HomeMy WebLinkAbout2026-00033896 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 1111111 H IIIl MIN 0111111011 IHIH
DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY X 4269477-
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INVESTIGATING AGENCY DAMAGE TO ANY El g500 OR LESS TYPE OF REPORT El A No Injury 1 Drive Away
AGENCY CRASH REPORT NO. TRFW
Elgin Police Department ONE PERSON'S ❑g501-g1.500 ®ON SCENE 3
VEHICLE/PROPERTY N OVER$1,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash
❑AMENDED YR 202612026-00033896 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 2 71
® ❑ RELATED ❑Y ®N 06 13 2026 ®AM ®YES 0 NO U1 —<
N STATE ST Elgin PRIVATE mo /day/yr 10:15 ❑PM FLOW CONDITION Ill
�0C.'J!MI O E S W DAVIS Rd COUNTY PROPERTY 0 Y ® N DOORING Ely #OF MOTOR 0 SLOW 1 (/)
Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD 0 STOPPED U2 --I
❑ AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ® FREE FLOW # LNS 0
DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 COVES 0 NOV 0!CV 0 DV DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 4 0
FOR DAMAGED AREA(S) FRONT TOWED U1 O
BENITEZ SORIANO.JULIO.G. 0 6 /
yr 13-UNDER CARRIAGE 101 ! 2 FIRE 0 N
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED 0 0 U2 4 rn
M 2 4 n 15-OTHER
❑Y ®N
SYSTEM
❑UNK VEH. AT CRASH D 99-UNKNOWN 9 t6•TOP 3 `Distraction Value 9 ALGN 2
r j. COM VEH 0 0 1 CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 7_it a _5 *ItYes.See Sidebar U1 4 0
F. FIRST CONTACT 00 7 ,_
Z AURORA IL 60505 0 1 0 2984363 IL 2027 Is
TELEPHONE
IL D 0 1 FTEW1 EG9JFB53572 STATE FARM N Y 0 N U2 I—
M
13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
99 9 Same 2686554-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
p; DRIVER ❑ PARKED 0 DRIVERLESS 0 FED 0 PEDAL 0 EWES 0 NOV 0 kKV 0 DV
/1 9 9 0 Nissan Rogue 2018 oo-NONE 0-. Qj-O DUE TO CRASH ❑ (� 2 x
...
Yr 13-UNDER CARRIAGE 10( ) 2 FIRE ❑ N U2 C
M 2 8 ❑ SYSTEM IN ENGAGED 15-OTHER 9,16-TOP 3 0 X
Y ❑N ❑UNK VEH. AT CRASH 99-UNKNOWN POINT OF i *Oistracton Value
8 4
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR FIRST CONTACT 12 O7 -L"_i�_ COM VEH ❑ N U1 CO
. •If Yes.See SidebarC
Z WAU KEGAN IL 60085 B 1 0 FD87851 IL 2027 IAR0
Z
IL D 0 5N1AT2MT9JC746678 PROGRESSIVE ®Y ❑N RDEF XI
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 =
Elgin Fire 99 9 Same 995801319 BAC
E
HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 <
Sherman RESPONDER U1 =
(UNIT) (SEAT) (DOB) (SEXI {SAFT) (AIR) (INJI 1(EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(A.DDRESS)1(TELEPHONE) (EMS) (HOSPITAL)
1 3 10 /
D
/ / 1 0
EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z
N 1 ® 19 1 06/13 /2026 10 18 0 AM 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
v 2 0 05 18 06/13 /2026 10 22 0 PM El Construction
O 0 ]$I CITATIONS ISSUED El PENDING SECTION CITATION NO. EMS ARRIVED TIME 5
3 ®AM ❑Maintenance U2
—a, ARREST NAME BENITEZ SORIANO.JULIO.G. 15-109-B 1570-000124 06/13/2026 10 27 ❑PM SLMT
N 1 0 19 1 N CITATIONS ISSUED ❑PENDING SECTION CITATION NO. ROAD CLEARANCE TIME AM® El Utility 45
2 N 11 1 ARREST NAME PINEDA AVEN DANO. BRAU D.G. 3-707 1570-000126 06/13 /2026 11 15 ❑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
1570-Tomlin. Eli 500 331-Ziegler 07 / 14/2026 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
I ADDITIONAL UNITS FORMS.
A CMV is defined as any motor vehicle used to transport passengers or property and: Z
Not To Scale i ( Z
l I A
} 1. Has a weight rating more than 10,000 pounds(example:truck or truck trailer
i- --_.r 1-_--; _ } combination):or —I
i N INDICATE NORTH pI
BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C
} (example:shuttle or charter bus):or
< <---- -•-•; I transporting mployeeslin 5 he courses r o their employmenters d example:employee
} } } 73
transporter-usually a van type vehicle or passenger car):or 73
__ __ 4. Is used ordesi natedtotrans transport passengers,includingwwjt} } g po the driver,
for direct compensation(example:large van used for specific purpose):or
L--_-a-___ •3t l I. 1 L 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires m
_ placarding(example:placards will be displayed on the vehicle). ,Zmt
1 CARRIER NAME Z
ADDRESS
0
V)
C)
CITY/STATE/ZIP g
- i. i. i. i. 4. MOTOR CARR.ID 0 Interstate 0 Intrastate
I r i ❑ Not in Comm./Gout. 0 Not in Comm./Other
--- --1 - USDOT NO. ILCC NO. m
XI
Source of above z
. xi
Did HAZMAT spill from vehicle(do NOT consider FUEL from vehicle's 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 Black
u 1 TOWED •
TOTAL VEHICLE LENGTH ft. NO.OF AXLES_
DUE TO ❑ DISABLING DAMAGE ® NOT DISABLING DAMAGE DAMAGE EXTENT: 0 TOWED BY/TO.
SELECT CODES FROM THE BACK OF CRASH BOOKLET
U 2 TOWED DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 3 TOWED BY/TO:
DUE TO ® Redmons VEHICLE CONFIG._CARGO BODY TYPE LOAD TYPE