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Driver's Name - Last PAZ- LOBO |
First ALEX |
Middle J |
Suffix
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City GRAND ISLAND |
State NE - Nebraska, US |
Zip 68801 |
Driver's Age 29 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State NO - None, US |
Class
|
Endorsements None |
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
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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 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 3 - Extricated by mechanical means |
Transported to: STATE MEDICAL EXAMINER'S OFFIC |
Transported by: ADAIR CO. AMB./JOHNSON FUNERAL |
Insurance Co. Name
|
Year 2011 |
Make Chevrolet - CHEV |
Model SSM |
Style CP |
Approximate Cost to Repair or Replace 30000 |
Initial Travel Direction 2 - East |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 09 - Top |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 05 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 9 - Unknown |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 03 - Ran off road, left |
Second Event 04 - Crossed centerline/median |
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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