Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
5/29/2011		 Time of Accident
06:53 AM 		County
Polk - 77		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011031098
Literal Description
I-80 EB TO I-35 NB 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
452135.6
Y-Coordinate
4611234.
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1 		Driver's Name - Last
CLOUTMAN		 First
DONALD		 Middle
GENE		 Suffix
City
BEMIDJI		 State
MN - Minnesota, US		 Zip
56601
Driver's Age
64		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
MN - Minnesota, US		 Class
D - Chauffeur		 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
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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2003		 Make
Dodge - DODG		 Model
DAKOTA		 Style
PU		 Approximate Cost to Repair or Replace
8000
Initial Travel Direction
2 - East		 Vehicle Action
08 - Leaving traffic lane		 Speed Limit
45		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
02 - Four-tire light truck (pick-up, panel)		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
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)
06 - Rain		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
3 - Dawn		 Surface Conditions
2		 Type of Roadway Junction/Feature
19 - On-ramp		 Workers Present?
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NARRATIVE

UNIT#1 WAS EXITING I-80 EB ONTO I-35 NB RAMP. DRIVER OF UNIT #1 SAID HE APPLIED BRAKES AND LOST CONTROL OF THE VEHICLE. UNIT #1 ENTERED THE SOUTH DITCH AND MADE HARD CONTACT WITH THE LEFT FRONT AGAINST THE DTICH BANK. UNIT #1 CAME TO REST ON IT'S WHEELS. NO INJURIES
Officer
CHAMPLIN 		Badge No.
220		 Time Officer Notified of Accident
06:53		 Time Officer Arrived At Scene
06:58
Name of Agency
P01		 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 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011