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Driver's Name - Last HUBBARD |
First DAVID |
Middle EUGENE |
Suffix
|
City MOORLAND |
State IA - Iowa, US |
Zip 50566 |
Driver's Age 44 |
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? 3 - Urine |
Drug Test Given?
|
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 9 - Unknown |
Airbag Deployment 9 - Unknown |
Airbag Switch Status 9 - Unknown |
Ejection 2 - Partially ejected |
Ejection Path
|
Trapped 9 - Unknown |
Transported to: TRINITY REGIONAL MEDICAL CENT. |
Transported by: TRINITY REGIONAL MEDICAL CENT. |
Insurance Co. Name
|
Year 2005 |
Make Chevrolet - CHEV |
Model K2500 HD |
Style PK |
Approximate Cost to Repair or Replace 12000 |
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 01 |
Traffic Controls 09 - Railway crossing device |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 8 - Other (explain in narrative) |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 01 - Ran off road, right |
Second Event 03 - Ran off road, left |
Third Event
|
Fourth Event 11 - Overturn/rollover |
Most Harmful Event (by vehicle) 11 - Overturn/rollover |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
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City
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State
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Zip
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Number of Axles
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Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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