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HomeMy WebLinkAbout2026-00011500 ILLINOIS TRAFFIC CRASH REPORT sheet 1 of 2 Sheets 11111111 MIMI I 0100100 DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X004152123' u1 1 U21 3 4 1 Ut 2 U2 1 U1 1 U2 1 U1 1 U2 1 2 10 U1 3 U2 1 .P0119* 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-$1.500 ®ON SCENE 2 VEHICLE/PROPERTY ®OVER 51,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash 0 AMENDED YR 2026I 2026-00011500 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 r1 ® ❑ RELATED ®Y 0 N 02 28 2026 ®AM ❑YES ®NO U1 -< BIG TIMBER RD Elgin 06:02 g PRIVATE mo /day/yr ❑PM FLOW CONDITION III FT N E S W N MCLEAN BLVD COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR 0 SLOW 15 co ❑ Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD ❑ STOPPED U2 —I ® AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N 51 FREE FLOW # LNS 0 g DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL 0 EWES 0 uuv 0!Cy ❑Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 5 n T TOWED U1 0NAME(LAST,FIRST,M) mo yr SANTANA. LITZ!. B. Honda Civic 2005 00-NONE ©, • 0 0 DUE TO CRASH ® ❑ 13-UNDER CARRIAGE 1U 1 2 FIRE ❑ NI STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL)THERDISTRACTED 0 0 U2 5 M F 2 8 SYTM❑Y ®SNE❑UNK VEH. 0 AT CRASH 99-UNKNOWN 9 16•TOP 3 ,Distraction Value 9 ALGN X. r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s, i�a 4 COM VEH 0 j$J 1 0 I= 60110 B 1 0 FIRST CONTACT 12 7 ; _5 *IIYes.SeeSidebar Ut Z FY6441 IL 2026 REAR TELEPHONE IL D 2HGES16615H612360 AMERICAN ALLIANCE ❑Y ®N U2 I-- 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Elgin Fire 99 9 Same I LAA-1133713-00 1 r o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER RESPONDER D Sherman ❑Y El 2 ou g DRIVER ❑ PARKED ❑DRIVERLESS ❑ FED ❑PEDAL ❑EWES ❑!My 0 NCv ❑DV 1 9 5 9 Cadillac XT5 2023 00-NONE 0. Qj'-O, DUE TO CRASH rg ❑ 2 x o 13-UNDER CARRIAGE 10( I 2 FIRE 0 ® U2 C F 2 8 SYSTEM IN 0 ENGAGED 0 15-OTHER 9,16-TOP 3 X ❑Y i N ❑UNK VEH. AT CRASH 99-UNKNOWN *OistracI Dn Value 9 0 POINT OF 8 i1�I 4 COM VEH 0 ® U1 CO N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR FIRST CONTACT 12 7 B -s •• •IfYes,See Sidebar ZWOODSTOCK IL 60098 0 1 0 EJ59145 IL 2026 IL D 1 GYFZDR43PF182260 ALLSTATE ❑Y ®N RDEF EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Elgin Fire 99 9 Same 856633020 SAC E HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPONDER U1 = (UNIT) (SEAT) (DOB1 (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)((A.DDRESS)((TELEPHONE) (EMS) (HOSPITAL) 2 3 07 / 2 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur 0 Y U2 Z N 1 ® 11 1 02,28 /2026 08 33 ®❑pM 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) v 2 0 2 06 02,28 /2026 06 02 ❑PM El Construction 4 R 3 0 ]$I CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 3 ®AM ❑Maintenance U2 -a, ARREST NAME SANTANA. LITZI. B. 11-902 1505000568 02/28/2026 06 08 ❑PM NCITATIONS ISSUED PENDING SLMT 1 ® 11 1 0 - Utility o SECTION CITATION NO. ROAD CLEARANCE TIME ❑ y AM 45 t 2 ElARREST NAME 02/28 /2026 06 45 M PM ElUnknown work zone type u, 2 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑y 45 1505-Caliendo.Anthony 501 04 ,07/2026 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 truck trailer -< c ` --I -' r INDICATE NORTH combination):or -I i BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C 'J I I I (example:shuttle or charter bus):or X s 3. Is designed to carry 15 or fewer passengers and operated by a contract corner 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__...I. - 4. Is used or designated to transport between 9 and 15 passengers,including the driver. C I I - 4.,' /fit t } } for direct compensation(example:large van used for specific purpose):or N �- CU L L--_-a-___� }�Ta— cM° �nrr, - t i. < r. L 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires m (l D — ' placarding(example:placards will be displayed on the vehicle). ;p — — — — —1 CARRIER NAME Z ! I `' I __ ADDRESS 0 I I Pbr ro Sryacr. , • , • , (n 0 CITY/STATE/ZIP g MOTOR CARR.ID 0 Interstate 0 Intrastate I I T I ❑ Not in Comm./Govt. 0 Not in Comm./Other --- --1 - USDOT NO. ILCC NO. m XI Source of above z . 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 '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 Gray Silver 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