Crash Information

L O C A T I O N	Date of Accident 6/22/2011	Time of Accident 04:55 PM	County Warren - 91	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011036363
	Literal Description US 0065 / NE LOOP and SB/WB US 0069 / US 69				Legal Intervention? No	Private Property? No
					X-Coordinate: 452227.3
					Y-Coordinate 4595196.

U N I T 1	Driver's Name - Last GRAU			First VICTORIA			Middle GENEVIEVESTEWAR		Suffix
	City CARLISLE			State IA - Iowa, US				Zip 500470000
	Driver's Age 22					Citation Charge Code 1 321.306		Citation Charge 1 IMPROPER USE OF LANES
	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 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 6 - Not applicable	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 2005		Make		Model ALTIMA		Style 4D		Approximate Cost to Repair or Replace 500
	Initial Travel Direction 3 - South	Vehicle Action 06 - Changing lanes	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 1	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 22 - Vehicle in/from other roadway	Second Event 21 - Vehicle in traffic	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 HEEMSTRA			First LAURA			Middle MICHELLE		Suffix
	City LACONA			State IA - Iowa, US				Zip 501390000
	Driver's Age 41					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 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:					Transported by:
	Insurance Co. Name
	Year 1996		Make Oldsmobile - OLDS		Model 88		Style 4D		Approximate Cost to Repair or Replace 2000
	Initial Travel Direction 3 - South	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 2	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 22 - Vehicle in/from other roadway	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway
	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) 22 - Vehicle in/from other roadway
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 06 - Rain	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 2	Type of Roadway Junction/Feature 16 - Intersection with ramp	Workers Present?

P
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Name- Last
HEEMSTRA

First
NICOLE

Middle
RAE

Suffix

City

State

Zip Code

Age
18

Sex
Female

Unit No.
2

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:

Transported by:

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
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A
G
R
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M

0

NARRATIVE

UNIT TWO WAS INITIALLY TRAVELING HIGHWAY 5 WB/SB PRIOR TO MERGING ONTO THE HIGHWAY 5 OFF-RAMP TO ENTER HIGHWAY 69 SOUTHBOUND. AS UNIT TWO REACHED THE BOTTOM OF THE RAMP, UNIT TWO WAS REAR ENDED BY UNITY ONE, WHOM WAS TRAVELING SOUTH ON HWY 69 AND MERGING ONTO HWY 5 EB/NB RAMP. FEMALE PASSENGER OF UNIT TWO INDICATED NECK PAIN. EMS ARRIVED ON-SCENE AND EVALUATED FEMALE SUBJECT.

Officer MAJOR	Badge No. 049	Time Officer Notified of Accident 17:00	Time Officer Arrived At Scene 17:00
Name of Agency P02	Date of Report 6/22/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653