Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
2/2/2011		 Time of Accident
01:35 PM 		County
Allamakee - 03		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011008589
Literal Description
NO NAME and Iowa 0076 / IOWA 76 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
645257.6
Y-Coordinate
4776665.
U
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1 		Driver's Name - Last
STACH		 First
JAMES		 Middle
C		 Suffix
JR
City
LA CROSSE		 State
WI - Wisconsin, US		 Zip
546010000
Driver's Age
40		 Citation Charge Code 1
321.174		 Citation Charge 1
NO DRIVERS LICENSE
Gender
Male		 State
WI - Wisconsin, US		 Class
D - Chauffeur		 Endorsements
None		 Restrictions

J - Tem Rest License		 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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
PRAIRIE DU CHIEN HOSPITAL		 Transported by:
HARPERS FERRY EMS
Insurance Co. Name
Year
1998		 Make
Chevrolet - CHEV		 Model
CAVALIER		 Style
NA		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
02 - Turning left		 Speed Limit
55		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
4		 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?
U
N
I
T

2 		Driver's Name - Last
MCGEOUGH		 First
LAURIE		 Middle
BERNADETTE		 Suffix
City
WAUKON		 State
IA - Iowa, US		 Zip
521720000
Driver's Age
47		 Citation Charge Code 1
321.304		 Citation Charge 1
PASSING WITHIN AN INTERSECTION
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
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:
NA		 Transported by:
NA
Insurance Co. Name
Year
2000		 Make
Ford - FORD		 Model
WIN		 Style
VN		 Approximate Cost to Repair or Replace
5000
Initial Travel Direction
1 - North		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
3 - Functional 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?
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
5 - Broadside		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
12 - T - intersection		 Workers Present?
P
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N 		I
N
J
U
R
E
D 		Name- Last
KANOTHE		 First
JOHNATHON		 Middle
 Suffix
City
 State
 Zip Code
Age
12		 Sex
Male		 Unit No.
1		 Seating Position
99 - Unknown		 Injury Status
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
PRAIRIE DU CHIEN		 Transported by:
MARMAC EMS
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
P
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N 		I
N
J
U
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D 		Name- Last
STACH		 First
LUCAS		 Middle
 Suffix
City
 State
 Zip Code
Age
18		 Sex
Male		 Unit No.
1		 Seating Position
99 - Unknown		 Injury Status
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
PRAIRIE DU CHIEN		 Transported by:
MARMAC EMS
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
P
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N 		I
N
J
U
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D 		Name- Last
ANTONY		 First
DEVON		 Middle
 Suffix
City
 State
 Zip Code
Age
18		 Sex
Male		 Unit No.
1		 Seating Position
99 - Unknown		 Injury Status
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
PRAIRIE DU CHIEN		 Transported by:
HARPERS FERRY EMS
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
D
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R
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NARRATIVE

UNIT 1 AND 2 WERE NORTHBOUND ON HWY 76. UNIT 1 WAS SLOWING DOWN TO TURN LEFT ONTO TURKEY RUN RD. UNIT 2 DID NOT SEE THE LEFT TURN SIGNAL AND PULLED OUT TO PASS UNIT 1. AS UNIT 1 PROCEEDED TO TURN LEFT UNIT 2 HIT UNIT 1 IN THE DRIVERS DOOR. BOTH VEHICLES CAME TO REST IN THE WEST DITCH.
Officer
DRISCOLL 		Badge No.
298		 Time Officer Notified of Accident
13:40		 Time Officer Arrived At Scene
13:50
Name of Agency
P10		 Date of Report
2/2/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046