Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/1/2011		 Time of Accident
12:15 PM 		County
Harrison - 43		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011008184
Literal Description
SB/WB Interstate 0029 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
249044.7
Y-Coordinate
4614172.
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1 		Driver's Name - Last
CLARK		 First
RALPH		 Middle
D		 Suffix
City
PAPILLION		 State
NE - Nebraska, US		 Zip
680460000
Driver's Age
63		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
Gender
Male		 State
NE - Nebraska, 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:
 Transported by:
Insurance Co. Name
Year
2002		 Make
 Model
CONV		 Style
TT		 Approximate Cost to Repair or Replace
8000
Initial Travel Direction
3 - South		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
06 - Left Rear		 Most Damaged Area
06 - Left Rear		 Extent of Damage
2 - Minor damage		 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
01 - None		 Driver Condition
1 - Apparently normal		 Vision Obscured
12 - Blowing snow		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
12 - Jackknife		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
12 - Jackknife
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
3 - Median		 Weather Conditions (up to two)
10 - Blowing sand, soil, dirt, snow		 Environment
2 - Weather condition		 Location
 First Harmful Event of Crash (use codes 11-42 only)
12 - Jackknife
Manner of Crash/Collision
1 - Non-collision		 Roadway
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
3		 Type of Roadway Junction/Feature
02 - Bridge/overpass/underpass		 Workers Present?
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NARRATIVE

Vehicle one was going south on I-29. Vehicle one was crossing the bridge at the 84 mile marker. Vehicle one slid out of control and jackknifed going over the bridge. Vehicle one went going off the road to the left. Vehicle one went into the median.
Officer
KOBER 		Badge No.
426		 Time Officer Notified of Accident
12:16		 Time Officer Arrived At Scene
12:26
Name of Agency
P15		 Date of Report
2/1/2011		 Investigation made at scene?
 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 15 Office
5912 NW 2nd Ave
Des Moines,IA 50313-
Phone: (515) 281-6176
Fax: (515) 289-1066