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HomeMy WebLinkAbout2025-00061622 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111 IIIIII DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY X003969738 u, 1 U21 3 4 1 U1 3 U2 1 U, 1 1_12 1 U, 1 U2 1 1 10 u1 1 U2 3 *P 0119* INVESTIGATING AGENCY AGENCY CRASH REPORT NO. TRFW ' DAMAGE TO ANY El 5500 OR LESS TYPE OF REPORT El A No Injury 1 Drive Away Elgin Police Department ONE PERSON'S El$501-$1.500 ®ON SCENE 1 VEHICLE/PROPERTY ®OVER 51,500 El NOT ON SCENE(DESK REPORT) ® B Injury and for Tow Due To Crash El AMENDED YR 2025I 2025-00061622 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 rn ® ❑ RELATED ®Y 0 N 09 19 2025 ❑AM ❑YES ®NO U1 S RANDALL RD Elgin02:31 _ g PRIVATE mo /day/yr ®PM FLOW CONDITION m FT!MI N E S W SOUTH ST COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ❑SLOW 15 Cn ❑ Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD ❑ STOPPED U2 --I Igi AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ® FREE FLOW # LNS 0 Q83 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EDUCE 0 uuv 0 ncv 0 ov DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 0 0 0 3 ! yr HyundaiSonata 2009 00-NONE DUE TO CRASH ® ❑©1 1z - E 13-UNDER CARRIAGE 10 1 2 FIRE ❑ al STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED ❑ 0 U2 0 m M 2 SY n 15-OTHER 8 ❑Y ®SNE M❑UNK VEH. AT CRASH IN n D 99-UNKNOWN 9 16•TOP 3 `Distraction Value ALGN 2 r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF & i�S �i COM VEH 0 j$J 1 0 SOUTH ELGIN N I L 60177 0 1 0 FIRST CONTACT 11 7_: __S *llYes.See Sidebar U1 ZFA40736 IL 2025 E TELEPHONE IL D 0 5NPET46C49H425176 Alamo El ®N U2 1— 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Same IL002506 1 r `o HOSPITAL(TAKEN TO) INCIDENT IF'V OWNER STREET,CITY,STATE,ZIP PHONE NUMBER RESPONDER 73 > Refused ElY ElN 2 0 m N DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 i,uv 0 i v 0 Dv � !1 9 9 2 FR Toyota Highlander 2024 00-NONE ,�__' tz 0 DUE TO CRASH 0 2 73 0Yr 13-UNDER CARRIAGE 10 2 FIRE 0 El U2 C c F 2 4 SYSTEM IN 0 ENGAGED 0 15-OTHER 9 16-TOP 3 ❑Y gi N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistraelion Value 4 POINT OF 8 i1� 4 COM VEH ❑ ® U1 CO N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR 6 FIRST CONTACT 1 Y __S •• •If Yes.See Sidebar — Frankfort IL 60423 0 1 TWOMOMSB IL 2026 REAR 0 N IL D 0 STDFZRBH3NS212984 Allstate ❑Y ®N RDEF 7:l EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST.M) POLICY NUMBER 1 X Same 966702205 BAc $ HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPOND O N U1 = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(ADDRESS)!(TELEPHONE) (EMS) (HOSPITAL) 1 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z Nu 1 CD 11 1 09,19 l2025 02 31 ®PM in a Work Zone?AM NJ DIRP co 1 I PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME ❑AM If YES check one below: U1 5 C) o� T 2 0 25 2 ) ! 0 PM ❑Construction * N 3 0 $I CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 1 ❑AM 0 Maintenance U2 o ® 11 1 ARREST NAME Sweetman-Byrne.Aaron. M. 11-305-A 1529-000498 / ! 0 PM SLMT o N ❑CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME ' ❑Utility 2 El NAME AM T r 1 r ❑❑PM ❑Unknown work zone type 45 U1 n OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME 2 2 3 ❑ 1529-Audi red.Jonathan 801 391-Jacobucci 10 /07,2025 09 00 D PM Workerspresenl7 ®N U2 45 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. r ----r••--, , ; A CMV is defined as any motor vehicle used to transport passengers or property and: Z 1. Has a weight rating more than 10,000 pounds(example:truck or truck trailer -< i- }--__r-_--; I I L...._ combination)or INDICATE NORTH p0 I- p I I 1 BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver -I Nat. (example:shuttle or charter bus):or C) L A 4 3. Is designed to carry 15 or fewer passengers and operated by a contract carrier I O - } } } transporting employees in the course of their employment(example:employee X transporter-usually a van type vehicle or passenger car):or w I- I- --I-- ---I eil:n -e I. 4. Is used or designated to transport between 9 and 15 passengers,including w } } } g po passen rs,includi the driver, u s t for direct compensation(example:large van used for specific purpose):or O L i____a____.i 1�' I _ t i. i t 5. Is any vehicle used to transport anyhazardous material(HAZMAT)thatrequires m placarding(example:placards will be displayed on the vehicle). XI m D I CARRIER NAME b I _ ADDRESS O D i i. w i. i. i. 4. o CITY/STATE/ZIP g - MOTOR CARR.ID 0 Interstate 0 Intrastate -'- - 0I I T I I ❑ Not in Comm./Govt. ❑ Not in Comm./Other - ------1 USDOT NO. ILCC NO. m XI Source of above z . IDOT PERMIT NO. WIDELOAD'; ❑Yes 0 No 2 TRAILER VIN 1 m co 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 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. w Black Gray u 1 TOWED • TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT- 3 TOWED BY/TO. Redmons/Impound Lot Garage . SELECT CODES FROM THE BACK OF CRASH BOOKLET U 2 TOWED DISABLING DAMAGE NOT DAMAGE EXTENT: 3 TOWED BY/TO: DUE TO ® DISABLING DAMAGE Redmons/Impound Lot Garage VEHICLE CONFIG._CARGO BODY TYPE_LOAD TYPE