Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
1/1/2012		 Time of Accident
04:16 AM 		County
Delaware - 28		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2012000034
Literal Description
NB/EB US 0020 / US 20 (Milepost 284) measuring 1567 Feet East from US 0020 / US 20 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
638925.8
Y-Coordinate
4703440.
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1 		Driver's Name - Last
ROBINS		 First
JOHN		 Middle
MICHAEL		 Suffix
City
RAYMOND		 State
IA - Iowa, US		 Zip
50667
Driver's Age
47		 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
X - Hazmat & Tank		 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
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
1 - Not trapped
Transported to:
RMC MANCHESTER		 Transported by:
EMS
Insurance Co. Name
FLYING J TRANSPORTATION LLC
Year
2008		 Make
 Model
9200I		 Style
SEMI TRACTOR		 Approximate Cost to Repair or Replace
25000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
09 - Tractor/semi-trailer		 Cargo Body Type
04 - Cargo tank		 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
06 - Evasive action (swerve, panic braking, etc.)		 Second Event
21 - Vehicle in traffic		 Third Event
 Fourth Event
12 - Jackknife		 Most Harmful Event (by vehicle)
21 - Vehicle in traffic
Emergency Vehicle Type
1 - Not applicable		 Emergency Status
3 - Not Applicable
Carrier Name
FLYING J TRANSPORTATION LLC		 City
LOGAN		 State
UT - Utah, US		 Zip
84321
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 Placard #
1203-		 Hazardous Materials Released?
2 - No
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2 		Driver's Name - Last
NURRE		 First
DANIEL		 Middle
JOSEPH		 Suffix
City
DYERSVILLE		 State
IA - Iowa, US		 Zip
52040
Driver's Age
50		 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?
2 - Blood		 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
1 - Deployed front of person		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
3 - Extricated by mechanical means
Transported to:
RMC- MANCHESTER		 Transported by:
EMS
Insurance Co. Name
Year
1994		 Make
Dodge - DODG		 Model
R15		 Style
PU		 Approximate Cost to Repair or Replace
2000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
01 - Front		 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.
02 - Four-tire light truck (pick-up, panel)		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
99 - Unknown		 Driver Condition
9 - Unknown		 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?
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
2 - Head-on		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT ONE WAS TRAVELING EAST BOUND ON HWY 20 WHEN IT ENCOUNTERED UNIT TWO THAT WAS TRAVELING WEST BOUND IN THE EAST BOUND LANE. THE VEHICLES COLLIDED IN THE INSIDE LANE OF EAST BOUND HWY 20
Officer
HAHN 		Badge No.
039		 Time Officer Notified of Accident
05:04		 Time Officer Arrived At Scene
05:46
Name of Agency
P10		 Date of Report
1/1/2012		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046