Ohio Traffic Crash Report Form PDF Details

The Ohio Traffic Crash Report form is a comprehensive document used for recording details of traffic accidents within the state of Ohio. This form, identified by its local report number and revision indicator OH-1(Rev.10/99), plays a crucial role in the documentation of crash data. It captures a wide array of information, including but not limited to, crash severity, whether the crash involved a hit/skip, the date and time of the crash, geographical details such as latitude and longitude, and specifics about the crash location. Additionally, the form contains sections for the detailed documentation of each involved unit's and occupant's information, including names, addresses, and any injuries sustained. Vehicle information, such as make, model, year, and insurance details, is also recorded, along with any charges or citations issued at the scene. The form even has provisions for documenting the road and weather conditions at the time of the accident, pre-crash actions, and the sequence of events leading to the crash, thus providing a holistic view of the circumstances surrounding each incident. Photos, diagrams, and narratives can be added to supplement the reported data, ensuring a thorough account of each crash. This detailed approach not only aids in the immediate needs post-crash but also serves broader purposes, including traffic safety analysis and policy development aimed at preventing future accidents.

QuestionAnswer
Form Name Ohio Traffic Crash Report Form
Form Length 3 pages
Fillable? Yes
Fillable fields 185
Avg. time to fill out 15 min
Other names Ohio traffic crash report, OSHP crash reports, Ohio crash reports, crash reports Ohio

Form Preview Example

TRAFFIC CRASH REPORT

LOCAL REPORT # *

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OH-1(Rev.10/99)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIVATE

 

 

 

PHOTOS

OH-2

OH-3

OH-1P OTHER

 

 

 

CRASH SEVERITY

 

 

HIT/SKIP

 

 

 

 

PROPERTY

 

 

1 NOT HIT/SKIP

TAKEN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 FATAL

3 PDO

‘X’

 

 

 

 

2 SOLVED

‘X’

 

 

 

 

 

 

 

 

 

 

2 INJURY

4 UNKNOWN

 

 

 

 

 

IF YES

 

 

 

 

 

 

 

 

 

 

IF YES

 

 

 

 

3 UNSOLVED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N.C.I.C.# *

TIME OF CRASH

 

DAY OF WEEK

 

 

 

 

 

 

 

 

 

REPORTING AGENCY *

 

# UNITS

CITY *

VILLAGE *

TWP *

NAME (OF CITY, VILLAGE OR TOWNSHIP) *

UNIT ERROR

 

DATE OF CRASH *

98= ANIMAL

99= UNKNOWN

COUNTY # *

LATITUDE

LONGITUDE

CRASH OCCURRED ON

 

TYPE LOCATION POINT USED

PREFIX CRASH LOCATION

TYPE LOC

 

 

 

 

 

1 NAMED STREET

3 NUMBERED ROUTE

 

 

 

 

 

2 NUMBERED STREET

 

 

 

 

 

 

 

 

 

 

 

 

 

REFERENCEPOINTUSED

AT / REFERENCE

 

 

DIST REFERENCE

DR

PREFIX

REFERENCE

 

REF POINT 01

STATE LINE

 

 

 

 

 

02

INTERSECTION 2 STREETS

 

 

 

 

 

03

COUNTY LINE

LOCAL INFORMATION

04

HOUSE NUMBER

08

PLACE NAME W/O REFERENCE

05

TOWNSHIP BOUNDARY

09

DRIVEWAY

06

MILE POST

10

STREET OR ROUTE W/O

07

CORPORATION LIMIT

 

REFERENCE

UNIT #

A

#OF OCC.

NAME (LAST, FIRST, MIDDLE)

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

 

 

 

 

 

SOCIAL SECURITY NUMBER

 

DATE OF BIRTH

 

 

AGE

 

SEX

HOME PHONE #

WORK PHONE #

 

DL STATE

DL #

 

LP STATE

LP #

INJURED

1 NONE

4 OTHER

TRANSPORTED BY

INJURED TAKEN TO

 

 

 

 

 

 

TAKEN BY

2 EMS

5

UNKNOWN

 

 

 

 

 

 

 

 

 

3 POLICE

 

 

 

 

Motorist-Motorist/Non

OWNER NAME (IF SAME, WRITE “SAME”)

 

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

YEAR

 

MAKE

MODEL

COLOR

INSURANCE COMPANY

 

 

TOWING SERVICE

OWNER PHONE #

 

OFFENSE CHARGED

 

OFFENSE DESCRIPTION

 

 

 

 

CITATION #

LOCAL

 

 

 

 

 

 

 

 

 

 

 

CODE?

 

 

 

 

 

 

 

 

 

 

 

‘X’

 

 

 

 

 

 

 

 

 

 

 

IF YES

 

B

UNIT #

# OF OCC.

 

 

 

 

 

 

 

 

 

 

NAME

(LAST, FIRST, MIDDLE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

 

 

 

 

 

SOCIAL SECURITY NUMBER

 

DATE OF BIRTH

 

 

AGE

 

SEX

HOME PHONE #

WORK PHONE #

 

DL STATE

DL #

 

LP S

LP #

INJURED

1 NONE

4 OTHER

TRANSPORTED BY

INJURED TAKEN TO

 

 

 

 

TATE

 

 

 

 

 

 

 

TAKEN BY

2 EMS

5

UNKNOWN

 

 

 

 

 

 

 

 

 

3 POLICE

 

 

 

 

 

OWNER NAME (IF SAME, WRITE “SAME”)

 

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

 

YEAR

 

MAKE

MODEL

COLOR

INSURANCE COMPANY

 

 

TOWING SERVICE

OWNER PHONE #

OFFENSE CHARGED

 

OFFENSE DESCRIPTION

 

 

 

CITATION #

 

 

LOCAL

 

 

 

 

 

 

 

 

 

 

 

CODE?

 

 

 

 

 

 

 

 

 

 

 

‘X’

 

 

 

 

 

 

 

 

 

 

 

IF YES

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

UNIT #

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

NAME (LAST, FIRST, MIDDLE)

HOME PHONE #

 

 

 

 

 

 

Occupant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

INJURED TAKEN BY

TRANSPORTED BY

 

 

 

 

 

1 NONE

4 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 EMS

5 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 POLICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UNIT #

 

 

 

 

 

 

 

 

 

 

DATE

OF BIRTH

 

 

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME (LAST, FIRST, MIDDLE)

HOME PHONE #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS (STREET, CITY, STATE, ZIP CODE)

 

 

 

 

INJURED TAKEN BY

TRANSPORTED BY

 

 

 

 

 

1 NONE

4 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 EMS

5 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 POLICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGE

SEX

INJURED TAKEN TO

AGE

SEX

INJURED TAKEN TO

 

SEATING POSITION

 

SAFETYEQUIPMENT

 

AIRBAG

 

 

AIRBAGSWITCH

 

EJECTION

 

01

FRONT – LEFT (MC DRIVER)

 

MOTORIST

 

1

NOT-DEPLOYED

 

 

1

NOT PRESENT

 

1

NOT EJECTED

A

02

FRONT – MIDDLE

A

01

NONE USED

A

2

DEPLOYED-FRONT

A

2

IN ON POSITION

A

2

TOTALLY EJECTED

03

FRONT

– RIGHT

02

SHOULDER BELT ONLY

3

DEPLOYED-SIDE

 

3

IN OFF POSITION

3

PARTIALLY EJECTED

 

 

 

 

 

 

 

04

SECOND – LEFT (MC PASS)

 

03

LAP BELT ONLY

 

4

DEPLOYED BOTH

 

 

4

UNKNOWN

 

4

NOT APPLICABLE

 

05

SECOND – MIDDLE

 

04

SHOULDER/LAP BELT

 

 

FRONT/SIDE

 

 

 

 

 

5

UNKNOWN

B

06 SECOND – RIGHT

B

05 CHILD SAFETY SEAT

B

5

NOT APPLICABLE

 

B

 

 

B

 

 

 

07

THIRD – LEFT

 

06

MC HELMET USED

 

6

UNKNOWN

 

 

 

 

 

 

 

 

 

(MC PASSENGER/SIDE CAR)

 

07

USE UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

08

THIRD

– MIDDLE

 

NON-MOTORIST

 

 

 

 

 

 

 

 

 

 

C

09

THIRD

– RIGHT

C

08

NONE USED

C

 

 

 

C

 

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

SLEEPER SECTION OF CAB

 

09

HELMET USED

 

 

 

 

 

 

 

 

 

 

 

11

ENCLOSED CARGO AREA

 

10

PROTECTIVE PADS

 

 

 

 

 

 

 

 

 

 

D

12

UNENCLOSED CARGO AREA

D

11

REFLECTIVE CLOTHING

D

 

 

 

D

 

 

D

 

 

13

TRAILING UNIT

12

LIGHTING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BLANK FOR

14

EXTERIOR

 

13

OTHER

 

 

 

 

 

 

 

 

 

 

15

OTHER

 

 

14

UNKNOWN

 

 

 

 

 

 

 

 

 

 

WITNESS

 

 

 

 

 

 

 

 

 

 

 

 

16

NON-MOTORIST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

HSY7001

 

 

 

 

 

 

 

TOP COPY - ODPS

BOTTOM COPY - AGENCY

 

 

 

TRAPPED

1NOT TRAPPED

A2 EXTRICATED BY MECHANICAL MEANS

3FREED BY

BNON-MECHANICAL MEANS

4UNKNOWN

C

D

INJURIES

1NO INJURY

A 2 POSSIBLE

3NON-

INCAPACITATING

4INCAPACITATING

B5 FATAL INJURY

6 UNKNOWN

C

D

SUPPLEMENT *

‘X” IF YES

UNITNUMBERS

DAMAGEAREA

PRE-CRASH ACTIONS

SEQUENCE OF EVENTS

POSTEDSPEED

DRUGTEST STATUS

A

B

 

 

 

A

 

 

B

 

 

 

 

 

A

 

 

B

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

B

 

 

A

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

MOTORIST

 

 

 

 

 

1

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

1

NONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NON-MOTORIST LOCATION

 

 

 

01 MOVEMENTS ESSENTIALLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

EST

R

EFUSED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRAFFICCONTROL

 

 

 

 

T

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STRAIGHT AHEAD

 

 

 

 

 

 

 

 

 

3

TEST GIVEN, CONTAMINATED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 BACKING

 

 

 

 

 

2

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE/UNUSABLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4 TEST GIVEN, RESULTS KNOWN

 

 

 

A

 

 

B

A

 

 

03 CHANGING LANES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04 OVERTAKING/PASSING

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

B

 

5

TEST GIVEN, RESULTS UNKNOWN

01 MARKED CROSSWALK AT

 

 

 

05 TURNING RIGHT

 

 

 

 

 

 

01 NO CONTROLS

 

 

 

 

 

 

6

UNKNOWN

 

 

 

 

INTERSECTION

 

 

 

 

06 TURNING LEFT

 

 

 

3

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 STOP SIGN

 

 

 

 

 

 

 

 

 

DRUGTESTTYPE

 

02 INTERSECTION/ NO CROSSWALK

 

 

 

07 MAKING U-TURN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 YIELD SIGN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 NON-INTERSECTION CROSSWALK

 

 

 

08 ENTERING TRAFFIC LANE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04 TRAFFIC SIGNAL

 

 

 

 

 

 

 

 

 

 

 

 

 

04 DRIVEWAY ACCESS CROSSWALK

 

 

 

09 LEAVING TRAFFIC LANE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

4

05 TRAFFIC FLASHERS

 

 

 

 

 

 

 

 

 

 

 

 

05 IN ROADWAY

 

 

 

 

 

10 PARKED

 

 

 

 

 

 

 

 

 

 

A

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

06 SCHOOL ZONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 NOT IN ROADWAY

 

 

 

11 SLOWING/STOPPED IN TRAFFIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NON-COLLISION

 

 

07 RAILROAD CROSSBUCKS

 

 

1

NONE

 

 

 

 

 

07 MEDIAN (BUT NOT SHOULDER)

 

 

 

12 DRIVERLESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

OVERTURN/ROLLOVER

 

08 RAILROAD FLASHERS

 

 

 

2

BLOOD

 

 

 

 

 

08 ISLAND

 

 

 

 

 

 

 

 

13 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02

FIRE/EXPLOSION

 

 

 

AILROAD

G

ATES

 

 

 

 

3

URINE

 

 

 

 

 

09 SHOULDER

 

 

 

B

 

 

14 UNKNOWN

 

 

 

 

 

 

 

09 R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

IMMERSION

 

 

 

ONSTRUCTION

B

ARRICADE

 

4

OTHER

 

 

 

 

 

10 SIDEWALK

 

 

 

 

 

 

 

NON-MOTORIST

 

 

 

 

 

 

10 C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

JACKKNIFE

 

 

11 POLICE OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11 WITHIN 10 FEET OF ROADWAY

 

 

 

15 ENTERING/CROSSING IN SPECIFIED

 

 

 

 

 

 

 

DRUGTEST1&2 RESULT

 

 

 

05

CARGO/EQUIPMENT LOSS/SHIFT

 

12 PAVEMENT MARKINGS

 

 

 

 

(NOT SHOULDER, MEDIAN,

 

 

 

 

LOCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06

EQUIPMENT FAILURE

 

13

CROSSWALK LINES

 

 

 

 

 

 

 

 

 

 

 

 

 

SIDEWALK, ISLAND)

 

 

 

16

WALKING, RUNNING, JOGGING,

 

 

 

 

 

A

 

 

 

 

 

 

B

 

 

 

 

07

SEPARATION OF UNITS

 

14 WALK/DONT WALK SIGNAL

 

 

 

 

 

 

 

 

12 BEYOND 10 FEET OF ROADWAY

 

 

 

 

PLAYING, CYCLING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08

RAN OFF ROAD RIGHT

 

15 TRAFFIC CONTROL DEVICE INOPERATIVE,

 

 

 

 

 

 

 

 

 

(WITHIN TRAFFICWAY)

 

 

 

17 WORKING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

RAN OFF ROAD LEFT

 

 

MISSING, OBSCURED

 

 

 

 

 

 

 

 

 

 

 

 

13 OUTSIDE TRAFFICWAY

 

 

 

18 PUSHING VEHICLE

 

 

 

 

 

 

1

 

2

 

 

 

1

2

 

 

 

 

10

CROSS MEDIAN/CENTERLINE

 

16 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14 SHARED USE PATHS OR TRAILS

 

 

 

19 APPROACHING/LEAVING VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

DOWNHILL RUNAWAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOSTDAMAGEDAREA

20 PLAYING/WORKING ON VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15 UNKNOWN

 

 

 

 

12

OTHER NON-COLLISION

 

DIRECTION

 

 

 

 

 

 

 

 

 

1

NONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21 STANDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

UNKNOWN NON-COLLISION

 

 

 

 

 

 

 

 

 

 

2

MARIJUANA

 

 

 

TYPEOFUNIT

 

 

 

 

 

 

 

 

 

 

FROM

TO

 

 

 

 

 

FROM

TO

 

 

 

 

 

 

 

 

 

22 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COLLISIONW/PERSON,VEHICLE,

 

 

 

 

 

 

3

COCAINE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23 UNKNOWN

 

 

 

OROBJECTNOTFIXED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

OPIATES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

B

 

 

 

 

 

 

 

14

PEDESTRIAN

 

 

 

A

 

 

 

 

 

 

 

 

B

 

 

5

AMPHETAMINES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

 

 

B

 

 

 

 

 

 

 

 

 

 

15

PEDALCYCLE

 

 

 

 

 

 

 

 

 

 

 

 

 

6

PCP

 

 

 

 

 

 

 

 

 

 

 

01 NONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTRIBUTINGCIRCUMSTANCES

16

RAILWAY VEHICLE

 

 

1

NORTH

 

 

 

 

 

 

 

 

 

 

7

OTHER

 

 

 

 

 

MOTORIST

 

 

 

 

02 CENTER FRONT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

ANIMAL – FARM

 

 

 

 

 

 

 

 

 

 

 

 

8 UNKNOWN AT TIME OF REPORTING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

SOUTH

 

 

 

 

 

 

 

 

 

 

01 SUB-COMPACT

03 RIGHT FRONT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

ANIMAL – DEER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

EAST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 COMPACT

 

 

 

04 RIGHT SIDE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF INTERSECTION

 

 

 

 

 

 

 

 

 

 

 

19

ANIMAL – OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

WEST

 

 

 

 

 

 

 

 

 

 

 

03 MID SIZE

 

 

 

 

05 RIGHT REAR

 

 

 

A

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

MOTOR VEHICLE IN TRANSPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

NORTHEAST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04 FULL SIZE

 

 

 

06 REAR CENTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

PARKED MOTOR VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTORIST

 

 

 

 

 

6

NORTHWEST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05 MINIVAN

 

 

 

 

07 LEFT REAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

WORK ZONE MAINTENANCE EQUIPMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 NONE

 

 

 

 

 

7

SOUTHEAST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 SPORT UTILITY VEHICLE

08 LEFT SIDE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

23

OTHER MOVABLE OBJECT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 FAILURE TO YIELD

 

 

 

8

SOUTHWEST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 PICKUP

 

 

 

 

09 LEFT FRONT

 

 

 

 

 

 

 

 

 

 

 

 

01 NOT AN INTERSECTION

 

 

 

 

 

 

 

24

UNKNOWN MOVABLE OBJECT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 RAN RED LIGHT, OR STOP SIGN

 

9

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08 PANEL/VAN

 

 

10 TOP AND WINDOWS

 

 

 

 

 

 

 

 

 

02 FOUR-WAY INTERSECTION

 

 

COLLISIONWITHFIXEDOBJECT

 

 

 

 

 

 

 

 

 

 

04 EXCEEDED SPEED LIMIT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09 SINGLE UNIT TRUCK;

11 UNDERCARRIAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

T-INTERSECTION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05 UNSAFE SPEED

 

 

25

IMPACT ATTENUATOR/CRASH CUSHION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 AXLES, 6 TIRES

12

LOAD/TRAILER

 

 

 

CONDITION

 

 

 

 

 

 

 

 

 

04

Y-INTERSECTION

 

 

 

 

 

26

BRIDGE OVERHEAD STRUCTURE

 

 

 

 

 

 

 

 

 

 

 

 

06

IMPROPER TURN

 

 

 

 

 

 

 

 

 

 

 

 

10 SINGLE UNIT TRUCK; 3+ AXLES

13 TOTAL (ALL AREAS)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05 TRAFFIC CIRCLE/ROUNDABOUT

 

 

27

BRIDGE PIER OR ABUTMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 LEFT OF CENTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11 TRUCK/TRAILER

14 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 FIVE-POINT, OR MORE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08 FOLLOWED TOO CLOSELY/ACDA

28

BRIDGE PARAPET

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12 TRUCK TRACTOR (BOBTAIL)

15 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 ON RAMP

 

 

 

 

29

BRIDGE RAIL

 

 

 

A

 

 

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

IMPROPER LANE CHANGE/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

TRACTOR/SEMI-TRAILER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08 OFF RAMP

 

 

 

 

 

 

30

GUARDRAIL FACE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DROVE OFF ROAD/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14 TRACTOR/DOUBLE SHORT

 

 

 

 

 

 

 

1

PPARENTLY

N

ORMAL

 

 

 

09 CROSSOVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POINTOFIMPACT

 

 

IMPROPER PASSING

 

31

GUARDRAIL END

 

 

A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

TRACTOR/DOUBLE LONG

 

 

 

 

 

2

PHYSICAL IMPAIRMENT

 

 

 

10

DRIVEWAY/ACCESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 IMPROPER BACKING

32

MEDIAN BARRIER

 

 

 

 

 

 

16 FIFTH WHEEL OR

 

 

 

 

 

3

EMOTIONAL

 

 

 

 

 

 

 

 

11 RAILWAY GRADE CROSSING

 

 

 

33

HIGHWAY TRAFFIC SIGN POST

 

 

 

 

 

 

 

 

 

 

 

 

11 IMPROPER START FROM PARKED POSITION

 

 

 

 

 

 

 

 

 

 

CONVERTER DOLLY

 

 

 

 

4

ILLNESS

 

 

 

 

 

 

 

 

 

12 SHARED-USE PATHS OR TRAILS

 

 

 

 

34

OVERHEAD SIGN POST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12 STOPPED OR PARKED ILLEGALLY

 

 

 

 

 

 

 

 

 

 

17

TRACTOR/TRIPLES

 

A

B

 

5

ELL

A

SLEEP

, F

AINTED

 

ATIGUED

TC

13 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13 OPERATING VEHICLE IN ERRATIC,

35

LIGHT/LUMINARIES SUPPORT

 

F

 

 

 

 

 

, F

, E

 

 

 

 

 

 

 

 

 

18 MOTORCYCLE

 

 

 

 

 

6

UNDER THE INFLUENCE OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36

UTILITY POLE

 

 

 

 

 

 

 

 

 

 

 

 

 

01 NONE

 

 

RECKLESS, CARELESS, NEGLIGENT OR

 

 

 

 

 

 

 

 

 

 

 

 

19 MOTORIZED BICYCLE

 

 

 

 

 

MEDICATIONS/DRUGS/ALCOHOL

 

OCCURRENCE

 

 

 

 

 

 

37

OTHER POST, POLE OR SUPPORT

 

 

 

 

02 CENTER FRONT

 

 

AGGRESSIVE MANNER

 

 

 

 

20 SCHOOL BUS

 

 

 

7

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 RIGHT FRONT

 

 

38 CULVERT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14 SWERVING TO AVOID (DUE TO WIND,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21 CHURCH BUS

 

 

 

 

8

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04 RIGHT SIDE

 

 

SLIPPERY SURFACE, VEHICLE, OBJECT,

39

CURB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22 PUBLIC BUS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40

DITCH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05 RIGHT REAR

 

 

NON-MOTORIST IN ROADWAY, ETC)

 

 

ALCOHOL/DRUG SUSPECTED

 

 

 

 

 

 

 

 

 

 

23 OTHER BUS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 REAR CENTER

 

15 FAILURE TO CONTROL

41

EMBANKMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24 POLICE VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

ON ROADWAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 LEFT REAR

 

16 VISION OBSTRUCTION

42

FENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25 FIRE TRUCK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

ON SHOULDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08 LEFT SIDE

 

17 DRIVER INATTENTION

43

MAILBOX

 

 

 

A

 

 

 

 

 

 

 

B

 

 

 

 

 

26 AMBULANCE/RESCUE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

IN MEDIAN

 

 

 

09 LEFT FRONT

 

44

TREE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18 FATIGUE/ASLEEP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27 TAXI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

ON ROADSIDE

 

 

 

 

 

 

 

 

 

 

 

 

45

OTHER FIXED OBJECT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 TOP AND WINDOWS

19 OPERATING DEFECTIVE EQUIPMENT

 

1

NONE

 

 

 

 

 

 

 

 

 

 

 

 

28 MOTOR HOME

 

 

 

 

 

 

 

 

 

 

 

 

5

ON GORE

 

 

 

 

11 UNDERCARRIAGE

 

20 LOAD SHIFTING/FALLING/SPILLING

46

WORK ZONE MAINTENANCE EQUIPMENT

2

YES – ALCOHOL SUSPECTED

 

 

 

 

29 TRAIN

 

 

 

 

 

 

 

6

OUTSIDE TRAFFICWAY

 

 

 

 

 

12 LOAD/TRAILER

 

21 OTHER IMPROPER ACTION

47

UNKNOWN FIXED OBJECT

 

3

YES – HBD NOT IMPAIRED

 

30 FARM VEHICLE

 

 

 

 

7

UNKNOWN

 

 

 

 

13 TOTAL (ALL AREAS)

22 UNKNOWN

 

 

 

 

48

OTHER

 

 

4

YES – DRUGS SUSPECTED

 

 

 

 

31 FARM EQUIPMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14 OTHER

 

NON-MOTORIST

 

 

49

UNKNOWN

 

 

5

YES – ALCOHOL / DRUGS SUSPECTED

 

 

 

 

 

 

 

 

 

32 SNOWMOBILE

 

 

 

 

 

 

ROADCONTOUR

 

 

15 UNKNOWN

 

23 NONE

 

 

 

 

 

 

 

 

 

6

UNKNOWN

 

 

 

 

 

 

 

 

 

33 CONSTRUCTION EQUIPMENT

 

 

 

 

 

 

FIRSTHARMFUL EVENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24 IMPROPER CROSSING

 

ALCOHOLTESTSTATUS

 

 

 

 

 

 

 

 

 

 

 

 

34 ALL OTHERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTION

 

25 DARTING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NON-MOTORIST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26 LYING AND/OR ILLEGALLY IN ROADWAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

35 ANIMAL W/RIDER

 

 

 

 

A

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27 FAILURE TO YIELD RIGHT OF WAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36 ANIMAL W/BUGGY

 

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

B

 

 

 

1

STRAIGHT LEVEL

 

 

A

B

28 NOT VISIBLE (DARK CLOTHING)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ICYCLE

 

 

 

 

 

OF THE SEQUENCE OF EVENTS – WHICH

 

 

 

 

 

 

 

 

 

 

 

 

 

2

STRAIGHT GRADE

 

37 B

 

 

 

 

 

 

 

 

29 INATTENTIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38

 

EDESTRIAN

 

 

 

 

 

 

 

 

ONE IS THE FIRST HARMFUL EVENT (1-4)

1

NONE

 

 

 

 

 

 

 

 

 

 

3

CURVE LEVEL

 

 

P

 

 

 

 

 

1

NON-CONTACT

 

30 FAILURE TO OBEY TRAFFIC SIGNS,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EDALCYCLIST

 

 

 

 

 

 

2

TEST REFUSED

 

 

 

 

 

 

4

CURVE GRADE

 

 

39 P

 

 

 

 

 

2

NON-COLLISION

 

 

SIGNALS, OR OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40 SKATER

 

 

 

 

 

 

MOSTHARMFUL EVENT

 

3

TEST GIVEN, CONTAMINATED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

STRIKING

 

31 WRONG SIDE OF THE ROAD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-N

 

 

M

 

 

 

 

SAMPLE/UNUSABLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THER

ON

OTORIST

 

 

 

 

 

 

 

 

 

ROADCONDITIONS

 

41 O

 

 

 

4

STRUCK

 

32 OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

42 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

4

TEST GIVEN, RESULTS KNOWN

 

PRIMARY

 

 

 

SECONDARY

 

 

 

5

BOTH STRIKING AND STRUCK

33 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5 TEST GIVEN, RESULTS UNKNOWN

 

 

 

 

 

 

 

 

 

 

INEMERGENCYRESPONSE

6

UNKNOWN

 

 

 

 

 

 

 

 

 

A

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLEDEFECT

 

 

OF THE SEQUENCE OF EVENTS – WHICH

ALCOHOL

TEST TYPE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODEONLYIF‘19’

 

ONE IS THE MOST HARMFUL EVENT (1-4)

 

 

 

 

 

 

 

 

 

 

 

 

 

A

 

 

 

 

B

 

 

 

SELECTEDABOVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STRIKINGVEHICLE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 WET

 

 

 

 

 

 

1

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

SPEED DETECTED

 

 

 

A

 

 

 

 

 

 

 

B

 

 

 

03 SNOW

 

 

 

 

 

 

 

 

 

 

OVERRIDE/UNDERRIDE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

ICE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

NONE

 

 

 

4

BREATH

 

 

 

 

 

 

 

 

3

UNKNOWN

 

 

 

 

 

 

 

 

A

 

 

 

B

 

 

 

 

 

 

 

 

05 SAND, MUD, DIRT, OIL, GRAVEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

BLOOD

 

 

 

5

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 WATER (STANDING, MOVING)

 

 

 

 

 

 

 

 

 

A

B

 

 

 

 

 

 

 

 

A

B

 

3

URINE

 

 

 

 

 

 

 

 

 

 

DAMAGESCALE

 

 

01 T

S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 SLUSH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

URN

IGNALS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

**

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02 HEAD LAMPS

 

 

1

STATED

 

 

ALCOHOLTESTRESULT

 

 

08 D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 NO UNDERRIDE OR OVERRIDE

 

 

 

 

 

 

 

 

 

 

 

 

EBRIS

 

 

 

 

 

 

 

 

 

 

 

 

03

TAIL LAMPS

 

 

 

2

ESTIMATED SPEED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

UT

, H

OLES

 

UMPS

NEVEN

 

 

 

 

 

 

 

 

2

UNDERRIDE, COMPARTMENT

 

 

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

, B

, U

 

 

 

 

 

 

 

 

04

BRAKES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAVEMENT **

 

 

 

A

 

 

 

 

B

 

INTRUSION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05 STEERING

 

 

 

 

SPEED

 

 

 

 

 

 

 

 

 

A

 

 

 

10 OTHER

 

 

 

 

 

 

 

 

 

 

3

UNDERRIDE, NO COMPARTMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06 TIRE BLOWOUT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11 UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

INTRUSION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

NONE

 

 

 

 

 

 

 

07 WORN OR SLICK TIRES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* *SECONDARY ROAD CONDITIONS ONLY

 

 

 

 

 

4

UNDERRIDE, COMPARTMENT

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

2

NON-FUNCTIONAL DAMAGE

08 TRAILER EQUIPMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTRUSION UNKNOWN

 

A

 

 

 

 

 

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

3

FUNCTIONAL DAMAGE

 

 

DEFECTIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

OVERRIDE, MOTOR VEHICLE IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ISABLING

 

AMAGE

09 MOTOR TROUBLE

 

 

 

 

 

 

 

 

 

LOCAL REPORT # *

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

D

 

 

 

D

 

 

TRANSPORT

 

 

ISABLED

F

ROM

P

RIOR

 

 

 

SUPPLEMENT

 

 

 

 

 

 

 

 

 

 

 

 

5

SEVERE

 

 

 

 

6

OVERRIDE, OTHER VEHICLE

10 D

 

 

 

 

B

 

‘X” IF YES *

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

UNKNOWN

 

 

 

 

CRASH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11 OTHER DEFECTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOP COPY - ODPS BOTTOM COPY - AGENCY

Narrative

MANNEROFCOLLISIONORIMPACT

SCHOOLBUSRELATED

Diagram

Writean“N”

 

 

 

 

 

 

 

onthecompass

 

 

 

 

 

 

 

diagramtoindicate

 

 

 

 

 

 

 

thedirectionof

 

 

 

 

1

NO

 

north.

1

 

NOT COLLISION BETWEEN

 

 

 

 

TWO VEHICLES IN TRANSPORT

2

YES, DIRECTLY INVOLVED

 

 

2

 

REAR-END

3

YES, INDIRECTLY INVOLVED

 

 

3

 

HEAD-ON

 

4

UNKNOWN

 

 

4

REAR-TO-REAR

WORKZONERELATED

 

 

5

 

BACKING

 

 

 

 

 

 

 

 

 

6

 

ANGLE

 

 

 

 

 

7 SIDESWIPE, SAME DIRECTION

 

 

 

 

8 SIDESWIPE, OPPOSITE DIRECTION

 

 

 

 

9

 

UNKNOWN

1

NO

 

 

 

 

 

 

 

 

 

 

 

 

2

YES

 

 

WEATHER

 

3

UNKNOWN

 

 

 

 

 

 

 

 

 

 

 

TYPEOFWORKZONE

 

 

01 CLEAR

 

 

 

 

 

02 CLOUDY

 

1

LANE CLOSURE

 

 

03

FOG, SMOG, SMOKE

2

LANE SHIFT/CROSSOVER

 

 

04 RAIN

 

3

WORK ON SHOULDER OR MEDIAN

 

 

05

SLEET, HAIL (FREEZING RAIN DRIZZLE)

4

INTERMITTENT/ MOVING WORK

 

 

06 SNOW

 

5

OTHER

 

 

07 SEVERE CROSSWINDS

LOCATIONOFCRASH IN

 

 

08

BLOWING SAND,SOIL, DIRT,SNOW

 

 

WORKZONE

 

 

09 OTHER

 

 

 

 

 

10 UNKNOWN

 

 

 

 

LIGHTCONDITIONS

 

 

 

 

PRIMARY

SECONDARY

1

BEFORE FIRST WORK ZONE

 

 

 

 

 

 

 

 

 

 

 

 

 

WARNING SIGN

 

 

 

 

 

 

2

ADVANCE WARNING AREA

 

 

1

 

DAYLIGHT

 

3

TRANSITION AREA

 

 

 

 

4

ACTIVITY AREA

 

 

2

 

DAWN

 

 

 

 

 

 

 

 

 

3

 

DUSK

 

WORKERSPRESENT

 

 

4

 

DARK – LIGHTED ROADWAY

 

 

 

 

5

 

DARK –NOT LIGHTED

 

 

 

 

6

 

DARK – UNKNOWN LIGHTING

 

 

 

 

7

 

GLARE

 

 

 

 

 

8

 

OTHER

 

1

NO

 

 

9

 

UNKNOWN

2

YES

 

 

 

 

 

 

3

UNKNOWN

 

 

 

Truck/Bus

THE CRASH INVOLVED ONE OR MORE OF THE FOLLOWING:

A THE CRASH RESULTED IN ONE OR MORE OF THE FOLLOWING:

 

 

A TRUCK (MOTOR VEHICLE) WITH A GVWR MORE THAN 10,000 POUNDS; OR

N

A FATALITY; OR

 

 

 

 

A TRUCK (MOTOR VEHICLE) WITH A HAZARDOUS MATERIALS PLACARD; OR

AN INJURY REQUIRING TRANSPORTATION FOR IMMEDIATE MEDICAL TREATMENT; OR

 

 

 

 

D

 

UNIT #

A BUS DESIGNED FOR AT LEAST 8 PERSONS, INCLUDING DRIVER .

AT LEAST ONE VEHICLE WAS TOWED DUE TO DISABLING DAMAGE OR REQUIRED INTERVENING ASSISTANCE BEFORE PROCEEDING UNDER ITS OWN POWER.

 

 

 

 

 

 

 

 

 

COMPANY (FROM SHIPPING PAPERS)

 

 

COMPANY PHONE

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS (STREET, CITY, ST, ZIP CODE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

US DOT

 

 

 

 

 

 

ICC MC

 

 

PUCO

 

 

TRAILER LP ST.

TRAILER LP YEAR

TRAILER LP #

 

PLACARD #

# DIA.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CARGOBODYTYPE01

 

 

 

 

 

 

 

 

 

 

 

 

 

Weight (GVWR)

CDLClass

 

 

Hazardous

 

Hazardous

 

NOT APPLICABLE

 

05

POLE

09

CONCRETE MIXER

 

1

CLASS A

MaterialsPlacard

 

 

 

MaterialReleased

02

BUS (9-15 INCLUDING DRIVER)

06

CARGO TANK

10

UTO

T

RANSPORTER

1

LESS/EQUAL 10,000

2

LASS

B

1

NO

1

NO

A

 

2

10,001 - 26,000

C

03

V

AN

/E

NCLOSED

B

OX

07

LATBED

11

ARBAGE EFUSE

3

LASS

C

2

YES

2

YES

 

 

 

 

F

G

 

/R

 

 

 

C

04

G

RAIN

/C

HIPS RAVEL

08

UMP

12

THER

 

3

MORE THAN 26,000

4

CLASS M

3

UNKNOWN

3

NOT APPLICABLE

 

 

/G

 

 

D

O

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

UNKNOWN

 

 

 

5

CLASS D

 

 

4

UNKNOWN

Police Action

DATE CRASH REPORTED

TIME REC CALL

OFFICERS NAME *

DISPATCH

BADGE # *

ARRIVEDCLEAREDOTHERTOTAL MINUTES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHECKED BY

 

DATE REPORT FILED

*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORTTAKENBY

1 POLICE AGENCY

REPORTTAKEN AT

1 SCENE

 

 

LOCAL REPORT #

*

SUPPLEMENT

*

 

 

2 MOTORIST

 

 

 

2 STATION

‘X” IF YES

 

 

 

 

 

 

 

 

 

 

3 OTHER

 

 

 

 

 

 

 

TOP COPY - ODPS

BOTTOM COPY - AGENCY

 

 

 

How to Edit Ohio Traffic Crash Report Form Online for Free

The Ohio Traffic Crash Report Form (OH-1) helps record specifics such as date, time, location, involved parties, and the sequence of events. It is important to follow the prescribed steps carefully to ensure the accuracy of this document.

1. Gather Required Information

Before starting the form, collect all necessary information. It includes driver details, vehicle information, insurance data, and specifics about the crash circumstances. Having all relevant documents and notes at hand will streamline the process.

2. Complete the Basic Information Section

Enter the date, time, and location of the crash. Make sure to provide accurate details as this sets the context for the report. Include street names, direction of travel, and any landmarks to identify the exact location of the accident.

3. Detail the Involved Parties

Fill out the sections related to drivers, passengers, pedestrians, or property owners involved in the crash. This part requires personal information, vehicle details, and insurance information for all parties involved.

4. Describe the Accident

Provide a detailed description of the accident. This covers the sequence of events leading up to the crash, the point of impact, and the aftermath. Use the diagram section to draw the positions of the vehicles before, during, and after the collision, if applicable.

5. Check Off Contributing Circumstances

Identify and mark any contributing factors to the accident. These can include weather conditions, road conditions, traffic signals, and driver behaviors such as speeding or failure to yield.

6. Add Witness Information

If there were any witnesses to the accident, include their statements and contact information. Witnesses can provide additional perspectives that might support the details of the crash report.

7. Review and Sign the Form

Once all sections are completed, review the information for accuracy and completeness. Any inaccuracies can affect legal proceedings and insurance claims. Sign the form to certify that the information provided is accurate.