U
N
I
T
1
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Driver's Name - Last KONECNE |
First JUSTIN |
Middle EDWARD |
Suffix
|
City FORT DODGE |
State IA - Iowa, US |
Zip 50501 |
Driver's Age 33 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements N - Tank |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 2 - Blood |
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 1 - Fatal |
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: TRINITY REGIONAL |
Transported by: DAYTON AND TRINITY |
Insurance Co. Name
|
Year 2007 |
Make
|
Model FXST DOM |
Style MC |
Approximate Cost to Repair or Replace 10000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 35 |
Point of Initial Impact 99 - Unknown |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 14 - Motorcycle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 6 - Under the influence of alcohol/drugs/medications |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
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
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
|
Placard #
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Hazardous Materials Released?
|