Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
11/2/2010		 Time of Accident
07:40 AM 		County
Plymouth - 75		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010062555
Literal Description
NB HWY 12 MM 24.5 / S 240TH 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
205987.9
Y-Coordinate
4734157.
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1 		Driver's Name - Last
HANSEN		 First
TREVOR		 Middle
EDWARD		 Suffix
City
SIOUX CITY		 State
IA - Iowa, US		 Zip
511090000
Driver's Age
14		 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

7 - Minor Sch License		 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
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2001		 Make
 Model
CHK		 Style
SW		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
09 - Top		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
5 - Asleep, fainted, fatigued, etc		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
11 - Overturn/rollover		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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?
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Y

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If Property other than vehicles damaged explain Object Damaged
BARB WIRE FENCE		 Estimate of Damage
500
Owner's Name - Last
BANKS		 First
KIRK		 Middle
DEVIN		 Suffix
Owner Company Name
City
WESTFIELD		 State
IA - Iowa, US		 Zip
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
2 - Shoulder		 Weather Conditions (up to two)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
3 - Dawn		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT ONE WAS NORTHBOUND ON HIGHWAY 12. THE DRIVER FELL ASLEEP AND WENT INTO THE WEST DITCH, ROLLING ONCE.
Officer
WILLIS 		Badge No.
316		 Time Officer Notified of Accident
07:47		 Time Officer Arrived At Scene
08:09
Name of Agency
P06		 Date of Report
11/2/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 06 Office
503 W 44th St
Spencer,IA 51301-2089
Phone: (712) 262-1424
Fax: (712) 262-3222