Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/8/2010		 Time of Accident
06:30 AM 		County
Benton - 06		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010069115
Literal Description
US 0030 / 73 ST measuring 2288 Feet East from Iowa 0021 / IOWA 21 and US 0030 / 73 ST and US 0030 / US 30 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
558888.4
Y-Coordinate
4646056.
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1 		Driver's Name - Last
ROLING		 First
ANDREW		 Middle
J		 Suffix
City
MARION		 State
IA - Iowa, US		 Zip
523020000
Driver's Age
46		 Citation Charge Code 1
321.285		 Citation Charge 1
FAILURE TO STOP WITHIN THE ASSURED CLEAR DISTANCE
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

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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2000		 Make
Chevrolet - CHEV		 Model
BLAZER		 Style
SUV		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
06 - No Passing Zone (marked)		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
5 - Asleep, fainted, fatigued, etc		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
21 - Vehicle in traffic		 Second Event
99 - Unknown		 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
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2 		Driver's Name - Last
CLEMENS		 First
RICKY		 Middle
LLOYD		 Suffix
City
VAN HORNE		 State
IA - Iowa, US		 Zip
523460000
Driver's Age
47		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
 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
VAVROCH TRUCKING INC
Year
2004		 Make
International - INTL		 Model
 Style
SEMI		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
05 - Rear		 Most Damaged Area
05 - Rear		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
06 - No Passing Zone (marked)		 Vehicle Config.
09 - Tractor/semi-trailer		 Cargo Body Type
03 - Dump truck (grain, gravel)		 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
VAVROCH TRUCKING INC		 City
KEYSTONE		 State
IA - Iowa, US		 Zip
52249
Number of Axles
5		 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)
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
3 - Dawn		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT #1 WAS EB ON HWY 30 NEAR HWY 21. UNIT #2 WAS EB ON HWY 30 NEAR HWY 21. THE DRIVER OF UNIT #1 REAR ENDED UNIT #2. UNIT #1 AND UNIT #2 CAME TO REST ON THE SOUTH SHOULDER OF HWY 30 FACING EAST.
Officer
MILLER 		Badge No.
366		 Time Officer Notified of Accident
06:35		 Time Officer Arrived At Scene
06:41
Name of Agency
P11		 Date of Report
12/8/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327