Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
6/21/2011		 Time of Accident
08:00 PM 		County
Jasper - 50		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011036162
Literal Description
US 6 E AND N 39TH AVE E 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
517533.0
Y-Coordinate
4620317.
U
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1 		Driver's Name - Last
SCHILLING		 First
HARRY		 Middle
ALBERT		 Suffix
JR
City
NEWTON		 State
IA - Iowa, US		 Zip
502080000
Driver's Age
26		 Citation Charge Code 1
321.174		 Citation Charge 1
FAILURE TO HAVE VALID LICENSE/PERMIT WHILE OPER. MOTOR
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

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
6 - Helmet used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
NEWTON SKIFF		 Transported by:
KELLOGG AMBULANCE
Insurance Co. Name
Year
2000		 Make
Honda - HOND		 Model
CBR 600		 Style
MOTORCYCLE		 Approximate Cost to Repair or Replace
1000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
08 - Left Front		 Most Damaged Area
07 - Left Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
14 - Motorcycle		 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
01 - Ran off road, right		 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
2 - Shoulder		 Weather Conditions (up to two)
02 - Partly cloudy		 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		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
12 - T - intersection		 Workers Present?
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NARRATIVE

THIS ACCIDENT IS BASED ON INFORMATION FROM DRIVER # 1. AND NOT FROM MY INVESTIGATION AT THE TIME OF THE ACCIDENT. UNIT # 1 WAS GOING WEST ON HIGHWAY 6. A NON-CONTACT (N/C) VEHICLE WAS GOING EAST BOUND AND CROSSED THE WEST BOUND LANE TO GO LEFT ON COUNTY GRAVEL. N/C FAILED TO YEILD TO UNIT # 1. UNIT # 1 MERGED ONTO THE SHOULDER TO AVOID IMPACT, LOST CONTROL AND ROLLED HIS MOTORCYCLE ON THE GRAVEL SHOULDER.
Officer
ROZENDAAL 		Badge No.
183		 Time Officer Notified of Accident
20:15		 Time Officer Arrived At Scene
20:18
Name of Agency
P01		 Date of Report
6/21/2011		 Investigation made at scene?
No		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011