Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/11/2011		 Time of Accident
08:30 AM 		County
Johnson - 52		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011002121
Literal Description
SB/WB Interstate 0080 measuring 0.1 Miles East from Interstate 0080 (Milepost 244) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
621224.9
Y-Coordinate
4615956.
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1 		Driver's Name - Last
JAQUEZ		 First
MARTHA		 Middle
 Suffix
City
IOWA CITY		 State
IA - Iowa, US		 Zip
52245
Driver's Age
46		 Citation Charge Code 1
 Citation Charge 1
Gender
Female		 State
MX - Mexico, MX		 Class
B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR		 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
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2000		 Make
Ford - FORD		 Model
EPD		 Style
SW		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 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
01 - Ran off road, right		 Second Event
37 - Tree		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
37 - Tree
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)
08 - Snow		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
37 - Tree
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
3		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEHICLE 1 WAS WESTBOUND I 80 AT THE 244.10 MILEMARKER. ACCORDING TO THE THE DRIVER, THE VEHILCE SLID ON THE ICE AND LOST CONTROL. THE VEHICLE SLID OFF THE ROAD INTO THE NORTH DITCH AND HIT A TREE WITH THE DRIVERS DOOR.
Officer
DEGEN 		Badge No.
428		 Time Officer Notified of Accident
08:40		 Time Officer Arrived At Scene
08:40
Name of Agency
P11		 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 11 Office
5400 16th Ave SW
Cedar Rapids,IA 52404-2240
Phone: (319) 396-1944
Fax: (319) 396-4327