Loading...
HomeMy WebLinkAbout2026-00056975 ILLINOIS TRAFFIC CRASH REPORT sheet 1 of 4 Sheets 01111101111 Mil 1 II 111111III������ M DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANV X 84264 u, 1 U21 2 4 1 u, 5 U2 1 u, 1 1_12 1 u, 1 U2 1 5 10 u, 4 U2 1 *P 0119 INVESTIGATING AGENCY AGENCY CRASH REPORT NO. TRFW ' DAMAGE TO ANY El$500 OR LESS TYPE OF REPORT El A No Injury 1 Drive Away Elgin Police Department ONE PERSON'S 1215501-$1.500 ®ON SCENE 15 VEHICLE/PROPERTY ❑OVER$1,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash El AMENDED YR 202612026-00056975 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 15 mSADLER AVE El 11:21 ® ❑ RELATED ®Y 0 N 09 18 2026 ❑AM ❑YES ®NO U1 _ _ g PRIVATE mo !day!yr ®PM FLOW CONDITION III FT!MI N E S W NANCY ANN LN COUNTY PROPERTY ❑Y 21N DOORING Ely #OF MOTOR El SLOW 1 cn ❑ Cook HIT&RUN ❑Y ® N WITH VEHICLES INVLD ❑ STOPPED U2 —I ® AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST®N 51 FREE FLOW # LNS 0 Q83 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED ❑PEDAL 0 EOUES 0 Nuv 0 icy ❑Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N O C) FRO T TOWED U1 Q mo • Caballero-Torres.Axel.Y. Ford Edge 2018 00-NONE ©, O , DUE TO CRASH ❑ EZI NAME(LAST,FIRST,M) yr 13-UNDER CARRIAGE lo El , 2 FIRE ❑ 0 STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) DISTRACTED ❑ U2 0 171 M 2 4 ❑Y SYSTEM IN ENGAGED 15-OTHER 9 16.70P 3 _ ❑N ❑UNK VEH. AT CRASH 99-UNKNOWN `Distraction Value ALGN r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF iL 6 I,.4 COM VEH ❑ ❑ 1 0 ~ ELGIN I L 60123 0 1 0 FIRST CONTACT 12 7_: __5 *IIYes.See Sidebar U1 Z FA25416 IL 2027 REAR TELEPHONE IL D 2FM PK4G96J BC10313 None ❑Y ❑N U2 13 . m 13 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m Jacobo-Parker. Evelyn. M. None 2 r `o HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY.STATE,ZIP PHONE NUMBER RESPONDER 2 X m g DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 m,ly ❑Ncv ❑Dv !2 O 0 8 Chrysler 200 2015 00-NONE 012..-_, DUE TO CRASH rg ❑ 2 x o 13-UNDER CARRIAGE 10 I 2 FIRE El El U2 C Ti F 2 4 ❑Y ❑N ElUNK VEH. AT CRASH 99-UNKNOWN Oistraglon Value 0 N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF 8 -iI�1:, 4 COM VEH ❑ ❑ U1 CO FIRST CONTACT 11 7 -5 •If Yes.See Sidebar H ELGIN IL 60120 0 1 0 G F21337 IL 2027 IL D 1 C3CCCAB6FN654068 American Family ❑Y ®N RDEF .X1 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Same 2133-3377-53 BAG $ HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPONDER u1 = (UNIT) (SEAT) (D08) (SEX) {SAFT) (AIR) (INJI (EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME)1(A.DDRESS)1(TELEPHONEI (EMS) (HOSPITAL) 1 3 07 / F 2 3 0 1 0 m / / #OCCS D / / UI 2 D / / 1 0 EV MOST EVNT LOG DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur ❑Y U2 Z N 1 El 11 4 09,18 l2026 11 21 ®PM 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 � 0 2 06 23 , r ❑PM ❑Construction >E R 3 ❑ $I CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 5 ❑AM ❑Maintenance U2 —a, ARREST NAME Caballero-Torres.Axel,Y. 11-801 298001434 , r ❑PM SLMT o N 1 ® 11 4 •igi CITATIONS ISSUED 0 PENDING SECTION CITATION NO. ROAD CLEARANCE TIME • El Utility AM 30 F 2 El ARREST NAME Caballero-Torres.Axel,Y. 3-708` 298001435 , r 0 pM ❑Unknown work zone type U1 2 2 3 ID OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ❑AM Workers present? ❑Y 30 298-Lopez, Mirko 302 10 , 13,2026 01 30 ®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 -< c ` --I -' r INDICATE NORTH combination):or —I BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C (example:shuttle or charter bus):or n N® 3. Is desgned to carry 15 or fewer passen ers and o rated a contract carrier O I- I- -A- --i ` - } } } transporting employees in the course of their employment(example:employee � X transporter-usually a van type vehicle or passenger car):or w L L.___a____.i 4. sl usedordesi natedtotrans rtbetween9and15 ssen rs,includingthedriver, Not To Scale } } } for direct compensation(examp large van used for specific purpose):or C L L____a____I [... . L i _ 5 Is any vehicle used to transport any hazardous material(HAZMAT)that requires •u placarding(example:placards will be displayed on the vehicle). XI D /,'..\ CARRIER NAME « ' _ 1 ADDRESS GI Pornorrirnpa , .._0i. i. i. i. 4. 0 ll UM2 Sadler/km. CITY/STATE/ZIP MOTOR CARR.ID 0 Interstate 0 Intrastate 1 I r 1 ❑ Not in Comm./Govt. 0 Not in Comm./Other -"-------1 - USDOT NO. ILCC NO. m XI Source of above z . MCS ❑Yes 0 No 0 Unknown Out of Service ❑Yes ❑No Z Form Number 0 m Xl IDOT PERMIT NO. WIDELOAD'; ❑Yes 0 No 2 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 Gray Black u 1 TOWED TOTAL VEHICLE LENGTH ft. NO.OF AXLES_ DUE TO ❑ DISABLING DAMAGE ® NOT DISABLING DAMAGE DAMAGE EXTENT: 2 TOWED BY/TO. _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 VEHICLE CONFIG._CARGO BODY TYPE LOAD TYPE