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HomeMy WebLinkAbout2026-00057306 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 2 Sheets III III 11 IIII UHI U� I� 1111111111111111111 DRAG TRFD TRFC WEAT DRVA VIS VEHD LGHT COLL MANY X8158/ u, 1 U21 3 4 2 U1 4 U2 1 U1 1 u2 1 U, 1 U2 1 5 11 U1 1 U211 *P 0119* INVESTIGATING AGENCY DAMAGE TO ANY El 5500 OR LESS TYPE OF REPORT ® q No Injury 1 Drive Away AGENCY CRASH REPORT NO. TRFW ' Elgin Police Department ONE PERSON'S ®5501-S1,500 ®ON SCENE 15 VEHICLE/PROPERTY ❑OVER 51,500 ❑NOT ON SCENE(DESK REPORT) ❑AMENDED ❑ B Injury and/or Tow Due To Crash YR 202612026-00057306 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 1 -n ® ❑ RELATED PRIVATE ®Y 0 N 09 20 2026 12,— ❑YES ®NO U1 -< BIG TIMBER RD Elgin mo /day/yr 08:39 ®PM FLOW CONDITION m •®15((1 !MI N E S © North State St COUNTY PROPERTY :IY ® N DOORING ❑y #OF MOTOR 0 SLOW 1 (n Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD ® STOPPED U2 --I 0 AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N ❑ FREE FLOW # LNS 0 (g:DRIVER ❑ PARKED ❑DRIVERLESS ❑ PED ❑PEDAL ❑EWES ❑uuv ❑!CV 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 2 C) FROr4r TOWED U1 Q NAME(LAST,FIRST,M) Prather.Aaron.J. mo yr Honda Crosstour 2010 -NONE 11 1 OUE TO CRASH ❑ VI 13-UNDER CARRIAGE 10 i 12 2 FIRE ❑ IE STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL)THERDISTRACTED 0 Ea U2 2 m M 2 4 SYTM❑Y ®S NE❑UNK VEH. 0 AT CRASH 0 15-99-UNKNOWN 9 16•TOP 3 *Distraction Value 9 ALGN 2 r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF $ it 6 4 COM VEH 0 Ea 1 0 F. FIRST CONTACT 12 7 , _5 *IIYes.See Sidebar Ut Z Chebanese IL 60922 0 1 0 GC24847 IL 2027 Is TELEPHONE IL D 0 5J6TF2H56AL008198 State Farm ❑v Il N U2 m 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST.M) POLICY NUMBER RSUR co Elgin Fire 99 9 Prather. Matthew.A. 1575646-SFP-13 2 m o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER 2 Eg DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 lily 0 i v 0 Dv /1 9 8 8 Honda Accord 2006 00-NONE 1("j 12..-_1 DUETOCRASH ❑ I1 2 x o 13-UNDER CARRIAGE 10 1 2 FIRE ❑ ® U2 C c M 2 4 SYSTEM IN 0 ENGAGED 0 15-OTHER 9 16-TOP 3 X ❑Y NJ N ❑UNK VEH. AT CRASH 99-UNKNOWN *Oistracton Value 9 0 POINT OF s iI 4 COM VEH ❑ ® U1 CO N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR - 6 �'_ FIRST CONTACT 6 Y__{_O ._5 •IfYes,See Sidebar = Schaumburg IL 60193 0 1 0 BA24847 IL 2027 REAR 0 C D IL D 0 3HGCM56496G704549 Progressive ❑Y ®N RDEF EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Elgin Fire 99 9 Same 977670590 SAC E HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPONDER u1 = (UNIT) (SEAT) (DOB) (SEX) {SAFT) (AIR) (WI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)((ADDRESS)(TELEPHONE) (EMS) (HOSPITAL) 2 6 04 / U1 1 D / / 2 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur 0 Y U2 Z u 1 ® 11 1 91 /01 /026 08 39 ®AM in a Work Zone? ®N DIRP co 1 t PRIMARY CAUSE SECONDARY CAUSE EMS NOTIFIED TIME If YES check one below: 7 T PROPERTY OWNERS ADDRESS:STREET,CITY,STATE,ZIP ❑AM U1 C) 2 ❑ 28 11 91 /01 /026 08 44 ®PM ❑Construction R 1 3 ❑ xi CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 7 z J ❑AM ❑Maintenance U2 a ® 11 1 ARREST NAME Prather.Aaron.J. 11-601 S1542-001037 9/ /01 /026 08 47 El pm SLMT o N ❑CITATIONS ISSUED ❑PENDING SECTION CITATION NO. ROAD CLEARANCE TIME • El Utility 0 AM r 2 El ARREST NAME 9/ /0/ /026 08 39 ®PM El Unknown work zone type U1 30 2 2 3 ❑ OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 45 1542 Chafe. Ethan 501 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. .. .. , A CMV is defined as any motor vehicle used to transport passengers or property and: Z r ,r• -, 4.L_ 0 r 1. Has a weight rating more than 10,000 pounds{example:truck or truck trailercomb nat` ` ' ' /Yot Sire ! r INDICATE NORTH bn)or P7iqj I BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C - i. e. ,. (example:shuttle or charter bus):or — ' — — 3. Is designed to carry 15 or fewer passengers and operated a contract carrier O -- - } }} transporting employees in the course of thir employment(example:employee 73 "nit 9 ) "t °_,.,,,rr transporter-usually a van type vehicle or passenger car):or w .— C L -----_____J. -�' — 1 i— '' t - } } } •4. Is used or designated to transport between 9 and 15 passengers,including the driver, to i I for direct compensation(example:large van used for specific purpose):or ` } } } _ 5. Is any vehicle used to transport anyhazardous material(HAZMAT)that requires 71 a placarding(example:placards will be displayed on the vehicle). m 4• h / CARRIER NAME r 1 Zr ADDRESS O r D f w 1 ! CITY/STATE/ZIP 0 r rr - MOTOR CARR.ID El Interstate El Intrastate I I T I f I ❑ Not in Comm./Govt. Not in Comm./Other ;____Y____1USDOT NO. ILCC NO. 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 Gray Blue.Dark 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 TODUE TO DISABLING DAMAGE NOT DISABLING DAMAGE DAMAGE EXTENT: 2 TOWED BY/TO. DUE TO ® VEHICLE CONFIG. CARGO BODY TYPE LOAD TYPE