U
N
I
T
1
|
Driver's Name - Last STEIL |
First CARL |
Middle JOSEPH |
Suffix
|
City EAGLE GROVE |
State IA - Iowa, US |
Zip 505330000 |
Driver's Age 55 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
Endorsements N - Tank |
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 02 - Front: Center |
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
|
Year 2000 |
Make Caterpillar - CAT |
Model LOADER |
Style 928G |
Approximate Cost to Repair or Replace 0 |
Initial Travel Direction 3 - South |
Vehicle Action 09 - Backing |
Speed Limit 25 |
Point of Initial Impact 05 - Rear |
Most Damaged Area
|
Extent of Damage 1 - None |
Underride/Override 6 - Override, parked/stationary vehicle |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 21 - Maintenance/construction vehicle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 88 - Other (explain in narrative) |
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 BOYD |
First MICHELLE |
Middle JACQUELINE |
Suffix
|
City EAGLE GROVE |
State IA - Iowa, US |
Zip 505330000 |
Driver's Age 24 |
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
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 4 - Possible |
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: TRIMARK |
Transported by: FAMILY MEMBER |
Insurance Co. Name
|
Year 2009 |
Make Ford - FORD |
Model FOC |
Style 4D |
Approximate Cost to Repair or Replace 8000 |
Initial Travel Direction 3 - South |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 25 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 3 - Underride, no compartment intrusion |
Total Occupants 1 |
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 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?
|
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 2 - Weather condition |
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 1 - Daylight |
Surface Conditions 4 |
Type of Roadway Junction/Feature 11 - Four-way intersection |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT 1 WAS MOVING SNOW ON CEDAR STREET SOUTHBOUND. UNIT 2 WAS TRAVELING SOUTHBOUND ON CEDAR AND CAME TO A STOP DIRCTLY BEHIIND UNIT 1. UNIT 1 BACKED INTO THE FRONT UNIT 2. |
|
Officer
BURNS |
Badge No. 028 |
Time Officer Notified of Accident 10:39 |
Time Officer Arrived At Scene 11:02 |
Name of Agency P07 |
Date of Report 12/22/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218