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HomeMy WebLinkAbout2026-00003592 ILLINOIS TRAFFIC CRASH REPORT sheet 1 of 6 Sheets 01111101111 I001111010 *IIII IlI III DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X004107194 u, 2 U21 3 4 3 U1 4 U2 1 U1 1 U2 1 U1 1 U2 1 5 10 U, 4 U2 *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 ❑5501-51,500 ®ON SCENE 2 VEHICLE/PROPERTY ®OVER$1,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash El AMENDED YR 2026I 2026-00003592 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 -n N STATE ST Elgin11:03 ® ❑ RELATED ®Y 0 N 01 18 2026 ❑AM ❑YES ®NO U1 -< _ _ g PRIVATE mo !day/yr ®PM FLOW CONDITION MFT!MI N E S W W HIGHLAND G H LAN D AVECOUNTY PROPERTY ❑Y ® N DOORING Ely #OF MOTOR ❑SLOW 1 cn ❑ Kane HIT ❑Y ® N WITH VEHICLES INVLD IN STOPPED U2 —I igl AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) &RUN PEDALCYCLIST®N ❑ FREE FLOW # LNS 0 Qg3 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL 0 EWES 0 NIIV 0 Ncv 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 4 n f'rr TOWED U1 0 NAME(LAST,FIRST,M) REYES SOFIA. MELANIE. M. mo yr Scion TC 2006 00-NONE „_, ) © FIREDUE TO CRASH ® ❑ 13-UNDER CARRIAGE ❑ IE STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) 10 O DISTRACTED 0 0 U2 4 M F 2 4 ❑Y ®SNE❑ is-OTHER UNK VEH. O ATCRASHD O 99-UNKNOWN 9 16•TOP 3 *Distraction Value 9 ALGN 2 T CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF $ :i1 B �i, COM VEH 0 1 0 ~ ELGIN I L 60120 0 1 0 FIRST CONTACT 1 7_. __5 *II Yes.See Sidebar U1 Z FL33146 IL 2026 E TELEPHONE IL D 0 JTKDE177460097555 AMERICAN INSURANCE ❑Y ®N U2 I-- 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m co 99 9 RODRIGUEZ.JOANNA PAIL00014348 3 1— "6 HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER 2 XI m g DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL ❑EWES 0 i,Mv 0 NOV 0 DV CIRCLE NUMBER(S) U1 !1 9 yf 5 Jeep(after 19 et•}tegade 2019 00-NONE 11_"1 01 O DUE TO CRASH ❑ 2 x 13-UNDER CARRIAGE I FIRE ❑ ® U2 , M 2 4SYSTEM IN 0 ENGAGED 0 15-OTHER 9,19-TOP 3 x 0Y NJ 0 UNK VEH. AT CRASH 99-UNKNOWN *Distraction value 9 POINT OF i1 '3 8 N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR FIRST CONTACT 12 Y s I-5 •COM VEH ❑ ® u1 to(ryes.See Sidebar m PROSPECT HEIGHTS IL 60070 0 1 0 AL51525 IL 2026 iiEaR IL D 0 ZACNJABB1KPK86684 KEMPER ❑Y 0 N RDEF XI EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST.M) POLICY NUMBER 1 = 99 9 Muniz. Irma 12AU000921234 BAG $ HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP U1 = ;UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) 1(EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME))(ADDRESS))TELEPHONE) (EMS) (HOSPITAL) 1 4 10 / D / / 2 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 ,18 l2026 11 03 ®PM in a Work Zone? ®N DIRP co 1 I PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 5 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 o" 2 0 08 28 1 1 ❑PM ❑Construction >F 3 0 Dyg CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 3 ❑AM 0 Maintenance U2 -a, ARREST NAME REYES SOFIA. MELANIE. M. 11-601 748162 / ! El PM 1 ® 1 1 1 CITATIONS ISSUED 0PENDING N ® UtilitySLMT uSECTION CITATION NO. ROAD CLEARANCE TIME AM ❑ o t 2 0 ARREST NAME REYES SOFIA. MELANIE. M. 6-101 748161 01 t 18 /2026 00 45 ❑PM El Unknown work zone type u1 30 n 7 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME 2 2 3 0 0 AM Workers present? ❑Y 30 1 558 Lundvick.John 601 388-Nelis / ❑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 } }---.-I'----; ® I I - combination):or more than pounds(example:truck ortruckrtrarler 1. Has a weight rating10 000i -< INDICATE NORTH p0 BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C Gilac I- 1^':r7." t I I L _ } (example:shuttle or charter bus):or C) L A I 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 L L.___a____.l - 4. Is used ordesi natedtotrans transport passengers,including N ` - } } } g po passen rs,indudi the driver, l for direct compensation(example:large van used for specific purpose):or O a --' t l. I. I ._ 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires I°J...l♦i .- l placarding(example:placards will be displayed on the vehicle). XI --i - CARRIER NAME —I 1 I I - ADDRESS '0 Not To Scale D I o CITY/STATE/ rn ZIP - MOTOR CARR.ID 0 Interstate El Intrastate l l . l � ❑ Not in Comm./Govt. 0 Not in Comm./Other i— ------1 - USDOT NO. ILCC NO. rn XI 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? ❑ Yes II No ElUnknown A 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 0 TRAILER WIDTH(S) 0-96" 97-102" >102' m TRAILER 1 ❑ ❑ 0 Z TRAILER 2 ❑ 0 ❑ O u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. Z Maroon Silver u 1 TOWED TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT' 3 TOWED BY/TO. _Adieu/Impound Lot Garage . SELECT CODES FROM THE BACK OF CRASH BOOKLET U 2 TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 2 TOWED BYlT6 DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE