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HomeMy WebLinkAbout2026-00024551 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets II III HH II11II UHI U� I�X4 1111111 1111111IUU Oil DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY 04222703 u, 1 U21 3 4 1 U1 2 U2 1 u, 1 1_12 1 1.11 1 U2 1 1 10 u, 1 U2 3 *PO 11 9* INVESTIGATING AGENCY AGENCY CRASH REPORT NO. TRFW ' DAMAGE TO ANY ❑5500 OR LESS TYPE OF REPORT 0 A No Injury 1 Drive Away Elgin Police Department ONE PERSON'S ❑$501-$1.500 ®ON SCENE 14 VEHICLE/PROPERTY ®OVER$1,500 El NOT ON SCENE(DESK REPORT) El Injury and f or Tow Due To Crash El AMENDED YR 202612026-00024551 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 2 m ® ❑ RELATED ®Y 0 N 05 01 2026 ®AM ❑YES ® PRIVATE NO U1 N RAN DALL RD 1 ALFT LN Elgin mo /day/yr 06:09 ❑PM FLOW CONDITION m 025 ®!MI NOS W N RANDALL RD I ALFT LN COUNTY PROPERTY ❑Y ® N DOORING El #OF MOTOR ElSLOW 1 cn Kane HIT&RUN ❑Y ® N WITH VEHICLES INVLD ❑ STOPPED U2 --I ❑ AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ® FREE FLOW # LNS 0 gi DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL 0 EWES 0 uuv 0!CV 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 04 n FOR DAMAGEDAREA(S) FROM TOWED U1 Q NAME(LAST,FIRST,M) Tunison. Daniel. D. 0 8 / 1 9 8 3 Dodge Ram 1500(pickup) 2019 T 00-NONE Q. ©' 7.1 DUE TO CRASH ® ❑ mo yr 13-UNDER CARRIAGE m:/ FIRE ❑ STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) O O DISTRACTED 0 0 U2 04 II fi M 2 SYTHER 4 ❑Y ®SNE DUNK VEH. 0 AT CRASH M IN ENGAGED 0 99-UNKNOWN 9 16•TOP 3 ,Distraction Value 5 ALGN = r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF T_iL a 4 COM VEH 0 1� 1 O F. FIRST CONTACT 12 _;—,__5 *II Yes.See Sidebar U1 Z Crystal Lake IL 60014 0 1 4176169B IL 2026 REAR TELEPHONE IL D 1 C6SRFJT8KN532314 All State ❑Y ®N U2 m in EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m 99 9 Same 802796529 2 r `o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER RESPONDER D Refused 0 Y El 2 0 g DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 NMv 0 NCv 0 CIRCLE NUMBER(S) U1 DV /1 9 9 9 Kia Motors Cooporte 2024 00-NONE 11_ 12 t2 _, DUE TO CRASH p 2 0 13-UNDER CARRIAGE 10 2 FIRE 0 ® U2 C c M 2 4 SYSTEM IN 0 ENGAGED 0 15-OTHER O9 16.70P 3 X ❑Y ®N ❑UNK VEH. AT CRASH 99-UNKNOWN *0istracllon Value 9 g N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF O a 11,0 COM VEH ❑ ® U1 CO C FIRST CONTACT 7 O7 I O;-_:OS •If Yes.See Sidebar PINGREE GROVE IL 60140 0 1 0 AE78752 IL 2026 REAR Si)0 IL D 3KPF44AC6RE715657 State Farm ❑Y ®N RDEF EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = 99 9 Same 3703174SFP13 BAc $ HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPONDER ui = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJ) (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(ADDRESS)!(TELEPHONE) (EMS) (HOSPITAL) 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 4 05,01 r2026 06 09 gi 0 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 5 n T 0 2 ❑ 2 25 ) ) 0 PM ❑Construction * Z 3 0 1!>I CITATIONS ISSUED ❑PENDING SECTION CITATION NO. EMS ARRIVED TIME 3 ❑AM ❑Maintenance U2 o1 ® 11 4 ARREST NAME Tunison. Daniel. D. 11-305-A 1506-503 ) r El PM SLMT o N 0 CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME El Utility t 2 ❑ ARREST NAMEAM T 1 / ❑❑pM ❑Unknown work zone type 50 U1 n OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME 2 2 3 0 ❑AM Workers present? ❑Y 50 1506-Nunez. Maria 901 - r ( ❑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. .. .. , I I I 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 _ I I 0 combination):or -< —I ` r_ --; INDICATE NORTH p1 Not To Scale i BY ARROWi. 2 Is used or designed to transport more than 15 passengers including the driver C ` ALIT?LN 1 ` ` (example:shuttle or charter bus):or X 1 J I 1 I — 3. Is desgned to car 15 or fewer passengers and operated a contract carrier I O UNIT carry oY/ C. } } I- . transporting employees in the course of their employment(example:employee Qytransporter-usually a van type vehicle or passenger car):or C !! --- ----; —�— ♦ ',,, — - } } 1 •4. Is used or designated to transport between 9 and 15 passengers,including the driver, _®fir Ai,' l for direct compensation(example:large van used for specific purpose):or to L L____a____� 0111111111 �3 i i t 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires m w1N placarding(example:placards will be displayed on the vehicle). — — UNIT 3— . 1 CARRIER NAME ADDRESS Z 'Z O CITY/STATE/ZIP g i. i. i. MOTOR CARR.ID ❑ Interstate ❑ Intrastate I I T I I ❑ Not in Comm./Govt. Not in Comm./Other I ‘I. ' , _Y_ __, I USDOT NO. ILCC NO. m XI Source of above z ' . IDOT PERMIT NO. WIDELOAD-; ❑Yes 0 No = TRAILER VIN 1 m to 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 Silver Black 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 DUE TO DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 2 TOWED BY/TO: DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE