U
N
I
T
1
|
Driver's Name - Last CAMERON |
First MICHAEL |
Middle DOUGLAS |
Suffix
|
City BURNSVILLE |
State MN - Minnesota, US |
Zip 55306 |
Driver's Age 31 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MN - Minnesota, US |
Class D - Chauffeur |
Endorsements None |
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 5 - Not deployed |
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 2001 |
Make
|
Model 3.2 |
Style 4D |
Approximate Cost to Repair or Replace 3500 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 01 - Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 2 |
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 WIJEKULARATNE |
First LAKSHMAN |
Middle D |
Suffix
|
City LAS VEGAS |
State NV - Nevada, US |
Zip 891461109 |
Driver's Age 61 |
Citation Charge Code 1 321.306 |
Citation Charge 1 IMPROPER USE OF LANES |
Gender Male |
State NV - Nevada, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements N - Tank |
Restrictions
P - Special Permit |
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:
|
Transported by:
|
Insurance Co. Name
|
Year 2009 |
Make International - INTL |
Model TRACTOR |
Style SEMI |
Approximate Cost to Repair or Replace 0 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 65 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 1 - None |
Underride/Override 1 - None |
Total Occupants 2 |
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 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 04 - Crossed centerline/median |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 04 - Crossed centerline/median |
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) 02 - Partly cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 4 - Dark, roadway lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 17 - On-ramp merge area |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE #2 WAS CHANGING LANES TO ALLOW ANOTHER VEHICLE TO MERGE ONTO SOUTHBOUND I-35, DID NOT SEE VEHICLE #1 IN THE INSIDE LANE AND STRUCK VEHICLE #1 WHEN CHANGING LANES. |
|
Officer
SONNENFELT |
Badge No. 295 |
Time Officer Notified of Accident 19:50 |
Time Officer Arrived At Scene 20:03 |
Name of Agency P01 |
Date of Report 2/13/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011