U
N
I
T
1
|
Driver's Name - Last HARLAN |
First MAX |
Middle WAYNE |
Suffix
|
City STOCKPORT |
State IA - Iowa, US |
Zip 526510000 |
Driver's Age 36 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
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 3 - Non-incapacitating |
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: N/A |
Transported by: N/A |
Insurance Co. Name
|
Year 2000 |
Make Dodge - DODG |
Model DUR |
Style SW |
Approximate Cost to Repair or Replace 2500 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 04 - Stop signs |
Vehicle Config. 04 - Sport utility 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 21 - Vehicle in traffic |
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?
|
U
N
I
T
2
|
Driver's Name - Last HENDRICKS |
First ROGER |
Middle WILLIAM |
Suffix
|
City BIRMINGHAM |
State IA - Iowa, US |
Zip 525350000 |
Driver's Age 43 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, 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? 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
|
Year 1991 |
Make International - INTL |
Model 4900 |
Style 6X6 |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 25 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
Vehicle Config. 06 - Single-unit truck (>=3 axles) |
Cargo Body Type 04 - Cargo tank |
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 21 - Vehicle in traffic |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
Emergency Vehicle Type 3 - Fire |
Emergency Status 1 - Yes, in emergency |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged STOP SIGN |
Estimate of Damage 150 |
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name CITY OF BIRMINGHAM |
City BIRMINGHAM |
State IA - Iowa, US |
Zip
|
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) 03 - Cloudy |
Environment 2 - Weather condition |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 5 - Broadside |
Roadway 01 - None apparent |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 4 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT #1 WAS TRAVELING EAST ON CHESHIRE STREET, WHEN IT FAILED TO STOP AT A STOP SIGN. UNIT #2 WAS TRAVELING NORTH ON WATER STREET, WHEN IT WAS UNABLE TO AVOID STRIKING UNIT #1. BOTH VEHICLES WERE RESPONDING TO A STRUCTURE FIRE IN THE CITY LIMITS OF BIRMINGHAM. |
|
Officer
BUCKALEW |
Badge No. 090 |
Time Officer Notified of Accident 12:11 |
Time Officer Arrived At Scene 12:25 |
Name of Agency P13 |
Date of Report 1/21/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 13 Office
1300 S Grand Ave
Mt Pleasant,IA 52641-1862
Phone: (319) 385-8715
Fax: (319) 385-2743