U
N
I
T
1
|
Driver's Name - Last FISHER |
First MARIANNE |
Middle NICOLE |
Suffix
|
City CHARLES CITY |
State IA - Iowa, US |
Zip 506160000 |
Driver's Age 27 |
Citation Charge Code 1 321J.2(2)(a) |
Citation Charge 1 OPER VEH WH INT (OWI) / 1ST OFF |
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 2 321.322(1) |
Citation Charge 2 FAIL TO OBEY STOP SIGN AND YIELD RIGHT OF WAY |
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 2004 |
Make Pontiac - PONT |
Model GRAND PRIX |
Style 4D |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 07 - Left Side |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 3 |
Traffic Controls 04 - Stop signs |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 6 - Under the influence of alcohol/drugs/medications |
Vision Obscured 04 - Embankment |
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?
|
U
N
I
T
2
|
Driver's Name - Last ADAMS |
First NICHOLAS |
Middle ALLEN |
Suffix
|
City STACYVILLE |
State IA - Iowa, US |
Zip 504760000 |
Driver's Age 19 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
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
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 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 2000 |
Make Oldsmobile - OLDS |
Model INTRIGUE |
Style 4D |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 35 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 1 |
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 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 1 - On Roadway |
Weather Conditions (up to two) 01 - Clear |
Environment 3 - Physical obstruction |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 5 - Broadside |
Roadway 01 - None apparent |
Type
|
Light Conditions 4 - Dark, roadway lighted |
Surface Conditions 4 |
Type of Roadway Junction/Feature 11 - Four-way intersection |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE ONE WAS NORTHBOUND AND STOPPED AT THE STOP SIGN. VEHICLE TWO WAS EASTBOUND ON HWY 122 AND IN THE LEFT HAND LANE. VEHICLE ONE PULLED OUT INTO THE INTERSECTION AND WAS STRUCK BY VEHICLE TWO IN THE REAR DRIVER SIDE DOOR. VEHICLE TWO CAME TO REST IN IT'S SAME LANE JUST PASS THE INTERSECTION. VEHICLE ONE CAME TO REST FACING WEST BOUND AND WAS PUSHED INTO THE SNOW PULLED ALONG THE STREET. VEHICLE ONE STATED SHE COULD NOT SEE VEHICLE TWO DUE TO THE SNOW EMBANKMENT AT THE CORNER OF THE INTERSECTION. |
|
Officer
WILLIAMSON |
Badge No. 381 |
Time Officer Notified of Accident 23:07 |
Time Officer Arrived At Scene 23:07 |
Name of Agency P08 |
Date of Report 1/24/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381