Crash Information

L O C A T I O N	Date of Accident 6/20/2011	Time of Accident 03:59 PM	County Monroe - 68	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011035950
	Literal Description 278TH ST MEASURING 111 METERS WEST FROM 690TH AVE AND 278TH ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 522532.5
					Y-Coordinate 4527815.

U N I T 1	Driver's Name - Last WILLIAMS			First DYLON			Middle EDWARD		Suffix
	City MORAVIA			State IA - Iowa, US				Zip 52571
	Driver's Age 18					Citation Charge Code 1 321.445		Citation Charge 1 FAIL TO WEAR/MAINTAIN SAFETY BELTS
	Gender Male	State IA - Iowa, US	Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat	Endorsements None	Restrictions B - Cor Lenses	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 4 - Possible	Occupant Protection 1 - None used		Airbag Deployment 5 - Not deployed	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: MERCY HOSPITAL-CENTERVILLE					Transported by: MERCY EMS
	Insurance Co. Name
	Year 1997		Make Ford - FORD		Model RANGER		Style PICKUP		Approximate Cost to Repair or Replace 6000
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 09 - Top	Most Damaged Area 09 - Top	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 2	Traffic Controls 01 - No controls present	Vehicle Config. 02 - Four-tire light truck (pick-up, panel)	Cargo Body Type 01 - Not applicable	Vehicle Defect 02 - Brakes	Driver Condition 1 - Apparently normal	Vision Obscured 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 03 - Ran off road, left	Second Event 11 - Overturn/rollover	Third Event	Fourth Event	Most Harmful Event (by vehicle) 11 - Overturn/rollover
	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?

ACCIDENT ENVIRONMENT		ROADWAY CHARACTERISTICS Major Contributing Circumstances:	WORKZONE RELATED?	SEQUENCE OF EVENTS
Location of First Harmful Event 4 - Roadside	Weather Conditions (up to two) 01 - Clear	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 11 - Overturn/rollover
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 6	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
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Name- Last
SIMONDALE

First
JAKE

Middle
MICHAEL

Suffix

City

State

Zip Code

Age
15

Sex
Male

Unit No.
1

Seating Position
03 - Front: Right Side

Injury Status
4 - Possible

Occupant Protection
1 - None used

Airbag Deployment
5 - Not deployed

Airbag Switch Status
9 - Unknown

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
1 - Not trapped

Transported to:
MERCY HOSPITAL-CENTERVILLE

Transported by:
MERCY EMS

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

D
I
A
G
R
A
M

0

NARRATIVE

THE VEHICLE WAS TRAVELING SOUTHBOUND ON 690TH AVENUE. THE VEHICLE TRIED TO TURN/FOLLOW THE BEND IN THE ROAD TO THE WEST ON 278TH STREET. THE BRAKES DID NOT WORK TO SLOW THE VEHICLE DOWN IN THE BEND. THE VEHICLE SWERVED LEFT AND THE DRIVER OVERCORRECTED SENDING IT TO THE RIGHT OF THE ROAD. THE DRIVER THEN OVERCORRECTED AGAIN AND SENT THE VEHICLE INTO THE SOUTH DITCH OF 278TH STREET. THE VEHICLE ROLLED OVER ONCE AND LANDED ON ITS TOP COMING TO REST FACING WEST IN THE SOUTH DITCH.

Officer DANIELS	Badge No. 089	Time Officer Notified of Accident 16:01	Time Officer Arrived At Scene 16:19
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