Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/19/2011		 Time of Accident
09:10 AM 		County
Warren - 91		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011004273
Literal Description
I-35 NB 67 MM 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
434885.7
Y-Coordinate
4595429.
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1 		Driver's Name - Last
BLISS		 First
MARK		 Middle
D		 Suffix
City
OLATHE		 State
KS - Kansas, US		 Zip
66061
Driver's Age
59		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
KS - Kansas, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 Endorsements
T - Dbl/Trpl Trlr		 Restrictions

None		 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
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
ROADWAY EXPRESS
Year
2007		 Make
 Model
TT		 Style
CONV		 Approximate Cost to Repair or Replace
100
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
04 - Right Rear		 Most Damaged Area
04 - Right Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
10 - Traffic director		 Vehicle Config.
06 - Single-unit truck (>=3 axles)		 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
01 - Ran off road, right		 Second Event
23 - Parked motor vehicle		 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
ROADWAY EXPRESS		 City
LOS ANGELES		 State
CA - California, US		 Zip
90058
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 Placard #
 Hazardous Materials Released?
3 - Not applicable
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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
1992		 Make
Chevrolet - CHEV		 Model
C15		 Style
PK		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
1 - North		 Vehicle Action
12 - Legally Parked		 Speed Limit
70		 Point of Initial Impact
06 - Left Rear		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
0		 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
8 - Other (explain in narrative)		 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
2 - Shoulder		 Weather Conditions (up to two)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
23 - Parked motor vehicle
Manner of Crash/Collision
6 - Sideswipe, same direction		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEHICLE 1 STRUCK A PICKUP ON THE SHOULDER AT THE 67 MM NORTHBOUND. THE DRIVER STATED HE SAW A CAR COMING UP CLOSE ON HIS LEFT SIDE, SO HE GOT OVER AND THEN NOTICED THE CAR PARKED ON THE SHOULDER. HE TRIED TO AVOID THE PICKUP BUT WAS UNABLE TO DO SO.
Officer
WINKLER 		Badge No.
043		 Time Officer Notified of Accident
09:25		 Time Officer Arrived At Scene
09:29
Name of Agency
P02		 Date of Report
1/19/2011		 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