Loading...
HomeMy WebLinkAbout2026-00054695 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 4 Sheets 01111101111 IIIIII II II I flfl 111111111110 DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY XO04369760 u, 1 U21 1 1 1 U1 7 U2 1 U, 1 U2 1 U, 1 U2 1 1 11 U1 1 U211 *P 0119* INVESTIGATING AGENCY DAMAGE TO ANY ❑5500 OR LESS TYPE OF REPORT ❑ A No Injury 1 Drive Away AGENCY CRASH REPORT NO. TRFW ' Elgin Police Department ONE PERSON'S El$501-$1.500 ®ON SCENE 1 VEHICLE/PROPERTY ®OVER 61,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash El AMENDED YR 2026I 2026-00054695 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 —n ® ❑ RELATED ❑Y ®N 09 08 2026 ❑AM ❑YES ®NO U1 -< W ROUTE 20/SHANNON PKWY Elgin 05:29 _ _ g PRIVATE mo /day/yr ®PM FLOW CONDITION m 10 !MI N E s w route 201 shannonpkwyCOUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR ❑SLOW 2 Cl) ® ® © Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD ❑ STOPPED U2 --I 0 AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ® FREE FLOW # LNS 0 183 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL ❑E°JES ❑NW ❑Ncv 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 4 0 FTtOntr�TOWED U1 0mo Steffen.Asher. R. Hyundai Sonata 2015 00-NONE ©1 • >2 �/OUETOCRASH ® CI (LAST,FIRST,M) yr 13-UNDER CARRIAGE 10 I 2 FIRE ❑ STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL)THERDISTRACTED ® 0 U2 al 4 rn M 2 8 SYTM❑Y ®SNE❑UNK VEH. O AT CRASH 0 15-99-UNKNOWN 9 16•TOP 3 `Distraction Value 5 ALGN X. r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s, i�a 4 COM VEH 0 j$J 1 0 H 1- HAMPSHIRE IL 60140 0 1 0FIRST CONTACT 12 7 ; _5 *If Yes.See Sidebar U1 ZGH13047 IL 2027 REAR TELEPHONE IL D 0 5N PE24AA8FH 156412 State Farm ❑Y Igl N U2 m 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Elgin Fire 99 9 Schrock. Hannah. R. 4093103-SFP-13 1 r o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER /1 9 yf 4 Ford F150 2012 00-NONE 0. Q!•-O DUE TO CRASH rg ❑ 2 x 0 13-UNDER CARRIAGE 10) I 2 FIRE 0 ® U2 C c F 2 4SYSTEM IN 0 ENGAGED 0 15-OTHER 9,16-TOP 3 X 0 Y ®N 0 UNK VEH. AT CRASH 99-UNKNOWN *Distraction Value 0 N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 5 1 6 .I. 4 COM VEH ❑ ® Ut CO F,,, FIRST CONTACT 6 O7 ,�=Q)OS •)ryes.See Sidebar C ELGIN IL 60120 B 1 0 3609374B IL 2027 IAR Si)0 M IL D 0 1 FTFW1 EF8CFB86450 State Farm ❑Y ®N RDEF EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Elgin Fire 99 9 Arreguin. Donaciano 2542582-SFP-13 BAC E HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE:ZIP 996 < Provena St.Joseph RESPONDER U1 = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)((ADDRESS),(TELEPHONE! (EMS) (HOSPITAL) 1 3 03 / F 2 8 0 1 0 m / / #OCCS > / / UI 2 m / / 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 09/08 /2026 05 29 ®AM in a Work Zone? ®N DIRP co 1 I PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 7 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 v 2 0 28 41 09,08 /2026 05 33 ®PM ❑Construction >E R O 0 El CITATIONS ISSUED El PENDING SECTION CITATION NO. EMS ARRIVED TIME 7 3 ❑AM ❑Maintenance U2 a ® 11 1 ARREST NAME Steffen.Asher. R. 11-601-Ax 489000584 09,08/2026 05 38 ®PM SLMT o0 AM H 0 CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME • El Utility t 2 0 11 1 ARREST NAME 09,08 /2026 06 40 0 PM ❑Unknown work zone type U1 45 2 2 3 0 OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 45 489-Reynolds.Allison 800 337-Thompson 10 ,20/2026 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. 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 -< ` ` -' -' r INDICATE NORTH combination):or —I BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C } r . ,. (example:shuttle or charter bus):or I ii Not To Scats J 3. Is designed to carry 15 or fewer passengers and operated a contract carrier O F -A- --' - } } 1. transporting employees In the course of their employment(example:employee w rio transporter-usually a van type vehicle or passenger car):or w L t I. 4. Is used or designated to transport between 9 and 15 passengers,includingN --- ----; - } } } g po the driver. I I for direct compensation(example:large van used for specific purpose):or L L--_-a-....l ude' 3 L _ 5 Is any vehicle used to transport any hazardous material(HAZMAT)that requires r placarding(example:placards will be displayed on the vehicle). XI —1 CARRIER NAME Z ADDRESS 0 1 r CCITY/STATE/ZIPV) MOTOR CARR.ID 0 Interstate 0 Intrastate 0 I I T I ❑ Not in Comm./Govt. 0 Not in Comm./Other ----------1 - USDOT NO. ILCC NO. m Xl Source of above z . IDOT PERMIT NO. WIDELOADo ❑Yes 0 No = TRAILER VIM 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 Silver Red 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 Redmons/Impound Lot Garage VEHICLE CONFIG._CARGO BODY TYPE_LOAD TYPE