HomeMy WebLinkAbout2026-00028274 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 2 Sheets III H IM UHI U l� liii1UUI11llfli DUO
DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X004243496
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INVESTIGATING AGENCY DAMAGE TO ANY ❑$500 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$1,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and f or Tow Due To Crash
El AMENDED
YR 202612026-00028274 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 15 �I
❑ ® RELATED ❑Y ®N 05 18 2026 ❑AM ❑YES ®NO U1 -<
S RANDALL RD Elgin02:08
_ _ g PRIVATE mo /day/yr ®PM FLOW CONDITION ITl
CO20 !MI N E S W HO S Rd COUNTY PROPERTY ❑Y ® N DOORING ❑Y #OF MOTOR ❑SLOW 1 (n
pp Cook 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
(i DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EOUES 0 NOV 0 icy ❑Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) y N 2 n
FOR DAMAGED AREA(S) f'T TOWED U1 O
NAME(LAST,FIRST,M) Mc Connell. Brandon. L. mo yr
Jeep(after 19� nd Cherokee 2017 00-NONE Q 12 0DUE TO CRASH ® ❑
13-UNDER CARRIAGE 10 i 1: 2 FIRE ❑ al E
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED El0 U2 2 rn
M 2 4 SYTM❑Y ®SNEDUNK VEH. O ATCRASHD 0 99-U 15-UNKNOWN THER9 76•TOP 3 `Distraction Value ALGN X.
T. CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR
F. POINT OF s iI S 4 COM VEH El Ea 4 0
FIRST CONTACT 12 7 , _5 *II Yes.See Sidebar U1
Z CARPENTERSVILLE IL 60110 0 1 0 CU40328 IL 2026 is
TELEPHONE
IL D 0 1 C4RJFJTOHC747916 State Farm ❑Y Igi N U2 19 , m
in EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
99 9 Same 3870961-SFP-13 1 r
`o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER
RESPONDER D
Refused ❑Y ® N 2 XI
x DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 iiuv 0 KDV 0 DV
!1 9 9 5 Mitsubishi Outlander 2026 00-NONE 'o,1 t2 (,�2 FIRE DUE ID
CRASH rg ® U2 2 C
o 13-UNDER CARRIAGE
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F 2 4 SYSTEM IN 0 ENGAGED 0 15-OTHER 9.1,6•TOP 3 X
❑Y i N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistrac on Value 3
POINT OF 8 i 4 COM VEH ❑ ® U1 CO
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR 6
FIRST CONTACT 6 O7 ,�at
•If Yes,See Sidebar C
Dupont WA 98327 0 1 0 FP330033 IL 2027 PEAR 0 Si)
WA D 0 JA4ARUAU2TU017506 EAN Holdings ❑Y ®N RDEF XI
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 X
99 9 EAN Holdings 39S208536 BAC
E
HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP
ui =
(UNIT) (SEAT) (D08) (SEX) {SAFT) (AIR) (WI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME))(A.DDRESS))TELEPHONE) (EMS) (HOSPITAL)
2 3 04 /
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 05,18 l2026 02 08 ®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
0 2 0 28 15 I ! ❑PM ❑Construction
R 3 0 xi CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 5
❑AM ❑Maintenance U2
o1 ® 11 1 ARREST NAME Mc Connell. Brandon. L. 11-601-Ax SO471000593 ! ! El PM SLMT
o N
•
❑CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME ❑Utility
45
t 2 ARREST NAME AM
1 r ❑❑PM ❑Unknown work zone type U1
n 7 El OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME
❑Y 45
471-Evans, Lakysha 801 - r ! 0 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 -<
i- }-- --I-- --' i f r INDICATE NORTH combination):or -IBY ARROW 2 Is used or designed to transport more than 15 passengers including the driver Ci ff } (example:shuttle or charter bus):or) f ram` „ „A, 3. Is desgned to carry 15 or fewer passen ers and o rated a contract carrier O
I- <.__-A-.--� r ff - _ i. } } } transportingemployees in the course of their employment
.- • transporter- a van vehicle or (example:employee w
_ usually type passenger car):or C
L L.___a.._..l - 1 4. Is used ordesi natedtotrans transport passengers,including y} } } g po passen rs,includi the driver,
Ofor direct compensation(example:large van used for specific purpose):or
I I o
__ ' _ i i t 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires m
I placarding(example:placards will be displayed on the vehicle). ;p
I —I
I I CARRIER NAME Z
I i. ADDRESSo
D
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i CITY/STATE/ZIP n
, lc. t) - MOTOR CARR.ID ❑ Interstate ❑ Intrastate
l _Nora arose I ❑ Not in Comm./Govt. Not in Comm./Other 0
�I. --- --1 % 1 - USDOT NO. ILCC NO. C
m
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? A
❑ Yes II El Unknown C
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' -n
TRAILER 1 ❑ ❑ 0 Z
TRAILER 2 ❑ 0 0 o
u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. w
Black Blue
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 Other/Unknown VEHICLE CONFIG._CARGO BODY TYPE_LOAD TYPE