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HomeMy WebLinkAbout2025-00069325 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 2 Sheets 01111101111 IIIIII II II II III IIIII I 11111111 DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X�0O327O u, 1 U21 3 4 1 U1 2 U2 1 U, 1 1_12 1 U, 1 U2 1 1 10 u1 3 U2 1 *P 0119* INVESTIGATING AGENCY DAMAGE TO ANY El 5500 OR LESS TYPE OF REPORT ❑ A No Injury 1 Drive Away AGENCY CRASH REPORT NO. TRFW ' Elgin Police Department ONE PERSON'S El$501-$1.500 ®ON SCENE 14 VEHICLE/PROPERTY ®OVER$1,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash El AMENDED YR 2O25I 2025-00069325 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 15 �I ® ❑ RELATED ®Y ❑N 10 23 2025 ❑AM ❑YES ®NO U1 -< BIG TIMBER RD Elgin02:07 g PRIVATE mo /day/yr ®PM FLOW CONDITION m FT!MI N E S W N RANDALL RD COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ❑SLOW 15 cn ❑ Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD 0 STOPPED U2 —I ® AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ® FREE FLOW # LNS 0 g DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 uuv 0!CV 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 0 C) f T TOWED U1 Q FOR DAMAGEDAREA(S) FRO Dunning.Adam.C. 0 5 / yr 13-UNDER CARRIAGE ©i OI- 2 FIRE 0 STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) O 2 DISTRACTED 0 0U2 0 m M 2 SYTM IN ENGAGEis-OTHER 8 ❑Y ®SNE❑UNK VEH. 0 ATCRASHD 0 99-UNKNOWN 9a TOP 3 `Distraction Value 9 ALGN 2 r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s :il S �i,4 COM VEH 0 j$J 1 0 ~ Lake In The Hills IL 60156 0 1 0 FIRST CONTACT 1 7_; __5 *IIYes.SeeSidebar U1 ZZY92787 IL 2026 TELEPHONE IL D 0 KM8JU3AC9DU629205 Encova ❑Y ®N U2 M 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Elgin Fire 99 9 Dunning.Victoria.A. 5002491171 1 r o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER 2 ou g DRIVER 0 PARKED 0 DRIVERLESS 0 FED 0 PEDAL 0 EWES 0!My 0 NOV 0 Dv !2 0 0 1 Hyundai Santa Fe 2017. 00-NONE ®i Q!•-O DUE TO CRASH rg ❑ 2 x o y Yr 13-UNDER CARRIAGE 10( I 2 FIRE ❑ ® U2 C F 2 5 SYSTEM IN 0 ENGAGED 0 15-OTHER 9,16-TOP 3 X ❑Y i N DUNK VEH. AT CRASH 99-UNKNOWN *Oistraglon Value 9 0 POINT OF 8 i1�I-4 COM VEH ❑ ® U1 CO N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR FIRST CONTACT 12 7 B _5 •If Yes,See Sidebar H Gilberts IL 60136 B 1 0 RLX970 IL 2025 I0 C IL D 0 5N MZTDLBOH H000921 State Farm ❑Y ®N RDEF EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Elgin Fire 99 9 Monteleone.Julia. D. 393 6785-A22-23C SAC E HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP U1 = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(A.DDRESS)/(TELEPHONEI (EMS) (HOSPITAL) UI 1 D / / 1 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur 0 Y U2 Z N 1 ® 11 4 10,23 /2025 02 07 ®AM in a Work Zone? ®N DIRP co 1 t PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 7 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 C) 2 0 2 4 2 28 10,23 /2025 02 08 PM , ® , 0 Construction * R 3 0igi CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 3 z J ❑AM ❑Maintenance U2 a ® 11 4 ARREST NAME Dunning.Adam.C. 11-901-A S1542-000518 10/23/2025 02 09 Igi pM ❑Utility SLMT El CITATIONS ISSUED 0 PENDING SECTION CITATION NO. ROAD CLEARANCE TIME AM• t 2 0 ARREST NAME Dunning.Adam.C. 11-601 S1542-000519 10/23 /2025 03 05 ®PM El Unknown work zone type U1 45 2 2 3 ❑ OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 45 1542-Chace. Ethan 502 11 , 18,2025 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••--, , ; 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 truckrtrailer -< INDICATE NORTH BY ARROW combination):or 2 Is used or designed to transport more than 15 passengers including the driverC _ } (example:shuttle or charter bus):or .. 1 1 v v Not Tb Sub ' T` 1 ` 1 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 —` transporter-usually a van type vehicle or passenger car):or w L .:. .}----; ` - •} } } 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 L �____a____� �� ti 0 t i. i t 5. Is anyvehicle used to transport anyhazardous material(HAZMAT)that requires m ,� placardig(example:placards will be isplayed on the vehicle). :0 1 '� ` CARRIER NAME Z \ __ ADDRESS 0 m �� D i w.. tt `_ n i 1 ++ .' T CITY/STATE/ZIP g r + i. i. i. i. MOTOR CARR.ID 0 Interstate 0 Intrastate ❑ Not in Comm./Govt. ❑ Not in Comm./Other 00 --- --1 USDOT NO. ILCC NO. C m XI Source of above z . Form Number 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' -n TRAILER 1 ❑ ❑ 0 Z TRAILER 2 ❑ 0 0 o u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. w White Gray u 1 TOWED • TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT- 3 TOWED BY/TO. Arties/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 Arties/Impound.Lot Garage VEHICLE CONFIG._CARGO BODY TYPE_LOAD TYPE