Crash Information

L O C A T I O N	Date of Accident 12/21/2012	Time of Accident 06:35 PM	County Webster - 94	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2012067631
	Literal Description 600 FT N OF 150TH ST ON P-56				Legal Intervention? No	Private Property? No
					X-Coordinate: 403308.6
					Y-Coordinate 4714298.

U N I T 1	Driver's Name - Last BROWN			First AUSTIN			Middle WALTER		Suffix
	City FORT DODGE			State IA - Iowa, US				Zip 50501
	Driver's Age 20					Citation Charge Code 1		Citation Charge 1
	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	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 3 - Urine			Drug Test Given? 3 - Urine		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position 01 - Front: Left Side / Motorcycle Driver	Injury Status 2 - Incapacitating	Occupant Protection 1 - None used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 1 - Switch in ON position		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: TRMC					Transported by: TRMC
	Insurance Co. Name
	Year 2002		Make General Motors - GMC		Model SRA		Style PK		Approximate Cost to Repair or Replace 10000
	Initial Travel Direction 1 - North	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	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 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 04 - Crossed centerline/median	Second Event 21 - Vehicle in traffic	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?

U N I T 2	Driver's Name - Last REIGELSBERGER			First JOSEPH			Middle MICHAEL		Suffix
	City ROLFE			State IA - Iowa, US				Zip 505810000
	Driver's Age 23					Citation Charge Code 1		Citation Charge 1
	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? 2 - Blood			Drug Test Given? 3 - Urine		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 2 - Shoulder and lap belt used		Airbag Deployment 1 - Deployed front of person	Airbag Switch Status 1 - Switch in ON position		Ejection 1 - Not ejected	Ejection Path	Trapped 3 - Extricated by mechanical means
	Transported to: TRMC					Transported by: TRMC
	Insurance Co. Name
	Year 2002		Make Ford - FORD		Model ECP		Style SW		Approximate Cost to Repair or Replace 8000
	Initial Travel Direction 3 - South	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 5 - Severe, vehicle totaled	Underride/Override 1 - None
	Total Occupants 03	Traffic Controls 01 - No controls present	Vehicle Config. 04 - Sport utility vehicle	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 01 - Ran off road, right	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 2 - Head-on	Weather Conditions (up to two) 01 - Clear	Roadway 02 - Road surface condition	Type
Light Conditions 5 - Dark, roadway not lighted	Surface Conditions 3	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
E
R
S
O
N

I
N
J
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R
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D

Name- Last
LUNDT

First
DEBRA

Middle
SUSAN

Suffix

City

State

Zip Code

Age
57

Sex
Female

Unit No.
2

Seating Position
07 - Rear: Left Side

Injury Status
1 - Fatal

Occupant Protection
1 - None used

Airbag Deployment
6 - Not applicable

Airbag Switch Status
3 - No ON/OFF switch present

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
3 - Extricated by mechanical means

Transported to:
TRMC

Transported by:
TRMC

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

P
E
R
S
O
N

I
N
J
U
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E
D

Name- Last
LUNDT

First
ANASTASHIA

Middle
JANE

Suffix

City

State

Zip Code

Age
23

Sex
Female

Unit No.
2

Seating Position
03 - Front: Right Side

Injury Status
2 - Incapacitating

Occupant Protection
2 - Shoulder and lap belt used

Airbag Deployment
1 - Deployed front of person