Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
9/22/2010		 Time of Accident
05:30 PM 		County
Scott - 82		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010055321
Literal Description
US 0061 / SERAMP 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
702617.8
Y-Coordinate
4618749.
U
N
I
T

1 		Driver's Name - Last
KLEIN		 First
ROBERT		 Middle
WILLIAM		 Suffix
City
DE WITT		 State
IA - Iowa, US		 Zip
527420000
Driver's Age
48		 Citation Charge Code 1
321.285		 Citation Charge 1
FAILURE TO STOP WITHIN THE ASSURED CLEAR DISTANCE
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
 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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
1996		 Make
Chevrolet - CHEV		 Model
S10		 Style
PK		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 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
1		 Traffic Controls
04 - Stop 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
34 - Curb/island/raised median		 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
WOLF		 First
RAYMOND		 Middle
ALOYSIUS		 Suffix
City
ELDRIDGE		 State
IA - Iowa, US		 Zip
527480000
Driver's Age
50		 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
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
2001		 Make
Dodge - DODG		 Model
CVN		 Style
VN		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 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
1		 Traffic Controls
04 - Stop signs		 Vehicle Config.
03 - Van or mini-van		 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
3 - Rear-end		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
16 - Intersection with ramp		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

UNIT 2 WAS STOPPED AT THE STOP SIGN AT THE END OF THE NORTHBOUND PARKVIEW EXIT RAMP. UNIT 2 PULLED FORWARD TO GET A BETTER VIEW OF THE INTERSECTION. UNIT 1 CAME DOWN THE RAMP AND THOUGHT UNIT 2 WAS GOING TO PROCEDE. UNIT 1 REARENDED UNIT 2.
Officer
OLIVER 		Badge No.
460		 Time Officer Notified of Accident
17:40		 Time Officer Arrived At Scene
17:50
Name of Agency
P12		 Date of Report
9/22/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504