Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
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N 		Date of Accident
1/2/2011		 Time of Accident
12:10 PM 		County
Dubuque - 31		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011000228
Literal Description
DOUBLE J LN AND IOWA 0136 / IOWA 136 SOUTH OF NEW VIENNA 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
655282.2
Y-Coordinate
4710350.
U
N
I
T

1 		Driver's Name - Last
KUEMPEL		 First
MARCIA		 Middle
 Suffix
City
CEDAR RAPIDS		 State
IA - Iowa, US		 Zip
52404
Driver's Age
35		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE TO HAVE 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
321.20B		 Citation Charge 2
NO INSURANCE
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
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2002		 Make
Chevrolet - CHEV		 Model
IMP		 Style
4D		 Approximate Cost to Repair or Replace
3500
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
9 - Unknown		 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?
P
R
O
P
E
R
T
Y

D
A
M
A
G
E
If Property other than vehicles damaged explain Object Damaged
STOP SIGN		 Estimate of Damage
250
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
STATE OF IOWA
City
DYERSVILLE		 State
IA - Iowa, US		 Zip
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)
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		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
12 - T - intersection		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

VEHICLE 1 NORTH BOUND, DRIVER LOST CONTROL AND ENTERED THE EAST DITCH SLIDDING ACROSS DOUBLE J LANE AND COLLIDING WITH A STOP SIGN. COMING TO REST FACING NORTH WEST DRIVER LEFT THE SCENE
Officer
DRISCOLL 		Badge No.
127		 Time Officer Notified of Accident
12:20		 Time Officer Arrived At Scene
12:25
Name of Agency
P10		 Date of Report
1/2/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046