIT #1 FROM BEHIND AND BOTH VEHICLES STOPPED ON THE TRAVEL PORTION OF THE ROAD. VEHICLE #2 DID NOT HAVE A LICENSE PLATE DISPLAYED BECAUSE IT WAS PURCHASED THE DAY OF THE ACCIDENT.
Officer
DONAHUE 		Badge No.
386		 Time Officer Notified of Accident
23:33		 Time Officer Arrived At Scene
23:36
Name of Agency
P16		 Date of Report
5/28/2011		 Investigation made at scene?
No		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 16 Office
Lucas State Office Bldg
Des Moines,IA 50319-
Phone: (515) 281-3879
Fax: (515) 281-6478