U
N
I
T
1
|
Driver's Name - Last WOODEN |
First RANDALL |
Middle DEAN |
Suffix
|
City PARKVILLE |
State MO - Missouri, US |
Zip 64152 |
Driver's Age 48 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MO - Missouri, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements X - Hazmat & Tank |
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 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to:
|
Transported by:
|
Insurance Co. Name VAN WYK FREIGHT |
Year 2005 |
Make
|
Model TRACTOR |
Style TRACTOR |
Approximate Cost to Repair or Replace 20000 |
Initial Travel Direction 4 - West |
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 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 02 - Van/enclosed box |
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 22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name VAN WYK FREIGHT |
City GRINNELL |
State IA - Iowa, US |
Zip 50112 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 3 - Not applicable |
U
N
I
T
2
|
Driver's Name - Last DENHAM |
First GEORGETTE |
Middle S |
Suffix
|
City WEST HARRISON |
State IN - Indiana, US |
Zip 470600000 |
Driver's Age 51 |
Citation Charge Code 1 321.321 |
Citation Charge 1 FAILURE TO YIELD UPON ENTERING HIGHWAY |
Gender Female |
State IN - Indiana, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements T - Dbl/Trpl Trlr |
Restrictions
|
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 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: MERCY HOSPITAL |
Transported by: MITCHELLVILLE |
Insurance Co. Name MAVERICK TRANSPORTATION |
Year 2007 |
Make
|
Model TRACTOR |
Style TRACTOR |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 2 - East |
Vehicle Action 07 - Entering traffic lane (merging) |
Speed Limit 70 |
Point of Initial Impact 05 - Rear |
Most Damaged Area 05 - Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 09 - Tractor/semi-trailer |
Cargo Body Type 05 - Flatbed |
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 22 - Vehicle in/from other roadway |
Second Event
|
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name MAVERICK TRANSPORTATION |
City GARY |
State IN - Indiana, US |
Zip 46406 |
Number of Axles 5 |
Gross Vehicle Weight Rating 80000 |
Placard #
|
Hazardous Materials Released? 3 - Not applicable |
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) 22 - Vehicle in/from other roadway |
Manner of Crash/Collision 3 - Rear-end |
Roadway 01 - None apparent |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 1 |
Type of Roadway Junction/Feature 17 - On-ramp merge area |
Workers Present?
|
D I A G R A M
0 |
|
NARRATIVE |
UNIT 2 WAS ENTERING THE INTERSTATE FROM THE REST AREA RAMP WHEN IT FAILED TO YIELD TO UNIT 1 AND WAS REARENDED. |
|
Officer
SALESBERRY |
Badge No. 284 |
Time Officer Notified of Accident 04:35 |
Time Officer Arrived At Scene 04:48 |
Name of Agency P01 |
Date of Report 2/1/2012 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011