Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/11/2011		 Time of Accident
07:14 AM 		County
Delaware - 28		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011002091
Literal Description
Iowa 0038 / IOWA 38 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
649236.7
Y-Coordinate
4686170.
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1 		Driver's Name - Last
BEITZ		 First
SHAWNA		 Middle
MARIE		 Suffix
City
HOPKINTON		 State
IA - Iowa, US		 Zip
522370000
Driver's Age
30		 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
2 - Incapacitating		 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:
IOWA CITY		 Transported by:
ANAMOSA HOSPITAL
Insurance Co. Name
Year
2004		 Make
Chevrolet - CHEV		 Model
TRAILBLAZER		 Style
SUV		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 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
04 - Crossed centerline/median		 Second Event
21 - Vehicle in traffic		 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
SAUSER		 First
LEO		 Middle
NICHOLAS		 Suffix
JR
City
MONTICELLO		 State
IA - Iowa, US		 Zip
523100000
Driver's Age
70		 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

 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
9 - Unknown		 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:
 Transported by:
Insurance Co. Name
Year
2009		 Make
International - INTL		 Model
BLUEBIRD		 Style
BUS		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
5		 Traffic Controls
01 - No controls present		 Vehicle Config.
16 - School bus (seats > 15)		 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)
08 - Snow		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
2 - Head-on		 Roadway
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
4		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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D 		Name- Last
REUTER		 First
MASON		 Middle
JAMES		 Suffix
City
 State
 Zip Code
Age
8		 Sex
Male		 Unit No.
02		 Seating Position
88 - Other (explain in narrative)		 Injury Status
4 - Possible		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
ANAMOSA HOSPITAL		 Transported by:
MONTICELLO AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
REUTER		 First
ZACHARY		 Middle
THOMAS		 Suffix
City
 State
 Zip Code
Age
5		 Sex
Male		 Unit No.
02		 Seating Position
88 - Other (explain in narrative)		 Injury Status
4 - Possible		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
ANAMOSA HOSPITAL		 Transported by:
MONTICELLO AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
STARK		 First
NICOLE		 Middle
DANIELLE		 Suffix
City
 State
 Zip Code
Age
11		 Sex
Female		 Unit No.
02		 Seating Position
88 - Other (explain in narrative)		 Injury Status
4 - Possible		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
ANAMOSA AMBULANCE		 Transported by:
MONTICELLO AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
STARK		 First
BROOKLYN		 Middle
PAIGE		 Suffix
City
 State
 Zip Code
Age
7		 Sex
Female		 Unit No.
02		 Seating Position
88 - Other (explain in narrative)		 Injury Status
4 - Possible		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
ANAMOSA HOSPITAL		 Transported by:
MONTICELLO AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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NARRATIVE

VEHICLE NUMBER ONE WAS SOUTHBOUND ON HIGHWAY 38. THE DRIVER LOST CONTROL, CROSSED THE CENTER INTO THE NORHBOUND LANE AND STRUCK A SCHOOL BUS TRAVELING NORTH. BOTH VEHICLES CAME TO REST ON THE ROADWAY.
Officer
STICKNEY 		Badge No.
408		 Time Officer Notified of Accident
07:15		 Time Officer Arrived At Scene
07:41
Name of Agency
P10		 Date of Report
1/11/2011		 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