U
N
I
T
1
|
Driver's Name - Last HASTY |
First MASON |
Middle COLE |
Suffix
|
City STUART |
State IA - Iowa, US |
Zip 50250 |
Driver's Age 16 |
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
Y - Intermediate 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 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 3 - Deployed both front/side |
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 1995 |
Make Chevrolet - CHEV |
Model MONTE CARLO |
Style CAR |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 09 - Railway crossing device |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 06 - Hillcrest |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 04 - Crossed centerline/median |
Second Event 06 - Evasive action (swerve, panic braking, etc.) |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
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 NOURSE |
First TINA |
Middle MARIE |
Suffix
|
City MENLO |
State IA - Iowa, US |
Zip 50164 |
Driver's Age 36 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
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 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 3 - Deployed both front/side |
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 2006 |
Make Pontiac - PONT |
Model GS1 |
Style 4D |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 3 |
Traffic Controls 09 - Railway crossing device |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 06 - Hillcrest |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
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) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 2 - Head-on |
Roadway 01 - None apparent |
Type
|
Light Conditions 2 - Dusk |
Surface Conditions 6 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT 1 WAS TRAVELING SOUTHBOUND ON S MADISON JUST SOUTH OF WHITE POLE ROAD AND CAME TO THE RAILROAD TRACKS. THIS IS ALSO A HILL CREST AND WAS TO THE LEFT OF CENTER. THE ROADWAY IS VERY NARROW AND NOTICED A CAR ON THE OTHER SIDE. THE 2 UNITS STRUCK EACH OTHER AND CAME TO A REST IN THE TRAVEL PORTION. |
|
Officer
DINKLA |
Badge No. 188 |
Time Officer Notified of Accident 17:23 |
Time Officer Arrived At Scene 17:49 |
Name of Agency P04 |
Date of Report 11/28/2010 |
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