HomeMy WebLinkAbout2026-00011536 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111 10011110 OH I l IOU I 0
DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY X004152121
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INVESTIGATING AGENCY DAMAGE TO ANY ❑$500 OR LESS TYPE OF REPORT El 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 ❑NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash
0 AMENDED YR 2026I 2026-00011536 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 r1
® ❑ RELATED PRIVATE ❑Y ®N 02 28 2026 ®AM ❑YES El NO U1 -<
N RANDALL RD Elgin mo /day/yr 11.40 ❑PM FLOW CONDITION III
_ _
®05 FT/8 N E OS W H IGG I NS Rd COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR 0 SLOW 1 fA
Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD 0 STOPPED U2 —I
❑ AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ® FREE FLOW # LNS O
g DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 NOV 0 ncv 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 07 n
NT
SLAUGHTER.CALEB. D. Honda Fit 2013 00-NONE 0: Q i 0 TOWED U1 Q
DUE TOCRASH ® ❑
NAME(LAST,FIRST,M) mo yr 13-UNDER CARRIAGE } FIRE 0
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) O O DISTRACTED ID U2 07 r11
M 2 4 ❑Y ®N
SYSTEM
❑UNK VEH. O AT CRASHD O 99-UNKNOWN 9 16•TOP 3 *Distraction Value 9 ALGN 2
r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF S_iL S 4 COM VEH 0 Ea 1 O
F. FIRST CONTACT 12 7_;—_,_-5 *IIYes.See Sidebar U1
Z CRYSTAL LAKE IL 60012 0 1 GA20712 IL 2026 Ia
TELEPHONE
IL D J H MG E8H34DC030926 STATE FARM ❑Y ®N U2 m
in EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
99 9 SLAUGHTER.CHRISTOPHE 3882272-SFP-13 1 r
`o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER
RESPONDER
2 XI
g DRIVER ❑ PARKED 0 DRIVERLESS ❑ PED 0 PEDAL ❑EWES 0 uv 0 NOV 0 Dv
$ /1 9 yf 7 Nissan Murano 2016', 00-NONE 'o,I t2 ( 2 DUE TO CRASH rg ® U2 2 C
o mo 13-UNDER CARRIAGE
F 2 5 SYSTEM IN 0 ENGAGED 0 15-OTHER 9.1,6•TOP 3 X
❑Y i N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistracton Value 9 0
POINT OF 8 i 4 COM VEH ❑ ® U1 CO
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR 5
m HOFFMAN ESTATES I L 60192 0 1 FQ79210 I L 2027 FIRST CONTACT 6 O,Q`Os •If See Sidebar 0 C
Z D
IL D 5N1AZ2MH1GN163982 NIA ❑Y ❑N RDEF XI
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 =
99 9 Same NIA BAc $
HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 <
Refused RESPONDER
U1 =
KNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) (EJCTI (EPTH) PASSENGERS&WITNESS ONLY (NAME)((A.DDRESS)((TELEPHONE) (EMS) (HOSPITAL)
1 3 05 / M 2 4 0 1
m
/ / #OCCS D
/ / UI 2 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 1 02,28 /2026 11 40 ®❑pM in a Work Zone? ®N DIRP co
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
o"
2 0 28 99 / / ❑PM• ❑Construction >E
Z 3 0 Dyg CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 1
❑AM ❑Maintenance U2
a SLAUGHTER.CALEB. D. 11-601 1506-491 / / PM '
—, ARREST NAME ❑
o U 1 ® 11 1 CITATIONS ISSUED 0PENDING TIME • 0 Utility SLMT
o NSECTION CITATION NO. ROAD CLEARANCE 0 AM 45
t 2 El ARREST NAME ZANON.ANG ELIQU E.C. 3-707 1506-490 , / pM Unknown work zone type U1
2 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 45
1506-Nunez. Maria 901 04 , 13,2026 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
0 ADDITIONAL UNITS FORMS.
r ----r••--, , ; A CMV is defined as any motor vehicle used to transport passengers or property and: Z
r I Not To Scale i I.
Has a weight rating more than 10,000 pounds(example:truck or truck trailer -<
INDICATE NORTH combination):or p0
j L., I
BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C
ll I _ } (example:shuttle or charter bus):or
X
L A 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 CO
L L.___a__ •4. Is used ordesi natedtotrans rtbetween9and15passengers,includingthedriver,
I 1 d HIGGINs4RD } } } for direct compensation(examp large van used for speific purose):or
L L--_-a-___I ' t i i L 5. Is any vehicle used to transport anyhazardous material(HAZMAT)that requires
O
'D
. . . . 1!i placarding(example:placards will be displayed on the vehicle). m
;0
CARRIER NAME Z
it _ 1 ADDRESS D
Pw
CITY/STATE/ZIP g
_ MOTOR CARR.ID 0 Interstate ElIntrastate
I I T I I ❑ Not in Comm./Govt. Not in Comm./Other
0
I USDOT NO. ILCC NO. m
m
73
Source of above z
. MCS ❑Yes 0 No 0 Unknown Out of Service ❑Yes ❑No Z
Form Number 0
m
Xl
IDOT PERMIT NO. WIDELOAD'; 0 Yes 0 No 2
TRAILER VIN 1 m
to
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
Red White
u 1 TOWED TOTAL VEHICLE LENGTH ft. NO.OF AXLES_
DUE TO ® DISABLING DAMAGE ❑ NOT DISABLING DAMAGE DAMAGE EXTENT 3 TOWED BY/TO:
Other . SELECT CODES FROM THE BACK OF CRASH BOOKLET
U 2 TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 3 TOWED BY/TO.
DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE