Iowa State Patrol: Department of Public Safety

Crash Information


L
O
C
A
T
I
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N
Date of Accident
1/7/2011
Time of Accident
08:39 PM
County
Shelby - 83
Accident occurred within corporate limits of (city)
Law Enforcement Case Number:
2011001259
Literal Description
MAPLE RD 600 BLOCK
Legal Intervention?
No
Private Property?
No
X-Coordinate:
307354.0
Y-Coordinate
4607989.
U
N
I
T

1
Driver's Name - Last
BENSON-BLAINE
First
COLTON
Middle
EDWARD
Suffix
City
HARLAN
State
IA - Iowa, US
Zip
515370000
Driver's Age
20
Citation Charge Code 1
321.440
Citation Charge 1
DEFECTIVE TIRES
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
718.6
Citation Charge 2
FALSE REPORTS TO LAW ENFORCEMENT
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
1 - Switch in ON position
Ejection
1 - Not ejected
Ejection Path
Trapped
1 - Not trapped
Transported to:
MYRTUE MEMORIAL ER
Transported by:
PERSONAL VEHICLE
Insurance Co. Name
Year
1998
Make
General Motors - GMC
Model
SRA
Style
PK
Approximate Cost to Repair or Replace
4000
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
4 - Disabling damage
Underride/Override
1 - None
Total Occupants
01
Traffic Controls
01 - No controls present
Vehicle Config.
02 - Four-tire light truck (pick-up, panel)
Cargo Body Type
01 - Not applicable
Vehicle Defect
04 - Blowout
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)
11 - Overturn/rollover
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
4 - Roadside
Weather Conditions (up to two)
01 - Clear
Environment
1 - None apparent
Location
First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision
Roadway
01 - None apparent
Type
Light Conditions
5 - Dark, roadway not lighted
Surface Conditions
1
Type of Roadway Junction/Feature
01 - No special feature
Workers Present?
P
E
R
S
O
N
I
N
J
U
R
E
D
Name- Last
DYER
First
JOSHUA
Middle
JAMES
Suffix
City
State
Zip Code
Age
22
Sex
Male
Unit No.
01
Seating Position
03 - Front: Right Side
Injury Status
3 - Non-incapacitating
Occupant Protection
9 - Unknown
Airbag Deployment
5 - Not deployed
Airbag Switch Status
1 - Switch in ON position
Ejection
1 - Not ejected
Ejection Path
1 - Not ejected/not applicable
Trapped
1 - Not trapped
Transported to:
MYRTUE MEMORIAL ER
Transported by:
PERSONAL VEHICLE
NON-MOTORIST Type
Location
Action
Condition
Safety Equipment
Contributing Circumstances
Unit No. of Vehicle Striking
P
E
R
S
O
N
I
N
J
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R
E
D
Name- Last
BALLANTYNE
First
BRETT
Middle
Suffix
City
State
Zip Code
Age
16
Sex
Male
Unit No.
001
Seating Position
09 - Rear: Right Side
Injury Status
3 - Non-incapacitating
Occupant Protection
9 - Unknown
Airbag Deployment
5 - Not deployed
Airbag Switch Status
1 - Switch in ON position
Ejection
1 - Not ejected
Ejection Path
1 - Not ejected/not applicable
Trapped
1 - Not trapped
Transported to:
MYRTUE MEMORIAL ER
Transported by:
PERSONAL VEHICLE
NON-MOTORIST Type
Location
Action
Condition
Safety Equipment
Contributing Circumstances
Unit No. of Vehicle Striking
D
I
A
G
R
A
M

0
NARRATIVE

Unit 1 southbound Maple Road in 600 Block. Unit 1 lost control after tire blow out. Unit 1 rolled several times, coming to rest on wheels in ditch. Unit 1 found to have defective tires. Driver of Unit 1 provided false information for report. Driver of Unit 1 charged with providing false information. Unit 1 sustained disabling damage.
Officer
PAULSEN
Badge No.
148
Time Officer Notified of Accident
22:14
Time Officer Arrived At Scene
22:19
Name of Agency
P04
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 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325