Iowa State Patrol: Department of Public Safety

Crash Information

L
O
C
A
T
I
O
N 		Date of Accident
1/17/2011		 Time of Accident
06:03 PM 		County
Delaware - 28		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011003756
Literal Description
NB/EB US 0020 / US 20 (Milepost 274) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
622965.2
Y-Coordinate
4702378.
U
N
I
T

1 		Driver's Name - Last
LANSING		 First
JAIME		 Middle
KAY		 Suffix
City
CASCADE		 State
IA - Iowa, US		 Zip
52033
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

B - Cor Lenses		 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
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2003		 Make
Ford - FORD		 Model
FOC		 Style
4D		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
01 - Front		 Most Damaged Area
09 - Top		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
01		 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
03 - Ran off road, left		 Second Event
11 - Overturn/rollover		 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
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)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
5		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

Unit 1 was traveling East on Highway 20 when the driver lost control, entered the median, and rolled the vehicle one time. Assisted by the Delaware County Sheriff's Office.
Officer
JANSSEN 		Badge No.
326		 Time Officer Notified of Accident
18:03		 Time Officer Arrived At Scene
18:04
Name of Agency
P10		 Date of Report
1/17/2011		 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