Iowa State Patrol: Department of Public Safety

Crash Information

L
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A
T
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N 		Date of Accident
5/1/2011		 Time of Accident
07:45 PM 		County
Worth - 98		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011025856
Literal Description
I-35 MILE MARKER 203 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
471602.9
Y-Coordinate
4791799.
U
N
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1 		Driver's Name - Last
MATEKOLE		 First
ALBERT		 Middle
SACKITEY		 Suffix
City
CHASKA		 State
MN - Minnesota, US		 Zip
55318
Driver's Age
38		 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
 Injury Status
 Occupant Protection
 Airbag Deployment
 Airbag Switch Status
 Ejection
 Ejection Path
 Trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2011		 Make
Chevrolet - CHEV		 Model
MALIBU		 Style
4DR		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
 Vehicle Action
 Speed Limit
 Point of Initial Impact
 Most Damaged Area
 Extent of Damage
 Underride/Override
Total Occupants
 Traffic Controls
 Vehicle Config.
 Cargo Body Type
 Vehicle Defect
 Driver Condition
 Vision Obscured
 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
Emergency Vehicle Type
 Emergency Status
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
 Weather Conditions (up to two)
 Environment
 Location
 First Harmful Event of Crash (use codes 11-42 only)
25 - Animal
Manner of Crash/Collision
 Roadway
 Type
Light Conditions
 Surface Conditions
 Type of Roadway Junction/Feature
 Workers Present?
D
I
A
G
R
A
M

0
NARRATIVE

VEH 1 WAS NORTHBOUND ON I35 AT THE 203MM. A DEER RAN OUT OF THE EAST DITCH. VEH 1 WAS UNABLE TO AVOID THE DEER AND IT STRUCK THE RIGHT FRONT FENDER/BUMPER AREA.
Officer
PALAS 		Badge No.
265		 Time Officer Notified of Accident
 Time Officer Arrived At Scene
Name of Agency
P08		 Date of Report
5/1/2011		 Investigation made at scene?
 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