Crash Information

L O C A T I O N	Date of Accident 9/29/2010	Time of Accident 07:45 AM	County Jasper - 50	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2010056514
	Literal Description WB INTERSTATE 80 - 203 FEET EAST OF (MILEPOST 151)				Legal Intervention? No	Private Property? No
					X-Coordinate: 473009.7
					Y-Coordinate 4614461.

U N I T 1	Driver's Name - Last WHITSEL			First BURL			Middle F		Suffix
	City BROGUE			State PA - Pennsylvania, US				Zip 17309
	Driver's Age 71					Citation Charge Code 1		Citation Charge 1
	Gender Male	State PA - Pennsylvania, US	Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat	Endorsements	Restrictions	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: N/A					Transported by: N/A
	Insurance Co. Name
	Year 2007		Make Dodge - DODG		Model RAM 1500		Style 4D		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 4 - West	Vehicle Action 10 - Slowing/stopping	Speed Limit 55	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 2	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 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	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 ROBINSON			First SAMUEL			Middle L		Suffix
	City YOUNGSTOWN			State OH - Ohio, US				Zip 44505
	Driver's Age 59					Citation Charge Code 1 321.285		Citation Charge 1 FAILURE TO STOP WITHIN THE ASSURED CLEAR DISTANCE
	Gender Male	State OH - Ohio, US	Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more	Endorsements None	Restrictions	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: N/A					Transported by: N/A
	Insurance Co. Name
	Year 2010		Make		Model TT		Style SEMI		Approximate Cost to Repair or Replace 1000
	Initial Travel Direction 4 - West	Vehicle Action 10 - Slowing/stopping	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 2	Traffic Controls 11 - Workzone signs	Vehicle Config. 07 - Truck/trailer	Cargo Body Type 02 - Van/enclosed box	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	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?

P R O P E R T Y D A M A G E	If Property other than vehicles damaged explain	Object Damaged 2007 PACE AMERICAN - TRAILER		Estimate of Damage 700
	Owner's Name - Last WHITSEL	First BURL	Middle F	Suffix
	Owner Company Name
	City BROGUE	State PA - Pennsylvania, US		Zip

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 4 - Within or adjacent to work activity	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 01 - Clear	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? Yes

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Name- Last
WHITSEL

First
GARY

Middle
E

Suffix

City

State

Zip Code

Age
59

Sex
Male

Unit No.
1

Seating Position
03 - Front: Right Side

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
1 - Not ejected/not applicable

Trapped
1 - Not trapped

Transported to:
N/A

Transported by:
N/A

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

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Name- Last
FOSTER

First
JUSTIN

Middle
WAYNE