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Driver's Name - Last BURDICK |
First MEARL |
Middle EDGAR |
Suffix JR |
City NORTHWOOD |
State NH - New Hampshire, US |
Zip 03261 |
Driver's Age 50 |
Citation Charge Code 1 321.20B-B |
Citation Charge 1 VIOLATION - FINANCIAL LIABILITY - ACCIDENT |
Gender Male |
State NH - New Hampshire, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements N - Tank |
Restrictions
B - Cor Lenses |
Citation Charge Code 2
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Citation Charge 2
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Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3
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Citation Charge 3
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Citation Charge Code 4
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Citation Charge 4
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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
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Trapped 1 - Not trapped |
Transported to: NA |
Transported by:
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Insurance Co. Name
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Year 1999 |
Make General Motors - GMC |
Model 2500 |
Style PICK UP |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 07 - Left Side |
Most Damaged Area 07 - Left Side |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 02 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
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)
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SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 01 - Ran off road, right |
Third Event
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Fourth Event 08 - Cargo/equipment loss or shift |
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
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City
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State
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Zip
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Number of Axles
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Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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