Iowa State Patrol: Department of Public Safety

Crash Information


L
O
C
A
T
I
O
N
Date of Accident
6/20/2011
Time of Accident
01:39 PM
County
Warren - 91
Accident occurred within corporate limits of (city)
Law Enforcement Case Number:
2011035914
Literal Description
US 0065 / US 65 and US 0069 / US 69 and G058 / HWY G58
Legal Intervention?
No
Private Property?
No
X-Coordinate:
452826.1
Y-Coordinate
4570590.
U
N
I
T

1
Driver's Name - Last
SMITH
First
BRIAN
Middle
CRAIG
Suffix
City
ACKWORTH
State
IA - Iowa, US
Zip
500010000
Driver's Age
40
Citation Charge Code 1
321.321
Citation Charge 1
FAILURE TO YIELD UPON ENTERING THROUGH HIGHWAY
Gender
Male
State
IA - Iowa, US
Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more
Endorsements
N - Tank
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
5 - Uninjured
Occupant Protection
2 - Shoulder and lap belt used
Airbag Deployment
9 - Unknown
Airbag Switch Status
9 - Unknown
Ejection
1 - Not ejected
Ejection Path
Trapped
1 - Not trapped
Transported to:
Transported by:
Insurance Co. Name
Year
2001
Make
Ford - FORD
Model
F15
Style
PK
Approximate Cost to Repair or Replace
5000
Initial Travel Direction
2 - East
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
02 - Right Front
Most Damaged Area
02 - Right Front
Extent of Damage
5 - Severe, vehicle totaled
Underride/Override
1 - None
Total Occupants
2
Traffic Controls
04 - Stop signs
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)
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
City
State
Zip
Number of Axles
Gross Vehicle Weight Rating
Placard #
Hazardous Materials Released?
U
N
I
T

2
Driver's Name - Last
NORMAN
First
LACY
Middle
LYNN
Suffix
City
LUBBOCK
State
TX - Texas, US
Zip
79423
Driver's Age
25
Citation Charge Code 1
Citation Charge 1
Gender
Female
State
TX - Texas, US
Class
C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat
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
5 - Uninjured
Occupant Protection
2 - Shoulder and lap belt used
Airbag Deployment
1 - Deployed front of person
Airbag Switch Status
9 - Unknown
Ejection
1 - Not ejected
Ejection Path
Trapped
1 - Not trapped
Transported to:
Transported by:
Insurance Co. Name
Year
2006
Make
Mercury - MERC
Model
MON
Style
MD
Approximate Cost to Repair or Replace
4000
Initial Travel Direction
1 - North
Vehicle Action
01 - Movement essentially straight
Speed Limit
55
Point of Initial Impact
01 - Front
Most Damaged Area
01 - Front
Extent of Damage
5 - Severe, vehicle totaled
Underride/Override
1 - None
Total Occupants
5
Traffic Controls
01 - No controls present
Vehicle Config.
03 - Van or mini-van
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
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
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
LIGHT POST
Estimate of Damage
3000
Owner's Name - Last
First
Middle
Suffix
Owner Company Name
STATE OF IOWA(DOT)
City
State
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)
21 - Vehicle in traffic
Manner of Crash/Collision
5 - Broadside
Roadway
01 - None apparent
Type
Light Conditions
1 - Daylight
Surface Conditions
1
Type of Roadway Junction/Feature
11 - Four-way intersection
Workers Present?
P
E
R
S
O
N
I
N
J
U
R
E
D
Name- Last
PAGE
First
BAILEY
Middle
JO
Suffix
City
State
Zip Code
Age
23
Sex
Male
Unit No.
2
Seating Position
07 - Rear: Left Side
Injury Status
3 - Non-incapacitating
Occupant Protection
9 - Unknown
Airbag Deployment
9 - Unknown
Airbag Switch Status
9 - Unknown
Ejection
1 - Not ejected
Ejection Path
1 - Not ejected/not applicable
Trapped
1 - Not trapped
Transported to:
MERCY HOSPITAL
Transported by:
NORWALK AMBULANCE
NON-MOTORIST Type
Location
Action
Condition
Safety Equipment
Contributing Circumstances
Unit No. of Vehicle Striking
P
E
R
S
O
N
I
N
J
U
R
E
D
Name- Last
JACKSON
First
LEONA
Middle
JEAN
Suffix
City
State
Zip Code
Age
67
Sex
Female
Unit No.
2
Seating Position
07 - Rear: Left Side
Injury Status
3 - Non-incapacitating
Occupant Protection
9 - Unknown
Airbag Deployment
9 - Unknown
Airbag Switch Status
9 - Unknown
Ejection
1 - Not ejected
Ejection Path
1 - Not ejected/not applicable
Trapped
1 - Not trapped
Transported to:
MERCY HOSPITAL
Transported by:
NORWALK 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

UNIT 1 WAS ATTEMPTING TO CROSS HWY 69 ONTO HWY 65 FROM G-58. UNIT 2 WAS TRAVELING NORTHBOUND ON HWY 69. THE DRIVER OF UNIT 1 DID NOT SEE UNIT 2 APPROACHING THE INTERSECTION OF THE TWO HIGHWAYS AND PULLED OUT IN FRONT OF UNIT 2. UNIT 2 WAS UNABLE TO AVOID UNIT 1 AND STRUCK THE TRUCK IN THE FRONT RIGHT. BOTH VEHICLES WERE TOTALED. TWO PASSENGERS OF UNIT 2 WERE TRANSPORTED TO MERCY HOSPITAL IN DES MOINES BY AMBULANCE.
Officer
KLEIN
Badge No.
152
Time Officer Notified of Accident
14:05
Time Officer Arrived At Scene
14:16
Name of Agency
P02
Date of Report
6/20/2011
Investigation made at scene?
Yes
T.I. #



Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653