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Driver's Name - Last VANWAGNER |
First RANDALL |
Middle BRUCE |
Suffix
|
City MONTICELLO |
State MN - Minnesota, US |
Zip 55362 |
Driver's Age 47 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MN - Minnesota, 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 3 - Non-incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 3 - Extricated by mechanical means |
Transported to: DECATUR COUNTY HOSPITAL |
Transported by: DECATUR COUNTY AMBULANCE |
Insurance Co. Name NORTHWEST DAIRY FORWARDING INC |
Year 2009 |
Make
|
Model CONVENTIONAL |
Style TT |
Approximate Cost to Repair or Replace 50000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
Vehicle Defect 01 - None |
Driver Condition 5 - Asleep, fainted, fatigued, etc |
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) 37 - Tree |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name NORTHWEST DAIRY FORWARDING INC |
City HAM LAKE |
State MN - Minnesota, US |
Zip 55304 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 3 - Not applicable |