U
N
I
T
1
|
Driver's Name - Last SCHMELING |
First THOMAS |
Middle AARON |
Suffix
|
City AMES |
State IA - Iowa, US |
Zip 500100000 |
Driver's Age 26 |
Citation Charge Code 1 321.445 |
Citation Charge 1 FAIL TO WEAR SAFETY BELTS |
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 2 321.98 |
Citation Charge 2 OPERATION W/O REGISTRATION |
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 1 - None 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: MARY GREELEY |
Transported by: AMBULANCE |
Insurance Co. Name
|
Year 2008 |
Make Chevrolet - CHEV |
Model IMPALA LT |
Style 4DR |
Approximate Cost to Repair or Replace 7000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
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 88 - Other (explain in narrative) |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 52 - Hit and run |
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
|
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
|
Make
|
Model
|
Style
|
Approximate Cost to Repair or Replace
|
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 9 - Unknown |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
Vehicle Defect 99 - Unknown |
Driver Condition 9 - Unknown |
Vision Obscured 99 - Unknown |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 52 - Hit and run |
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 1 - On Roadway |
Weather Conditions (up to two) 01 - Clear |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
Roadway 01 - None apparent |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE # 1 TRAVEILING SOUTH BOUND ON INTERSTATE 35 REAR ENDED VEHICLE # 2. VEHICLE #2 DID NOT STOP AFTER COLLISION. VEHICLE # 1 WAS LOOKING OVER HIS SHOULDER CHECKING HIS BLIND SPOTS RIGHT BEFORE IMPACT |
|
Officer
SALDIVAR |
Badge No. 281 |
Time Officer Notified of Accident 18:22 |
Time Officer Arrived At Scene 18:29 |
Name of Agency P07 |
Date of Report 1/26/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218