U
N
I
T
1
|
Driver's Name - Last
GONZALEZ-LOPEZ |
First
ANTONIO |
Middle
|
Suffix
|
City
WEBSTER CITY |
State
IA - Iowa, US |
Zip
50595 |
Driver's Age
30 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender
Male |
State
NO - None, US |
Class
|
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
2 - Incapacitating |
Occupant Protection
9 - Unknown |
Airbag Deployment
5 - Not deployed |
Airbag Switch Status
9 - Unknown |
Ejection
1 - Not ejected |
Ejection Path
|
Trapped
2 - Freed by non-mechanical means |
Transported to:
MERCY HOSPITAL IN DES MOINES |
Transported by:
MERCY-ONE HELICOPTER |
Insurance Co. Name
|
Year
2004 |
Make
|
Model
XTR XTRERRA |
Style
XE/SE LL |
Approximate Cost to Repair or Replace
30000 |
Initial Travel Direction
3 - South |
Vehicle Action
01 - Movement essentially straight |
Speed Limit
|
Point of Initial Impact
08 - Left Front |
Most Damaged Area
08 - Left Front |
Extent of Damage
5 - Severe, vehicle totaled |
Underride/Override
2 - Underride, compartment intrusion |
Total Occupants
02 |
Traffic Controls
04 - Stop signs |
Vehicle Config.
04 - Sport utility vehicle |
Cargo Body Type
01 - Not applicable |
Vehicle Defect
99 - Unknown |
Driver Condition
9 - Unknown |
Vision Obscured
01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event
24 - Railway vehicle/train |
Second Event
01 - Ran off road, right |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle)
24 - Railway vehicle/train |
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
|
First
|
Middle
|
Suffix
|
City
|
State
|
Zip
|
Driver's Age
|
Citation Charge Code 1
|
Citation Charge 1
|
Gender
|
State
|
Class
|
Endorsements
None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given?
|
Drug Test Given?
|
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
|
Make
|
Model
|
Style
|
Approximate Cost to Repair or Replace
|
Initial Travel Direction
4 - West |
Vehicle Action
01 - Movement essentially straight |
Speed Limit
|
Point of Initial Impact
01 - Front |
Most Damaged Area
01 - Front |
Extent of Damage
|
Underride/Override
|
Total Occupants
02 |
Traffic Controls
|
Vehicle Config.
|
Cargo Body Type
|
Vehicle Defect
|
Driver Condition
|
Vision Obscured
|
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event
22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle)
22 - Vehicle in/from other roadway |
Emergency Vehicle Type
|
Emergency Status
|
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged
SIGN POSTS |
Estimate of Damage
500 |
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name
MARYANN'S SPECIALY FOODS |
City
WEBSTER CITY |
State
IA - Iowa, US |
Zip
|
| 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)
01 - Clear |
Environment
1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only)
22 - Vehicle in/from other roadway |
Manner of Crash/Collision
1 - Non-collision |
Roadway
01 - None apparent |
Type
|
Light Conditions
1 - Daylight |
Surface Conditions
1 |
Type of Roadway Junction/Feature
03 - Railroad crossing |
Workers Present?
|
P
E
R
S
O
N
|
I
N
J
U
R
E
D
|
Name- Last
HUERTA-DURAN |
First
FRANCISCO |
Middle
|
Suffix
|
City
|
State
|
Zip Code
|
Age
53 |
Sex
Male |
Unit No.
01 |
Seating Position
01 - Front: Left Side / Motorcycle Driver |
Injury Status
1 - Fatal |
Occupant Protection
1 - None used |
Airbag Deployment
5 - Not deployed |
Airbag Switch Status
9 - Unknown |
Ejection
3 - Totally ejected |
Ejection Path
9 - Unknown |
Trapped
1 - Not trapped |
Transported to:
HAMILTON HOSPITAL |
Transported by:
AMBULANCE |
| NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D
I
A
G
R
A
M
0 |
 |
| NARRATIVE |
VEHICLE #1 WAS SOUTH BOUND EXITING THE PARKING LOT AT MARY ANN'S SPECIALTY FOODS AND APPROACHED THE ILLINOIS CENTRAL GULF RAILROAD CROSSING THAT HAD STOP SIGNS BUT NO CROSSING ARMS. VEHICLE #1 FAILED TO STOP AND YIELD THE RIGHT OF WAY TO A WEST BOUND TRAIN. VEHICLE #1 WAS STRUCK ON THE DRIVER SIDE BY THE WEST BOUND TRAIN AT THE CROSSING AND A PASSENGER INSIDE THE VEHICLE WAS EJECTED. VEHICLE #1 WAS PUSHED TO THE NORTH WEST DITCH TO IT'S FINAL RESTING PLACE. THE DRIVER OF VEHICLE #1 WAS AIRLIFTED BY MERCY -ONE TO MERCY HOSPITAL IN DES MOINES. THE PASSENGER WHO WAS EJECTED WAS PRONOUNCED DEAD BY THE HAMILTON COUNTY MEDICAL EXAMINER. THE TRAIN ENGINEER AND CONDUCTOR WERE NOT INJURED. CHARGES ARE PENDING COMPLETION OF TI REPORT. |
|
Officer
EIMERS |
Badge No.
273 |
Time Officer Notified of Accident
12:44 |
Time Officer Arrived At Scene
13:00 |
Name of Agency
P07 |
Date of Report
5/31/2011 |
Investigation made at scene?
Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218