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HomeMy WebLinkAbout2025-00066092 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111 I011011001 00 000 DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY X4639$:148 u, 1 u21 1 1 1 u, ' U299 u, 1 U2 1 u,99 U2 99 1 11 u, 1 U2 1 *P 0119 INVESTIGATING AGENCY AGENCY CRASH REPORT NO. TRFW ' DAMAGE TO ANY ❑$500 OR LESS TYPE OF REPORT ❑ A No Injury 1 Drive Away Elgin Police Department ONE PERSON'S El$501-$1.500 ®ON SCENE 1 VEHICLE/PROPERTY ®OVER$1,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash 0 AMENDED YR 2025I 2025-00066092 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 '1 ® ❑ RELATED PRIVATE ❑Y ®N 10 08 2025 ❑AM ❑YES ®NO U1 —< S RANDALL RD Elgin mo /day/yr 06.19 ®PM FLOW CONDITION III 01 DO!MI N EON Bowes Rd COUNTY PROPERTY ❑Y ® N DOORING Ely #OF MOTOR 0 SLOW 1 cn Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD 0 STOPPED U2 —1 ❑ AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ® FREE FLOW # LNS 0 183 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 uuv 0 icy ❑Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 3 0 r tf�TOWED U1 O mo Huffman. Mitchell. P. Honda Civic 2010 00-NONE ©, >2 �/OUETOCRASH ® ❑ NAME(LAST,FIRST,M) yr 13-UNDER CARRIAGE 10.I 2 FIRE ❑ STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED EI El U2 3 <<T1 M 2 4 SYTM❑Y ®S NE DUNK VEH. O AT CRASH 0 99-U 15-UNKNOWN THER9 16•TOP 3 *Distraction Value 9 ALGN = r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s iL 6 1,.4 COM VEH 0 Ei 1 0 ~ North Aurora IL 60542 0 1 0 FIRST CONTACT 12 7_: __5 *lIVes.See Sidebar U1 Z DN18176 IL 2025 REAR 7 TELEPHONE IL D 0 2HG FG 1 B65AH512283 None ®Y ❑N U2 m in EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Same None 1 r `o HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER RESPONDER D Refused ❑Y ® N 2 7] N DRIVER ❑ PARKED 0 DRIVERLESS 0 FED 0 PEDAL 0 EWES 0 r My 0 NOV 0 DV /1 9 yf 2 Toyota Camry 2023 00-NONE 'o,� t2 (,�2 DUE O CRASH 0 ® U2 2 C o 13-UNDER CARRIAGE M 2 4 ,6 SYSTEM IN 0 ENGAGED 0 15-OTHER 9.16 •TOP 3 ❑Y i N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistrac on Value 9 4 POINT OF 8 i 4 COM VEH ❑ ® U1 CO N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR 6 FIRST CONTACT 6 O7 ,�=QOS •If Yes.See Sidebar C Roselle IL 60172 0 1 0 EJ34636 IL 2026 IAR 4 fn Z D IL D 0 4T1 G 11 AK5PU778195 State Farm ❑Y J N RDEF M EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 X Same 0773104-SFP-13 BAG $ HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY,STATE,ZIP 996 < Refused RESPONDER U1 = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)((ADDRESS)(TELEPHONE) (EMS) (HOSPITAL) 2 3 01 / 2 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur 0 Y U2 Z N 1 El 11 1 10;08 /2025 06 19 ®AM in a Work Zone? ®N DIRP D 1 I PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 1 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 0 2 0 28 03 / / ❑PM ❑Construction >E R 3 0 $I CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 1 ❑AM 0 Maintenance U2 -, 1 ® 11 1 ARREST NAME Huffman. Mitchell. P. 11-601-Ax 1525000770 / / El PM SLMT j$[CITATIONS ISSUED 0 PENDING SECTION CITATION NO. ROAD CLEARANCE TIME AM• 0 Utility T 2 El ARREST NAME Huffman. Mitchell. P. 3-707 1525000769 10108 /2025 06 49 ®PM 0 Unknown work zone type U1 50 2 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 50 1525-NavE.Oscar 702 10 ;28,2025 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. r ----r••--, , I I ; A CMV is defined as any motor vehicle used to transport passengers or property and: -< Not To Scale j 1. Has a weight rating more than 10,000 pounds(example:truck or truck trailer ` ` --I -' t j I I r INDICATE NORTH combination):or -I BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C - } (example:shuttle or charter bus):or - ------I-----I -, ,- - transporting mploned to aeeslin the course of 5 or fewer he r employmentrs tl operated example:employee a contract X I I } r } transporter-usuallyvehicle passenger g�� � wally a van type or passe ge car):or CO L L.___a__ 4. Is used ordesi natedtotrans transport passengers,including y} } } g po passen rs,includi the driver, for direct compensation(example:large van used for specific purpose):or i. 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires m Iplacarding(example:placards will be displayed on the vehicle). ;p I -I CARRIER NAME Z i r ADDRESS N T. 0 (7 CITY/STATE/ZIPg MOTOR CARR.ID 0 Interstate 0 Intrastate I I T I I I ❑ Not in Comm./Govt. Not in Comm./Other ----------- - USDOT NO. ILCC NO. rn I Source of above z . own tank)? 0 Yes 0 No 0 Unknown Did HAZMAT Regulations violation contribute to the crash? r ❑ Yes 0 No 0 Unknown g D Did Carrier Safety Regulations MCS)violation contribute to the crash? A ❑ Yes II El Unknown C Was a driver/vehicle Examination Report Form completed? r HAZMAT ❑Yes 0 No ❑Unknown Out of Service ❑Yes ❑No 7 MCS ❑Yes 0 No 0 Unknown Out of Service ❑Yes ❑No C Z Form Number 0 m Xl IDOT PERMIT NO. WIDELOAD'; ❑Yes 0 No 2 TRAILER VIN 1 m co LOCAL USE ONLY TRAILER VIN 2 m v TRAILER WIDTH(S) 0-96" 97-102" >102' T TRAILER 1 ❑ ❑ 0 Z TRAILER 2 ❑ 0 0 O u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. Z Gray White u 1 TOWED • TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ❑ DISABLING DAMAGE ® NOT DISABLING DAMAGE DAMAGE EXTENT 1 TOWED BY/TO. Redmons/Impound Lot Garage . SELECT CODES FROM THE BACK OF CRASH BOOKLET U 2 TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 1 TOWED BY/TO: DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE