Iowa State Patrol: Department of Public Safety

Crash Information

L
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C
A
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N 		Date of Accident
6/13/2011		 Time of Accident
07:03 AM 		County
Polk - 77		 Accident occurred within corporate limits of (city)
Urbandale - 7875		 Law Enforcement Case Number:
2011034243
Literal Description
WB INTERSTATE 80 - 768 FEET NORTH OF (MILEPOST 126) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
435285.2
Y-Coordinate
4609023.
U
N
I
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1 		Driver's Name - Last
ROOZEBOOM		 First
BRITTANY		 Middle
ANN		 Suffix
City
DES MOINES		 State
IA - Iowa, US		 Zip
503130000
Driver's Age
22		 Citation Charge Code 1
 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

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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
Year
1995		 Make
Mitsubishi - MITS		 Model
3GT		 Style
2D		 Approximate Cost to Repair or Replace
3500
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 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?
U
N
I
T

2 		Driver's Name - Last
DITTMER		 First
DENNIS		 Middle
RAY		 Suffix
City
NEWTON		 State
IA - Iowa, US		 Zip
502080000
Driver's Age
53		 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
 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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
JMT TRUCKING CO
Year
2007		 Make
Volvo - VOLV		 Model
DUMP TRUCK		 Style
TL		 Approximate Cost to Repair or Replace
500
Initial Travel Direction
3 - South		 Vehicle Action
06 - Changing lanes		 Speed Limit
65		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
02 - Right Front		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
06 - Single-unit truck (>=3 axles)		 Cargo Body Type
03 - Dump truck (grain, gravel)		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
88 - Other (explain in narrative)		 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
JMT TRUCKING CO		 City
DES MOINES		 State
IA - Iowa, US		 Zip
50313
Number of Axles
3		 Gross Vehicle Weight Rating
80000		 Placard #
 Hazardous Materials Released?
2 - No
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)
03 - Cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
6 - Sideswipe, same direction		 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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0
NARRATIVE

VEHICLE 1 WAS WESTBOUND/SOUTHBOUND ON INTERSTATE 80/35 AT THE 126MM IN THE OUTSIDE LANE. VEHICLE 2 WAS ALSO WESTBOUND/SOUTHBOUND ON INTERSTATE 80/35 AT THE 126MM IN THE MIDDLE LANE. VEHICLE 2 SIGNALED TO CHANGE LANES FROM THE MIDDLE TO THE OUTSIDE LANE OF TRAFFIC. VEHICLE 1 WAS IN VEHICLE 2 BLIND SPOT. VEHICLE 2 THEN STRUCK VEHICLE 1 CAUSING THE VEHICLE TO GO OFF THE ROAD TO THE RIGHT.
Officer
PEARSTON 		Badge No.
168		 Time Officer Notified of Accident
07:03		 Time Officer Arrived At Scene
07:03
Name of Agency
P01		 Date of Report
6/13/2011		 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