Crash Information

L O C A T I O N	Date of Accident 12/2/2010	Time of Accident 05:25 PM	County Sioux - 84	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2010068178
	Literal Description 200 FEET NORTH OF 330TH ON 75				Legal Intervention? No	Private Property? No
					X-Coordinate: 241735.5
					Y-Coordinate 4784830.

U N I T 1	Driver's Name - Last HOMMES			First JOCELYN			Middle R		Suffix
	City ROCK RAPIDS			State IA - Iowa, US				Zip 51246
	Driver's Age 16					Citation Charge Code 1 321.288		Citation Charge 1 FAIL TO MAINTAIN CONTROL
	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 3 - Non-incapacitating	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: SIOUX CENTER HOSPITAL					Transported by: HULL RESCUE
	Insurance Co. Name
	Year 2002		Make Volkswagon - VOLK		Model BUG		Style CAR		Approximate Cost to Repair or Replace 4000
	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 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 2	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 01 - Ran off road, right	Second Event 33 - Ditch/embankment	Third Event	Fourth Event	Most Harmful Event (by vehicle) 33 - Ditch/embankment
	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 4 - Roadside	Weather Conditions (up to two) 01 - Clear	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 33 - Ditch/embankment
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	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?

P
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S
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N

I
N
J
U
R
E
D

Name- Last
HOMMES

First
JOHN

Middle
D

Suffix

City

State

Zip Code

Age
50

Sex
Male

Unit No.
01

Seating Position
03 - Front: Right Side

Injury Status
3 - Non-incapacitating

Occupant Protection
2 - Shoulder and lap belt used

Airbag Deployment
1 - Deployed front of person

Airbag Switch Status
9 - Unknown

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
1 - Not trapped

Transported to:

Transported by:

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
I
A
G
R
A
M

0

NARRATIVE

VEH #1 SB #75 WENT OFF ON TO SHOULDER AND THEN DOWN THE WEST DITCH AND FIELD. THE VEHICLE CONTINUED TO THE SOUTHWEST. THE VEHICLE WENT OVER 330TH ST AND THEN DOWN IN THE DITCH. THE VEHICLE CAME TO REST FACING SOUTH IN THE FIELD.

Officer ZYLSTRA	Badge No. 159	Time Officer Notified of Accident 17:31	Time Officer Arrived At Scene 17:39
Name of Agency P06	Date of Report 12/2/2010	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