Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/7/2011		 Time of Accident
07:51 AM 		County
Henry - 44		 Accident occurred within corporate limits of (city)
Mount Pleasant - 5292		 Law Enforcement Case Number:
2011001022
Literal Description
S GRAND AVE and E BELL DR and MT PLEASANT CORRECTIONAL 		Legal Intervention?
No		 Private Property?
Yes
X-Coordinate:
622916.9
Y-Coordinate
4534845.
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1 		Driver's Name - Last
PHOUMSAMPHORN		 First
SOWAT		 Middle
ANTHONY		 Suffix
City
MOUNT PLEASANT		 State
IA - Iowa, US		 Zip
526410000
Driver's Age
25		 Citation Charge Code 1
321.288		 Citation Charge 1
FAILURE TO MAINTIN CONTROL
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
321.98		 Citation Charge 2
OPERATION WITHOUT REGISTRATION
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:
N/A		 Transported by:
N/A
Insurance Co. Name
Year
2003		 Make
Ford - FORD		 Model
ECP		 Style
SW		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
45		 Point of Initial Impact
01 - Front		 Most Damaged Area
06 - Left Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
2		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
01 - Ran off road, right
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?
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Y

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If Property other than vehicles damaged explain Object Damaged
STEEL POLES ON SIDEWALK		 Estimate of Damage
1004
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
CITY OF MT. PLEASANT
City
MT. PLEASANT		 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)
08 - Snow		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
38 - Poles (utility, light, etc.)
Manner of Crash/Collision
1 - Non-collision		 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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NARRATIVE

UNIT #1 WAS SOUTH BOUND ON GRAND AVE. IN MT. PLEASANT, UNIT #1 LOST CONTROL AND ENTERED THE WEST DITCH. WHILE GOING IN THE DITCH UNIT #1 RAN OVER 3 STEEL POLES ON THE SIDE WALK.
Officer
WARD 		Badge No.
191		 Time Officer Notified of Accident
07:51		 Time Officer Arrived At Scene
08:02
Name of Agency
P13		 Date of Report
1/7/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743