U
N
I
T
1
|
Driver's Name - Last WHITE |
First THOMAS |
Middle CRITTENDEN |
Suffix
|
City KIRKWOOD |
State MO - Missouri, US |
Zip 63122 |
Driver's Age 50 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MO - Missouri, US |
Class
|
Endorsements
|
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 01 - Front: Left Side / Motorcycle Driver |
Injury Status 5 - Uninjured |
Occupant Protection 9 - Unknown |
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 2003 |
Make
|
Model COACH |
Style MOTORHOME |
Approximate Cost to Repair or Replace 2500 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 02 |
Traffic Controls 01 - No controls present |
Vehicle Config. 13 - Motor home/recreational vehicle |
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 21 - Vehicle in traffic |
Second Event 06 - Evasive action (swerve, panic braking, etc.) |
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 UNKNOWN |
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
|
Style
|
Approximate Cost to Repair or Replace
|
Initial Travel Direction
|
Vehicle Action
|
Speed Limit
|
Point of Initial Impact
|
Most Damaged Area
|
Extent of Damage
|
Underride/Override
|
Total Occupants
|
Traffic Controls
|
Vehicle Config.
|
Cargo Body Type
|
Vehicle Defect
|
Driver Condition
|
Vision Obscured
|
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 06 - Evasive action (swerve, panic braking, etc.) |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 06 - Evasive action (swerve, panic braking, etc.) |
Emergency Vehicle Type
|
Emergency Status
|
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) 01 - Clear |
Environment 1 - None apparent |
Location 3 - Within transition area for lane shift |
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 05 - Work Zone (construction, maintenance, utility) |
Type 1 - Lane Closure |
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE #1 AND #2 TRAVELING NORTH ON INTERSTATE #29 WERE ENERING CONSTRUCTION ZONE. #2 IN LEFT LANE SWERVED TO THE RIGHT LANE AND SLOWED. #1 ALSO UNDER HEAVEY BRAKING, CAME IN CONTACT WITH BOAT TRAILER PULLED BY VEHICLE #2 ON THE RIGHT FRONT CORNER OF VEHICLE VEHICEL #2 FAILED TO STOP AND LEFT THE STATE INTO NEBRASKA. |
|
Officer
FARLEY |
Badge No. 027 |
Time Officer Notified of Accident 18:32 |
Time Officer Arrived At Scene 18:50 |
Name of Agency P04 |
Date of Report 7/31/2010 |
Investigation made at scene? No |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325