U
N
I
T
1
|
Driver's Name - Last ANDERSON |
First RONNIE |
Middle EDWARD |
Suffix
|
City NEWFOLDEN |
State MN - Minnesota, US |
Zip 56738 |
Driver's Age 59 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MN - Minnesota, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
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 6 - Not applicable |
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 RON ANDERSON |
Year 1998 |
Make
|
Model TRACTOR |
Style TRUCK |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 06 - Left Rear |
Most Damaged Area 06 - Left Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 05 - Flatbed |
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 01 - Ran off road, right |
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 RON ANDERSON |
City NEWFOLDEN |
State MN - Minnesota, US |
Zip 56738 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 3 - Not applicable |
U
N
I
T
2
|
Driver's Name - Last BRIGHTON |
First PEGGY |
Middle IRENE |
Suffix
|
City SIOUX CITY |
State IA - Iowa, US |
Zip 511050000 |
Driver's Age 64 |
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
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 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2006 |
Make Pontiac - PONT |
Model GRAND PRIX |
Style 4DR |
Approximate Cost to Repair or Replace 10000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
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 06 - Evasive action (swerve, panic braking, etc.) |
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?
|
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) 02 - Partly cloudy |
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 5 - Dark, roadway not lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLES 1 AND 2 WERE WESTBOUND IN THE RIGHT LANE. ACCORDING TO THE DRIVER OF VEHICLE 1. HE HAD HIS RIGHT TURN SIGNAL ON TO TAKE THE 93 EXIT OFF RAMP. THE DRIVER OF VEHICLE 2 STATED SHE SWERVED TO THE LEFT TO AVOID RUNNING INTO THE REAR OF VEHICLE 1. VEHICLE 2 WENT ACROSS THE LEFT LANE AND INTO THE MEDIAN. VEHICLE 2 CAME TO REST IN THE MEDIAN FACING EAST. THE DRIVER OF VEHICLE 1 STATED THAT HE HEARD A NOISE AND SAW VEHICLE 2 GOING INTO THE MEDIAN. VEHICLE 1 CAME TO REST ON THE RIGHT SHOULDER WESTBOUND. |
|
Officer
GRANNER |
Badge No. 352 |
Time Officer Notified of Accident 17:48 |
Time Officer Arrived At Scene 18:23 |
Name of Agency P03 |
Date of Report 11/30/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504