HomeMy WebLinkAbout2026-00036634 ILLINOIS TRAFFIC CRASH REPORT sheet 1 Df 2 Sheets II
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INVESTIGATING AGENCY DAMAGE TO ANY ❑5500 OR LESS TYPE OF REPORT 0 A No Injury 1 Drive Away
AGENCY CRASH REPORT NO. TRFW
Elgin Police Department ONE PERSON'S ❑$501-$1.500 ®ON SCENE 2
VEHICLE/PROPERTY ®OVER 51,500 ❑NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash
0 AMENDED YR 2026I 2026-00036634 VENT
ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 '7
® ❑ RELATED ®Y ❑N 06 24 2026 ®AM ❑YES ®NO U1
N RANDALL RD Elgin 00:10
_ _ g PRIVATE mo /day/yr ❑PM FLOW CONDITION m
FT!MI N E S W FOX LN COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ®SLOW 1 (n
❑ Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD ❑ STOPPED U2 --I
lgI AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ❑ FREE FLOW # LNS 0
Qgl DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 Mlles 0 Nuv 0 NU 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 2 n
0 7 /
BMW 528 2015 OD-NONE „ Q--�, DUE TO CRASH ® ❑ E
13-UNDER CARRIAGE 16 i : 2 FIRE ❑ al
STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED N ❑ U2 2 m
M 2 SYTM IN ENGAGE15-OTHER
4 ❑Y ®SNE❑UNK VEH. 0 AT CRASHD 0 99-UNKNOWN 9 16•TOP 3 *Distraction Value 1 ALGN 2
r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 6 iL 6 �i, COM VEH 0 1� 1 0
14 —F. 60110 0 1 0 FIRST CONTACT 2 7_; __5 *IIYes.SeeSidebar U1
Z FT84849 IL 2027 REAR
TELEPHONE
IL D 0 WBA5A7C50FD627590 STATEFARM ❑Y ®N U2 1—IL' -
in EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m
Elgin Fire 99 9 Same 0103341 SFP13 1 1—
"5 HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER
RESPONDER D
Sherman ❑Y El 2 0
N DRIVER ❑ PARKED 0 DRIVERLESS 0 FED 0 PEDAL 0 EWES 0 i My 0 NCV 0 DV
yr 19) 12 ` 2 FIRE ❑ ® U2 C
o 13-UNDER CARRIAGE
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F 2 8 SYSTEM IN 0 ENGAGED 0 15-OTHER 9.1,6-TOPO3 * X
❑Y i N ElUNK VEH. AT CRASH 99-UNKNOWN Distraction Value 9 0
N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 8- l 6 j• ( 4 COM VEH ❑ N U1 CO
FIRST CONTACT 2 7-'_, _5 •(ryes,See Sidebar
H ELGIN IL 60123 B 1 0 CK85911 IL 2026REAR
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IL D 0 1C4PJLDB1JD523529 STATEFARM gi Y ❑N RDEF71
EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 =
Elgin Fire 99 9 CASTILLO. PABLO.J. 2466332SFP13 BAC
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HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP
U1 =
(UNIT) (SEAT) (DOBI (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME),(A.DDRESS)/(TELEPHONE! (EMS) (HOSPITAL)
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EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z
N 1 ® 11 1 06/24 /2026 00 10 ®❑PM in a Work Zone? ®N DIRP co
1 t PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 1
T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ®AM U1
Si 2 0 25 45 06,24 /2026 00 10 ❑PM ❑Construction >E
R O ❑ xi CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 5
3 ®AM ❑Maintenance U2
-a, ARREST NAME CUNNINGHAM CRNCEC. KYLE. F. 11-305-A 1558000211 06/24/2026 00 15 ❑PM SLMT
1 El 11 1 0 CITATIONS ISSUED SECTION CITATION NO. ROAD CLEARANCE TIME PENDING Utility
N
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AM u, 45
t 2 El ARREST NAME 06/24 /2026 01 00 0 PM 0 Unknown work zone type
2 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 45
1558-Lundvick.John 502 08 ,04/2026 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
ADDITIONAL UNITS FORMS.
. 0
r ----r••--, , ; A CMV is defined as any motor vehicle used to transport passengers or property and: Z
LIYot To Sca/a I 1. Has a weight rating more than 10,000 pounds(example:truck or truck trailer -<
i- ;.___-r----; INDICATE NORTH combination):or —I
71
y t t t BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C
6 r::i r� (example:shuttle or charter bus):or C
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 73
transporter-usually a van type vehicle or passenger car):or co
L }-----}----; - } } } •4. Is used or designated to transport between 9 and 15 passengers,including the driver,
C
/ vngz for direct compensation(example:large van used fors specific purose):or O
L L____a____. - ?i _ t i i t 5. Is any vehicle used to transport any hazardous material(HAZMAT)that requires
ice: placarding(example:placards will be displayed on the vehicle). ,Zmt
4 — — D
Untr 1 CARRIER NAME Z
ADDRESS
ti t I t I t ' 0T.
CITY/STATE/ZIP g
MOTOR CARR.ID 0 Interstate ❑ Intrastate
I I T I I I ❑ Not in Comm./Govt. Not in Comm./Other
❑ 0
--- '-4 - USDOT NO. ILCC NO. m
Source of above z
. Form Number m
m
IDOT PERMIT NO. WIDELOAD' ❑Yes 0 No 2
TRAILER VIN 1 m
LOCAL USE ONLY TRAILER VIN 2 Ma
TRAILER WIDTH(S) 0-96" 97-102" >102' -n
TRAILER 1 0 0 0 Z
TRAILER 2 ❑ 0 0 O
u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. Z
Blue Silverw
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 DISABLING DAMAGE NOT DAMAGE EXTENT: 3 TOWED BY/TO:
DUE TO ® Redmons/Impound Lot Garage VEHICLE CONFIG._CARGO BODY TYPE_LOAD TYPE