Crash Information

L O C A T I O N	Date of Accident 7/11/2011	Time of Accident 12:34 AM	County Carroll - 14	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011040136
	Literal Description E025 / 170TH ST				Legal Intervention? No	Private Property? No
					X-Coordinate: 337232.6
					Y-Coordinate 4663597.

U N I T 1	Driver's Name - Last WOODS			First JANELLE			Middle MARIE		Suffix
	City LAKE CITY			State IA - Iowa, US				Zip 51449
	Driver's Age 19					Citation Charge Code 1		Citation Charge 1
	Gender Female	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 2 - Non-Com Inst Permit (Veh less than 16001 GVWR)	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 2 - Blood			Drug Test Given? 2 - Blood		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position 01 - Front: Left Side / Motorcycle Driver	Injury Status 1 - Fatal	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 3 - No ON/OFF switch present		Ejection 3 - Totally ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: CARROLL HOSPITAL					Transported by: CARROLL COUNTY AMBULANCE
	Insurance Co. Name
	Year 1999		Make Ford - FORD		Model EXPEDITION		Style SUV		Approximate Cost to Repair or Replace 8000
	Initial Travel Direction 4 - West	Vehicle Action 01 - Movement essentially straight	Speed Limit 50	Point of Initial Impact 02 - Right Front	Most Damaged Area 09 - Top	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 1 - None
	Total Occupants 3	Traffic Controls 01 - No controls present	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 01 - Ran off road, right	Second Event 06 - Evasive action (swerve, panic braking, etc.)	Third Event	Fourth Event 03 - Ran off road, left	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 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) 11 - Overturn/rollover
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 5 - Dark, roadway not lighted	Surface Conditions 6	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
E
R
S
O
N

I
N
J
U
R
E
D

Name- Last
HICKERSON

First
ROGER

Middle
DALE

Suffix
JR

City

State

Zip Code

Age
28

Sex
Male

Unit No.
1

Seating Position
04 - Center: Left Side / Motorcycle Passenger

Injury Status
2 - Incapacitating

Occupant Protection
1 - None used

Airbag Deployment
6 - Not applicable

Airbag Switch Status
3 - No ON/OFF switch present

Ejection
3 - Totally ejected

Ejection Path
9 - Unknown

Trapped
1 - Not trapped

Transported to:
MERCY HOSPITAL DES MOINES

Transported by:
MERCY AIRCARE

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
HAHN

First
ASHLEY

Middle
ANN

Suffix

City

State

Zip Code

Age
27

Sex
Female

Unit No.
1

Seating Position
06 - Center: Right Side

Injury Status
3 - Non-incapacitating

Occupant Protection
1 - None used

Airbag Deployment
6 - Not applicable

Airbag Switch Status
3 - No ON/OFF switch present

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
2 - Freed by non-mechanical means

Transported to:
CARROLL HOSPITAL

Transported by:
CARROLL COUNTY 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

V1 WAS WESTBOUND ON 170TH ST AT A HIGH RATE OF SPEED. V1 WENT OFF ONTO RIGHT SHOULDER AND THE DRIVER STEERED HARD TO THE LEFT. V1 LOST CONTROL AND ROLLED SEVERAL TIMES OFF THE ROADWAY TO THE LEFT. THE DRIVER AND ONE REAR PASSENGER WERE EJECTED. THE DRIVER OF V1 WAS KILLED FROM INJURIES SUSTAINED IN THE CRASH. THE TWO PASSENGERS RECIEVED SERIOUS INJURIES.

Officer HILT	Badge No. 221	Time Officer Notified of Accident 01:09	Time Officer Arrived At Scene 02:06
Name of Agency P04	Date of Report 7/11/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 04 Office
3710 Highway 30 E
Denison,IA 51442-7560
Phone: (712) 263-4621
Fax: (712) 263-2325