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<br />00 - No PROPERTYWITNESS 91 TRACS KEY NO.(Military Time)(up to 2 choices)99 - Unknown98 - Other10 - Snow09 - Sleet or Hail08 - Severe Crosswinds07 - Rain06 - Freezing Rain/Drizzle05 - <br /> Fog, Smog, Smoke04 - Cloudy03 - Clear02 - Blowing Snow01 - Blowing Sand, Soil, DirtROADWAY ENVIRONMENTCONTRIBUTING CIRCUMSTANCES –(up to 2 choices)99 - Unknown98 - Other22 - Worn, Travel-Polished <br /> Surface (construction/maintenance/utility)21 - Work Zone20 - Weather Conditions19 - Visual Obstruction(s)18 - Traffic Incident17 - Traffic Control Device16 - Toll Booth/Plaza <br /> Related15 - Shoulders (none, low, soft, high)14 - Ruts, Holes, Bumps13 - Roadway Width Restricted (wet, icy, snow, slush, etc.)12 - Road Surface Condition11 - Related to a Bus <br /> Stop10 - Obstruction in Roadway09 - Non-Highway Work08 - Obstructed Crosswalks07 - Glare06 - Debris05 - Backup Due to Regular Congestion04 - Prior Non-Recurring Incident03 - Prior Crash02 <br /> - Animal(s)01 - Absence of Sidewalks00 - None CRASH DATA CRASHDATE OFIF CRASH WAS OUTSIDE CITY LIMITS, INDICATE DISTANCE FROM NEAREST TOWN Investigator's Motor Vehicle Crash Report <br /> CRASH OCCURREDROAD ON WHICHIF AT INTERSECTIONIF NOT AT INTERSECTIONMILEPOSTDISTANCE FROM State of Nebraska CRASHPLACE OF ofSheet WEATHER CONDITIONS OWNER NAMEPHONEOWNER NAMEPHONE NDOT <br /> Form 40, September 2020(Print or type)NAMENAMEADDRESSPHONEADDRESSPHONE 90830 OFFICER NO.TROOP/TEAM/BEAT HALL COUNTY SHERIFF'S OFFICE DEPARTMENT ERIC LITTLE INVESTIGATOR NAME APPROVED <br /> BY ERIC LITTLE INVESTIGATOR SIGNATURE 11/30/2023 DATE OF REPORTOBJECT DAMAGED ,ADDRESSAPPROX. COST OF DAMAGEOBJECT DAMAGEDADDRESSAPPROX. COST OF DAMAGE NEW L 2 OF VEHICLESTOTAL <br /> NO.ALTS LOCAL NO./ DISTRICT:L23112651 AGENCY CASE NO.NOYESPHOTOGRAPHS TAKEN?NOYESINVESTIGATION MADE AT SCENE?11/30/2023 M M / D D / Y Y Y Y SMTHFTSW 13:35 CRASHTIME OF 13:50 CLEARANCEROADWAYTI <br />ME OF HALL COUNTYCITYNOYESSECONDARY?040.8330824 US HWY 281 HIGHWAY NO.STREET/NOYESPRIVATE PROPERTY?-098.3786062 LONGITUDE 1888 FEET SENW 227 OF MILEPOST 34 HIGHWAY NO.NAME OF INTERSECTING <br /> ROADWAYMILESFEET 435 WNES W WOOD RIVER RD OF NEAREST STREET, BRIDGE, RAILROAD CROSSING 0.05 MILES WNES 1.52 MILESAND WNES GRAND ISLAND OF NEAREST CITY OR TOWN YESNOPROPERTY?NEBRASKA <br /> DEPT. OF TRANSPORTATIONDOES CRASH INVOLVE DAMAGE TO 01 Number of ApproachesTYPE OF INTERSECTION05 - Five or more (5+)04 - Four (4)03 - Three (3)02 - Two (2)01 - Not at Intersection <br /> 0002 within a work zone?or was it related to an activitymaintenance or utility work zone,Was the crash in a construction,WORK ZONE99 - Unknown02 - No 02 Within Interchange Area?RELATION <br /> TO JUNCTION99 - Unknown02 - No 97 Overall Intersection Geometry97 - Not Applicable03 - Perpendicular + or T02 - Roundabout/Traffic Circle O01 - Angled/Skewed Y 97 Workers Present?99 <br /> - Unknown97 - Not Applicable02 - No 00 Specific Junction Location99 - Unknown shoulder or roadside)98 - Other Location (median,07 - Shared Use Path or Trail06 - Railway Grade <br /> Crossing05 - Intersection or Related04 - Entrance/Exit Ramp or Related03 - Driveway Access or Related02 - Crossover Related01 - Acceleration/Deceleration Lane00 - Non-Junction 97 Overall <br /> Traffic Control Device97 - Not Applicable05 - Yield04 - Stop - Partial03 - Stop - All Way02 - Signalized01 - No Control 97 Type of Work Zone99 - Unknown98 - Other97 - Not Applicable04 <br /> - Work on Shoulder or Median03 - Lane Shift/Crossover02 - Lane Closure01 - Intermittent or Moving Work 0397 99 - Unknown98 - Other97 - Not Applicable05 - Termination Area04 - Activity <br /> Area03 - Transition Area02 - Advance Warning Area01 - Before Work Zone Warning SignLocation of the Crash 01 ROADWAY SURFACE CONDITION99 - Unknown98 - Other08 - Water (standing, moving)07 <br /> - Snow06 - Slush05 - Sand04 - Oil03 - Mud, Dirt, Gravel02 - Ice/Frost 03 MANNER OF CRASH / COLLISION IMPACT99 - Unknown98 - Other07 - Sideswipe-Same Direction06 - Sideswipe-Opposite <br /> Direction05 - Rear-to-Side04 - Rear-to-Rear03 - Front-to-Rear02 - Front-to-Front01 - Angle Two Motor Vehicles00 - Not a Collision Between 97 Law Enforcement Present99 - Unknown97 <br /> - Not Applicable Present03 - Only Law Enforcement Vehicle02 - Not Present01 - Officer Present 01 LIGHT CONDITION99 - Unknown98 - Other05 - Dark-Unk. Lighting04 - Dark-Not Lighted03 <br /> - Dark-Lighted02 - Dawn/Dusk01 - Daylight 01 ROADWAY SURFACE99 - Unknown98 - Other05 - Gravel04 - Dirt03 - Concrete02 - Brick01 - Asphalt 00 SCHOOL BUS RELATED99 - Unknown02 - School <br /> Bus Indirectly Involved01 - School Bus Directly Involved <br /> <br />