U
N
I
T
1
|
Driver's Name - Last CARLSON |
First MARTHA |
Middle ELLEN |
Suffix
|
City WINFIELD |
State IA - Iowa, US |
Zip 526590000 |
Driver's Age 84 |
Citation Charge Code 1 321.321 |
Citation Charge 1 FAILURE TO YIELD UPON ENTERING THROUGH HIGHWAY |
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 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 2008 |
Make Chevrolet - CHEV |
Model IMT |
Style 4D |
Approximate Cost to Repair or Replace 12000 |
Initial Travel Direction 2 - East |
Vehicle Action 02 - Turning left |
Speed Limit 65 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 03 |
Traffic Controls 05 - Yield signs |
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 21 - Vehicle in traffic |
Second Event
|
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?
|
U
N
I
T
2
|
Driver's Name - Last DAWLEY |
First LEONARD |
Middle PAUL |
Suffix
|
City MANKATO |
State MN - Minnesota, US |
Zip 56001 |
Driver's Age 39 |
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 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 J & R SCHUGEL TRUCKING INC |
Year 209 |
Make International - INTL |
Model
|
Style CON |
Approximate Cost to Repair or Replace 7500 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
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 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 J & R SCHUGEL TRUCKING INC |
City NEW ULM |
State MN - Minnesota, US |
Zip 56073 |
Number of Axles 2 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 2 - No |
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) 03 - Cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 5 - Broadside |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 1 |
Type of Roadway Junction/Feature 07 - Crossover in median |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT 2 WAS NORTHOUND ON HIGHWAY 218 WHEN UNIT 1 FAILED TO YIELD ENTERING NORTHBOUND HIGHWAY 218 FROM NORTH IOWA AVENUE. UNIT 1 WAS THEN STRUCK BY UNIT 2. |
|
Officer
DOLF |
Badge No. 361 |
Time Officer Notified of Accident 13:50 |
Time Officer Arrived At Scene 13:55 |
Name of Agency P13 |
Date of Report 12/9/2010 |
Investigation made at scene?
|
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743