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HomeMy WebLinkAbout2026-00002607 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111 10011110101 111 111 ���� ����� DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X 142b4& u, 1 U21 1 1 11 U, 4 U2 1 U1 1 U2 1 U1 1 U2 1 1 14 U, 1 U2 1 .P0119* INVESTIGATING AGENCY DAMAGE TO ANY El 5500 OR LESS TYPE OF REPORT 0 A No Injury 1 Drive Away AGENCY CRASH REPORT NO. TRFW Elgin Police Department ONE PERSON'S El$501-$1.500 ®ON SCENE 2 VEHICLE/PROPERTY ®OVER 51,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash 0 AMENDED YR 202612026-00002607 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 rn ® ❑ RELATED ®Y 0 N 01 14 2026 ®AM ❑YES ®NO U1 E CHICAGO ST Elgin07:50 _ _ g PRIVATE mo /day/yr ❑PM FLOW CONDITION m FT!MI N E S W STADIUM DR COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ®SLOW 3 Cl) ❑ Cook HIT&RUN ❑Y ® N WITH VEHICLES INVLD 0 STOPPED U2 —I ® AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ❑ FREE FLOW # LNS 0 Q83 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL 0 EDUCE 0 uuv 0!CV 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 1 n 1 0 / yr 13-UNDER CARRIAGE ©,I :: FIRE 0 STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14--TOTAL(ALL) DISTRACTED 0 0 U2 1 M M 2 OTHER 4 ❑Y ®SYSNEM IN DUNK VEH. O AT CRASH D O 99-UNKNOWN 9 76.70P 3 ,Distraction Value 9 ALGN = r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s, i�6 4 COM VEH 0 j$J 1 0 ~ ELGIN I L 60120 0 1 0 FIRST CONTACT 12 7 ; _5 *IIYes.See Sidebar U1 Z FJ15833 IL 2025 E TELEPHONE IL D 0 JF2SHACC5CH462722 Progressive El IlN U2 I- 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m co 99 9 Rangel. Barbara 980101635 3 r `o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER 2 XI g DRIVER ❑ PARKED 0 DRIVERLESS ❑ PED ❑PEDAL ❑EWES ❑iiuv 0 i v ❑Dv �y !1 9 8 4 Honda Odyssey 2013 00-NONE O-i Q!'-O DUE TO CRASH p 2 x 0 13-UNDER CARRIAGE 10( I 2 FIRE ❑ ® U2 C il M 2 4 SYSTEM IN 0 ENGAGED 0 ®-OTHER 9,16-TOP 3 9 0 X ❑Y i N DUNK VEH. AT CRASH 99-UNKNOWN *0istracton Value N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s-it 6 11:,-4 COM VEH ❑ ® U1 CO FIRST CONTACT 12 7�.REAR-5 •If Yes.See Sidebar n ELGIN M IL 60120 0 1 0 BQ97216 IL 2025 IL D 0 SFNRL5H6XDB062307 Progressive ❑Y ®N RDEF Xl EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 X 99 9 Corona.Castro 976618879 BAc $ 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)!{ADDRESS)((TELEPHONE) (EMS) (HOSPITAL) :A / / UI 1 D / / 1 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z N 1 ® 11 1 01 ,14 /2026 07 50 ®❑pm in a Work Zone? ®N DIRP co 1 t PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 3 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 � o" 2 0 11 28 ) ! ❑PM, ❑Construction * Z 3 0 1!>I CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 7 ❑AM 0 Maintenance U2 o1 ® 11 1 ARREST NAME Lozano. Rangel. M. 11-1201-A- W485-3877 / ! ❑PM SLMT o N ❑CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME ❑Utility AM U, 40 t 2 El ARREST NAME 01/14 /2026 08 50 In PM 0 Unknown work zone type n 7 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME 2 2 3 ❑ ❑AM Workers present? ❑Y 40 485-Quintana.Josue 302 275-Engelke , / ❑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. A. r ----r•---, , I ; A CMV is defined as any motor vehicle used to transport passengers or property and: Z Not To Scale N z 1. Has a weight rating more than 10,000 pounds(example:truck or truck trailer c ` '' -1 135€ 0 r INDICATE NORTH combination):or —I BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C i_ unttlll _ _ (example:shuttle or charter bus):or i 111 u-1 __ Unit*,_.• X t 3. Is designed to carry 15 or fewer passengers and operated by a contract carrier I 0 L } -A----1 - } } } transporting employees in the course of their employment(example:employee X transporter-usually a van type vehicle or passenger car):or w C L L.___a__._.l / 4. Is used ordesi natedtotrans rtbetween9and15passengers,induding[hedrrver, } for direct compensation(example:large van used for speific purose):or O L �____a..... = ® I. }� i t 1 L 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires D placarding(example:placards will be displayed on the vehicle). ,Zmt 1 CARRIER NAME Z 37 ADDRESS 0T.rn n / CITY/STATE/ZIP g MOTOR CARR.ID 0 Interstate ❑ Intrastate . I . . / ❑ Not in Comm./Govt. Not in Comm./Other ❑ 0 i— --- --1 - USDOT NO. ILCC NO. m XI Source of above z . MCS 0 Yes 0 No 0 Unknown Out of Service 0 Yes ❑No 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 0 TRAILER WIDTH(S) 0-96" 97-102" >102' -n TRAILER 1 0 0 0 Z TRAILER 2 ❑ 0 0 O u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. w Red Gray u 1 TOWED • TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT' 2 TOWED BY/TO. Arties/Impound Lot Garage . SELECT CODES FROM THE BACK OF CRASH BOOKLET U 2 TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 2 TOWED BY1T6 DUE TO ® Arties VEHICLE CONFIG._CARGO BODY TYPE LOAD TYPE