U
N
I
T
1
|
Driver's Name - Last GRIFFIN |
First KORY |
Middle MARK |
Suffix
|
City DAVENPORT |
State IA - Iowa, US |
Zip 528010000 |
Driver's Age 25 |
Citation Charge Code 1
|
Citation Charge 1
|
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
|
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 2009 |
Make Chevrolet - CHEV |
Model CROWN VIC |
Style 4 DOOR POLICE |
Approximate Cost to Repair or Replace 50 |
Initial Travel Direction 2 - East |
Vehicle Action 03 - Turning right |
Speed Limit 25 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 08 - Left Front |
Extent of Damage 2 - Minor 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 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 2 - Police |
Emergency Status 1 - Yes, in emergency |
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 VAUGHN |
First BRITTNIE |
Middle A |
Suffix
|
City ROCK ISLAND |
State IL - Illinois, US |
Zip 61201 |
Driver's Age 20 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State IL - Illinois, US |
Class D - Chauffeur |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2007 |
Make Pontiac - PONT |
Model G6 |
Style 4 DOOR |
Approximate Cost to Repair or Replace 1500 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
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 02 |
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 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 6 - Outside Trafficway |
Weather Conditions (up to two) 03 - Cloudy |
Environment 2 - Weather condition |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 5 - Broadside |
Roadway 02 - Road surface condition |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 3 |
Type of Roadway Junction/Feature 04 - Business drive |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT #1 WAS EAST BOUND ON 59TH STREET TURNING INTO THE PARKING LOT. UNIT #2 WAS STOPPED WAITING TO COME OUT OF THE PARKING LOT FACING NORTH BOUND. UNIT #1 TURNED INTO THE PARKING LOT AND SLID ON THE ICE CAUSING HIM TO MAKE CONTACT WITH UNIT #2. |
|
Officer
HANK |
Badge No. 123 |
Time Officer Notified of Accident 00:03 |
Time Officer Arrived At Scene 00:11 |
Name of Agency P12 |
Date of Report 1/1/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504