U
N
I
T
1
|
Driver's Name - Last GALLAHER |
First STEVEN |
Middle WILLIAM |
Suffix
|
City ST LOUIS |
State MO - Missouri, US |
Zip 63129 |
Driver's Age 45 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MO - Missouri, US |
Class
|
Endorsements
|
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 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: REFUSED |
Transported by: REFUSED |
Insurance Co. Name
|
Year 2006 |
Make Toyota - TOYT |
Model SIENNA |
Style SUV |
Approximate Cost to Repair or Replace 1500 |
Initial Travel Direction 1 - North |
Vehicle Action 09 - Backing |
Speed Limit 55 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 4 |
Traffic Controls 06 - No Passing Zone (marked) |
Vehicle Config. 04 - Sport utility vehicle |
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 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 21 - Vehicle in traffic |
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 JOHNSON |
First RONNY |
Middle JERELL |
Suffix
|
City LA FERIA |
State TX - Texas, US |
Zip 78559 |
Driver's Age 31 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State TX - Texas, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
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 1 - None used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: NA |
Transported by: NA |
Insurance Co. Name
|
Year 2009 |
Make
|
Model TT |
Style SEMI |
Approximate Cost to Repair or Replace 500 |
Initial Travel Direction 1 - North |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 06 - No Passing Zone (marked) |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
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?
|
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) 03 - Cloudy |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
Roadway 01 - None apparent |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 2 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT #1 STOPPED FOR JACK KNIFED SEMI (NON CONTACT VEHICLE). DRIVER OF UNIT #1 STATED THAT JACK KNIFED SEMI BEGAN TO BACK UP, THEREFORE HE STARTED TO BACK UP TO AVOID BEING HIT BY NON CONTACT VEHICLE AND BACKED INTO THE FRONT OF UNIT #2 WITH THE REAR OF UNIT #1. SGT MICHELSEN COVERED PROPERTY DAMAGE ACCIDENT ON JACK KNIFED SEMI CASE #2011037242. |
|
Officer
BURN |
Badge No. 478 |
Time Officer Notified of Accident 22:00 |
Time Officer Arrived At Scene 22:20 |
Name of Agency P03 |
Date of Report 6/26/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504