Iowa State Patrol: Department of Public Safety

Crash Information


L
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C
A
T
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N
Date of Accident
8/3/2010
Time of Accident
06:59 PM
County
Webster - 94
Accident occurred within corporate limits of (city)
Law Enforcement Case Number:
2010045663
Literal Description
D033 / 255TH ST and 255TH ST and P059 / NELSON AVE measuring 722 Feet West from 255TH ST
Legal Intervention?
No
Private Property?
No
X-Coordinate:
406954.9
Y-Coordinate
4697013.
U
N
I
T

1
Driver's Name - Last
LOCK
First
MICHELLE
Middle
OPAL
Suffix
City
FT DODGE
State
IA - Iowa, US
Zip
50501
Driver's Age
45
Citation Charge Code 1
321.20B-B
Citation Charge 1
VIOLATION - FINANCIAL LIABILITY - ACCIDENT
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
3 - No ON/OFF switch present
Ejection
1 - Not ejected
Ejection Path
Trapped
1 - Not trapped
Transported to:
Transported by:
Insurance Co. Name
Year
2000
Make
Ford - FORD
Model
WINDSTAR
Style
VAN
Approximate Cost to Repair or Replace
0
Initial Travel Direction
4 - West
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
03 - Right Side
Most Damaged Area
03 - Right Side
Extent of Damage
1 - None
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
8 - Other (explain in narrative)
Vision Obscured
01 - Not obscured
Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
13 - Other non-collision
Second Event
Third Event
Fourth Event
Most Harmful Event (by vehicle)
13 - Other non-collision
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)
02 - Partly cloudy
Environment
1 - None apparent
Location
First Harmful Event of Crash (use codes 11-42 only)
13 - Other non-collision
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?
P
E
R
S
O
N
I
N
J
U
R
E
D
Name- Last
LOCK
First
SHANE
Middle
A
Suffix
City
State
Zip Code
Age
45
Sex
Male
Unit No.
1
Seating Position
03 - Front: Right Side
Injury Status
2 - Incapacitating
Occupant Protection
1 - None 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:
TRINITY REGIONAL
Transported by:
AMBULANE
NON-MOTORIST Type
Location
Action
Condition
Safety Equipment
Contributing Circumstances
Unit No. of Vehicle Striking
D
I
A
G
R
A
M

0
NARRATIVE

DRIVER WAS WEST BOUND WHEN THE FRONT SEAT PASSENGER REMOVED HIS SEATBELT AND SAT ON THE FRONT PASSENGERS SIDE WINDOW. HE THEN FELL OUT OF THE VEHICLE AND STRUCK HIS HEAD.
Officer
MILLER
Badge No.
421
Time Officer Notified of Accident
19:00
Time Officer Arrived At Scene
19:20
Name of Agency
P07
Date of Report
8/3/2010
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