U
N
I
T
1
|
Driver's Name - Last FOLSOM |
First MICHELLE |
Middle MARIE |
Suffix
|
City OELWEIN |
State IA - Iowa, US |
Zip 506620000 |
Driver's Age 35 |
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
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2005 |
Make Ford - FORD |
Model ECP |
Style SW |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 3 - South |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 70 |
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 5 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 88 - Other (explain in narrative) |
Driver Condition 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 13 - Other non-collision |
Second Event 21 - Vehicle in traffic |
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 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 99 - Unknown |
Most Damaged Area 99 - Unknown |
Extent of Damage 9 - Unknown |
Underride/Override 9 - Unknown |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 99 - Unknown |
Vehicle Defect 99 - Unknown |
Driver Condition
|
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event
|
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle)
|
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) 06 - Rain |
Environment 2 - Weather condition |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 02 - Road surface condition |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 2 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE #1 WAS GOING SOUTH ON INTERSTATE 35 WHEN IT BECAME DISABLED AFTER DRIVING THROUGH DEEP WATER RUNNING ACROSS THE ROADWAY. AFTER BECOMING DISABLED PARTIALLY ON THE INSIDE LANE ON INTERSTATE 35, IT WAS STRUCK ON THE PASSENGER SIDE BY AN UNKNOWN SEMI TRACTOR TRAILER ALSO GOING SOUTH ON INTERSTATE 35. THE SEMI DID NOT STOP AT THE SCENE. THERE WAS HEAVY RAIN WITH REDUCED VISIBILITY AT HE TIME OF THE ACCIDENT. |
|
Officer
TJEPKES |
Badge No. 074 |
Time Officer Notified of Accident 23:35 |
Time Officer Arrived At Scene 23:35 |
Name of Agency P01 |
Date of Report 8/10/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011