U
N
I
T
1
|
Driver's Name - Last BOWER |
First MICHELLE |
Middle T |
Suffix
|
City ROCK ISLAND |
State IL - Illinois, US |
Zip 61201 |
Driver's Age 20 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Female |
State IL - Illinois, US |
Class D - Chauffeur |
Endorsements N - Tank |
Restrictions
N - Non-resident CDL |
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 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2006 |
Make Ford - FORD |
Model CROWN VIC |
Style 4DR |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 11 - Workzone signs |
Vehicle Config. 15 - Moped/All-Terrain 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 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 03 - Ran off road, left |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 23 - Parked motor vehicle |
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
|
First
|
Middle
|
Suffix
|
City
|
State
|
Zip
|
Driver's Age
|
Citation Charge Code 1
|
Citation Charge 1
|
Gender
|
State
|
Class
|
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given?
|
Drug Test Given?
|
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position
|
Injury Status
|
Occupant Protection
|
Airbag Deployment
|
Airbag Switch Status
|
Ejection
|
Ejection Path
|
Trapped
|
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 2004 |
Make Caterpillar - CAT |
Model 330CCH2R |
Style BACKHOE |
Approximate Cost to Repair or Replace 0 |
Initial Travel Direction 2 - East |
Vehicle Action 12 - Legally Parked |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 99 - Unknown |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 0 |
Traffic Controls 07 - Warning sign |
Vehicle Config. 21 - Maintenance/construction vehicle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 88 - Other (explain in narrative) |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
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 3 - Median |
Weather Conditions (up to two) 08 - Snow |
Environment 8 - Other (explain in narrative) |
Location 4 - Within or adjacent to work activity |
First Harmful Event of Crash (use codes 11-42 only) 23 - Parked motor vehicle |
Manner of Crash/Collision 3 - Rear-end |
Roadway 02 - Road surface condition |
Type 3 - Work on shoulder or median |
Light Conditions 1 - Daylight |
Surface Conditions 4 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present? Yes |
D I A G R A M
0 |
|
NARRATIVE |
UNIT 1 WAS WESTBOUND IN INSIDE LANE. A NON- CONTACT CAR SWITCHED LANES WHILE PASSING A SEMI. DRIVER OF UNIT 1 SWERVED TO AVOID COLLISION AND LOST CONTROL ON ICY ROADS. UNIT 1 SPUN AROUND AND STRUCK A BACKHOE PARKED IN THE MEDIAN. A WORKER WAS BRUSHED BY THE BUMPER AND WAS NOT INJURED. UNIT 1 SPUN AROUND COMING TO REST ON THE INSIDE SHOULDER FACEING WEST. |
|
Officer
NEVILLE |
Badge No. 328 |
Time Officer Notified of Accident 15:50 |
Time Officer Arrived At Scene 15:50 |
Name of Agency P12 |
Date of Report 1/17/2011 |
Investigation made at scene?
|
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504