Crash Information

L O C A T I O N	Date of Accident 2/3/2011	Time of Accident 10:00 AM	County Clarke - 20	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011008765
	Literal Description 270TH AVE MEASURING 10 FEET SOUTH OF 270 AVE AND KANSAS ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 441791.0
					Y-Coordinate 4543992.

U N I T 1	Driver's Name - Last PEDERSEN			First GERALD			Middle LEE		Suffix
	City OSCEOLA			State IA - Iowa, US				Zip 502130000
	Driver's Age 83					Citation Charge Code 1 321.313		Citation Charge 1 UNSAFE STARTING OF A STOPPED VEHICLE
	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 B - Cor Lenses	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 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2007		Make Dodge - DODG		Model CARAVAN		Style MINI VAN		Approximate Cost to Repair or Replace 3000
	Initial Travel Direction 3 - South	Vehicle Action 03 - Turning right	Speed Limit 55	Point of Initial Impact 05 - Rear	Most Damaged Area 05 - Rear	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 01 - No controls present	Vehicle Config. 03 - Van or mini-van	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 21 - Vehicle in traffic	Second Event	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 HOLLIDAY			First JULIE			Middle MARIE		Suffix
	City WOODBURN			State IA - Iowa, US				Zip 502750000
	Driver's Age 46					Citation Charge Code 1		Citation Charge 1
	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		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 4 - Possible	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 5 - Not deployed	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2004		Make Pontiac - PONT		Model GRA		Style 4D		Approximate Cost to Repair or Replace 4000
	Initial Travel Direction 3 - South	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 2 - Minor damage	Underride/Override 1 - None
	Total Occupants 01	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 21 - Vehicle in traffic	Second Event	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	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 8	Type of Roadway Junction/Feature 05 - Farm/residential drive	Workers Present?

D
I
A
G
R
A
M

0

NARRATIVE

VEHICLE 1 WAS STOPPED AT HIS MAIL BOX FACING SOUTHBOUND ON 270TH ST IN THE NORTHBOUND LANE. VEHICLE 2 WAS SOUTHBOUND ON 270TH ST. VEHICLE 2 WAS GETTING READY TO DRIVE BY VEHICLE 1 WHEN VEHICLE 1 TRIED TO TURN RIGHT INTO THE RESIDENTIAL DRIVEWAY TO THE WEST. VEHICLE 2 TRIED TO SLOW BUT WAS UNABLE TO AVOID CONTACT. VEHICLE 2 STRUCK VEHICLE 1 IN THE PASSENGER REAR PORTION OF THE VEHICLE. VEHICLE 2 CAME TO REST IN THE ROADWAY FACING SOUTHBOUND. VEHICLE 1 CONTINUED INTO THE RESIDENTIAL DRIVEWAY.

Officer DANIELS	Badge No. 089	Time Officer Notified of Accident 10:03	Time Officer Arrived At Scene 10:35
Name of Agency P02	Date of Report 2/3/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653