Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
8/19/2011		 Time of Accident
02:35 PM 		County
Polk - 77		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011048470
Literal Description
I80 WB TO HWY 65 SB RAMP 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
456295.8
Y-Coordinate
4612141.
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1 		Driver's Name - Last
CHAREST		 First
THOMAS		 Middle
 Suffix
City
BRIGHTON		 State
IA - Iowa, US		 Zip
525400000
Driver's Age
62		 Citation Charge Code 1
 Citation Charge 1
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
 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
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
4 - Not applicable (motorcycle, bicycle, etc.)		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
MERCY MEDICAL CENTER		 Transported by:
MERCY ONE AIR AMBULANCE
Insurance Co. Name
Year
2002		 Make
 Model
FLHRCI		 Style
MC		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
4 - West		 Vehicle Action
08 - Leaving traffic lane		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
07 - Warning sign		 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
21 - Vehicle in traffic		 Second Event
03 - Ran off road, left		 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)
02 - Partly cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
18 - Off-ramp diverge area		 Workers Present?
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NARRATIVE

UNIT #1 WAS TRAVELING WESTBOUND ON I80 NEAR THE 141 MILE MARKER. UNIT #1 TOOK THE OFF RAMP (CLOVER LEAF) TO MERGE ONTO HIGHWAY 65 SOUTHBOUND. UNIT #1 FOR AN UNKNOWN REASON LOST CONTROL AND TIPPED OVER ON THE RAMP, EJECTING THE DRIVER TOWARDS THE GRASS AREA. UNIT #1 CAME TO A REST IN THE TRAVEL PORTION OF THE RAMP.
Officer
MOSES 		Badge No.
167		 Time Officer Notified of Accident
14:35		 Time Officer Arrived At Scene
14:44
Name of Agency
P01		 Date of Report
8/20/2011		 Investigation made at scene?
Yes		 T.I. #


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