U
N
I
T
1
|
Driver's Name - Last HABERSHAM |
First KEVIN |
Middle
|
Suffix
|
City NEWARK |
State NJ - New Jersey, US |
Zip 071041872 |
Driver's Age 48 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State NJ - New Jersey, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements
|
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 4 - Breath |
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 2011 |
Make International - INTL |
Model
|
Style TT |
Approximate Cost to Repair or Replace 3000 |
Initial Travel Direction 4 - West |
Vehicle Action 10 - Slowing/stopping |
Speed Limit 55 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 07 - Left Side |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 04 - Stop signs |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
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 02 - Ran off road, straight |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 12 - Jackknife |
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?
|