Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
6/21/2011		 Time of Accident
09:50 AM 		County
Cedar - 16		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011036039
Literal Description
SB/WB Interstate 0080 measuring 58 Meters East from Interstate 0080 (Milepost 261) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
647891.2
Y-Coordinate
4613676.
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1 		Driver's Name - Last
RUIZ		 First
BLANCA		 Middle
R		 Suffix
City
BERWYN		 State
IL - Illinois, US		 Zip
60402
Driver's Age
34		 Citation Charge Code 1
 Citation Charge 1
Gender
Female		 State
IL - Illinois, US		 Class
D - Chauffeur		 Endorsements
N - Tank		 Restrictions

N - Non-resident CDL		 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
9 - Unknown		 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
2000		 Make
Chevrolet - CHEV		 Model
SUBURBAN		 Style
SUV		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
09 - Top		 Most Damaged Area
07 - Left Side		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
5		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
04 - Blowout		 Driver Condition
1 - Apparently normal		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
04 - Crossed centerline/median		 Third Event
 Fourth Event
 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?
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
2 - Shoulder		 Weather Conditions (up to two)
01 - Clear		 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

UNIT 1 WAS WEST BOUND ON I-80. LEFT REAR TIRE BLEW CAUSING UNIT TO VEER INTO THE MEDIAN. UNIT 1 ENTERED MUDDY MEDIAN AND ROLLED OVER, COMING TO REST ON IT'S TOP. THE OCCUPANTS WERE WEARING SEATBELTS AND ESCAPED UNINJURED
Officer
NEVILLE 		Badge No.
328		 Time Officer Notified of Accident
08:55		 Time Officer Arrived At Scene
09:00
Name of Agency
P12		 Date of Report
6/21/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504