Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/16/2011		 Time of Accident
11:40 PM 		County
Pottawattamie - 78		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011003507
Literal Description
NB INTERSTATE 0029 (MILEPOST 52) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
256914.2
Y-Coordinate
4569262.
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1 		Driver's Name - Last
BURNHAM		 First
WILLIAM		 Middle
NELSON		 Suffix
JR
City
COUNCIL BLUFFS		 State
IA - Iowa, US		 Zip
515030000
Driver's Age
52		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
Gender
Male		 State
IA - Iowa, US		 Class
B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR		 Endorsements
N - Tank		 Restrictions

N - Non-resident CDL		 Citation Charge Code 2
321J.2(2)(a)		 Citation Charge 2
OPER VEH WH INT (OWI) / 1ST OFF
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
1 - Deployed front of person		 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
2002		 Make
Ford - FORD		 Model
F15		 Style
PK		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
1 - North		 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.
02 - Four-tire light truck (pick-up, panel)		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
6 - Under the influence of alcohol/drugs/medications		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
33 - Ditch/embankment		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
33 - Ditch/embankment
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)
07 - Sleet, hail, freezing rain		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
33 - Ditch/embankment
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
4 - Dark, roadway lighted		 Surface Conditions
2		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT #1 WAS TRAVELING NORTH ON I-29. AS THE DRIVER WAS NEAR MILEPOST 52, HE LOST CONTROL AND LEFT THE ROADWAY GOING DOWN INTO THE DITCH.
Officer
HOY 		Badge No.
325		 Time Officer Notified of Accident
23:41		 Time Officer Arrived At Scene
23:41
Name of Agency
P03		 Date of Report
1/16/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504