Crash Information

L O C A T I O N	Date of Accident 10/13/2011	Time of Accident 07:55 AM	County Polk - 77	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011058186
	Literal Description I-35 NB MM 90.1				Legal Intervention? No	Private Property? No
					X-Coordinate: 452071.0
					Y-Coordinate 4615979.

U N I T 1	Driver's Name - Last			First			Middle		Suffix
	City			State				Zip
	Driver's Age					Citation Charge Code 1		Citation Charge 1
	Gender	State	Class	Endorsements None	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given?			Drug Test Given?		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position	Injury Status	Occupant Protection		Airbag Deployment	Airbag Switch Status		Ejection	Ejection Path	Trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year		Make		Model		Style		Approximate Cost to Repair or Replace
	Initial Travel Direction	Vehicle Action	Speed Limit	Point of Initial Impact	Most Damaged Area	Extent of Damage	Underride/Override
	Total Occupants	Traffic Controls	Vehicle Config.	Cargo Body Type	Vehicle Defect	Driver Condition	Vision Obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 52 - Hit and run	Second Event	Third Event	Fourth Event	Most Harmful Event (by vehicle)
	Emergency Vehicle Type					Emergency Status
	Carrier Name			City		State			Zip
	Number of Axles			Gross Vehicle Weight Rating		Placard #			Hazardous Materials Released?

U N I T 2	Driver's Name - Last SCOTT			First MICHELE			Middle KATHERINE		Suffix
	City ALBIA			State IA - Iowa, US				Zip 525310000
	Driver's Age 18					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 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: NA					Transported by: NA
	Insurance Co. Name
	Year 1999		Make Oldsmobile - OLDS		Model ALO		Style 2D		Approximate Cost to Repair or Replace 1500
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 65	Point of Initial Impact 02 - Right Front	Most Damaged Area 02 - Right Front	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 01 - No controls present	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 06 - Evasive action (swerve, panic braking, etc.)	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) 01 - Clear	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 6 - Sideswipe, same direction	Weather Conditions (up to two) 01 - Clear	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

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NARRATIVE

UNIT 2 WAS NB ON I-35. TRAFFIC WAS BACKING UP FOR THE ORALABOR EXIT. UNIT 1 (RUN VEHICLE) CHANGED LANES AND MADE CONTACT WITH THE RIGHT FRONT OF UNIT 2. UNIT 1 DID NOT STOP. UNIT 2 PULLED TO THE RIGHT SHOULDER. NO INJURIES.

Officer CHAMPLIN	Badge No. 220	Time Officer Notified of Accident 08:00	Time Officer Arrived At Scene 08:00
Name of Agency P01	Date of Report 10/13/2011	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