U
N
I
T
4
|
Driver's Name - Last CLEMENS |
First REGINA |
Middle ANN |
Suffix
|
City GRANGER |
State IA - Iowa, US |
Zip 501090000 |
Driver's Age 48 |
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
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 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: METHODIST HOPITAL |
Transported by: ISP 74 |
Insurance Co. Name
|
Year 2011 |
Make Ford - FORD |
Model CROWN VIC |
Style 4D |
Approximate Cost to Repair or Replace 9000 |
Initial Travel Direction 3 - South |
Vehicle Action 88 - Other (explain in narrative) |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 88 - Other control (explain in narrative) |
Vehicle Config. 01 - Passenger car |
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
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 21 - Vehicle in traffic |
Emergency Vehicle Type 2 - Police |
Emergency Status 1 - Yes, in emergency |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
|
Hazardous Materials Released?
|
U
N
I
T
5
|
Driver's Name - Last MOLINA |
First ROY |
Middle VINCENT |
Suffix
|
City AMES |
State IA - Iowa, US |
Zip 500140000 |
Driver's Age 24 |
Citation Charge Code 1 321.288 |
Citation Charge 1 FAIL TO MAINTAIN CONTROL - 1050 MINOR PI |
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 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 9 - Unknown |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: N/A |
Transported by: N/A |
Insurance Co. Name
|
Year 1999 |
Make Honda - HOND |
Model ACC |
Style 2D |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 88 - Other control (explain in narrative) |
Vehicle Config. 01 - Passenger car |
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
|
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?
|
P
R
O
P
E
R
T
Y
D
A
M
A
G
E
|
If Property other than vehicles damaged explain |
Object Damaged 2 WIRE CABLE POST |
Estimate of Damage 200 |
Owner's Name - Last
|
First
|
Middle
|
Suffix
|
Owner Company Name IOWA DOT |
City
|
State IA - Iowa, US |
Zip
|
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 2 - Weather condition |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 3 - Rear-end |
Roadway 02 - Road surface condition |
Type
|
Light Conditions 1 - Daylight |
Surface Conditions 2 |
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 PIERCE |
First SHELLEY |
Middle LYNN |
Suffix
|
City
|
State
|
Zip Code
|
Age 31 |
Sex Female |
Unit No. 2 |
Seating Position 03 - Front: Right Side |
Injury Status 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 3 - Deployed both front/side |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path 1 - Not ejected/not applicable |
Trapped 1 - Not trapped |
Transported to: N/A |
Transported by: N/A |
NON-MOTORIST |
Type
|
Location
|
Action
|
Condition
|
Safety Equipment
|
Contributing Circumstances
|
Unit No. of Vehicle Striking
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE 4 (IOWA STATE PATROL CAR) WAS SITTING STATIONARY ON THE INSIDE SHOULDER OF INTERSTATE 35 JUST SOUTH OF THE 97 MILE MARKER WITH ALL THE EMERGENCY LIGHTS ON. VEHICLE 4 WAS HELPING WITH TRAFFIC CONTROL FOR ANOTHER ACCIDENT THAT WAS SOUTH OF HER LOCATION. VEHICLE 2 WAS SOUTHBOUND ON INTERSTATE 35 IN THE INSIDE LANE OF TRAVEL FROM THE 97 MILE MARKER. VEHICLE 1 WAS ALSO SOUTH BOUND ON INTERSTATE 35 FROM THE 97 MILE MARKER IN THE INSIDE LANE OF TRAVEL. VEHICLE 3 WAS SOUTHBOUND ON INTERSTATE 35 FROM THE 97 MILE MARKER IN THE OUTSIDE LANE OF TRAVEL. VEHICLE 5 WAS SOUTH BOUND ON INTERSTATE 35 FROM THE 97 MILE MARKER ON THE INSIDE LANE OF TRAVEL. VEHICLE 2 WAS SLOWING FOR VEHICLE 4'S EMEGENCY LIGHTS AND FOR TRAFFIC THAT WAS SLOWING/STOPPING AHEAD. VEHICLE 1 THEN RAN INTO THE REAR OF VEHICLE 2 PUSHING VEHICLE 2 INTO THE REAR OF VEHICLE 4. VEHICLE 1 THEN VEARED TO THE RIGHT STRIKING THE SIDE OF VEHICLE 3. VEHICLE 5 THEN COULD NOT GET STOPPED AND RAN INTO VEHICLE 4. VEHICLE 4 THEN HIT THE WIRE CABLE. |
|
Officer
PEARSTON |
Badge No. 168 |
Time Officer Notified of Accident 15:35 |
Time Officer Arrived At Scene 15:35 |
Name of Agency P01 |
Date of Report 10/12/2011 |
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