Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
6/27/2011		 Time of Accident
10:45 AM 		County
Cerro Gordo - 17		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011037313
Literal Description
SB INTERSTATE 35/199.45 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
471669.3
Y-Coordinate
4785242.
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1 		Driver's Name - Last
THOMAZIN		 First
MCKENZIE		 Middle
JO		 Suffix
City
MASON CITY		 State
IA - Iowa, US		 Zip
50401
Driver's Age
18		 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
2 - Incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
MERCY MASON CITY		 Transported by:
CLEAR LAKE AMBULANCE
Insurance Co. Name
Year
2005		 Make
Ford - FORD		 Model
ECP		 Style
SW		 Approximate Cost to Repair or Replace
6000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
01 - Front		 Most Damaged Area
09 - Top		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
08 - Moving vehicles		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
03 - Ran off road, left		 Third Event
 Fourth Event
11 - Overturn/rollover		 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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?
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Y

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If Property other than vehicles damaged explain Object Damaged
199.45MM DELINEATOR POS		 Estimate of Damage
300
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
IOWA DOT
City
AMES		 State
IA - Iowa, US		 Zip
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
3 - Median		 Weather Conditions (up to two)
02 - Partly cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
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

VEH 1 WAS SOUTHBOUND ON I35. ANOTHER CAR WAS ATTEMPTING TO PASS VEH 1. WHEN THE 2ND VEHICLE MERGED BACK, VEH 1'S DRIVER WAS STARTLED AND SWERVED. VEH 1 OVER CORRECTED AND CROSSED THE MEDIAN INTO THE NORTHBOUND LANES. VEH 1 THEN BECAME AIRBORNE, ROLLED AND CAME TO REST ON IT'S TOP FACING EAST IN THE EAST DITCH OF I35 NORTHBOUND.
Officer
PALAS 		Badge No.
265		 Time Officer Notified of Accident
10:48		 Time Officer Arrived At Scene
10:53
Name of Agency
P08		 Date of Report
6/27/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381