Iowa State Patrol: Department of Public Safety

Crash Information


L
O
C
A
T
I
O
N
Date of Accident
1/14/2011
Time of Accident
03:30 PM
County
Decatur - 27
Accident occurred within corporate limits of (city)
Law Enforcement Case Number:
2011003180
Literal Description
J20, AT 330TH AVE
Legal Intervention?
No
Private Property?
No
X-Coordinate:
451061.0
Y-Coordinate
4519707.
U
N
I
T

1
Driver's Name - Last
HEAD
First
CHELSEA
Middle
MARIE
Suffix
City
DERBY
State
IA - Iowa, US
Zip
50068
Driver's Age
17
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

Y - Intermediate License
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
3 - No ON/OFF switch present
Ejection
1 - Not ejected
Ejection Path
Trapped
1 - Not trapped
Transported to:
DECATUR CO HOSPITAL
Transported by:
AMBULANCE
Insurance Co. Name
Year
1997
Make
Chevrolet - CHEV
Model
MONTE CARLO
Style
2DR
Approximate Cost to Repair or Replace
100
Initial Travel Direction
2 - East
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
05 - Rear
Most Damaged Area
05 - Rear
Extent of Damage
2 - Minor damage
Underride/Override
1 - None
Total Occupants
2
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
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
N
I
T

2
Driver's Name - Last
KELLER
First
DAVID
Middle
WAYNE
Suffix
III
City
HUMESTON
State
IA - Iowa, US
Zip
50123
Driver's Age
16
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
None
Restrictions

Y - Intermediate License
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:
NO TREATMENT
Transported by:
NO TREATMENT
Insurance Co. Name
Year
1993
Make
Honda - HOND
Model
CIVIC
Style
4DR
Approximate Cost to Repair or Replace
300
Initial Travel Direction
2 - East
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
01 - Front
Most Damaged Area
01 - Front
Extent of Damage
2 - Minor damage
Underride/Override
1 - None
Total Occupants
1
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
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)
03 - Cloudy
Environment
1 - None apparent
Location
First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
3 - Rear-end
Roadway
02 - Road surface condition
Type
Light Conditions
1 - Daylight
Surface Conditions
3
Type of Roadway Junction/Feature
12 - T - intersection
Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

UNIT 1 WAS EASTBOUND AND SLOWING FOR ANOTHER UNINVOLVED VEHICLE THAT WAS TURNING LEFT. UNIT 2 WAS EASTBOUND AND CAME OVER THE HILL. UNIT 2 REAR-ENDED UNIT 1.
Officer
SCHMIDT
Badge No.
336
Time Officer Notified of Accident
15:30
Time Officer Arrived At Scene
16:30
Name of Agency
P02
Date of Report
1/14/2011
Investigation made at scene?
Yes
T.I. #



Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653