KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL

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Passengers & Pedestrians 854 continued Unit # Ped Type TU PT TU 02 PEDESTRIAN Last Name PEDESTRIAN First Name Cunningham Middle Name Date of Birth MN Phillip DOB PEDESTRIAN INFORMATION PEDESTRIAN ADDRESS (Number, Street, Sfx, etc.) City State Zip New address? 315 Ketcham AVE 21 Walter 04/25/1999 Atwood KS 66549 MN New address? Investigating Officer / Badge No. William Wonka Personal Phone Number Work Phone Number Personal Local Case No. 008 Example 17 Gender Age SE Used Eject/Trap 6 6 (785) 555-8922 M N D A Work Personal 11 N Inj Severity Eject Path Page of Transpt Unit Extrication? PT DOB Work Transport Unit A EMS Arrived 11:41 EMS Time Notified 11:30 EMS Time@Hosp 12:13 Injured taken by: Rawlins Co. EMS Injured taken to: Atwood General Transport Unit EMS Arrived EMS Time Notified EMS Time@Hosp Injured taken by: Injured taken to: TU# DirTrvl DL State Driver's License Number Special Data 02 N 13 00 NOT in roadway (driving lanes) PEDESTRIAN ROADWAY LOCATION BEFORE IMPACT TU# DirTrvl DL State Driver's License Number Special Data PEDESTRIAN ROADWAY LOCATION BEFORE IMPACT 00 NOT in roadway (driving lanes) IN or AT INTERSECTION NOT IN or AT INTERSECTION IN or AT INTERSECTION NOT IN or AT INTERSECTION 01 In crosswalk or bikeway 11 In crosswalk or bikeway 01 In crosswalk or bikeway 11 In crosswalk or bikeway 02 NOT in crosswalk or bikeway 03 In intersection without a crosswalk or bikeway 12 NOT in crosswalk or bikeway 13 In area without a crosswalk or bikeway 02 NOT in crosswalk or bikeway 03 In intersection without a crosswalk or bikeway 12 NOT in crosswalk or bikeway 13 In area without a crosswalk or bikeway 88 Other: 99 Unknown OTHER PEDESTRIAN LOCATION (Not in Driving Lanes) 01 Within a work zone 08 Driveway access crosswalk 02 In median (not shoulder) 09 Dedicated bike lane 03 On Island 10 Shared-use path or trails 04 Road shoulder (not ditch or median) 11 Inside building 05 Roadside (not on shoulder) 12 In legally parked vehicle 06 Sidewalk 88 Other: 07 Outside trafficway 99 Unknown 08 01 Walking / cycling to or from school PEDESTRIAN ACTION BEFORE CRASH 07 Standing, sitting, or lying 02 Approaching or leaving bus 08 Playing, running, walking 88 Other: 99 Unknown OTHER PEDESTRIAN LOCATION (Not in Driving Lanes) 01 Within a work zone 08 Driveway access crosswalk 02 In median (not shoulder) 09 Dedicated bike lane 03 On Island 10 Shared-use path or trails 04 Road shoulder (not ditch or median) 11 Inside building 05 Roadside (not on shoulder) 12 In legally parked vehicle 06 Sidewalk 88 Other: 07 Outside trafficway 99 Unknown PEDESTRIAN ACTION BEFORE CRASH 01 Walking / cycling to or from school 07 Standing, sitting, or lying 02 Approaching or leaving bus 08 Playing, running, walking 03 Approaching or leaving vehicle 09 Cycling 03 Approaching or leaving vehicle 09 Cycling 04 Working (not on vehicle) 10 Entering or crossing 04 Working (not on vehicle) 10 Entering or crossing 05 Working on vehicle 88 Other: 05 Working on vehicle 88 Other: 00 06 Pushing motor vehicle 99 Unknown PEDESTRIAN OBEDIENCE TO TRAFFIC SIGNAL 00 No pedestrian signal 03 Ped signal malfunction 01 Obeyed pedestrian signal 04 Not applicable 02 Disobeyed pedestrian signal 99 Unknown SUBSTANCE USE AP - Alcohol ingested (mark all that apply) DC - Illegal drugs contributed AC - Alcohol contributed MP - Medication ingested DP - Illegal drugs ingested MC - Medication contributed METHOD OF DETERMINATION IMPAIRMENT TEST (mark all that apply) (mark all that apply) ALCOHOL DRUGS NG - No Test given 00 No evidence of impairment TR - Test Refused (Alcohol/Drug) 01 Evidential Test (Breath,Blood,etc) PT - Prelim Positive Test (PBT) 02 Preliminary Breath Test PBT TG - Evidentiary Test given 03 Behavioral RP - Results pending Tests: HGN, walk-and-turn, one leg stand, etc. A Evidentiary Breath Eye Fluid 04 Passive Alcohol Sensor L 0. 0. (detects alcohol from driver's mouth) C O 05 Observed H Blood (BAC) Other (Odor, staggering, slurred speech, etc) O L 0. 0. 06 Other (e.g. saliva test) Drug screen result 06 Pushing motor vehicle 99 Unknown PEDESTRIAN OBEDIENCE TO TRAFFIC SIGNAL 00 No pedestrian signal 03 Ped signal malfunction 01 Obeyed pedestrian signal 04 Not applicable 02 Disobeyed pedestrian signal 99 Unknown SUBSTANCE USE AP - Alcohol ingested (mark all that apply) DC - Illegal drugs contributed AC - Alcohol contributed MP - Medication ingested DP - Illegal drugs ingested MC - Medication contributed METHOD OF DETERMINATION IMPAIRMENT TEST (mark all that apply) (mark all that apply) ALCOHOL DRUGS NG - No Test given 00 No evidence of impairment TR - Test Refused (Alcohol/Drug) 01 Evidential Test (Breath,Blood,etc) PT - Prelim Positive Test (PBT) 02 Preliminary Breath Test PBT TG - Evidentiary Test given 03 Behavioral RP - Results pending Tests: HGN, walk-and-turn, one leg stand, etc. A Evidentiary Breath Eye Fluid 04 Passive Alcohol Sensor L 0. 0. (detects alcohol from driver's mouth) C O 05 Observed H Blood (BAC) Other (Odor, staggering, slurred speech, etc) O L 0. 0. 06 Other (e.g. saliva test) Drug screen result Transport Units: A, B, C, ..., N
Investigating Department Reviewed by Local Case No. Page of Amended Report Kansas Motor Vehicle KHP J. Carpenter Example 18 1 5 DUI Accident Report Investigating Officer Name Badge Number County City Name Hit & Run KDOT Form 850A Rev 1-2009 Calvin Hobbs 555 SN PO Accident Severity Milepost Block No Dir Pfx On Road Name Road Type Dir Sfx SpdLmt Date of Accident (mm/dd/yyyy) Time Occur. Day 185.2 U075 FWY 65 08/02/2012 23:55 TH Fatal From Dist Ft/Mi From Dir FROM Dir Pfx Reference or At Road Name Road Type Dir Sfx SpdLmt Date Notified (mm/dd/yyyy) Time Notif. Day Injury 100 F N AT I070 RAMP 45 08/02/2012 23:58 TH PDO >= $1,000 PDO < $1,000 Narrative: Describe each traffic unit's pre-crash movement and direction of travel Date Arrived (mm/dd/yyyy) Time Arriv. Day TU1, while exiting WB I-70 to NB U-75, lost control and collided with the 08/03/2012 00:15 FR Private Property Latitude (AOI) bridge rail just north of the ramp gore area. 00 WORK ZONE TYPE ON AT 39.06911 00 None Apply Longitude (AOI) 01 Construction Zone - KDOT? CODING NOTE: What is signed as US-75 NB Ramp is really considered an I-70 ramp...The rule: "You are not ON the next route until you fully leave the previous route." (See page 25) KDOT? Object 1 Damaged & Nature of Damage (show in diagram) KDOT 01 Bridge rail cracked ON AT 01 Concrete 02 Blacktop (Asphalt) 03 Gravel 88 Other: 04 Dirt 05 Brick 99 Unknown SURFACE CONDITIONS ON AT 01 Dry 88 Other: 02 Wet 03 Snow 99 Unknown 04 Ice 05 Mud/dirt/sand 06 Debris (oil, etc.) 07 Standing/ moving water 08 Slush 01 Four-way intersection 02 Five-way or more 03 T - intersection 04 Y - intersection 05 L - intersection 06 Roundabout (See Manual 07 Traffic Circle for Definitions) 08 Part of an interchange 99 Unknown ROAD SPECIAL FEATURES (up to 3) 1 2 3 00 None 01 01 Bridge B134 02 Bridge Overhead 03 Railroad Bridge 04 RRXING 05 Interchange 06 Ramp 99 Unknown Owner Street Address Owner Last Name First Name Middle Name City State Zip KDOT? Object 2 Damaged & Nature of Damage (show in diagram) Owner Street Address Owner Last Name First Name Middle Name City State Zip -95.73119 Photos by ONLY CHOOSE ONE CODE PER CATEGORY UNLESS SPECIFIED OTHERWISE 04 LIGHT CONDITIONS 20 ACC. LOCATION 08 ACCIDENT CLASS 08 (of 1st Harmful Event) (mark 1 box per side) st Harmful Event Most Harmful Event 01 Daylight 04 Dark: street lights on ON ROADWAY: (within travel lanes) 1 11 Non-intersection 00 Other non-collision 02 Dawn 05 Dark: no street lights 12 Intersection + 01 Overturned/Rollover 03 Dusk 99 Unknown 13 Intersection-related + COLLISION WITH: 00 ADVERSE WEATHER CONDITIONS 02 Pedestrian 14 Access to Parking lot/Drvwy 03 Motor vehicle in-transport* 00 No adverse conditions 15 Interchange Area + 04 Legally Parked Vehicle 01 Rain, mist, drizzle 16 On Crossover 05 Railway train 02 Sleet, hail 17 Toll Plaza 06 Pedal cyclist 03 Snow OFF ROADWAY: 07 Animal Type: 04 Fog 20 Shoulder 08 Fixed object** 05 Smoke 21 Roadside (not shoulder) 09 Other object: 06 Strong wind 22 Median 99 Unknown 07 Blowing dust, sand, etc. 23 Parking lot or Rest area 02 **FIXED OBJECT TYPE 02 08 Freezing rain, mist, drizzle 88 Other: (mark 1 box per side if applicable) 1st Harmful Event Most Harmful Event 14 Rain & fog 99 Unknown 01 Bridge structure 16 Rain & wind 88 Other: +INTERSECTION TYPE 02 Bridge rail 24 Sleet & fog 03 Crash cush./Impact attenuator 36 Snow & wind 99 Unknown 04 Divider, median barrier 01 SURFACE TYPE 05 Overhead sign support KHP 06 Utility devices: pole,meter,etc 07 Other post or pole 08 Building 09 Guardrail 10 Sign post 11 Culvert 12 Curb 13 Fence/Gate 14 Hydrant 15 Barricade 16 Mailbox 17 Ditch 18 Embankment 19 Wall 20 Tree 21 RRXING fixtures 88 Other: 99 Unknown Personal Phone Work Phone Personal Phone Work Phone 1 02 Maintenance Zone - 03 Utility Zone - 99 Unknown - LOCATION IN WORK ZONE (AOI) 01 Before first warning sign 02 Advance warning area 03 Transition area 04 Activity area 05 Termination area 99 Unknown - WORK ZONE CATEGORY 01 Lane closure 02 Lane shift / crossover 03 Work on shoulder / median 04 Intermittent or moving vehicle 88 Other: 99 Unknown *COLLISION WITH VEHICLE (mark 1 box per side if applicable) st Harmful Event Most Harmful Event 01 Head on 02 Rear end 03 Angle - side impact 04 Sideswipe: opposite direction 05 Sideswipe: Same direction 06 Backed into 88 Other: 99 Unknown TRAFFIC CONTROLS (On / At Road) O/A Type Present OK/NF 00 None 1 1 1 O 09 OK 01 Officer, flagger 2 2 2 02 Traffic signal 3 3 3 03 Stop sign 4 4 4 04 Flasher 5 5 5 05 Yield sign 06 RR gates / signal 07 RR crossing signs 08 No passing zone 09 Center/Edge lines 10 Warning signs 11 School zone signs 12 Parking lines 88 Other: 99 Unknown
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KANSAS MOTOR VEHICLE ACCIDENT REPOR
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ADDITIONAL PASSENGERS & PEDESTRIANS
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Organization of the Accident Forms:
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ACCIDENT REPORTING QUALIFICATION, S
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BASIC TERMS AND QUALIFICATIONS Many
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GENERAL INFORMATION AND INSTRUCTION
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Special Notes on Working Vehicles A
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ACCIDENT LEVEL CODING 850A INVESTIG
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850A MILEPOST Enter the state milep
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Service or Rest Areas: Milepost: R
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TIME OCCURRED, TIME NOTIFIED, TIME
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property damage on the 850A in thes
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850A ACCIDENT LOCATION The Accident
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The Interchange diagram below indic
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Measuring Interchanges: For ramps,
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850A CODE '21' (1st harm occurs bey
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ACCIDENT CLASSES - CONTINUED 850A N
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850A Basic Sample Diagrams for CWOV
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LIGHT CONDITIONS Mark the option th
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850A BACK SIDE OF THE 850A COLLISIO
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TRAFFIC UNIT INFORMATION 850B SPECI
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DO NOT code legally parked vehicles
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850B DRIVER INFORMATION VIOLATIONS
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850B DRIVER ADDRESS Transcribe the
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850B EXTRICATION: Mark the extricat
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850B NON-COMMERCIAL DL A - For oper
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850B COMMERCIAL ENDORSEMENTS Enter
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850B PASSENGER INFORMATION PASSENGE
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850B CODING EXAMPLES FOR PASSENGERS
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850B REMOVED BY Record who removed
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10,000 lbs, record code ‘11.’ 8
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Present (‘P’) or Damaged (‘D
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852 COMMERCIAL MOTOR VEHICLES Vehic
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852 Important data fields for ident
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852 If this vehicle is leased or re
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Canadian carriers will not have any
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852 HAZMAT/ROADWAY INFORMATION Indi
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854 ADDITIONAL PASSENGERS & PEDESTR
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UNUSUAL ACCIDENT CODING SITUATIONS
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Towing Vehicles Vehicles in the lin
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DEFINITIONS / CLARIFICATIONS ACCIDE
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DEFINITIONS / CLARIFICATIONS HARMFU
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DEFINITIONS / CLARIFICATIONS Exampl
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DEFINITIONS / CLARIFICATIONS TRUCK
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ACCIDENT PHOTOGRAPHS An important p
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disappear and must be photographed
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90 COUNTY ABBREVIATIONS The followi
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NCIC CODES FOR COMMON AUTOMOBILE MA
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A. DRIVER INFORMATION: INSURANCE VE
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ACCIDENT CODING EXAMPLES Example No
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Accident Diagram 850A continued SPE
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Occupants & Vehicles VEHICLE# 01 SP
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02 Kansas Motor Vehicle Accident Re
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Occupants & Vehicles KDOT Form 850B
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Accident Narrative KDOT Form 851 Re
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100 F N AT I470 SN TOPEKA 3200 Gage
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Accident Narrative KDOT Form 851 Re
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0.5 M W AT K023 Public Works Lane C
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Passengers & Pedestrians KDOT Form
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EXAMPLE 7A Driver has Intent to Ent
Page 135 and 136: 120.0 I070 FWY 70 11/09/2012 13:20
Page 137 and 138: Occupants & Vehicles KDOT Form 850B
Page 139 and 140: Accident Narrative KDOT Form 851 Re
Page 141 and 142: Accident Diagram 850A continued SPE
Page 143 and 144: Occupants & Vehicles VEHICLE# 01 SP
Page 145 and 146: Investigating Department Reviewed b
Page 155 and 156: Hays Hays KS 67601 02 Kansas Motor
Page 165 and 166: Kansas Motor Vehicle Accident Repor
Page 175 and 176: 175 F N AT 8th 01 Kansas Motor Vehi
Page 181 and 182: 190 F W AT 2nd 01 Kansas Motor Vehi
Page 185: Accident Narrative KDOT Form 851 Re
Page 197 and 198: Passengers & Pedestrians 854 contin
Page 199 and 200: Example 20
Page 201 and 202: ROUNDABOUT CHARACTERISTICS EXAMPLE
Page 203 and 204: EXAMPLE 22 (3 OF 3) ROUNDABOUT ACCI
Page 205 and 206: 1 EXAMPLE 23 2 of 2 “1” locatio
Page 207 and 208: Investigating Department (Agency)
Page 209 and 210: Accident Code Sheet CONTRIBUTING CI
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KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL

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