U
N
I
T
1
|
Driver's Name - Last MADISON |
First JUSTIN |
Middle BERNARR |
Suffix
|
City DES MOINES |
State IA - Iowa, US |
Zip 503120000 |
Driver's Age 32 |
Citation Charge Code 1 321.20B-B |
Citation Charge 1 VIOLATION - FINANCIAL LIABILITY - ACCIDENT |
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 5 - Uninjured |
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 2004 |
Make Mercury - MERC |
Model SAB |
Style 4D |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
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 22 - Vehicle in/from other roadway |
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
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
U
N
I
T
2
|
Driver's Name - Last REINHART |
First GERALD |
Middle FRANK |
Suffix
|
City DES MOINES |
State IA - Iowa, US |
Zip 503170000 |
Driver's Age 67 |
Citation Charge Code 1 321.322(1) |
Citation Charge 1 FAIL TO OBEY STOP SIGN AND YIELD RIGHT OF WAY |
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
B - Cor Lenses |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 1998 |
Make Ford - FORD |
Model CROWN VICTORIA |
Style 4D |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 3 - South |
Vehicle Action 11 - Stopped for stop sign/signal |
Speed Limit 25 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 3 |
Traffic Controls 04 - Stop 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 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
|
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) 01 - Clear |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 4 - Angle, oncoming left turn |
Roadway 01 - None apparent |
Type
|
Light Conditions 4 - Dark, roadway lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 11 - Four-way intersection |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
ON 12/31/10 AT 1800 HRS, UNIT 1 WAS TRAVELING WEST BOUND ON LOCUST STREET WHEN UNIT 2 PULLED OUT FROM AT STOP SIGN AT E5TH ST, SOUTH BOUND AND STRUCK UNIT 1 IN THE PASSENGER SIDE FRONT END. |
|
Officer
MACK |
Badge No. 351 |
Time Officer Notified of Accident 18:00 |
Time Officer Arrived At Scene 18:05 |
Name of Agency P16 |
Date of Report 12/31/2010 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 16 Office
Lucas State Office Bldg
Des Moines,IA 50319-
Phone: (515) 281-3879
Fax: (515) 281-6478