HomeMy WebLinkAbout2025-00036091 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111
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DRAG TRFD TRFC WEAT DRVA VIS VEHD LGHT COLL MANY X003846071
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INVESTIGATING AGENCY DAMAGE TO ANY El 5500 OR LESS TYPE OF REPORT El A No Injury 1 Drive Away
AGENCY CRASH REPORT NO. TRFW '
Elgin Police Department ONE PERSON'S 1215501-$1.500 ®ON SCENE 1
VEHICLE/PROPERTY ❑OVER$1,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and for Tow Due To Crash
El AMENDED
YR 202512025-00036091 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 10 �l
® ❑ RELATED ®Y 0 N 06 06 2025 ®AM ❑YES ®NO U1 -<
N MCLEAN BLVD Elgin 11:39
_ _ g PRIVATE mo /day/yr ❑PM FLOW CONDITION ITl
FT!MI N E S W ABBOTT DR COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ❑SLOW Cl)
❑ Kane HIT ❑Y ® N WITH VEHICLES INVLD El STOPPED U2 --I
CO AT RUN AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ® FREE FLOW # LNS 0
Qg3 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEOAL 0 EOUES 0 uuv 0 Ncv 0 ov DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 4 0
2018
_ mo /2 O O 1 FOR DAMAGEDAREA(S) FROM TOWED U1 Q
p NAME(LAST,FIRST,M)
Espinosa-Sanchez.Abraham Unknown Unknown 00-NONE „ •
Q 0 DUE TOCRASH ® ❑
13-UNDER CARRIAGE 10 i FIRE ❑ al
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) O DISTRACTED ❑ ]$I U2 rn
M 5 4 SYTM❑Y ®SNE❑UNK VEH. 0 ATCRASHD 99-UUNKNOWN THER0:::).TOP 3 `DistractionValue ALGN
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r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF _iL ii,4 COM VEH ❑ E! 1 0
~ ELGIN N I L 60123 A 2 8 FIRST CONTACT 12 7_; __5 *If Yes.See Sidebar U1
ZMCYFY247 IL 2025 REAR
TELEPHONE
IL D 0 JYARN53EXJA003086 NIA ❑Y ❑N U2 m
5 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
Elgin Fire Same NIA 1 r
o HOSPITAL(TAKEN TO) INCIDENT IF IC OWNER STREET,CITY,STATE,ZIP PHONE NUMBER
RESPONDER D
Sherman ❑Y El 2 ou
0 DRIVER 0 PARKED 0 DRIVERLESS 0 FED 0 PEDAL 0 EWES 0 Iluy 0 NOV 0 DV
yr 12 _ C1
o 13-UNDER CARRIAGE 10 I 2 FIRE ❑ ❑ U2 C
c SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED
a SYSTEM IN ENGAGED 15-OTHER 9,16-TOP3 ❑ ❑ SPDR 0
❑Y El N ❑UNK VEH. AT CRASH 99-UNKNOWN *0istractlonvalue U1 4 -
POINT OF s-.;, 4
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR FIRSTO CONTACT Y 6 1j._5 CIO es See SidebarEH
0 C
CO
F` REAR` co
M . STATE CLASS CDL ID VIN INSURANCE CO. EXPIRED U2 O
❑Y ❑N RDEF73
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 X
BAC
HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY,STATE,ZIP 996 <
RESP❑YDNDER❑N U1 =
(UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(ADDRESS)1(TELEPHONE) (EMS) (HOSPITAL) 0
W 09 /
0
EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z
N 1 ® 43 1 06,06 ,2025 11 39 ®❑PM in a Work Zone? ®N DIRP co
1 t PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 1
T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ®AM U1
v t 2 0 28 99 O6,O6 ,2025 11 40 ❑PM ❑Construction
R 3 ❑ xi CITATIONS ISSUED PENDING SECTION CITATION NO. EMS ARRIVED TIME
z J ®AM ❑Maintenance U2
-a, ARREST NAME Espinosa-Sanchez.Abraham 11-601 1529-000410 06,06 r2025 11 41 ❑PM SLMT
o N 1 0 IZI CITATIONS ISSUED ❑PEENDING SECTION CITATION NO. ROAD CLEARANCE TIME ❑Utility
❑AM 35
t 2 El ARREST NAME Espinosa-Sanchez.Abraham 3-707 1529-000411 , , ❑PM ❑Unknown work zone type U1
n 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? 0 Y
1529-Audi red.Jonathan 501 07 ,07,2025 09 00 ❑PM ®N U2
REMEMBER TO USE BLACK INK,PRESS HARD,PRINT LEGIBLY AND COMPLETE ALL REQUIRED FIELDS!
A Diagram and Narrative are required on all Type B crashes, LARGE TRUCK, BUS, OR HM VEHICLE
even if units have been moved prior to officer's arrival.
IF MORE THAN ONE CMV IS INVOLVED,USE SR 1050A
ADDITIONAL UNITS FORMS.
N?McLean?Blvd.
r ----r••--, , ; A CMV is defined as any motor vehicle used to transport passengers or property and: Z
rrating than pounds(example:truck or truck trailer -<
1. Has a weight more10,000
i- }-_-_r_-__1 I I I. combination):or —I
n INDICATE NORTH p1
'I-- BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver n
} I I } (example:shuttle or charter bus):or 0
}_ -- 1 I I 3. Is designed to carry15 or fewer passengers and operated I a contract carrier O
--- ----i `
- } } } transporting employee � �In the course of their employment(example:employee X
I __t transporter-usually a van type vehicle or passenger car):or
C
i. `.. ___'i I I -'Abbott?Dr. _ } 1.} 4. Is used or designated to transport between 9 and 15 passengers,including the driver. N
for direct compensation(example:large van used for specific purpose):or O
L L____a____. L L L I 5. Is any vehicle used to transport anyhazardous material(HAZMAT)that requires
— — — m
placarding(example:placards will be displayed on the vehicle).
I- I- -:- '.. 4? r
CARRIER NAME Z
ADDRESS 0
T.
CITY/STATE/ZIP g
_ MOTOR CARR.ID 0 Interstate 0 Intrastate
0
. I . . - I ❑
; Not in Comm./Govt. Not in Comm./Other
Not To Scale
,____Y____., I I - USDOT NO. ILCC NO. m
XI
Source of above z
. MCS ❑Yes 0 No 0 Unknown Out of Service ❑Yes ❑No Z
Form Number 0
m
71
IDOT PERMIT NO. WIDELOAD'; ❑Yes 0 No 2
TRAILER VIM 1 m
to
LOCAL USE ONLY TRAILER VIN 2 m
0
TRAILER WIDTH(S) 0-96" 97-102" >102' -n
TRAILER 1 ❑ ❑ 0 Z
TRAILER 2 ❑ 0 0 o
u 1 COLOR U_COLOR TRAILER LENGTH(S)1 ft. 2 ft. w
Red
u 1 TOWED TOTAL VEHICLE LENGTH ft. NO.OF AXLES_
DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT 3 TOWED BY/TO:
_Allies SELECT CODES FROM THE BACK OF CRASH BOOKLET
U_TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: TOWED BY/TO:DUE TO VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE