Crash Information

L O C A T I O N	Date of Accident 2/1/2011	Time of Accident 08:30 PM	County Scott - 82	Accident occurred within corporate limits of (city) Walcott - 8052	Law Enforcement Case Number: 2011008356
	Literal Description NB/EB Interstate 0080				Legal Intervention? No	Private Property? No
					X-Coordinate: 687811.4
					Y-Coordinate 4608822.

U N I T 1	Driver's Name - Last CARLSON			First STANLEY			Middle R		Suffix
	City ALEXIS			State IL - Illinois, US				Zip 61412
	Driver's Age 60					Citation Charge Code 1 321.288		Citation Charge 1 CONTROL OF VEHICLE
	Gender Male	State IL - Illinois, US	Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more	Endorsements None	Restrictions F - Outside Mirror	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: N/A					Transported by:
	Insurance Co. Name
	Year 2005		Make		Model 379		Style CONVENTIONAL		Approximate Cost to Repair or Replace 150
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 65	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. 05 - Single-unit truck (2-axle, 6-tires)	Cargo Body Type 02 - Van/enclosed box	Vehicle Defect 01 - None	Driver Condition 1 - Apparently normal	Vision Obscured 12 - Blowing snow	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 03 - Ran off road, left	Second Event 23 - Parked motor vehicle	Third Event	Fourth Event	Most Harmful Event (by vehicle) 03 - Ran off road, left
	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 UNOCCUPPIED			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 2007		Make Chevrolet - CHEV		Model 4DR		Style 4DR		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 4 - West	Vehicle Action 88 - Other (explain in narrative)	Speed Limit 65	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 0	Traffic Controls 01 - No controls present	Vehicle Config. 01 - Passenger car	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 8 - Other (explain in narrative)	Vision Obscured 88 - Other (explain in narrative)	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 03 - Ran off road, left	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle) 03 - Ran off road, left
	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?

P R O P E R T Y D A M A G E	If Property other than vehicles damaged explain	Object Damaged NONE		Estimate of Damage
	Owner's Name - Last	First	Middle	Suffix
	Owner Company Name
	City	State		Zip

ACCIDENT ENVIRONMENT		ROADWAY CHARACTERISTICS Major Contributing Circumstances:	WORKZONE RELATED?	SEQUENCE OF EVENTS
Location of First Harmful Event 3 - Median	Weather Conditions (up to two) 08 - Snow	Environment 2 - Weather condition	Location	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 3 - Rear-end	Weather Conditions (up to two) 08 - Snow	Roadway 02 - Road surface condition	Type
Light Conditions 5 - Dark, roadway not lighted	Surface Conditions 3	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

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NARRATIVE

UNIT 2 HAD PREVIOUSLY GONE IN THE MEDIAN/DITCH DURING BLIZZARD CONDITIONS AND WAS UNOCCUPPIED. UNIT 1 WAS EB IN BLIZZARD CONDITIONS LATER AND WHEN HE LOST CONTROL AND ENTERED MEDIAN HIT UNIT 2. UNIT 2 HAD MINOR DAMAGE. UNIT 1 USDOT# 175048

Officer DRECHSLER	Badge No. 262	Time Officer Notified of Accident 20:40	Time Officer Arrived At Scene 20:40
Name of Agency P12	Date of Report 2/1/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 12 Office
22365 20th Ave
Stockton,IA 52769-9612
Phone: (563) 284-9501
Fax: (563) 284-9504