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HomeMy WebLinkAbout2026-00061309 ILLINOIS TRAFFIC CRASH REPORT Sheet 1 of 2 Sheets II III 11 IM UHI U� I� li ii flU1 1111111�I�I� DRAC TRFD TRFC WEAT DRVA VIS VEND LGHT COLL MANY X 03917* u, 1 U21 2 4 1 U1 2 U2 1 U1 1 U2 1 U, 1 U2 1 1 10 U, 3 U2 1 *P 0119 INVESTIGATING AGENCY DAMAGE TO ANY El 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-$1.500 ®ON SCENE 2 VEHICLE/PROPERTY ®OVER 51,500 El NOT ON SCENE(DESK REPORT) ® B Injury and/or Tow Due To Crash ❑AMENDED YR 2026I 2026-00061309 VENT ADDRESS NO. HIGHWAY or STREET NAME CITY TOWNSHIP INTERSECTION DATE OF CRASH TIME SECONDARY CRASH 2 m BENT ST Elgin05:03 ® ❑ RELATED ®Y 0 N 10 08 2026 ❑AM ❑YES El NO U1 -< _ _ g PRIVATE mo !day/yr ®PM FLOW CONDITION m FT!MI N E S W S LIBERTY ST COUNTY PROPERTY ❑Y ® N DOORING ❑y #OF MOTOR 0 SLOW 2 fA ❑ Kane HIT&RUN ❑V ® N WITH VEHICLES INVLD ❑ STOPPED U2 --I ® AT INTERSECTION WITH (NAME OF INTERSECTION OR ROAD FEATURE) PEDALCYCLIST IZI N ® FREE FLOW # LNS 0 Qg3 DRIVER ❑ PARKED ❑DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 uuv 0 Ncv 0 Dv DATE OF BIRTH MAKE MODEL YEAR CIRCLE NUMBER(S) Y N 0 0 FOR DAMAGED AREA(S) FROM TOWED U1 O Ran el-Cruz.!liana.m. mo1 / /1 9 8 5 Dodge Ram 1500(pickup) 2017 00-NONE ©, Q� a/DUE TO CRASH ® ❑ NAME(LAST,FIRST,M) g 13-UNDER CARRIAGE I FIRE ❑ STREET ADDRESS SEX SAFT AIR AUTOMATION LEVEL LEVEL 14-TOTAL(ALL) O 2 THERDISTRACTED 0 ]$! U2 O m F 2 4 SYTM❑Y ®SNE DUNK VEH. O AT CRASH 0 15-99-UNKNOWN 9 76•TOP 3 *Distraction Value 9 ALGN - r CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF s, it B �i 4 COM VEH 0 Ea 2 O ELGIN IL 60120 0 1 0 FIRST CONTACT 11 7_; -__5 *IIYes.SeeSidebar U1 Z4354595B IL 2027 REAR TELEPHONE IL D 0 1 C6RR7FT6HS581728 State Farm ❑Y Il N U2 m .5 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER RSUR m co Elgin Fire 99 9 Same 3981558-SFP-13 1 r o HOSPITAL(TAKEN TO) INCIDENT IF'V' OWNER STREET,CITY,STATE,ZIP PHONE NUMBER RESPONDER D Refused ❑Y El 2 ou m x DRIVER ❑ PARKED 0 DRIVERLESS 0 PED 0 PEDAL 0 EWES 0 Mdv 0 Ncv 0 DV yr t2,. 0 13-UNDER CARRIAGE FIRE 0 ® U2 c M 2 5 SYSTEM IN 0 ENGAGED 0 15-OTHER 9 6 TOP®* X ❑Y ®N DUNK VEH. AT CRASH 99-UNKNOWN Distraction value 9 0 N CITY STATE ZIP INJ EJCT EPTH PLATE NO. STATE YEAR POINT OF Dii s i3O COM VEH ❑ ® Ut CO F,,, FIRST CONTACT 7 O7 ;r0;-_:OS •If Yes.See Sidecar ELGIN IL 60120 0 1 0 3533139B IL 2027 REAR M IL D 0 1 FTZR45EX6PA31393 Geico ❑Y ®N RDEF71 EMS AGENCY PEDV PPA PPL VEHICLE OWNER(LAST,FIRST,M) POLICY NUMBER 1 = Elgin Fire 99 9 Same 6225717856 BAC E HOSPITAL(TAKEN TO) INCIDENT IF'Y' OWNER STREET,CITY STATE,ZIP 996 < Refused RESPONDER ut = (UNIT) (SEAT) (D08) (SEX) {SAFT) (AIR) (INJI 1(EJCT) (EPTH) PASSENGERS&WITNESS ONLY (NAME),(ADDRESS)/(TELEPHONE) (EMS) (HOSPITAL) 1 4 01 / / / UI 3 :A m / / 1 0 EV MOST EVNT LOC DAMAGED PROPERTY OWNER NAME DAMAGED PROPERTY POLICE NOTIFIED TIME Did crash occur 0 Y U2 Z U 1 ® 11 4 Ibanez Tamayo. Efren z100SX Ditch Witch 10,08 /2026 05 03 ®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 C) 2 ❑ 18 VILLAGE CT ELGIN IL 60120 2 18 10,08 ,2026 05 03 PM ® • ❑Construction >E 4 R ❑ CITATIONS ISSUED 0 PENDING SECTION CITATION NO. EMS ARRIVED TIME 3 3 ❑AM ❑Maintenance U2 o1 ❑ 11 4 ARREST NAME Rangel-Cruz.!liana.m. 11-901 1570-000306 10/08/2026 05 07 ®PM SLMT o N ❑CITATIONS ISSUED PENDING SECTION CITATION NO. ROAD CLEARANCE TIME ' 0 Utility 0 AM t 2 El 1 ARREST NAME 10/08 /2026 06 09 ®PM ❑Unknown work zone type U1 30 2 2 3 ❑ OFFICER ID SIGNATURE BEAT/DIST. SUPERVISOR ID. COURT DATE TIME ®AM Workers present? ❑Y 30 1570-Tomlin. Eli 400 11 , 10/2026 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 -< ` ` -' -' i r INDICATE NORTH combination):or -I Not To Scale I I A BY ARROW 2 Is used or designed to transport more than 15 passengers including the driver C O - i. e. r ,. (example:shuttle or charter bus):or 0 N 3. Is designed to carry15 or fewer passengers and operated a contract carrier O .- �----------; — t } } transporting employee in the course of their employment(example:employee transporter-usually a van type vehicle or passenger car):or w L -----}----; - ore. ® - t } 1 4. Is used or designated to transport between 9 and 15 passengers,including the driver. N for direct compensation(example:large van used for specific purpose):or L____a_ - - _ L � 5. Is any vehicle used to transport anyhazardous material(HAZMAT)that requires placarding(example:placards will be isplayed on the vehicle). XI ti T —D{ _ CARRIER NAME Z ADDRESS 'n D 0 CITY/STATE/ZIP MOTOR CARR.ID 0 Interstate 0 Intrastate I I . I ❑ Not in Comm./Govt. 0 Not in Comm./Other -----------1 - USDOT NO. ILCC NO. rn XI Source of above z . • m 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 v TRAILER WIDTH(S) 0-96" 97-102" >102' m TRAILER 1 ❑ ❑ 0 Z TRAILER 2 ❑ 0 0 o u 1 COLOR U 2 COLOR TRAILER LENGTH(S)1 ft. 2 ft. w Blue,Dark 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 . 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