Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/3/2010		 Time of Accident
11:35 AM 		County
Hamilton - 40		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010068361
Literal Description
Interstate 0035 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
453070.5
Y-Coordinate
4684258.
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1 		Driver's Name - Last
ZIEMER		 First
RODNEY		 Middle
A		 Suffix
City
LEAVENWORTH		 State
KS - Kansas, US		 Zip
66048
Driver's Age
57		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
KS - Kansas, 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?
 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
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 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
1999		 Make
Dodge - DODG		 Model
DAKOTA		 Style
PICKUP		 Approximate Cost to Repair or Replace
3500
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
99 - Unknown		 Most Damaged Area
99 - Unknown		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
02		 Traffic Controls
01 - No controls present		 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
12 - Jackknife		 Second Event
03 - Ran off road, left		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
12 - Jackknife
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

D
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G
E
If Property other than vehicles damaged explain Object Damaged
NONE		 Estimate of Damage
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
City
 State
 Zip
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
3 - Median		 Weather Conditions (up to two)
08 - Snow		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
12 - Jackknife
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
3		 Type of Roadway Junction/Feature
02 - Bridge/overpass/underpass		 Workers Present?
D
I
A
G
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M

0
NARRATIVE

VEH. NO. 1 WAS SOUTHBOUND ON I 35 AT THE 133 MM. VEH. NO. 1 LOST CONTROL, JACK KNIFED AND ENTERED THE MEDIAN AS SHOWN. VEH. NO. 1 HAD A FLAT BED, SMALL BUMPER HITCH TRAILER WITH A MOTORCYCLE ON THE TRAILER ATTACHED TO VEH. NO. 1.
Officer
WINTER 		Badge No.
130		 Time Officer Notified of Accident
11:40		 Time Officer Arrived At Scene
11:40
Name of Agency
P15		 Date of Report
12/3/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 15 Office
5912 NW 2nd Ave
Des Moines,IA 50313-
Phone: (515) 281-6176
Fax: (515) 289-1066