U
N
I
T
2
|
Driver's Name - Last FREEBERN |
First SCOTT |
Middle EDWARD |
Suffix
|
City DAKOTA DUNES |
State SD - South Dakota, US |
Zip 570495385 |
Driver's Age 35 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State SD - South Dakota, US |
Class
|
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 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2007 |
Make Chevrolet - CHEV |
Model SLV |
Style PK |
Approximate Cost to Repair or Replace 6000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 06 - No Passing Zone (marked) |
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 13 - Other non-collision |
Second Event 01 - Ran off road, right |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 13 - Other non-collision |
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
3
|
Driver's Name - Last UNKNOWN |
First
|
Middle
|
Suffix
|
City
|
State
|
Zip
|
Driver's Age
|
Citation Charge Code 1
|
Citation Charge 1
|
Gender
|
State
|
Class
|
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given?
|
Drug Test Given?
|
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 9 - Unknown |
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 UNKNOWN |
Year
|
Make
|
Model
|
Style
|
Approximate Cost to Repair or Replace
|
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact
|
Most Damaged Area
|
Extent of Damage
|
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 06 - No Passing Zone (marked) |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 99 - Unknown |
Vehicle Defect 05 - Other tire defect (explain in narrative) |
Driver Condition 9 - Unknown |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 09 - Equipment failure (tires, brakes, etc.) |
Second Event 13 - Other non-collision |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 09 - Equipment failure (tires, brakes, etc.) |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name UNKNOWN |
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 4 - Within or adjacent to work activity |
First Harmful Event of Crash (use codes 11-42 only) 13 - Other non-collision |
Manner of Crash/Collision 1 - Non-collision |
Roadway 01 - None apparent |
Type 2 - Lane shift/crossover (head-to-head traffic) |
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present? No |
D I A G R A M
0 |
|
NARRATIVE |
On 11/5/10 I was called to the 102 mile marker of I-29 for a property damage accident. Unit 1 and 2 were both pulled into the media of I-29 when I arrived on the scene. The driver of unit 1 and 2 stated that the duals had come off of a semi trailer that was traveling northbound. They said that the duals then struck unit 1 and unit 2. I could see that the driver's side mirror, driver's door and rear driver's side of unit 1 all had damage. The passenger side front of unit 2 had some extensive damage. The metal part of the bumper had been pushed into the tire and had cut the tire up, making the vehicle unsafe to drive. Schroder's Towing was contacted to remove the vehicle. The driver of unit 1 and unit 2 were unable to provide any vehicle information about the semi other than the duals of the trailer had come off and struck their vehicles. There were also two construction workers on scene. They stated that the semi had stopped a short distance north of the incident and then continued on. They also could not give me any vehicle description. One of the workers was on his cell phone with another worker that was looking for the semi. He stated that he was checking the Onawa area and would let him know if he located the semi. I gathered information from the driver's and started the accident report. I spoke with both driver's and advised them that I was also going to try and locate the semi and that I would mail them a copy of the accident report. I then left the scene and searched the rest area, Blencoe and Onawa area for the semi. I also contacted Trooper Farley who was working in the Sioux City area and asked him to check the area and watch for the semi. We were unable to locate the semi. |
|
Officer
HALVERSON |
Badge No. 307 |
Time Officer Notified of Accident 17:11 |
Time Officer Arrived At Scene 17:26 |
Name of Agency P04 |
Date of Report 11/5/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325