Iowa State Patrol: Department of Public Safety

Crash Information


L
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A
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Date of Accident
8/10/2010
Time of Accident
09:53 PM
County
Adair - 01
Accident occurred within corporate limits of (city)
Law Enforcement Case Number:
2010047136
Literal Description
250TH ST AND FALLOW AVE
Legal Intervention?
No
Private Property?
No
X-Coordinate:
365143.6
Y-Coordinate
4571924.
U
N
I
T

1
Driver's Name - Last
BURG
First
RICHARD
Middle
KEITH
Suffix
City
FONTANELLE
State
IA - Iowa, US
Zip
50846
Driver's Age
60
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
9 - Unknown
Airbag Deployment
9 - Unknown
Airbag Switch Status
9 - Unknown
Ejection
1 - Not ejected
Ejection Path
Trapped
3 - Extricated by mechanical means
Transported to:
ADAIR COUNTY HOSPITAL
Transported by:
ADAIR COUNTY AMBULANCE
Insurance Co. Name
Year
1996
Make
Oldsmobile - OLDS
Model
88 LS
Style
4DR
Approximate Cost to Repair or Replace
4500
Initial Travel Direction
2 - East
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
04 - Right Rear
Most Damaged Area
02 - Right Front
Extent of Damage
5 - Severe, vehicle totaled
Underride/Override
1 - None
Total Occupants
1
Traffic Controls
01 - No controls present
Vehicle Config.
01 - Passenger car
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
03 - Ran off road, left
Second Event
33 - Ditch/embankment
Third Event
Fourth Event
Most Harmful Event (by vehicle)
03 - Ran off road, left
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)
02 - Partly cloudy
Environment
1 - None apparent
Location
First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision
Roadway
01 - None apparent
Type
Light Conditions
5 - Dark, roadway not lighted
Surface Conditions
6
Type of Roadway Junction/Feature
01 - No special feature
Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

VEHICLE ONE WAS TRAVELING EAST ON 250TH ST. VEHICLE ONE LOST CONTROL ON THE GRAVEL ROAD, ENTERED THE NORTH DITCH AND CAME TO REST UPRIGHT. WITNESSES STATED VEHICLE ONE WAS FULLY ENGULFED IN FLAMES AND WERE UNABLE TO ASSIST THE DRIVER AND ONLY OCCUPANT OF THIS VEHICLE.THE DRIVER WAS PRONOUNCED DEAD AT THE SCENE.
Officer
BROSAM
Badge No.
078
Time Officer Notified of Accident
22:11
Time Officer Arrived At Scene
22:50
Name of Agency
P03
Date of Report
8/11/2010
Investigation made at scene?
Yes
T.I. #



Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504