Crash Information

L O C A T I O N	Date of Accident 7/11/2011	Time of Accident 05:16 PM	County Webster - 94	Accident occurred within corporate limits of (city) Fort Dodge - 2690	Law Enforcement Case Number: 2011040387
	Literal Description 5TH AVE S measuring 70 Feet East from 5TH AVE S and S 30TH ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 405110.3
					Y-Coordinate 4706072.

U N I T 1	Driver's Name - Last PETERSON			First GENE			Middle K		Suffix
	City FORT DODGE			State IA - Iowa, US				Zip 50501
	Driver's Age 81					Citation Charge Code 1		Citation Charge 1
	Gender Male	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 1 - Fatal	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: TRINITY REGIONAL MED. CENTER					Transported by: TRMC AMBULANCE
	Insurance Co. Name
	Year 1989		Make Ford - FORD		Model F15		Style PK		Approximate Cost to Repair or Replace 4000
	Initial Travel Direction 2 - East	Vehicle Action 08 - Leaving traffic lane	Speed Limit 35	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 2 - Underride, compartment intrusion
	Total Occupants 1	Traffic Controls 11 - Workzone signs	Vehicle Config. 02 - Four-tire light truck (pick-up, panel)	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 9 - Unknown	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 26 - Other non-fixed object (explain in narrative)	Third Event	Fourth Event	Most Harmful Event (by vehicle) 26 - Other non-fixed object (explain in narrative)
	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			First			Middle		Suffix
	City			State				Zip
	Driver's Age					Citation Charge Code 1		Citation Charge 1
	Gender	State	Class	Endorsements None	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given?			Drug Test Given?		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position	Injury Status	Occupant Protection		Airbag Deployment	Airbag Switch Status		Ejection	Ejection Path	Trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year		Make		Model SK330		Style EXCAVATOR		Approximate Cost to Repair or Replace
	Initial Travel Direction 2 - East	Vehicle Action 12 - Legally Parked	Speed Limit 35	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 1 - None	Underride/Override 5 - Override, moving vehicle
	Total Occupants 0	Traffic Controls 01 - No controls present	Vehicle Config. 21 - Maintenance/construction vehicle	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition	Vision Obscured 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 23 - Parked motor vehicle	Second Event 22 - Vehicle in/from other roadway	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 6 - Outside Trafficway	Weather Conditions (up to two) 01 - Clear	Environment 8 - Other (explain in narrative)	Location 4 - Within or adjacent to work activity	First Harmful Event of Crash (use codes 11-42 only) 26 - Other non-fixed object (explain in narrative)
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 01 - Clear	Roadway 04 - Ruts, holes, bumps	Type 1 - Lane Closure
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present? Yes

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NARRATIVE

UNIT ONE WAS TRAVELING EASTBOUND ON 5TH AVE SOUTH EAST OF SOUTH 30TH STREET IN FORT DODGE. UNIT ONE LOST CONTROL LEFT THE DEISIGNATED ROADWAY IN THE CONSTRUCTION ZONE AND REAR ENDED A PARKED EXCAVATOR.

Officer BURNS	Badge No. 028	Time Officer Notified of Accident 17:17	Time Officer Arrived At Scene 17:18
Name of Agency P07	Date of Report 7/11/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218