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Driver's Name - Last CERVANTES |
First JESUS |
Middle J |
Suffix
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City SHEBOYGAN |
State WI - Wisconsin, US |
Zip 530810000 |
Driver's Age 36 |
Citation Charge Code 1 321.20B-B |
Citation Charge 1 VIOLATION-FINANCIAL LIABILITY-ACCIDENT |
Gender Male |
State WI - Wisconsin, US |
Class D - Chauffeur |
Endorsements None |
Restrictions
None |
Citation Charge Code 2 321.288 |
Citation Charge 2 FAIL TO MAINTAIN CONTROL |
Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3 321.446 |
Citation Charge 3 FAILURE TO SECURE CHILD UNDER 18 YOA |
Citation Charge Code 4 321.446 |
Citation Charge 4
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Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 3 - Non-incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
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Trapped 1 - Not trapped |
Transported to: MERCY |
Transported by: LIFE FLIGHT |
Insurance Co. Name
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Year 2007 |
Make Chevrolet - CHEV |
Model
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Style PK |
Approximate Cost to Repair or Replace 15000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 8 |
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 5 - Asleep, fainted, fatigued, etc |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
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SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
Second Event 33 - Ditch/embankment |
Third Event
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Fourth Event
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Most Harmful Event (by vehicle) 33 - Ditch/embankment |
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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