HomeMy WebLinkAbout2026-00015445 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 2 Sheets 01111101111 0
I 1�110011000
DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X004175856
u, 1 U21 1 1 1 U1 2 U2 1 U, 1 u2 1 U, 1 u2 1 1 10 u1 3 u2 1 *P 0119*
INVESTIGATING AGENCY DAMAGE TO ANY El$500 OR LESS TYPE OF REPORT ® A No Injury 1 Drive Away
AGENCY CRASH REPORT NO. TRFW '
Elgin Police Department ONE PERSON'S 1215501-51.500 ®ON SCENE 1
VEHICLE/PROPERTY ❑OVER$1,500 ❑NOT ON SCENE(DESK REPORT)
0 AMENDED ❑ B Injury and for Tow Due To Crash YR 202612026-00015445 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 15 �l
® ❑ RELATED ❑Y ®N 03 20 2026 ❑AM ❑YES ®NO U1 -<
S MCLEAN BLVD Elgin 05:21
_ _ g PRIVATE mo /day/yr ®PM FLOW CONDITION M
1 O !MI N E S W Spyglass Hill Ct COUNTY PROPERTY ❑Y ® N DOORING ❑Y #OF MOTOR IR SLOW 1 (n
® pyg Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD 0 STOPPED U2 --I
O AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IR N ❑ FREE FLOW # LNS 0
18: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 1 0
FOR DAMAGEDAREA(S) FROM 0
Hill. Melissa 0 3 /
yr l FIRE 0
IE
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) 10 O DISTRACTED 0THER 0 U2 1 M
F 2 4 SYTM❑Y ®S NE DUNK VEH. 0 AT CRASH 0 15-99-UNKNOWN 9 76•TOP 3 *Distraction Value ALGN
-
r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF $,_iL 6 I, 4 COM VEH 0 0 1 0
H 1- BARTLETT I L 60103 0 1 0 FIRST CONTACT 1 7 : __5 *II Yes.See Sidebar U1
ZCD82677 IL 2026 REAR
TELEPHONE
IL D 0 2HNYD2H43BH518624 State Farm ❑Y ®N U2 m
13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
99 9 DE LA ESPADA.Terry. E. 3838290SFP13 1 r
`o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER
RESPONDER
2 c
N DRIVER ❑ PARKED ❑DRIVERLESS ❑ FED 0 PEDAL ❑EWES 0 NMv 0 KDV 0 DV
Yr
/1 9 9 6 Ford Mustang 2015 00-NONE 'o,� t2 (,-2 FIRE DUE o CRASH ® U2 2 cXj
o mo 13-UNDER CARRIAGE El
c
M 2 4 SYSTEM IN 0 ENGAGED 0 15-OTHER 911,6•TOP 3 X
❑Y ®N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistractlon Value 0
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 0..:�i��j- 6 il;, 4 COM VEH ❑ ® U1 CO
C
FIRST CONTACT 8 ® -5 *If Yes.See Sidebar
ELGIN IL 60123 0 1 0 CZ41892 IL 2022 REAR0 (p
IL D 0 1 FA6P8CF6F5433571 State Farm ❑Y 123 N RDEF71
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 =
99 9 Sanchez.Jessica 1460560SFP13 BAc $
HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP
U1 =
(UNIT) (SEAT) (DOG) (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)l(A.DDRESS)/(TELEPHONE) (EMS) (HOSPITAL)
1 6 07 / F 2 3 0 1 0 U2 996 m
/ / #OCCS >
71
/ / 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 03/20 /2026 05 21 ®pm in a Work Zone? ®N DIRP co
1 I PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME ❑AM If YES check one below: U1 3 n
T 2 2 o, 2 0 / / ❑PM• ❑Construction
Z3 0 DygCITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME ❑AM ❑Maintenance U2 3
o ® 11 1 ARREST NAME Hill. Melissa 11-901-A W1528-000351 / / El PM SLMT
MI CITATIONS ISSUED ❑PENDING SECTION CITATION NO. ROAD CLEARANCE TIME El AM• 0 Utility
T 2 El ARREST NAME luna Leon.Julio 3-414 W1528-000352 031 20 /2026 05 30 0 PM 0 Unknown work zone type U1 25
n T OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME
2 2 3 El ❑AM Workers present? ❑Y 25
1528-Rivera. Kevin 702 337-Thompson 1 / ❑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 ` -' -' r INDICATE NORTH combination):or —I
BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C
t - } (example:shuttle or charter bus):or
X
L A 1 i [ �zv.,�m..�senm Y 3. Is designed to carry 15 or fewer passengers and operated a contract carrier O
- I. } } transporting employees In the course of their employment(example:employee
g transporter-usually a van type vehicle or passenger car):or w
4. Is used or designated to transport between 9 and 15 passengers,including ((I)
} } C
g po the driver,
u�rrm for direct compensation(example:large van used for specific purpose):or O
/ 1
L L____a____� .) L t 5 Isanyvehcleusedtotransportan hazardous material(HAZMAT)thatrequires m
placarding(example:placards will be displayed on the vehicle). ;p
b 1 CARRIER NAME Z
ADDRESS 0V)
T 1 roes aa+.- i
CITY/STATE/ZIP n
MOTOR CARR.ID 0 Interstate ❑ Intrastate
I I T I ❑ Not in Comm./Govt. 0 Not in Comm./Other
;____Y____1 - USDOT NO. ILCC NO. m
XI
Source of above z
. Form Number
m
Xl
IDOT PERMIT NO. WIDELOAD'; ❑Yes 0 No 2
TRAILER VIM 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
Blue Yellow
u 1 TOWED TOTAL VEHICLE LENGTH ft. NO.OF AXLES_
DUE TO ❑ DISABLING DAMAGE ® NOT DISABLING DAMAGE DAMAGE EXTENT: 1 TOWED BY/TO:
_ SELECT CODES FROM THE BACK OF CRASH BOOKLET
U 2 TODUE TO DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 1 TOWED BY/TO.
DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE