U
N
I
T
1
|
Driver's Name - Last EIDNESS |
First JUDY |
Middle ANN |
Suffix
|
City LAKE MILLS |
State IA - Iowa, US |
Zip 504500000 |
Driver's Age 47 |
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 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: MERCY MEDICAL MASON CITY |
Transported by: PRIVATE VEHCILE |
Insurance Co. Name
|
Year 2006 |
Make Ford - FORD |
Model FREESTYLE |
Style 4D |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
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 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 21 - Vehicle in traffic |
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 WAGNER |
First WILLIAM |
Middle DWAIN |
Suffix
|
City BLAINE |
State MN - Minnesota, US |
Zip 55434 |
Driver's Age 47 |
Citation Charge Code 1 321.288 |
Citation Charge 1 FAIL TO MAINTAIN CONTROL |
Gender Male |
State MN - Minnesota, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
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 4 - Possible |
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: MERCY MEDICAL MASON CITY |
Transported by: FOREST CITY AMBULANCE |
Insurance Co. Name FREIGHTWAYS CORP |
Year 2002 |
Make
|
Model T800 |
Style SEMI TRACTOR |
Approximate Cost to Repair or Replace 15000 |
Initial Travel Direction 3 - South |
Vehicle Action 06 - Changing lanes |
Speed Limit 70 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 09 - Top |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 05 - Flatbed |
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 FREIGHTWAYS CORP |
City MNPLS |
State MN - Minnesota, US |
Zip 55448 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard # RED 2 |
Hazardous Materials Released? 2 - No |
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) 10 - Blowing sand, soil, dirt, 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 |
Roadway 01 - None apparent |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 4 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE ONE WAS TRAVELING SOUTHBOUND ON INTERSTATE 35. VEHICLE ONE WAS TRAVELING AT APPROXIMATELY 50 MILES PER HOUR DUE TO THE BLOWING SNOW. VEHICLE ONE NOTICED VEHICLE TWO APPROACHING AT A FASTER RATE. VEHICLE ONE STARTED TO SPEED UP TO AVOID BEING STRUCK. VEHICLE TWO ATTEMPTED TO GO AROUND VEHICLE ONE IN THE LEFT LANE. AS VEHICLE TWO STARTED TO CHANGE LANES VEHICLE TWO LOST CONTROL AND STRUCK VEHICLE ONE ON THE REAR PASSENGER SIDE. VEHICLE TWO PUSHED VEHICLE ONE INTO THE MEDIAN AND THEN VEHICLE TWO ENTERED THE WEST DITCH. VEHICLE ONE CAME TO FINAL REST FACING EAST IN THE MEDIAN AND VEHICLE TWO CAME TO FINAL REST ON ITS TOP FACING WEST. |
|
Officer
WILLIAMSON |
Badge No. 381 |
Time Officer Notified of Accident 06:45 |
Time Officer Arrived At Scene 06:55 |
Name of Agency P08 |
Date of Report 2/14/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 08 Office
4425 Washington Avenue
Mason City,IA 50401-7002
Phone: (641) 424-3625
Fax: (641) 423-8381