U
N
I
T
1
|
Driver's Name - Last CHILTON |
First KENNETH |
Middle CHARLES |
Suffix
|
City OSKALOOSA |
State IA - Iowa, US |
Zip 525770000 |
Driver's Age 86 |
Citation Charge Code 1 321.302 |
Citation Charge 1 IMPROPER OVERTAKING ON RIGHT |
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
B - Cor Lenses |
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 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2001 |
Make Ford - FORD |
Model FOC |
Style 4D |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 3 - South |
Vehicle Action 05 - Overtaking/passing |
Speed Limit 65 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
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 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
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 BROOKS |
First DENNIS |
Middle JAMES |
Suffix
|
City BUSSEY |
State IA - Iowa, US |
Zip 500440000 |
Driver's Age 56 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
Endorsements
|
Restrictions
L - Veh w/o Airbrakes |
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 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2003 |
Make Dodge - DODG |
Model R15 |
Style PK |
Approximate Cost to Repair or Replace 4000 |
Initial Travel Direction 3 - South |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 65 |
Point of Initial Impact 03 - Right Side |
Most Damaged Area 03 - Right Side |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
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?
|
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
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
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 VANTOORN |
First CHARLES |
Middle GLEN |
Suffix
|
City
|
State
|
Zip Code
|
Age 66 |
Sex Male |
Unit No. 2 |
Seating Position 03 - Front: Right Side |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE #2 WAS TRAVELING SOUTHBOUND ON HWY 63 IN THE RIGHT LANE. VEHICLE #1 WAS SLOWING TO MAKE A RIGHT HAND TURN ONTO 290TH ST. WITH HIS TURN SIGNAL ON. VEHICLE #1 WAS TRAVELING SOUTHBOUND ON HWY 63 IN THE RIGHT LANE COMING IN BEHIND VEHICLE #2. VEHICLE #1 ATTEMPT TO GO AROUND VEHICLE #1 ON THE RIGHT AND LOST CONTROL OF HIS VEHICLE ON THE GRAVEL SHOULDER. VEHICLE #1 STRUCK THE RIGHT SIDE OF VEHICLE #1 WITH THE FRONT OF HIS VEHICLE. BOTH VEHICLE THEN ROTATED TO THE RIGHT AND ENTERED THE WEST DITCH WITH VEHICLE #1FACING TO THE WEST AND VEHICLE #2 FACING NORTH. VEHICLE #1'S FRONT END WAS UNDER THE PASSENGER SIDE OF VEHICLE #2 WITH VEHICLE #2 ALMOST OVERTURNED ONTO THE DRIVERS SIDE. DRIVER OF VEHICLE #1 STATED HE WAS TRYING TO AVOID AN ACCIDENT BY PASSING ON THE RIGHT. |
|
Officer
NEELY |
Badge No. 482 |
Time Officer Notified of Accident 13:34 |
Time Officer Arrived At Scene 13:45 |
Name of Agency P13 |
Date of Report 9/27/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743