HIGHWAY PATROL

COLLISION REPORT
ammam?

 

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mum? mom- mm VENTURA Bum-mm: 13-07-099
NW datum? :3an MPOWNO min-um um um mr emu mama!
1 EATURIMY vm no
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mm mum 
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mum? mm mm mm Dunn; mum
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arena or CALIFORNIA
.. . on:

   NCIC NUMBER
07f27/2013 2255

. PAGE 11 ca at I
i.o. NUMEER
. 13-07-099

 

     



On Saturday July 27. 2018. at approximately 2252 hours, CHP unit (Officer #18885

and Officer Wilson At approximately 2285

hours they advised the was involved in a traffic collision on Road north ofVia
Acosta, and requested an ambulance to respond. I responded from Madera Road south of the
88418, and arrived on scene at approximately 2315 hours. Upon my arrival. I determined this
was a collision involving fatal injuries.

All times, speeds, and measurements in this report are approximate. All measurements were

obtained by Rolatape, engineering scale nylon tape. and visual estimation. This incident was
documented by CHP Dispatch in Venture Dad Leg #404.

ON SCENE CALIFORNIA HIGHWAY PATROL PERESQNNEL:
Department of California Highway Patrol 
810 Spring Road

Moorpark. California 83021
(sos) 

Sereant S. Carley #18723 On-scene Supervisor

Officer A. Aldrete I #20040 investigating Officer

Sergeant M. Curtin #13258 Scene Diagram and Measurements

Officer D. Laubscher #14454 Scene Diagram and Measurements

Officer .1. Gray #17882 Measurements and Traffic Control

Officer J. Clements #20022 Photographs and Traffic Control

Officer 8.. Lyanity #18885 Witnessing Officer and Traffic Control

Officer M. Wilson #1838?? Witnessing Officer and Vehicle Storage Report
Officer R. Alcantar #18024 Traffic  Dontrol

Officer Wren #18858 Traffic Control

Officer D. Wood #18880 Traffic Control

Officer d. Johnston #20841 Traffic Control

enemas or 1.0. stillness DATE nevraw?ria's NAME DATE

 

AALDRETE I 020040 03/03f20?l3 SGT. CURTIN 13256 03/132013

 

 

 

 

ulna-L

- -



 

.-. 4

 

 

Colorado State Patrol
Troop 5B

 

 

 

 

 

 

 

 

Case Number Connecting Case Report Type
513131176 Pursu'itiFatal
Date Time Location
10/22/2013 23:39 Colorado Highway 285 Mile Marker 28

 

OPSIS:
0n ?etober :22, at 23:35, Officer Adam Jennings with the Alamosa Police Department was on

patrol within the City and County of Alamosa Colorado. ??icer Jennings was parked at the

intersection of Main Street and West Avenue when he witnessed a vehicle trawl. through the

intersection southbound on West Avenue, driving in a reckless manuen Thouvehiclc continued

southbound on West Avenue, which turns into Colorado Highway 285. Officer Jennings attempted
Islate,contactingvehicle by utilizing emergency lights and siren. The vehicle did not stop and a
pursuit continued southbound on Colorado Highway 235 ,to mile marker 28,
within Alainosa County where the vehicle collided with an Alamosa County Sheriff?s Dodge pickup
and the driver of the pursued vehicle was killed. -. 



Susnects:


DOB: 04l15?989

525 Street

Alamosa, Colorado 81101
04v~364~0632 (Revolocd)

 

I Date of Reme Trooper/IBM# Supervisor?BMit Page

 

 

 

Technician Garth. Crowdicr 1636 Page 1 of 38

 

 

 

13-17417 
FORT POLICE SERVICES I I I

2221 masseuse so 11/18/2013
?l'yrr

FORT COLLINS, CO 30525 DUI
Of?cer?! I



lz'h?r?flr

970*221-6520


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Mil-Hi970-231-6284

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Agency RepellNo 1' superman:th Halls-Jim 

.13?17417. - . 9.3193 .l1/13/3013 0.1 33  . . 

I Disno'      

spsLoe .DRIVING UNDER THE INFLUENCE (CARIDR BOAT)


I 1939 IMACKINRC ET I II I COLLINE

    use?   
I   .I 115071;: so 111 - 11/12/2013 ,Io1I2sI11/1sI/2o1a. 01:UNIT IFcl ?mm?
Ass'imunor?ri'          

TRAFFIC UNIT $uoee aful :Sucoessful FCC79 01/14/2014

   
16:11:04 IWIIW
I I HPUIZDWAIWALGDHOL GRI A

I211 Artiole: oxso/mxoxev/ sodas osvxoss 2:21:11 as some means I
.  .. 
SFK
Article: GTHER (NONE DF THE ABOVE) DRIVER TRAVIS ACKERMAN 
LICENSE

ll

-  -- I

  
  
  

 

  

On 111813 at about 0123 soled in the 400 block of north Timberline Road on I..
an ATV (All-Terrain .VehioIleIJIIe?er' ff'oereII"   a on a noise def  
Iei't' AC HERMAN 5
Boulevard and Bannook Street and rolled the vsh'l'ol?i. ACKERMAN suffered serious Injuries

and was taken to Medical Center of Rockies where a felony blood draw series was completed. ACKERMAN's

passenger. Lindsay DAVIS, suffered serious injuries and was pronounced dead at Poudre XII/alley HospitaII.I .

gleam

   

Case status is open: AoriveICase (AC3?was   


 

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IRERORT FORM maximum

Latitude}! 11133046000402  I
?i'lmn: 013:0!) I Longitude: 
mm MierAamME . 955E 
0,841 {711.3 I1 15-134 my!? [31111]?ij I I 2 I I ?ah; I
on my NAM Tow?: coma or; mummy-Ia m; m'r?n?ecmm 
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1. mansun?nmmca .5 133mm Marin Q'Eam Exit "?wmQ Wm? D?n P'r'rva'w Pmny EIkaan Lat-i
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(LastIHm-Mzdma-Irimu I  QREII NAME 
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'sm- mean; I :a?xe' 'Imm. :Iraax-t'; -I
PA I meta  Middl?t?w? 1 ?5-45? [335' 

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I I  - . qulue 
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ly 6m ta?ih? ??fga' mile. 

 Vehicle arid Ve?i?ia??lw?ga nt??h I 

- Vehicle-#23 atbpp?d folluwing th?gmllismn, and than leftth

. - -

Euuth of. am 59. in tha Town (hf-Maw Haven. V?hlolw?and gin ?ue-?ght 'Ijangaraim.
when Vahldla #2 mliided With the-mar Tandy df. Vary-Idem,  a 

 Operator #1 a-u??yred ?igni?qahf injjurii?deceaa?'d once at Yale New Hakim in?ap'ital. While #?iwaaitnw??jfmw the sc?nerby?m?y-?Mmr?a

 

a Em'nm -Wimt3$$'

Maria 441961-JrfollaWE-?d Vehiclia maintaihin'gaya ?gmt'ac?t' I I

 'tn Fir?at?las?g??ar?hingakl #1  .
Traqpar Firs?tzcm'ss :her ?majfgandg??ghia. simnp?n?i?k a?p?iQ-stqp

anagram-#2 fallad'm' First plgs'gi??lemhlinski #1367? "33" 
V?h?iclem Tmnper FiirSf-QilgsajaParchinski #1 36711158. 

#zr'vapngadmm me roadway-um mli,i?jedI?withz savaral-lrea? 

. I 

in-tha ar?a'ftb? Eiditiaa, . .3

injuri'a?land -'Was. pro-mu nced da?aa?s?d atthteigceh?; (gee  '1 3Q?5117923far5p6?i??  

3' I I.

CASE STATUE: Thia case remains; pp'en for-further invagti?gatipn.

GE  

- OF

OTHER

THAN .

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MEHICLES mt;

 
  

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3mm OF CONNECTICUT, DEPARTMENT ee Pueme SAFETY-

mveenemen REPORT (Revue-eez-mme);
Page 1- me

Repert Type: manque; I
Inftielil?epon: C3 Report: aquplement: Rempen: 

Attachments:
SteteMente: EJTeletype: El Phetee: Other: 

emeezue-

 

   

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3 deer,
Imeleem 

- geese-e1. 15 N- 05515 -

  

 

 

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Ae?en Taken: en 
erQrey-Teyete regieue?en- 
erenee: - . . - 

 ?Gm-mm Eduta- ?15 to: eeteh He? feet the-vemee.
 he'd etwels-e Reete whee-ewes. -
 .59 enemmp end fe?iebeut' heir} esm'iiez-iep' IgeeteppeeIpriepte the-exit 
 :eIed ebeewed the beaming {with5336??.t?a1?neqe.le. nee-tee; {hie I

3 heed The operater negate? metala?gam anagram  WWII-I3
 then eeme up te me=:running etetlng juet lee I

the group-?97 '3ae1eetene A white ?nale -lnfom'1ed31me :ItIhet ghe

Wee e-deetor end weuld- etey Until EMS e'rrlved.- (?eefFete?MEtm Vehiclejnveeti'getive Repert??FS:I

3 for deemte-eeteh up-te the etheNehieIe. Igeiepeteh 

there-wasHeller-behind ?fje vehleIethth'JtS ?ame Eli'ejhte en.- Beef-id eew'the meek 
 1e; aheI'eerd- lighte en. The epemter ef metiveh'iele-ene-thg'e 'd?v?et?e- eide 

dewn'end Were. pointingetIihe-yehiele. I
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Iz?em eeverel time. The epereter wee dif?cuIlItIyieig-einteieleg I
?th eheulder. The vehicle behind? mygeruieer. I U?llmdef?y EA 
eyeteth eeverel times. end directed theepereter te: Theivehiele-elewee 

 

Dammit ee'ee woman-meg emmee-(nwreemmu meme! MYSELF a? Manual: 

I meme eAMMeUme-a?wmem $0 3V 

tweew'em'ee 
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SIGNATURE: L'Dje: 

I JEFFREY-SHUBHW me

 unni?me?m HAWNaIn't-zm new ewenu Mn were  9F mum REEQRT-PERTMHINGW 

"rm" '43" La" "ma-3m 1. 2:13-va - 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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213mm
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. to ml! backwards. beford its Gama on. quendd my door and and I
thew?hicl? hdading again disregarding my 
 Whlid made me. The vehicle. sped up it: m-mdh' hum tmvep
 and bath shdu'lddm-of-me highway. The awe? 01" appm?matdly'?o 
 ithd roadway than -
in? a m? 53*" dav?d iladn?'iltim?d m?sqemd'serdn'the night sthd?w 
nadir Where 'th? vehid'd'ldft the,? We dth'er mam .
Trudy I digp'atch that the? vdhi'cld had and. ai?i?gf With ware-nataddtl for; dadridd?on, I chidemaid tha'white I
. v??icrld. The-cap?ramr war-?wtiag?l?jtorsawydi II:
vehi?la 
dfitha Which Wadfacingldownhm . See Invadtlgal?wd?d?mt 0E3 

 



 

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 'on an ANOTHER 901305 36mm: 0575mm ram THE an Iggy-150m: - 


jqus'ridATdn SIGNATURE: dam-aims: 
3 ?rm EILEEN. PER-CHINEKH 1367 93m ram-4 dads pm

sunanvas'on 

riser JEFFREYE HUBUCI 0146

 

 

 

 

 

 

 

 

 

 

 

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13255 I I I II BROOKSVILLE. FL 34613
or- - inIven'Likzefii'srsuumam 5mm QEVIIRIWIIHJI 
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Gunlrnuhnu Antiun Han 0" Hanme  sandman npurulnu MU In Curalau or 27 D-iriunrdn? Olhnr Trim": ,7 Tim? arm? I)
I Empamw 3 No I'qu Endorsement I Slun #5 I Nurmm
7 a mud II: led 0er Road 3 AI: at F?ll?u?d 
one Impmpur guckmg I I0 . (In: Inf; I
Dlhar Intidu ma mm ?In 5 urn v?f- Gmand mama In, em?, 51mm I 
I 2 Emm?nm c?mmuntmm" mall-mm? Han JD Bwuwnd or Audldud DmtlI a (da rullan
Duncan call prime an: I (culmdo Inn unhIcIa. ?plain I 7  gm; TWSI an 19! Canadian! MV an  
n-30th  ?gram [EJgul Immwy.n1n 
7 "mum I7 ?gwwgu Speed 31 I: urnmd MV In Errahc, 77 DIMI. In Narmlwo
an 21 onn 5m Wrong way Ruck mm MAD mama manner BB Unknown
Driver Oanructlunu ma In Honor Lana 77 Diner Cantu ullnu Acuon
1 VIMM Na! DDIGUNIH 5 Land an Vuluttn 9 Smuku - - - 
I Mall,th I E- Hunld?n?IIF-?mud Unmet 190mm I I
4! TfJogIcrogefgumgu'? 333?? "mm $353" Hclmot um (HUI Eva Protection It") ?vatomn
DRIVER DR 1 I I
MDer?ulePm 3 an; A picnbm I Nut Amy won:
I 5 2 Omar a mu I 
MDIDT VEMCIO Sealing ?638110? Flow 3 ND Helm? 2 ?one UNIShoutdur and LIP Hull ?and
I (.031! 1 [?mnl 1 . I- Air Han D?pl?vw Deployed-Omar Ehulgd?r?lra? BritaUWd
2 Middle: 2 Emma 22 human or Tde Cal: m" MED) Imam 5 ?311qu mid 9 Unknown
3 RI I 3 1mm 3 Other Enmoaau Car 0 NH ?own" (EJECH I-?ourlh 4 Unoncmad Cargo on 1 Ell??um 1 NM Amman? command," 81 Sivale - Roma; ?mg
(Implaun In How 5 -, Elaclnd. golalle 3  {Ignapggam?c?mm 9 vi um - unr amng
. - -
33mm? Unkmw? wm?? ?rm? mm? m" 4 Mg. ?mum 4 nuplpyumlda unknown In chad RoutraInI Type: 
WIan 77 Ulnar. Eupmn an 

 

 

 

Mon-mmorlat Da?cripllun Locauan AI Time: at Crash 
I - I Inlurmamn Crouwmh Sidnwni?. 5 will?, IE on 5 ?we?
3 In 2 Unmurknd lelwalh 9 IHWIU a In Rm way.? I other 
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4' Olhnr II I 
5 Cum: [Int 0! Motor Wm:ch Not In Tmnanun 6 QICWIO UM 77 DIME 2 Wamnn In g??gm  SEMD- "(-121
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Ll - '1 WII I I'll of
Nan-Motorist response)
7 Unknown Typu nI NmIIMulnrist mum-I a mm." 
2 DH huh Rnudwny A Tram: {In ar an 
Saluty Equipment In . Failum In YmId aqucum la rivil 
Fullum In Dbuy ?I?m?lu 319M. I 
2 Huimm I3 N01 Applmula SI null. [If 10 In!me 
LIqu 5 Runway Impropmiv Manama. Vahlula 1} Fatima
(mm; II-urm, am} In 2nd .. Bung. .pmwnu' Inutlonllm aallnu. hid) 0" 
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5 cm: ALCOHOL TESTED mm 3 BPEUTE DRUG NESTED UG TEE 
Argo?m 115;; 1 'Insmm [3mm  I blow km" :0 U6 USE I Tu! Na! Ewan 3 I
1 Nu m? 2 Tan Raiumd 3 213mm (swan Unnu 0.23 2 Ya: :1 Tu! Swan 77 Omar. 2 Manama I
uIImcmn Ina UnhnawnI ?Imam? Ogl?f Flap In? In rm Unknan nun-?um a Unknuwn BB Unhn?wn. IT Emma? anp?ngg?gm
m. all -u 

SQUHCE 0? TRANSPORT T0 MEQICM. FACILITY 5M5 AGENCY NAME OR ID EMS RUN NUMBER
1an Tl??ipu??Law Enlumumunl 

 

El lam I BB Unkn?w?

         
    
  

ADDITIONAL 

IFERSOH - VEHICLE - NAME 
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2 PATRICK 08/0l/I974 . - 3

II CURRENT ADDRESS (Number and Blrom) CITY 8. STATE HIP CODE

10525 MAIRTYIIS I II I TAMPA. FL 33612

ms AGENCY NAME on ID EMS RUN NUMBER MEDICAL FACILITY IRANSPWIWED 

I1 mnnpunna I

TAMPA 3563    

NAME ., -, -. .- - mm: QFIBIRTHI .I . ..  - NJ 55;; A .I-II II II mm HU Ann 125CURRENT ADDRESS {Number and Hum} CITY 3. STATE anon

SOURCE OF TRANSPORT TD MEDICAL FACILITY EMS AGENCY NAME cm ID  EMS mm NUMBER  m" MEUIGAL FAGILIW 

Not Tmnwonud 

:1 EMS ?3 Law h?

 

 

 

 

?lather In Harralwu I'm 

du- I

HSMV 900m In? 

Page  I REPORTING OASE CRASH WOW NUMBER 
-- NARRATIVE - - I .
2m ANN   

AND WAS SOIITHEOUNO IN THE
LANE OF NEBRASKA AV AT- APPROXIMATELY 95 MPH. VEHICLE ONE THEN RAN THE REID TRAFFIC
ISIONAL AT TI IE INTERSECTION OF AV E. AS VEHICLE ONE WENT THROUGH THE INTERSECTION. IT
AIRBORNE DUE TO THE SFEEO IN WHICH IT STRIICR THE CREST IN THE ROAOWAV. VEHICLE
ONE THEN EOITOMEO OUT IN THE ROADWAV. WHICH CAUSED DRIVER ONE TO LOSE CONTROL. VEI IICLE ONE
THEN EEOAN TO ENTER A CLOCEWISE VAW. VEHICLE ONE LEFT TIIE ROADWAY AND STRUCR A CONCRETE SION
IN THE LOT OF 5202 NEBRASKA AV LEFT SIDE. THIS IMPACT CAUSED THE POLE TD 
FRACTURE AND SFLIT VEHICLE ONE INTO TWO FIECES. DRIVER ON E. WHO WAS UNRESTRAINED. WAS EIECTEO
FROM THE VEHICLE AND SIJSTAINEO FATAL INJURIES. VEHICLE ONE THEN CAME TO FINAI. REST AFTER STRIRINO
A ISUS EENCII. - - .

 

 

 

i

VEHICLE TWO WAS PROPERLY PARKED IN THE PARKING LOT OF 5202 NEBRASKA AV N. VEHICLE REAR WAS
STRUCK BY THE CONCRETE. POLE THAT WAS BY ONE AND 

 

 

   
    
      

  

ADDITIONAL. FASSHNOEHS
PEHEDM VEHICLE NAME

   
     

 

DATE OF 5E3 EJECTHU El"

 

 

CURRENT ADDRESS (NumIm Imu Emu . I A STATE I SIR COOS

 

 

 

'1 

ENS AOSNOV NAME OR ID  I I EMS SUN NUMBER MEDICAL TRANSPORTED "3
9 EMS '3 Eni?fcl?m?m 

 

I

77 0mm 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 SEX LacETME CODE I
SOOHCE OF TRANSPORT TO MEDICAL FACILITV EMS AGENCY NAME EMS RUN HUMMER MEDICAL FACILITY TRANSPORTED TO
I 
2 EMS 3 Law Entorcumnnl I
77 EH Orr 
ADDITIONAL VIOLATIONS I .
PERSON It NAME OF FL STATUTE NUMEEFI -: CHARGE CITATIDN NUMBER
II NAME Or Fl. STATUTE NUMBER Im? I II I I I  CITATION NUMEEN
REPORTING 
IOISAOCE NUMIIEN ANNA NAME FHP SO FD OTHER
47304 DST. F. R. MESSMER TAMFA POLICE DEPARTMENT [3 
HSMVEIDOWEWIDHFEVIOMOJ -  I I I
Faun   

Amer: 0- IRS: mi  

 

lJr-Jle el Green

Dete el Flenen

 

 

lnveet. Agency l-?teperl Number

 

Green l-"tepert Number.
:3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12:20 AM 01(0012?2013 12:20 AM 674559 3363-3-55
Meme e1 Vehicle Owner (Chuck Butt It "3t" Gerrenl Andree-tr {Nulnl'rer and 51mm} and Slain Zip Cede
U-HAUL Di? L?l p0 Bax 21503 DENIX AZ 350364503
Reiler Lieenee Number Stete liteg. Etiplree Permanent Flee. VIN Year Metre Length Airloe I
. 
:IIfraiier licence Number Slate Fleg. Expiree Permanent l'leg. Veer Melte Length Axles
WDI
Vehicle Direction On Street Road. i-ligl'IWHy Al Eel, Speed Fueled ?nned Teiel Let-lee
EM1 2700 ewe UHAUL PLOT 
CMV Gentigurelien Curiae Body Type Aree et lnltiel lmpect Moel Damaged Area
. - - - 7 ??rearm. 
Comm 'l reiler 'l ype (trailer one) lrttilt?il' Type (trailer MO) 6 
20.thdeltlelrl 
'i-lez. Met. Hei: Mai. Number . 21,1?in . 313mm

 

 

 

 

 

 

 

 

 

 

 

'1 Ne Genlrele

it Gellieien with NennFixed
Dialect

14 Meter Vehiele In Traneperl

 

 

 

 

 

Meter Carrier Name US Number
Motor Carrier Adrienne City and Slele Zip Corie Phone Number
eeinnirrveit-Cernrnereiei Vehiele Body Type Vehicle Delecte (one) Vehicle Deiecla {Mel Emergency Vuhiuln UHB Seminal Function 01 
19 Either Li ht Treette 1 ?mm 1 Me 1 Ne Epeeiat Funatien
(10,000 Ihe( .636 kg) er
teen)
Vehicle Maneuver Action 'l'reiliewey Headway Grade Heerjwey Alignment Meet i-lermtul Evm?tl Merit i- rerlul Event eteil
Parked rt Twe-Wey Div elect. - 1 Level 1 Blruigh?l a celtlelen with Nen~Fittecl 14 Meter Vehlele in Transport
Peeltive Median errier Dbl?:
'l'reltie Gentrel lJevlee Fer lite Vehieie Finn (1) Sequence of Emerita 5660M (3) 01 EVOMS Third l3) SHill-"3WJill Dl Willi?? (4) SMJEIWG ?l 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSON RECORD
ilereenrt Vehicle it Nt-ltlt?tt?Jl I I I. Dete el lilirllr Sex Phone Number Flo-Exam
1 1 Driver 1   '1 eatDeene'i'a '1 Male I Ne -
City State Zip Me
3026 REDMOND AVE JAC-KBONVILLE FL .3230?
Driver Lieertee Number tel-late httpirett Di- Type Fleq. L-?ne. Injury Severity Eieetlon
uaiDee?B?BS ti- Ez??peretar Ene?yteaglre?qam 5 Fetal (within 30 dew) ?4 Net Appllaeble

 

l-?loetreinl Syelorn

l-Ieleiel [lee
3 Ne Helmel

Air lilting Deployed

 

 

Protection

3 Net Applleeble

 

Beating Seat
77 Other (explain in

narrative)

 

Sealing Flow

1 Freni

Settling Loeelien Other
1 Not Applicable

 

 

 

Drivere Aellene at Time of Green (iiret)
2 ?pnmted MV in er Negligent Manner

Drivere Aetiene at ?t irrte et Green 

Improper Turn

Driver [Distracted Ely
ee Unknawn

 

Vision Dbelruetien

All Diner, Explain in
Narrative

 

Drivere Aetiene at Time 01 Green (third)
12 Dreve tee Feet tar 

 

Drivers Aeliene at Time at Greell 
17 Exceeded Fueled Speed

 

Drivere Condition at Time ei Cites?ill -
it Under the In?uence at Medleatlenemrugemleenal

 

 

 

 

 

 

 

 

 

 

 

 

Suepeeted Alcohol Alcohol Teelod . Aieertei 'l'eel Type Aleciim ?l'eet BAG Suspected Dme Drug "leaned Dme Teal Typo Drug Test Flow"
86 Unknown 13 Teal Given 1 Bleed 2 Gemle EB Unkt?lewrl 3 TQM 1 Bland 'l 
eeume et Tranepen te Medieel Facility EMS Agency Name er ID EMt-i Finn Number Medlcal Facility T0
2 EMS UF HEALTH

 

 

NARRATIVE . I.

Page 2 el 5

viz; .. .. ?with-ti  .
trawl it ii Line?in  

i.

 

[Jalch at Email Data at hoped lnveet. Agency ?epert Number HSMV Credit Report Number

 

 

 

 

 

 

 

 

eti?etizota 12:20 AM 01!Dotl201312:20 AM 674650 63860355
. It) Number Hank Name Troopz?i?oet Otlloer A enoy Phone Number Date Created
6977? GFFICER 6.0. HEMHACH JACKSD Oat D1. 2013

v1 wae traveling eastbound on Atlantie (tilt-to) at a high rate ot epeed. The vehicle toiled to negotiate a tut" ?ltt? Splint] F?htk Rd It??
control at the moteroyele and eraehed into the rear at V2.

Engine and 20 arrived on to treat the viotim. The viotlln wee traneported to UP Health With litouth?atehth? intuil??. HE WEB 
eooattod ahonly atter arriving at the hospital. .

rattle Homicide arrived on aoene at approximately 0200 houra and toelt oontrol ol the investigation.

 

 Ft nit Tree moat Gtt?oer it one en ti Data 0 
reaeum rrelnn?c'nxn eFHola 'aaelteolt'wLLE eatentt gimme nee-Elastic? Got 21, 2013
"51m aupplement he being Initiated to document the veri'lioatian at the vietimttapoaw Identity. The Identity woe vertiin by the Medical I?xelttinortilepaaia ?ttiae via Rapid .

 

Rank Name Tree Iti'oat (J?leerh eno Phone Number Date Created
DFFICER J. .GREGDHV JAG $0 VILLE SHEHIFFEDFFIGBM eao-oeeo little 11.2013

Inroahanoh SECTIUN ..

  
   
 
    
  
  
  
    
   
 
   
  
 
  
 
   
  
  
    
    
    
 
  

Data at Gifeeh
October at. 2015i
into at Craeh
12:20 AM

Looation ot catch
2700 Atlantic 

ol Vehicle #1
aim at Blunt .Jr, momma (Deceased
3025 Redmond Avo,doolteol1ville,, Fl.

Vehlole #1
teen Kawasakl Ninio Mic, White, FL Tag 2749.th

Dwner Vehlole #1
her it Madiaon
s?roe Gonzalez Eittitt. Ponaaoele. Fl. 32505

2207

I. T. Callahan F3257

Evidence Teohnlolon ELK. James #61113
Detective J. D. titretlorlrs woe:

Detootive .113. Huret it 30?

at the Scene

Deeoriptlon ol the Scene

Thin amen in the 27m block at anemia Blvd- Tale te alae at the intereeotion at Spring Park Rd and Beach Blvd. Eastbound Attentio Hollie Into-t lanes
. gwd+ortee become eaetbourtd Atlantic whlle two lanee leeoomo eaelaeond Boaeh Blvd. the hit two lanes remain Atlantic Blvd- The speed limit tor
hie area to tilt H. he roadway to eorrlpoeed at were aepheit paving, and the road is bordered by raiaod oenerete curbing-




I'll

a


a


nveatlgation

Dn DctoborI 1at 20.13, at AM, I vivatt demented b3 the Doteotive Die+tatoher and told to call JP. Morgan, to It ?ftieth thV?lfl?Q l'tltittlria?
niuriee. lwae'told that'a?elng e'motoroyo e'hed attern to to he rider teat oontrol ot the matareyete, an dropped the a turn. he Watt
rana orted to UF Health with ia'uriea that were aonat ared to he lite threatonlnp. I
melt Det Huret and ask that he rear end to UP Health to on the otlIn. responded the eoono.
pon arrival on the eoenel epeke wIith organ, He eaid that was on ea:e when a ebeerved a motoreyele trout behind a eat at
an Weetmont 5t. He eald he reooanrzed the motorevele an one operate lay a portion known to Maroon. That Portion. John h?d 599? ?l?fe?t?d

tor operating a vehicle on a liceneet at had been analgended -- 

that an said the, meterfolrele .turnedIrIlerth trout San Dleigo d, and to about To MPH. I I I I I
helntent ot lnltietine'e-tra eaterp 'aleo eat on the red and noti?ed a to at hie the dlreetion at travel. that no he Pa
urn eata'AtIantle Blvd. ho aotiva ed in emer?eno equipment. t-le eald the mo arayele than too ott anal on Atl?htt? at a the? mitt '01 TM ?Whit
eoelerated at await a high rate of epeed. that al- organ held-hemmed mtety-oanaeied the 'trettie'elotl. I I I
Morgan rotated that within a quarter at a mile he new the victim attera to turn right onto Rd. Aa he did the wallet lent normal at the Ihotoroyele and

it led the southeast eerner at the irrtereaotion. 3 I Met all held he now he motoloyoloeapoaw tit; tti home on. but did not EBB ?19 5i?? Whittle" Wit-t ht!
immediately notitied diapateh ot the oraeh and on ed tor "Ire 
During n1 were interment that an e?ieer at UF Health had learned that the viotlnt had died oelled De Huret to make euro he were aware ot thin. Dot Huret
dvleed him he had iuet arrived at the hospital and had neon tntormed. I naked Del Huret to obtain a not at tineorpr nta tram the victim so I ooutd will! the viatim?o ea:
identity. He then roll ended to the aaene and aaeleted ate in mappin?it My Investigation revealed that the Viotil'n tt?d "ltd the hit It?mp?itt hit? an" Git ?'19
the roadway. Ho an the then alld into the rear at a arlte Lt-Haul truek.
[During my nveetigation Dot Huret arrived on aoene. Hitl notaa allow:

an ?rueeda 10431-13 at ten AM, Detective Gregory ealled and advised that we were needed to respond to lite threatening iniury nineta araah at Boone
Park and At antlo BI . Deteetlve Gregor?! requeated that I reapond to i-leaith to oheoit on the walletarrived at U.F. Healt . went rate the Trauma Unit and woe edyleed by Ottieer Mayor that the Vietln?l had died ital? hl? Inlurt??- 99100.1th Groom tho"

he death. He requested that I ha the vlotlm ee they have not been able to oeltlvew Identity htm- t3"th Var

dviedd that they think the victi le .lIehn Arthur Blunt, one, ode 12432-73. I then the vietim. Dieter Mayer gave me viotimhapoam clothing and money
that watt recovered in his clothes, waa $360.91 In colon and ohange.

At 2:1 AM. i lett U.F. Health on route to the eoene. 
A1313 A I arrived on tho ecene. I met Deteottve Gregory who showed me the eoene. I then him With mapping the 
?t 3:32? . we eloared the aoene.

'itwent with Deteotlve Gregory to 3025 Redmond Ave. looking ter next at kin.

Page 3 ol 5

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3.. .



in

I.

 

Dale oi Craah

Dale ol i-?tapcn

 

Inveel. Agency Report Number

Crash Fiech Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

'1 Passenger car

1 None

02:44 PM 02:44 PM 
NEIITIB cl VBl?tilclc Clinical? Check Rex ll Business) C, Current Acitireea and Sireei) Gii and Sittie Zip Code
 eerie evaua AVENU FGH MVEHB FL 331101-6415
Eager License Number Slate Rag. Explicit Perritartonl Reg. VIN Year Make Lettglit Axles
Rattler Licence Number ?taie Reg. Eltt?rea Permanent Reg. VIN Year Matte Length Axles
Vettipr Direction On Street, Road. Highway A1 Eat. Speed Pcaiaci Speed ?total Lattea
TraVelIrtg. North ea 41 arena none 45 93 4? 5
GMV Con?guration Cargo Rody Type Area at initial impact Mesi Damage-(i Area
Comm GVW Trailer Type (irailer ene) Trailer Type (lrailer iwe) ?v 
Oil-ma
mm 
l-lae. Mat. Relaaee Haz Mat. Record Nuttlber Glass 
Matcr Carrier Noliic US DOT Number
Motor Carrier Address 3in and titan-t zip Code Phone 
GemmiNnn-Cnmmercial Vehicle Body Type Vehicle Delecla (one) Vehicle Delecia (two) Emergency Vehicle Use Speciual Function oi MV

 

1 Na 1 No Special Function

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Kellogg Malettvelt'l?c?cn Traich'tlgay Di Headway Grace Roadway Alignment Mesi Harmlul Event Meet l-ant?tiul Event Dela]!
er mg ??eeing war ay a I '1 Laval .
Foam? Madhn mm!" I I 1 Slralghi 2 cotliaiaragiigtgiNon Fitted 14 Motor Vehlela ln?i?rantpa?
Trollic: Control Devth For' his Vehicle Firm (1) Sequence cl Events Second (2) Sequence et Evente Sequence el Inmate Fourth ("il'Requence at Evenia
1 Na centralit- 3 Collision with Fixed Dialect 34 Traille Olga cupped 1 OverturniRoliovor 14 Motor Vehicle in Transport
24 Curb
PERRON RECORD
I'itarenntt Delimitation Vehicle}? Name Date bl iI-iinh Sex Phone Number Fla-Exam
2 1 Driver 1 SHANNON OMAR MITCHELL tritium-ace 1 Male Ne
Addtcaa city State Trip Code
4049 5 ORANGE etceecm Tilt. 21.13 ORLANDO FL cease
Driver License Number State Expirae Di. Type Ree. that. iniut'y {severity Election
FL 15Mult2012 ti ElOparator .1 Ne Hart 4 Ineapattitatina 1 Nat Elected
Endorsement I
Restraint System Air liter; Oriel eyed Helmet Protection Seating Location Seat Beating Location New Seating Location Other
3 Banal Lap 2 Not Deployed 3 N01 Applicable 1 Leii 1 Front
5

 

 

 

 

Drivers Actima at Time at Graeh (tire!)
31 Operated ll-W in Errelie. Reckless or Aggressive

Drivers Aclierts al Time at Crash {second}

Vittitm Obelructi on
1 Violent NM Dbseured

Driver Distracted By
1 Net Dietraoleci

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

annor
of Green (third) Drivers Actions at Time of Creelt (tourth) Drivera Condition at Time of crash
- ea Unknown
U80 Alcohol Tented Alcohol Teet Type Alcohol Teal Hoaull EAC- Suapeciod Drug Drug 'i'ealod Teal Type Drug Tent Reeull
ea Unknown 1 Test Nat ea Unknown 1 Teal Not Given

Given . .

Source Lit 'I'rattaburt to Medical Facility EMS Agency Name or Ii?) Ftun Number Medical Facilily Tranapened Tn
LEE COUNTY EMS LEE MEMORIAL
PERSON RECORD
Peraenii' Deacripiien I I I. Vehicle Name Data at Eilrii?t East injury Severity Ejection
3 3 Passenger KVLA Ola? Odi?ep??'? 2 Faulan 5 Fatal (within 3O 1 Nat

- . - daya) 

Address City Rtatn Zip Code
2650 EVANS AVENUE FORT MYERS 33901
Restraint System Air Bag Deployed i-ieintel Protection Seating Location Real Seating Location itew Seating .ccatien other
a chuckled not? Lap Hall 2 Nat Deployed :3 Not Applicable 3 1
a
Source at Tranltpott to Medical Facility ?Mt-i Agency Name or ii) We Run Number Medical Facility 't'ranapertee To
1 Not ?transported
PERSON RECORD
Pcr?ot?lt?t? Dottcripliot'l Vehicle 11 Nollie .. . Date e1 Etinh Sex Phone Number RurExum
1 Driver 2 t?  27lFabi1971 1 Male geese-teem No
ledl'EiHH City State Zip Code
511 NW ROTH AVENUE CAPE Oct-1A1. FL 
Slate Expires DL Type Ree. Eno. Injury covertly Election
Fl. a ElOperetor a No Rec 3 1 Nat Elected
Enderserneni

Restraint Ryetem Air Flag Deployed Helmet Ltee Protection Sealing Location Seal Scaling Location Row Sealing Location other
3 Submitted 31;! Lap Belt 3 3 Not Applicable 1 Latt 1 Front

 

 

Drivera Aetiona ell Tittle ct Crash (?rst)

1 Ne Centribuiing Action

Drivers Actions at Tittle el Craah {second}

Driver Disireclecl [3y

1 Nat Distracted

 

Viaien Obstruction

1 Viaian Nat Obeeured

 

 

Drivora Actiena at Time at Crash (third)

 

Drivera Aciiena el Time el Graeh (leurih)

 

Drivers al Tinte e1 Carth

1 Apparently

Normal

 

Page  ci 



Ul'l?it?liifil tinting! 


(l

. .t 


 

at cool i lethal/tn?; an: act.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date nt'Orneh Data at l-?lepnrl lnveel. Agency Fleporl Number HSMV Crash Flam? 
D2144 FM 02:44 PM 33693643
Suepecled Alcohol Una Aleel'lpl Tested Aleelml Test Type Alenhpl Teal l?leeull BAG Suepeelud 13mg  13mg Tested [ng TERI Twit! Drug TERI Result
1 Na 1 Teei Net 1 Na 1 Test Not Given
Given
Semen el Tranetmrl In Medieel Feeility EMS Agency Name er ll] Hun Number Medical Facility T0
2 EMS  CUUNTY LGD'i'iitliiti GULF COAST
WITNESSES
Name Address City State Hip Cede
BRIAN 5 HARVEY 14502 DOLGE VISTA none APT 102 mm WERE FL 3390B
WITNESSES
Name City State 21in Cede
DEAN DAGLIERI 19455 LA 5595".? DRWE FDHT MYERS FL 33957
WITNESSES
Name City State Zip Code
DEPUTY CHARLENE PALMESE 147m MILE cyp??ss PARKWAY FSHT MYERS FL 33912
WITNESSES
Neran City Stale 2h?) Cede
VIRGINIA DAGLIERI 19455 SERENA DRIVE FORT MYE R3 Fl. 33967
WITNESSES
Name City State dip Cede
DEPUTY GEGHGE VENTURI 14730 51x MILE PARKWAY WE '15 FL 33912
WITNESSES
Name City 51313 SIP 
MARK FATTEHSON 1am DRIVE NAPLES- FL 34103
WITNESSES
Narne City Stale  (lode
MAFIID JESUS BAHRIENTOE 1mm RAGEDALE BONITA FL 34135
WITNESSES
Name Address Guy State ?Elp Cede
KE LLV PHWELL 19293 View enwe FORT wane Fl. 33967
NISN VEHICLE PRQPEHTV DAMAGE
Vehicle? Perennli Prnperly Darnwe Ulher Than Vehicle l'i?el. Anteunl Business ()wner'e Nantn Address City Bx Slate Ell? 
ELD SIGN 200 Vee STATE NT 2031 HMS ISLAND RQAD FORT MYERS FL 
NUN VEHICLE PROPERTY DAMAGE
Vehicle? Perennti ert Dame - Other Than Vehicle Eel. Ameunt mnei?e Name Address City State Zip Code
610 OT EN EH I ONE WAY SIGN SUD Vee STATE DDT 2031 PINE ISLAND ROAD FDFIT MYERS FL 33990
NARRATIVE
1D Number Rank Name Tregp 2 Peat O?ieer??enm Phone Number Date Created
251?5 S. RUNGISH I FLORID IS MY PATROL. 2-19-3444?? New 08, 2013 
weetre In nun tell h.rete.ot nod inth Ineldo enhhound term at US 41 Ma Hand 45 a fumble the '01 Elm Carl? 
v' I a 'I'n 0:  1302 wee tr (a )Ih pp In 

evellng south in ineldo we heund lane of US 41 (State Hand 45). 

e, mm?en'n am ted-trail fillet-rule praemonizof?uar.?
e1:SeniceI'Ioe'Souleverd. 00 'nverteek another Vehicle'thet was traveling no Inst 0 nannbound Inna (lit US 41. D01 Hwarvad 1a the tend enteredth center
northbound lane. am ever corrected to the Ian and last control mentor-e eekwlee while traveling northwest eurose the Inelde lune
nd enteringvihe Inedian. V01 the median with the {rent ri ht eide etri inn severe treliie central el nu. V01 ?nwr?d in?ida IBM 0? ti?l-ltl?lb?und HS 41 and
overturned. 01 was upside-down an it elid the path 01 V02 thin the inside eeuthbound lane at US . The in: 1 meter partlun Di V02 struck the left rear side
nation at V01, eeuelng Ve1 to piece clockwise amend 11m mum at V02, V01 name In tinel reet Inning non west (ups de-dewn) within the meter and outside southbound

enee at US 41. V02 came in ?nal reet, facing eeulh, within the inelde eeuthbeund lane at US 1.

Name at Denndent: In Dian Ne?mlth
8216 at Birth; 01907-1 "if

I la at nth: 1436-20 3

lime at Death: 3:17 pm.

Whe prenauneod: Peretnedle Stan Bell
THI number: FHP71 11-13-023

THI Investigator: Cerpnrel Joti Ron ten

 

Photogrep etelwn lay: Corpuret do 1 Hengleh
1D Number Rank Name Tretl'?p Peel Ot?eer A?ene Phone Number Date Granted
2675 TROOPER 5. RONOISH FLORIDA ?3 AV PATROL 230-314-1730 Nov 15. 2013

An update In ?this report was dam to add i warrant the tallewlnq:

Added 4 additional witnonee
Changed We a: media 10 mg?
I

Garreated the Hi num
"Ham: ?Smith'me Date Created
2579. TROOPER e. RONGISH i-P FLORIDA nA?reeL 23941444730 00:06.2013

Pending THI Inveetigetien.

 

ID Number Rank Name Tree [Peat O?ieerh ene Phe eNuInber Date Created
2575 TROOPER S. RONOIEH l-P FLORIDA PATRO 23034-14730 2013

On 12(0Ett?2013 an update to title repert wee dene 1e eltew D01 and P01 in V01 were both ween'ng their belie eteng with showing this GIMM-

 

 

 

REPORTING 

Page :3 01 ii

.
a    
{minimal .t.ltI :wm 1. I ?may; i .

INFORMATION FROM THE INVESTIGATING OFFICERS REPORT OF MOTOR VEHICLE ACCIDENT

 

     
   

 

coon Number: 2013009220 Legui iniunmnuun: YES iniorsoCIIon with: 
Dale of Am: 0mm: Privoio Properly: no Div HWoy TM Dir: 
Timo of Am: 03:10 Hm. County: WARREN . 91 Distance 1: 
Ni: mo of Agency: Loo City: minimum . aw) airmen 1: 
?mm ?'37 ?3 Aoc Dir From City: "Hm" Distance 2: 
Of?cer: Rluour Cioaosi City: "um" ?3qu" 2: 
?30000 ii: 331 Miioa From City: "um" 00454055
Report Date: 02i10i2010 Road.5imoi.HWoy: "Hm" YwC-uordinatai 04575625
Di?cor 00:10 Hm. Coiinoblo Location: "Mm" Location Liiomi STATE ME MD AVE AND 
Ci?cor Arrived: 03:22 Hrs. Mliopool Nnmlioi: Domiptlmi: 151'" 51'
3mm: invosugoiod: YEB
Unit 001
CilvorNom - 1.000530%  I Timing: iriiwy Stain: 1 .- FATAL
Firm: iniimi om 4 .. was-r to: STATE MEDICAL Emma?
Middle: i  9.000601% . Vision Db5curad: D1 - Ho'r Tmnopannd by: FMIZER AMBULANCE
Addmo:   .. Emergency Vein 1 NCT APPLICAHLE
City: Tro?io Controls: 0: - TRAFFIC CICNALE Emergency 5 NCT APPLICABLE
Cioio: - Com. Gloom? Dwr:  WAY
ohm FROAD
53m {mg "m I - 12 - VEHICLE A.
'5'!an Moot Damaged 0? 3:12: 1:33:55
1100: 33 . - 
Slow: m: Undriidf?vrid: 'i -.NONE mm? mg. 
Lioonso Claim: 0 Emma: Com: 516500.00 Cam? mp: I I .
Lioonao Lndommnu NONE Ex: oi Damage: 5 mm?. VEHIDLE TCTALED Cam my WW I- um. APPUGMLE
LICENSE I - I
omadiimu: 48 Hr? EVW I CENTERLINEMECIAN 
?oating Position: in - mom: LEFT SIDE-I om: Evom: - PARKED moron VEHICLE a? 
DRIVER I
Plannid ii.
Ciivor Condiilon: Third Event: .
Cit Chi-0 (soda 1.
Toni Civon: vaa citation Guam 1.
Drug Toot Ghmn: ?(Es Founh Event: 
Toiol Cooupania: 2 CHEW CWHZI
Whmo WM 2003 23 VEHICLE Chum GIMME a:
Voliicio Mam: - voLii Aha mm at? c" cm 3
Which Modal: miss? I I ?ii .0 I
Vohioio Stylo: PC ?pmm- 1 - citation Charon 3:
. A. MFANH
Vehicle Con?g. PAHBEHGEH CAR Elam?; 1 . 34015450159 or an $er Coda 4:
Vehicia oi Hm? Pat?: 1513:3335: mum oimuonoiiaraa 4:
vohioio Mum: -MCVEMENT Essimmw $532?an MP 

Unit no: 
Limo: Home Loni: ?rowing: Iiilury 5mm:
Firm: initial 'i?ivl Bin 1 NORTH ta:
Middio: Vision Cbscurod: . tionnmitod by: - 
City: TRAFFIC aloNALo omaronnor Siam: 1 YES. IN EMERGENW
Siam: Cont. Cm: 20 - NO ACTION
zip: Point of inii I In a I I
Hum: m1Film?? Carrier Homo:
Gander: M051 Downed ?3 mm Coi?omddrooa:
Mu: Corrior CW:
Llconiio Elmo: U?d?idfm?di 1 ?0?45 came; 3mm;
lensa Claw: Rpi??'ip?l?: 0M1: cumm- 21p:
Lloo'nso NONE [ii-ii 01 0001000: 5 - WWI-E Cargo Body Woo: - NOT APPLICABLE
Liooniio Rooi?o?ona: NONE . . 2" TMFFIO Numbcroimoa:
Firm Evan!-
Spced Um?: 36 Honoi Released?
Coming Position: 3000M Event: Gm:

Dn'voi' Condition: 'i?lilnii Evonl: c? code, 1:
Noohol Given: (jaguar. Chum 1;
Drug Tool Clvon: Mil-""1 
Toloi Companion: 0 31 II VEHMLE Cli Chin Coiio 2: I
vohioio Your: 2011 Effr?n?jmm' CREW 3"
[do Mom: - - .
Vah I FORD roan ?witch oiai, micth Coda 3:
Vohioio Modal. CROWN W3 .
I Aim Citation Chomo 3:
Which Style. in 
Conii 01- PAMENCER CAR 
ii Ejection. cm (3th Codo 4:
mm: . PM: Guillan Charm: 4:
Vohloio Action: 12 LEGALLY PARKED ?mm mm?
Ai: IOWA 5mm: DIST oz 933mm 2:1? PM 1 ?f 2 mm gunman

 

Property Damage

 

   
 

 

 

 

Ubiocl DDmattGdi erase? LIGHT PGLE Company Ovmer Nitrite:  I 13F II OLA
Estimate OfDan?tautt: 5200,00 Street or rtFD: .   a; 
Ciiwnet?s Nettie Lest: City:
First: State: . I
Middle: zip Coder 
Suiitit:

Accident Environment

"?rst iiomttul Event Lee: 1 . ou??nenwnv Roadway Characteristics
Manner of attenuates Environment: 1 - NONE APPARENT
Light Conditions: at - DARK, ROADWAY Roadway? 0" - NONE 
Weather Conditions: 02 a PARTLY Type of Reed Junoiiteet: 't'i - FOUR-WAY 
Soriooe Conditions: 1 i. DRY Woriotono Related: ND

Location:
First HarmfuiEvl T?m?
- 23 - MOTOR VEHICLE Workers Present:

injured Person
No me - Lest: Dominant Protection: 1 - NONE useo
First: . Airbag Deployment: a
Middle: ELUGN Airbag switch States: a - HO SWITGH 
Suf?x: . Ejection: 1 a HOT EJEDTED
Address: Eisstten Path: 1 - NOT EJEOTEDMOT APPLICABLE
City: Trapped: 1- NOT TRAPPED
State: 
Zip Code: I tron~ltitsteiist
Ago: ti Type: 
Sort: MALE Location:
Unit Non 1 Action:
Healing OB - REAR: RIGHT HIDE Condition:
injury Etetua: 2 - teetety Equipment:
Tmnsoonsd to: BLANK CHILDREHB HDHPITAL contributing 
Transported by: INDIANDLA REWUE Unit No. oi Striking:

Narrative

   

I is. ad]; I 0 ares tensity parties facing NorHHn the Eastbound lenesloi U3
an  

Unit #1 was westbound on US Highway Highway in. Unit #2 was sloshing the set: e?s? s?ny raster vehicle's-to st or: 11$ Highway as due to the pursuit that was westbound

on US Highway 92. Unit #2 was tinooeupieti and had all of its emergency lighting equipment in operation.

Unit #1 intentionan crossed over into the eastbound lanes ooiliding into Unit passenger door. Unit #2 was irevoiinu Welt shove the posted speed Hm? at the time of the
oetiielen. Unit #1 oerne to rest inning south in the eastbound lanes. Unit #2 oeme to rest facing to the southeast in the eastbound tunes.

The driver of Unit #1 was killed in the oetiisien and a passenger in Unit #1 sustained senses Injuries in the oettlsion. Unit #1 anti Unit #2 were totaled in the oetitston. Unit #1
and Unit #2 were towed from the soene by Albert's Timing.

Tits remains under investigation.

Diagram
'l'leiier Perk 

1601 Sheet I 
Business Driveway I 

U5 Highway 92

IE
 at: as ?it. Wt?

 

 

"its:

 

5 ett?th 't Elli Street

 

Printed At: [owe 5mm .0151: 02 81277201 2:17 PM Page 3 oi 2 3: 2013009220

 

 

INFORMATION FROM THE INVESTIGATING OFFICERS REFORT DF MOTOR VEHICLE ACCIDENT

 

 

 

   
 

Gene Nun'tber; 2010005210 Legal Intervanlinn: V5.0 AI Wiihl 
Dela efAee: meme Ptivete Property: tic: Div HWev TM 
Time of Am: 12:25 Hre. County: EHELHY it: Disle?m 1: 
Heme emeenev: Ace Lee City: Dlteetien 1: "we"
(Juicer: Dammit City: "ems." Directien 2: 
133000 0: 100 Mliee Free: City: "Hm" 00304932
Report Date: 1305:2013 "mitt" 04637010
Officer Noti?ed: 12:26 Hie. Oeilneble Litetei FOENSTREET F50 AND US ?55
Di?mrmved: 12:26 Hre. Mllepeet Number. Dene-ileum:
Scene inveeligeted: YER
Unit 001
Dtivnr NBITIE rLa Twang: VEE injury 310100: - 
First: Initial TM Dir: a .- som?t-t Trensperleei te: ?in?x?h
Middle: Vision Obscured: 01 - NOT OBSOUREO Tinnemried hit: Hm:
Meme: Emergency Wit: 1 - HST APPLIGAEILE
City: Traf?c Contreie: 01 - HO OONTROLS PRESENT melee: a - NOT APPLIGABLE
Estate: CenL Omani" Otvr: 21' - OTHER 
Zip: Peint ei lnil 01 . FRONT 
Selim: . Impact: 
.
Gender: Male MeetOemegeei men? 33;:ng
09?: I 52 . IOeMer City:
License State. tit UnemelOvtiti. 1 - NONE 3mg:
Lieenee emote Oeet: 07.00000 ?Wrap:
License Endemmtti: NONE Ext ef Oemene: 5 SEVERE, VEHIOLE TOTALED 
License NONE ?mm? 21 - UEHIOLE IN meme ?1 "07 
Limit: :55 . 
Beeline 01 FRONT: LEFT HIDE i Event: 
DRIVER Plum?; 
Dtlver Coedltien: 0 11th Event: 61mm? ?od? 1:
?mm? Gm? ?53 Citation Charge 1:
Drug Tee: (elven: WEB Foutiit Event:
'I'etei 1 Olt Oetie 
Vehicle Year: 2003 g??ram?m 21 VEHICLE citation Charge 2:
Vehicle Make: PONTIAG- pete- mm at? an ch- 3
Vehiele Model: e; 
Vehiee Style: em - Gitetlen Ghereo 3:
Vehicle Gonna: oi . PABBENO an em Tim? 
Etmuon pm; 1 a HOT EJEGTEDIHOT . 
Vehicle Action: at - MOVEMENT 0000'? 1 "35?

Unit 002
Ditver Name - Lest: Tie-Men: YES telnet 0mm: 2 - I 1' NO
Firm: KENT InIIleiTrvIDln a meme Trettepertee'iie: 
- . HRIBTOFHEH Vleien 01 NOT 000001100 Trenltpo?eei by: AVOOA RESOUE
-  -: .- -. . EmemeneWeit: 2 - 
Olly: Ttefilt: Commie: 01 v- NO PREGENT Emergency -i - YES. iN. EMERGENCY
Stale: . Gent. Grimm. em: ee - TRAVELING WRONG WAY
Kip:  oedema .  . .  . .. . .. . .939." 
gum? "mac Cartier Nitrite:
Gender: Male Meet '35 REAR - Cams, mum:
Age: at: Center City:
Lieettee State: UndettiiOvtie: ?l - NONE Gamer State.
License Hermite Ceei: $10,000.00 Cam?. ZIP. 
Eneereetet: NONE: Ext ememege: - eeveetz. VEHICLE TOTALED Ca a Hm. APFUMBLE
Lieenee NONE Fm Emu 2? Nu?mr?ym
5m? 5? 
3000M 01 FRONT: LEFT SIDE Seemed E0001: Gm.
MOTOROYOLE DRIVER Ham 
Driver 1 Third Event: cm (3mg 1:
NGUIWI GIVWII NO mutton Charm, 1:
Oren "feet Olven: NO F0000 Even?
I 3 Meg; mm I 21 VEHIOLE let 1mm 0? cm? cm? 2:
Vehicle Melee: CHEVROLET - OHEV Nag mm 5M
Vehicle Model: TAHOE DB 5 Oil 0th Oede 3:
Vehicle Slide: ?enegw? - an mm?w mun-unetan - Citation Charm 3:
. - MFANH
Vehicle Gentle. 04 HPORT UTILITY VEHIOLE Election: 1 Hm. ??ch mm and? 4:
Vehicle Oefeet: 01 NONE Elm!? Pan? EQEETEWNOT Citation Charge 4:
Vehlcilil Action: 1e eLowtetetemPema 0?00? BELT
Printed N: law}: were PATROL eteret eieizeie 11:22 A 1 et 2 Fem ii: 2013005215

 

Accident Environment

 

 

First Event Lee: 1 . cm nmewm Roadway Characteristics
Manner . Erwironmenl: 1 - NONE APPARENT
Condiuone: 1 - DAYLIOHT Roadway: OI - NONE 
Weather 03 - OE - MIST Wee at Reed de?cit-?net: 01- NO EPEGIAL FEATURE
Surface Comments: 2 - WET ROBIN: H0
Lac-outta:
Fire! Harmful an or crash: 2, Tm
- ICLE IN TRAFFIC woman; Present:
Injured Peteett
Namm Laelt RINK Ompent Protection: 1 - NONE LIE-ED
Flreu Althea MPIOYMOMI 5
Middle: TODD Airbag Switch Status: 1 OWITGH IN ON POEITIDN
Bulfbt: Ejeetlee: 1 - NOT 
Addmee: I300 LINCOLN WAY .Ejectlen Path: 1 - NOT APPLIOABLE
City: Amza ?Trapdei - NOT TRAPPED 
Btetet IA 
2m Outlet anon-I 
Ann: 41 Tree:
Stet: MALE Lace?dn:
UnIt No; 002 Action:
3900"? 03 - FRONT: RIGHT SIDE 
Injury Statue: a - Safety Equlpmant:
Trenepetted to: trees - ?neldbullng 
Museum by: ?ma Striking:
Narrative

unwound on us Hwy 59. v1 stopped In the southbound lane endwee eonmeted by
'33? -WE'Omm?'ree?thIn'h v2 ??ned ahead or the pursuit When V1 slapped. v2 started beetles: towards V1- V1
then accelerated ferwerde end collided rear end of V2. The driver of 1 wee In the martian. Both mpente Of V2 wart! Muted.

Diagram

 

 

 

 

P?m?d IOWA - 

{#312015 11:22 A

Page 2 e! 3

Form II:

2015065216

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAIL REPORTS TO: En! I 001':
law; Du ??n-Inn: of aw Drum-nun a? um
30030000009010" INVESTIGATING 000105305 REPORT 301325035
Dem Malnaa. Iowa 00000-0204 VB [0 LE ENT Laual Prtvata
MOTOR A  
Data 0:0 Accident ?I'lma 0r Amtdant County Mddant amurmd oorparnla limits 0! (00y) mum ?We. ?impugn
09:1002013 01:13 HIE. - Marion 4775 GOUNTRY CLUB DR
it accident warmed autalda at city .
0 ?lm 0009101 11010033 arnaaraat ally 
On H000. Straat, or Htuhway: N, Intaraacllan whit:
A 
Nata: at an M11001 [0 mmptataly 600000001 0.0000, mm tha balow to am 010 axanl?.
I locattan tram a mltaponl or definable lntarmalian. bridga, ar {altruad manning, using two and dTraallona If namaoary. x'cnu'd'mm 003161?
0 Dlalanaa DIracIIan Distance: Dtraaltan ?5556'?
and 01 If Highway. Frole R0015
Mllapoat Number Da?nabta bridga, or railroad Ermaan 133mm? Tum mm'm
Dr 
Hm Suf?x Phraan
JEPTHA
r000" -  0t Strata Zip
1614 AVE NE EEDAR IA 02402
Data 0101th DrMIr'a ?manna Numbar Cltatian Ghama 0000 1 Clinthn Shame: 1
H003
Grand-1r Btata ?lm Endamamanta Raatriatlana 01?5"? Ghana? and? 2 Chum mm" 2
Mala IA 1: NONE l3
an 0000 0 3
Drug 'l'aal ?m mm" mm"
1081mm?: anauon charge Gad? 0000000001004
2 - 011000 3 urIna -
Boating P00001101 Injury 00.1100 1 0000000: IAtrtnaa 00pl0ym0m I 10:00:; 00mm Status 1 5.100110" 1 I 5190"? 1 I Tum 3
Tran-1000000 I0: - 'I?mns Mad by:
ET HOSPITAL . . ARE AMBULANCE
Ownar'a Mama Laat vlra . a 5qu Owner Harm!
amass I I
Adams: - Git - 00010 21
001 1740 20TH AVE Manon. IIA I ?002
Insurance Ga. Mama Inauranaa Paliay? LIE-0000 P1010 0' ?101?
AKM 32-1 IA 2010
VIN No. Your M0100 M000I Starla T011114 Approximate! 10
2000 Mammy - MERC MARINER SUV YES Ram-W Romano
[010anme V0hl010 00000 I Point at 00000 00010000 Extent 0f un?t-ride! Pdvata? 
Dlrac?an 4 #10000 01 Until 20 Inltlal Impacat 01 Am 00:01:00 0 Over?dn 1 015.0011500
Tra?tc: Vahtala .Gnruo Rudy V0100 Contribulinn 
00000000 01 0000010 01 00000. 04 M0 01 000.101 01 0000ltlan 0 Dbadurud 01 D?wrtur: to M0 00.12
OF EVENTE Hm Ewnl 01 amnntavunt 10 Third ?wnt 42 Fauth Event M001 Harmful Ewmt (by which) 42
Gommarclal Trattar 011001100 In Blair: Var-Ir to 5100! War 130101000159 511101001110!
Ltaanaa I'Iala I0. 0011: Trailar Unit: Vuhlqlu 1 Status 3.
Garrlar Namn Adrianna 131.010 ZIP
U5 DDT 0? hr MI: 0- Numbnr (If Gran Vahla'lr: Mll?l'l?l?
Mas Walght Rating 00011-0011?
If PM 0W 001? than Bland namuuad Estimate: of War- 
HOMEIRESIDENCEIGARAGE Dar-1000 000,000.00 W01 WW7 Yea
00mm Mama - Last Hm Mind?; Company Dwnar Mama
WHITEHILL GARELD LAVERNE -
$000! 0r RFD Glty 01010 010 code
11130 COUNTRY DR MARION IA 62002
ACCIDENT ENVIRONMENT I I ROADWAY wonazcmE EEQUENCE BF EVENTB
 00001" Luh??m Hm Ham-Inn Evan: aIGrth
Manner of Craalvcutlisian 1" 01 Roadway o1 Typa (HW 0011? 1142 001:0 34
Ugh! (100001000 4 800000 'l Inf O1 Wark?l't 

Printad At: Linn County 00000 0001012013 00:00 PM Page 1 Form 0: 201326036

 

 

 

Country Club Dr. 

 

not In it:an

 

 

mm 
NARRATIVE .
what happDnud (reform VDITIDIDD hy nambat?)

VEHIDLE 1 WAS TRAVELING WEST ON COUNTRY DLUD 11  DUEEHWTWEHICLE 1 WAR
TRAVELTND AT A HIGH RATE OF SPEED. AND WAD TD MAINTAIN CURVE 111 THE
RDAD. VEHICLE 1 LEFT THE ROADWAY TD THE 0F COUNTRY DLUD RD. AHD TRAVELLED A YARD.
VAULTING DVER THE DRIVEWAY AT 1130 DDUNTRT CLUB DR, THE GROUND WITH THE VEHICLE
1 AND DDUNDIHD OFF OF THE DRDUHD. AND mm THE RESIDENCE DARADE AT 1160 DDUHTRT DLDD DR. DRTVER 1
WAD THE DDEHD. I .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wham v- Lnut Firm MIT-MID 
I KEARNEY TIERRY 138
Mdrnun . Clty Slam 21p Dad:
2 MARION POLICE DEPT IA 52302
a Humamull 531nm ii - I Wark ?lm-'10 *1
(3'19) 3774511 377-1511 
Mama 4.1191 Miriam mem
1 WARD - CHRIS MPD 175 
Adams any - . Ema er-r cudd-
MARION DEPT MARIDN I 511102
3 Pharm- - Work Phone 
a - (319) 377-1511 1: .
mam ?ttng Ho. 11m Hal??f Accident Wa'mmr mm Sam
I 13311133.le - 209 01:11 .Hm. 1:11:55 . Hm.
Data DI Inuariioullun TJ. 1'4 -
0931019013 YES 209 
Dam Rivth it.ng Emai?n ?fhnr Tatsme Inwallanllon 
I I I I I Gaunt}; Bhnriff?s pmoo

 

FrintDT! At: Gum-11y Sheriff's. oflIDD 091'101?2013 053:05 PM Page 2 Farm 201326035

 

J-

 

gr] TECHNICAL COLLISION
 INVESTIGATION

osFIcER'e Ranger

  

 

FILE 1.3m052

On June 6. 2013. at 'or about 3:30 AM i, Trooper Nathan Miller #366. was contacted by.

Sergeant John Skeet #323 with the iowa State Patrol and was informed that there had

     

 :.attee-Iaaerease at had ended with a
- ei'iti? 'is?idieggsonai  cr?i?ion after the struck a stationary piece of heavy.

  

construction equipment. Sergeant Skeet advised that the location of the collision was
on 11th Street at the Intersection of Mitchell Avenue within the city limits of Waterloo. iA.

At or about 4:07 AM, i arrived at the scene of the motor vehicle collision. [noticed that - .
Trooper Macabe Schmidt #336 and Waterloo police officers. were on-the scene. -. I was I .
informed by Sergeant A Fannsr with the Waterloo Police Department that' the 

driver had been transported to Covenant Hospital prior to my arrival. i
noticed a yellow Kawasaki displaying an Iowa registration plate of AUG-401
wedged Into a large piece of construction I noticed that the and
excavator were located within a construction zone that Was closed to vehicle traffic.

The and excavator were located within the intersection of 11'? Street and,

Mitchell Avenue.

I

 Mark Nissan with the Waterlco'i?olice Department ldehtli i :91; if; y? - 
 08-09-89. as the driver of Involved in the  

his lows issued identification card.



Trooper Schmidt and i took measurements of the scene with a State of iowa- issued
Leioa Total Station. 

I noticed that 11 Street was a newly constructed asphalt paved street. I noticed that I

the roadway surface was relatively dry but appeared vvet due to high humidity. i; noticed
and recorded tire mark evidence from the Kawasaki ZXSODHC. on 11f? Street and on a
dirt pile leading up to the final point of rest for the The Waterloo Police
?epartment took digital photographs at the scene. Trooper Schmidt took digital
photographs at the scene. A Road Closed to Thru? Traffic sign was observed in the

southwest corner of the 11?? Street and Williston Avenue intersection. A Road-

Closed Ahead sign was observed and recorded in the southwest corner of 11 Street
and Patton Avanue intersection. A Road Closed barricade and orange snow fence was
observed and recorded atthe 11?" Street and Mitchell Avenue intersection. Can Am
Towing of Waterloo towed the Kawasaki from the scene to their storage

facility.

[in June 6, 2013. at .or about 1:12 PM. i conducted a vehicle examination on the
Kawasaki'ZXSUti-C at the Can Am Automotive and Towing storage facility (see vehicle
examination). . - - 

i

 

 

 

 (PURSUIT TRACKING NUMBER
PURSUIT REPURII.  WGIEI992 1-: DIN NAIU 
CHICAGQ POLICE DEPARTMENT.  {9371 0, W579422 I a: IUD
TD HIE PSEPMED BY THE 0.57ng 13.0249
DATE GP DCCURRENGE TIMEISTART TIME IEINISR DRIGINATING DISTRICT
ZIDEC 13 1226 1230 I309
LOCATION INITIATED ADUIDES) LOCATION FINISHED [Appf??lmnm MdIm)
5000 PRINCETON AVE 5502 HALSTED
DISTANCE TRAVELER PURSUSD VEHICLE HIGHEST SPEED PRIMART PGUGE VEHICLEHIGHEST SPEED
3? 3 MILRS 55 MPH . 45MPH . 
CPERATDR DP DEPARTMENT VEHICLE INITIATING PURSUITI NAMIS RANII: STAR NOI ND.
CAHILL BRIAN . 194%! 97367
SEAT ND. USHICIE USED VEHICLS TYPE (Spawn VEHIGLEJ US. I
I-v 009 963D MARRIED UNMARRSG IR SGUAD CAR 4462 -
5 NUMDER GE INVGLUED IN PURSUIT TGTAI. DUTSIDE UNITS. Tom, UNIT-s
3 TOTAL CPD CPU SEAT NUS {Spot-?y mama) 
5 I 0 . 
VIDLATIDN AT GEGINNINIG GP PURSUIT VICLATICN GPIDDSERVED DURING PURSUIT
EII EELDNT MISDEMEAIIDR SPECIPT CPPENSS I: CRASH: PRDP I: CRASH: INJURY DI ~{Sp?cim
TRAFFIC OTHER VEH Ht: DUI. t] WEAPUNS VIOLATION I: MISUEMSANDR -(Spu:lfy)
SUSPECPS ACTIDNS DURING PURSUIT (Chad-I all -
RI STGP SIGNIUDI-IT (How many?) 3 I ECRGED VEHICLE DEE RGAD SPESDING 1:3 WEAVING RI DRGVE WAT DI DRDVE LIGHTS Cl UTIISR  
RCAU TTPEICIISSE ?mtapply.) I SURFACE CDNDITIDN  
R: Two WAT RI CINE WAY I: DIVIDED TIND WAT I: EXPRESSWAY I: DRY Ia In I: MUIDDT
a ROAD I: ALLEY CI DIT-IER (Sundry: CI EITHER IMPAIRMENT .- - 
LIGHT all I.th Rpm.) WEATHER (CITGGII S11 than appfy.) I
1:1 DAWN RI CI SUSS LIGHTED El CLEAR CI CUJIIDT IS FOR
I I -. ERRAINING CI BNUWINB IDS

that 5991!.) I TRAFFIC CGNDITIGNS -PSUSSTRIAN (Chuck an mummy.) I
RUNS RT LIGHT MEDIUM I: a LIGHT I: MEDIUM -
II YEAR MARE I MODEL, STATE UCENSS H0. I I ERPIRATIDN DATE 3
- .3 1993- -- GREEN - . (3371553 - .- . -
NUMDER- MINI . WAS A TC IMPUUNU VEHICLE ST POLICE FUEEING W?a SISI MALE RACE AGE I DATE OF BIRTH -
- . 5, LINE PENAUS APPRUICS 
[Ll .
SI PHTSICAL DESCRIPIIDN GUADED
- MALE WHITE APPRDA: 225 DNA
II CHARGES: I: FELONY MISDEMEANDR DI TRAPPIC
I
. 3P GIFT DNA I
 SUMHER ARRESTED CS NUS -

 

 

 

SUMMARIES THE APPLICATIGN UP THE BALANCING TSSTIRATIUNALE AND PURSUIT INITIATIUN AND TSRMINATIDN. .3  - 

 

IUD HAD KNOWLEDGE THAT THE ABDVE VEHICLE WAS TAKEN IN AN ARMED THE CHASE DIE)wa- I.  
. SRCERD DE ISMPR UNTIL APTSR 5] 
ISMPR AND DRIVE INTD TRAFFIC. IUD TREN-DULLSD BACK. AND STAYED AT A RARE WHILE
THE FLEETNG VEHICLE PULLED AWAY. FROM TWU BLOCKS AWAY THE OBSERVED THE VEHICLE CRASH AT

55TH STREET AND GARFIELD BLVD. WHERE SELF PURS UIIT AND REQUESTED EMS.
I

 

  

 

 

 

 

 

 

DEPARTMENT VEHIGLE NAME STAR NDJIIJNIT I
- IS GAHILL . 
imMHU?quW?m
PASSENGER OFFICERS NAME IN PRIMARY VEHICLE STAR NDJUNIT . I
A. TCEMFS (QM I ?Itf:


GPDSENSD (REV. ma)



Se]: 16 2915 

HP Of 5 6066770668

KYIBRS IE RT

OF KENTUCKY

 

mam amuamr?
1 of 1* 
LIIZSENEEIID ETATE: xv

VICITIM NAME


mem: NUMBER: a?

mw
OF


6' 343 lb!

MAI-E WHITE

VICTIM OFFENDER VICTIM WAR 



IIEHJI
1 ALIAS:
NATE: KY

?11:an 5: 

NUMBER:

am'a: all: warm ?m

EEK
MALE
IND. 

NUT APPLICABLE
AHMED WITH

RAGE ETHNII:

HISPANIC
EEG. 

161??!

TYPE
WARRANT ARREST



SEQ. 

 


9f ALIAS:
HATE:

EMT:
HEN EEK

LIO ENGIHIIEI HUME-ER:

IMP CODE:
ETHHIG ORIGIN

?mag mm. mumle mm. ARREST TYPE
61' 1
AR REBTEE ARM-ED WITH 2
a
WITNESE MAME



1 a

LIGENEEIID STATE:
humus

IGITY:

ELDERBIIAD, BRAD
MUMEIER:

STATE:

[9 2 (if 14 Number: C13G30234

ZIP WEE:

CODE:

Agency 1 000'] 00

page 3

 

KSP RECORDS

 

 

 

PHCNE

WPE:
RESIDENT: 


HISPANIC

DFFENDERWIGTIMW NEH

ARREST DATE
YES minimum
HF 

KY HEEIJEHT:

RESIDENT
HEIGHT WEIIM-IT ETEWLDR 
new"

TED
.1
5



 

ARREET HATE
THE

DATE DF BIRT H: PHQNEI RESIDENT:

HEIGHT WEIGHT EYE COLOR HAIR comm


4 7
I5 3
9

DATE or: am 
33":  

man at: 32

Sep 16 2015 HP Fertility Of 5 6066770638 page 6

 

WET: gem spectrogram; KSP RECORDS

DRAFT connonwsnuu or someone

argument. Arnold advised (of?cer Breech that Litton had thrown some food at her and left the scene in her
Nissan car. Arnold advised Officer Dir-each that Litton had threatened suicide by driving head first into a
tractor trailer. She advised that Litton has had suicidal thoughts in the past. (officer Creech explained

to Arnold how to obtain a Mental illness petition on Litton and how to obtain an Emergency Protection
Drder. 

 

 

 

around 21:53 on O3i16i2013. Deputy Steve Molen was westbound on West KY 30. when he noticed a
rehicle parked facing'eastbound in the parking lot of Jonas Brothers Implement. Deputy Molen advised he
shined his spotlight on the parked vehicle and noticed someone was inside. Deputy Melon advised he
node a U-?I?urn to go back and check on suspicious vehicle. Molen advised as he was turning around the
rehiciepuiledfrorn the lot of Jonas Brothers and headed eastbound on KY so. 
- -- Molen advised'he then noticed
Nestbound traffic approaching, and the suspect vehicle drove into the westbound bound lanes. Molen
advised the westbound vehicle left the roadway to try and avoid the collision with the suspect vehicle.
Violen advised the suspect trehicle collided head on with the westbound vehicle. Melon advised be
contacted 911 Dispatch to have dispatched to the scene.

a 22:24. I arrived on the scene of the collision. Upon arrive! I noticed a black passenger car facing
eastbound in the westbound lane. The black passenger car had severe front and damage. i also noticed
a white passenger car, sitting on the north side grassy shoulder. facing southbound. ?the white passager
tar had severe front and damage -

Jpon Investigation it was learned the black passenger car was a 1998 Nissan 2DOSX bearing lt?r'
Registration of 244 33V. The driver of the vehicle was identi?ed as Justin i Litton. This was the same
rehicie that an attempt to locate was given on just minutes before. It was also learned the white
passenger car was a 2005 Suzuki Forenza bearing KY registration of one ERG. The driver was identi?ed
is Levi Stephens.

Nhiie Sgt. Greg Martin and were at the scene of the collision. we learnd that Levi Stephens had died
if injuries he obtained during the collision. St. Martin and I finished collecting information and evidence
teeded to start a reconstruction of the collision. . .

"he roadway was opened back up at 06:51 on 

Tin 03/17i20'13 at: 00:29. Detective Ohris (Bates obtained a Pulaski District Search Warrant from Judge
Scott Lawless, for 2 blood samples of Justin Isaiah Litton.

Detective Chris Gates executed the Search Warrant at the University of Kentucky Hospital in Lexington,

Detective Gates had the hospitai personal draw the blood as required for the Kentucky State Police
ilocdiUrine Gollection Kit. Detective Gates had the blood drawn at least 20 minutes apart. Detective
Bates signed a receipt for the blood at 02:25 on 03i1'i'i2013. The blood coilectedmas sent to labs for
nomination.

in 03/131201 2, I received information that Justin Litton was going to be released today from the University
if Kentucky Hospital. I then obtained a district court warrant the charge of murder for Justin Litton.

)n 03I16I2013 at 17:17. Justin Litton was arrested on a Pulaski District Court Warrant for Murder by the
iniversity of Kentucky Police Department. Of?cer Ramsay arrested Justin Litton after he was released by
he hospital' and was transported to the Fayette County Detention IDanton

3n 03l18/201 3, (Nicer Justin Crsach and iwent to the Fayette County Detention Center to transport Justin
.iiton back to the Pulaski Gounty Detention Center.

age 5 of incidentNumber: Agency DRI: 1000100 Badge it: 32

 DATA









11.




SUSPECTIARRESTEE DATA

 

Page 2 Of 3

 

KYIBRS REPORT
COMMONWEALTH OF KENTUCKY
VICTIM NAME

RECORDS

 

 

 

VICTIM SEQUENCE
1 Of 2
LICENSEIID STATE:

#55

. SENT-
KY

CITY: BCIWLING GREEN
DATE OF NINTH saw HEIGHT
I 5' 
GENDER RACE
MALE WHITE
RELATIONSHIP TO OFFENDER: VICTIM WAO

- ..

I 

LIGENEEJIID NUMBER:

VICTIM TYPE: INDIVID

OTATIE: 42101 
EYE COLOR



ZIP CDDE: Iw REEIDENT:
HAIR COLOR
GREEN
ETHNIC ORIGIN
NDT HISPANIC

VICTIM RELATIONSHIP TO OFFENDER: VIC-TIM WAE

WEIGHT
154 

PEACE 
YES

INJURY TYPE

3130. NAME:
of ALIAS:

STATE:

ADDRESS

CITY:

ESTE ARREST DATE
VEO
LIGENSEIID NUMBER:
HATE OF BIRTH:

PHONE: RESIDENT:

ZIP CODE:
ETHNIC EJRIGIN HEIGHT EYE 

WEIGHT HAIR 

AHREOTEE SEQ. l? MULTIPLE ARREST IND. ARREST TYPE CITATION NUMBERS
Of 4
ARRESTEE ARMED WITH 2 5
6
SEEI- 
of
STATE:
ADDRESS
CITY:
ESN

NAME: ARREST DATE
ALIAS:
NUMBER:

DATE OF PHONE: KY RESIDENT:
STATE:



CDEIE:

SEX ETHNIC: ORIGIN HEIGHT WEIGHT EYE COLOR - HAIR COLON

ARRESTEIE SEQ. II MULTIPLE ARREST IND. ARREST TYPE

Of I 4
ARMED WITH 2 5

3 
WITNESS NAME

RELATED GITATIDN NUMEERE

WITNESS SEQUENCE
Of

ADDRESS:

NUMBER:
DATE OF BIRTH
CITY:

21 GUIDE:

Incident Number: 03w13?0246 Aganccy CIRI: KSPOEOD Hadg? 983W

 

1g as REPORT: um; SUPPI .KSP RECORDS
COMMONWEALTH CIF KENTUCKY

 

 

 

SYNOPSIS:
Timothy "Kirk" Madison and Sandrice Parker was killed in a single vehicle collision.

MODUS OPERANDI:

on re TIME OF occunnervce:
April 29, 2013 between 0200 hours and 0244 hours.

ACCUSED:
SUSPECTS:
STOLEN PROPERTY:

OTHER PREFERTY:

EVIDENCE a How MARKED:
1) 2007 Suzuki Black 
VIN: J81 GT77A972102029

2) Black Helmet-

3) Taurus PT111
Serial TEU88200

awoarvce 
'lm3 Storage

TIGA WON:
The Kentucky State Police Post in Bowling Green received a call from the Bowling Green Police
Department. They advised that they were on the seen of a single vehicle double fatality collision.

Wheel arrived on the scene I wee briefed. 
point Sgt. Scott terminated the stop. After traveling
down Lovers Lane, he noticed a large fire near the entrance of Ewing Place. He pulled up to the fire and

realized that it was the that he had just attempted to stop. KSP Post 3 wee notified to conduct
an investigation. I was called out to reconstruct the collision.

The operator of the was identified as Timothy "Kirk" Madison. He was a 2.3 year. old white male.
He is a native of Morgantown. According to all accounts he had been at the Ramada Inn drinking and
partying. He had been there for several hours before leaving.

The passenger Was identified as Sandrice L. Parker. She was originally from Radcliff and a 24 year old
black female. She was also at the Ramada inn with her mother. She met some acquaintance there and
was going to meet them to go eat. She decided to ride with Madison.


struck a curb causing hirri"to'lo'os'e"control and struck a rock fence and both was ejected
from the The continued down the road until it struck the gate and caught on fire.
Page 4 of incident Number: sensuous - Li Agency oer: KSP0300 Badge see

it?? is"

 

DEVAL PATRICK

?Ztie Commonweaftfi of
Massachusetts
Deparnnent ofState ?I?o?ce

 

State Police Detective Unit
MARY ELIZABETH 
10 bederal SareeM
salsa, MA 019 all?
ALBEN a
sups'mrwawoswr Tel i (9 7 7 I?ll
Fax: (978)

-- To:
From:
S'uhj ect:

Ref:
OCME:

l.

 
    



Detective Lieutenant Norman   k, #1233991 Com-man cm?? SSW, SPDU
 I 1 

rail in. . am.? I
Trooper Peter C. Sher-her, #313 is - a State lice Detec Wigs? tut
- a.

?its; 

sg?.  .

 duff-h .If?gtal Motor 6? km
tig? Ave .3,

 
       

?its.

 salowng if Pursuit on
orth Au?dovsr on OWZWZOIB.

  
   
   
 

  

Route 495 South at 

. a 
 ?lighter .

.L I
201 asses ll -

?i ll
 is 1' la,
la: .IJI ll3,31% oopei Elise:

 

- - . ,gsgmig ed to the Massachusetts
. Unit,  Count ?we, pros. I?ll?) Tours lwas advised by the
Troop Duty 0*  to Route . South at Massachusetts Ave in North
I I I i A II
Andovsrwigh?gatal {?aj?f I  cl and met the followrng personnel.
  a ?g antler), Trooper Jay Martin 
(Airwing), Sergeant Barry Brodet?te

II In. I H. 

Trg,,pf,lagpit)an Don-"ta, ;,,g'e,per Russia   
??g??nme ene Semces), Trooper Brian Roderick

   
  
  
 

On Sunday, July
State Police Det 

  
  

.  
(sea

1 ?5ng . .
(CARE'?ga?frooper Han'ytt?tm, eti 
Sergeantt  ,th, and Metli1 (gram.

   

 i




. . waist, 

I mterwewed magpie Mc
approx. 0144 health-

.ilk 

..-
ass

 i?ilamon who advised me the following: On OWZWZOIB at

its r, 'r-?olice Of?cer Larry May observed a grey Honda 
(MXSZOB) travel Washington Street in Methuen. Of?cer May began following
the after ?Lilith: mg no rear lights on the vehicle. Of?cer May followed the motor

cycle onto Route 213 East where he attempted to effect a motor vehicle stop. The motor

   
  

. vehicle then accelerated in speed to approx. .90 and traveled onto Route 495 death.

 and s?d'Maihidh'Stroet, the 
greatly accelerated in speed and Officer May terminated the pursuit. Approx. hi south of
Route 495 South and Massachusetts Ave, Of?cer May located the on the deck in
the lane and the driver was unaccounted for. Methuen' Police and Lawrence Fire
Dept. personnel searched the area with negative results. The was towed by
Coady?s. State Police arrived. and booked the crash. Detective McMenamon stated the
suspect?s ?riends and family contacted Methuen Police and reported Angel Santiago missing.

Page 1 of 3

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gull'ijlly: 1913PAI5IIHDIID. Bun?gglaza manual pg?lw'f'hm an my? (PM ?mm mum?lm 36:14:33?! Inoltlont ll r-Iln Clans mm

STATE OF MICHIGAN TRAFFIC CRASH REPDRT Closed
WI ?ownmonl Numo IRWIMI
MI 0302100 MSP Metro Nani: PAUL HIPIETRD
Grinan LiIlnIIl I Grub Tlmo No. oI' Unlln Crush Typo melnl Glroumotnnoou ND I - Sw?m Ghl?kl
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PIRARSON I RD 
DInIonun Way Annm 
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lull-mall" Rand Rand Typo DIvInnd Floodwoy
va
um: Numbor LInlt Ema Mumnnr Dutoof?Irlh {Agni Type Endorsement0953911 978 (3-1) a a 33m: Fm! 01 15 an ass 
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 MV I HI 01 04 WILLIAM BEAUMONT HOSPITAL
OAK PARK. MI 40237 (W) I
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Yes GENERIC AMBULANCE SERVICE
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mumnw of NM mud Fourth
vonlo I17 - Molor van In transport 
(I Inolonlon MOST nvonl)
Powwow 0mm of mm (Mn) Elm: Eastman 
Injury Alma EIle Ejoolod 'I'roppod Ambulnnm
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Injury Altman Doplnyun: 'Iroopod Ambulnnm
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Injury man Amlwlonm I
Pnlnongor Information D?l? of ?rth (Ago) Son Rulmitll HWPIIHI
Injury Alfbn? 51mm Trapped Ambulance
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Pomon M?noo of Tro?'lo ControI Damaged Properly 
Gonlnul Nnrna: 
?mm? ##m?mm Own: a. Human

Conlnol Tim: 

 

 

 

 



STATE OF MINNESOTA DEPARTMENT OF PUBLIC SAFETY LAT 44:02:31.3896 LON 93:29:48.9011
LDGAL BABE ND. AMENDED . . .
13200153 ACCIDENT REPORT ME 1 0.: 1

rauu plian- VqucLEa KILLED INJURED Ham (PUBLIC DATA) YEAR DAY MILITARY TIME
02 01 2013 FRI 0357

 
MNTH 13 HWY IEIN 1W1- WOODVILLILTWP 028 00.85!) TWP 330THAV15

UNIT UNIT NON-MD
. I
01

 

51.53 NADA AVE
0515mm. MN 55128

TYPE TD HOE-F



Wilt WP

EVENT PLATE l'

ACCIDENT INVOLVED A COMMERCIAL HUS. OR HEAD
HUS REMEMBER TO NOTIFY THE STATE PATROL (roqulrod underMB169.7835nd169.4511).

1 I MOTOR

NARRATIVE:
ICLE #1 WW DRIVING AT A HIGH FATE OF HEW-ED
I  IIHWHICLE #1 DROVE. DVER
I THE ROAD I 
TO RIGHT, HIT A DRIVEWAY, HUI-TED AND 
IN 11 FIELD THEN BUILED. DRIVER VEHICLE 

#1 ms mm VEHICLE #1 MED on mm or
. DRIVER WAS DECEASED scam.

mam.
DISTRICT 2200 1:1 mm ovum

 Innesota State Patrol

All available for
incident number 13300344.

0? 12'2015

 

 

 

Incident Date/Time: 3/23/2013 6:23:00 PM
Incident Contra et: MN State Patrol District 2300 -
(507) 537-6277

.tneident Narnher: 13300344
Distriet: 2300

Number Individuals?u
Number of Vehicles: a

Location: COTTONWOOD RD 10} Road Ty pe: Black Top

CTY RD 
Milepost: NONE RECORDED Road Condition: NOT 
County: Cottonwood Number of Lanes: 2
Crash Type: Head On Divided/Undivided: UNDWIDED ROADWAY
Incident Classi?catien:FATAL Hazardous material: NOT PRESENT

Assisting Agencies:

 OF Slayton MN . DRIVER OF VEH 1 Phys. Cond. Deceased

Egg-pan 2: Steams, Jeffery 42 OF Marshall MN DRIVER OF VEH 2 Phys. Coed. Minor Injury

MI: 1993 Harley-Davidson MODEL UNKNOWN
vehicle 2: VEH YR WOW Ford Taurus

D1, a suspeet regarding a call to the Cottonwood County Sheriffs Of?ee reporting a

IlteidentDeseription:  I I I   I
person armed with a knife, had?sj?e'djj?fon?ij?ottenwood County Sheri?ls 

Murray County Sheriff?s  

A short time later a state trooper was traveling east'on OR 10 in Cottonwood. County when
he stopped. ahead of the trooper. The trooper stopped his squad ear, V2,

The V1 accelerated to a very high speed toward V2
and traveled into the V2's lane. struck V2 head-on as V2 was still stopped with
emergency lights aetivated. The D1. was ejeeted from V1 and died on scene. D2 so stained
non-life threatenng injuries.

Information BELIEVED COMPLETE
Last Updated: 3/25/2013 7:33:04 AM



1H




MIBEIGURI UNIFORM CRASH PAGE- GILL

1' mean IN FORMATIQN AGENGY {WI-51mm. PDMGE  
uee?e FOR WWII 9109
I I  .L 
(31:33 ?mm mm

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE some, DRIVER ND. CRASH PROPERTY DAMAGE ONLY NSJIILLEIJ NUMBER
when CLASSIFICATION ?11 I I ?df? 1M 
I CMBH TIMEIMIL.) TIME NOTIFIED (MILI INVEETIGATIDN DATE INVEETATSGENE
 - era/e? emu em eel/af?ne" sear 2? ?rm Nu
?gammy mammal,me coLuelunmvewme FGRIMPAGT WITH mun-en VEHICLE
FeIINumped  Anlmel Railway Vehtele 0 th
Igga?w?w Fire; Pecteieycle 1?3 Anlmalurnwn Trend. [If] Frenne Rear Dir.) (EXPIHIHI
.IWFE. meleelen E3  Emmi! mm MoterVohlclomTrunepdn I'Ieerwnenr Bldenwlpe (opp. be.) unmwn
Off [3 Gm" OlherUmecI Parked MolanehIele Remit: Bide I3 FeIFIneIShi?lnn (EWING)
. R??dww Nun-cumniu" Mulor Vahlcla I In   
GDMMERGIAL MOTOR VEHICLE INVOLVEMENT CRITERIA Anewer the Iq'llewihd'llo delermIne II IlIe."demereldl Vehlele" Ilelde In aeetlon 7G Inunt be eempleted.
1. Dem we ereeh {melee any e! Ihe Iellewlng? 2. Exemlne Vehieln In II It In a vahlcte based upon the fellewlnd:
1e. Apnredn MD No W'lh Nu .. Ne ddmmerelel vehicle Ileldn
1b. A. pardon Ireneperted tor medleeI eIIenIIen: 0R Ilelde need completion. 10.000 OR a ?Bad 
1c, duete demege, Amotorvehlcle fer etrnereineludlnd Gempimn Samlun In
WE an m"an 2' 3' an, A \rehlele IIezerdeue rneIerIeIe placard. [j uppruprlete vehicle. 
TAKEN BY WHOM . AVAILABI EFRO KI AWHDV
?xed CI Ne 
EWINH MI I AVAILABLEF 0 CI Agency
In I3 1964?: M51
2 LDGATIDN I
mum-w mu up . BEATIZQI-Fewer: 
-- -.  --  c-cI .. . -- a 
3196 ?rm" M. me I NEU .9 radiing51?% 313w. me. .. .DIBTANGEI-HDM 
4?3. ?25.15? v? m. Mar NA (41.: 5 
HY  Unknown .. 9mm, LIMIT INT. DIH. (3E0 -GCJDE
main I3 Ceumy Frlvele Property other . MIlee gm Mm?w 
TRAN: ALIGNMENT FRDFILE
[j (?ne-Way 'IWmWey:0Ivlded;Unpmteeled Median Slit-baht Laval Downhlil {If} Dip
Twe-Wny:NeIDluMed:Gundnueue GenlerTumLene MedlenIIerrIer Uphill Hillard!? In 
TYPE [3 NA ROAD .2.
ml [3 Men/1mm Ullknum??xplaln}  Dry 'Ij' endw Bluell [j Water aanelaraval Unknown (Expleln)
T-Inlereemlen I'th Rnundebdut In WEI CI Mudmln WNW CI 
new summer:- WEATHER CONDITION
 Generate El:qu Clear Rein  FOQIMIM UlherIExplelnI
Amman ?r?vnl [If] Mulli-?u?nud UnknewnIEkpleln)  Cloudy  Enew FreezlnM'l?empI CI CNUBWIMI 
cm
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a - named re, PROPERTY omen mm VEHIGLEB [j Mm
mar ewwee'e NAME ADDRESS. nEecmPTIdN 0F QWERTY. Me emme. '3 Mum-r Mum, a 

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NAME  \?lily, 5mm, Zip) 
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6 PEDESTHIAH NA Law I?nfumamurll (Dinner other Emergeney Pereennel El Worker Other Tremeweuy Worker CI other Fedeelrlen

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NC). (Lem. ADDRESS (mmel. Olly. Stale. 21p} NUMBER
EEK HY VEHII: INJ LITIGATION 

PORT on Roadway I3 In Dr'ivuwuy IZI On MedIen I leldnd

I On Sidewalk Roadway ELI Unknown

ceoeeme ROAID Ne OTHER Acrlone  NArNor'm MA
I-Ilgnm Gellan [j In Unknewn Game; TnHEmm annual
AgnInuI?SIgrml In Marked Groaawmk  In TranIdey [j Pleylnu In Treh?iewey CIlhur (Exp?udln) 
 Nu munal I In Unwed-Ind DrIVehIeIe In Tramway Aheue
 Unknown I Unknown [3 anIeIl?RerRedIEIepped Veh. With Mamet Trurfu: Unknown (Explein)
GIDNTRIBUTING CIRCUMSTANCES 13 None DISTRAGTED I IHATTENTIVE NA 
[3 Felled?ro?rleld AIeoheI VlelenUhetrueledIExpleIn)  ND 
Drum CI UnknewMExplaim I I -1k 

 

 

 

 

CIDPY ORIGINAL MISSOURI HIGHWAY TRAFFIC RECORDS DIVISION BOX 5'38 NW, NW 01(12

I . . REPORT ?3 PAGE 

 

 

      

 
 
    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  
   

   

 

 

 

 

 

    
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

         

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7' OWNERS. 8. OGGUPANTB
ND. .mlnn - PMNENUMBER
I.      I I. . 
-- ?nia- fin-?.  Min: C452) w-?nnw

Hen Emma unknown 

STATUE {j Disqu?lBDL El MG Elml?Nu?NA
 l/glf??  Unknown LI if] Unllnunkud [j 

nln?n - sax SEAT INJ Am melon my Notabalmmd {j Tmnl??mh Moving Whirl-(Emma)

Hi? I TION MG DEBTRUCTED thd?hmld Bulldan Eloppuanh 
1/5143? 1 gig. hf?? I NA [3 Embankment t] Pnrkoanh Ghana 

PROOF 0F INBUI I E: PHONE. N0. (Opllunul) Hill-m" NU BER NA  

 No El Not?anulmd 1 W15: .. Jar"  

OWNER NAME (Lani, Flm. 6H) s. (31ml. city. Slnlu. Hjnj; [351' am PHONE NUMBER SAD

MAKE MODEL CDLOR VEMWPE 'rm'AL no.0; occ,
93:510. nmev  5mm. . In
{lilc?u??ghl?? Mm, 'nfn'rn, YEAR MIN SCENE 1' Duemmaupwmg
[Mn Manx; inning-mnml??c.1317 my.? :1 Nu ..
El 190%de -- a

- a? manna"  (3'19 WW

NA Burnaglu I 2.1 Other $9 ?y 

I. I (Explain)  ..  ..    . .. 
37-121: . ,fof?f? 45 49,55

VEHIULE Wilma Unnd 1 I

amnu Hun {9.15 I WWIGCWV RATING

 [j Hun-113+ ATVH E3 melon I 

El Pumnnm'Vm Equlp, Hmwy Mack cargo Van?. All Tm:an

mm Von. Anolhanan} . 

L'l Span Vnhluln ?5  Echml?w (?uda)m Truck ramuruLJ Tmcg?gmr?w?ghor?mz Mat

13 leouulna [j ff] awn Game: Van ?in? ??g?mr?uh? mu? nr y)

[j lenunlna {9-15 WlDrIvor} ff] Tmnalucnmmumr  4Wh Plukup Truck Um I equal In 10.0001hu.

Bicycle GhnI-lnranur Olhuannw Trunk  Trunk Tm?mrwuh Wu um" I 10.1301 4.3mm?

Cl Fadnluwlam-n, LII WW Trunk Unlls El Gmm?r?hm 35-9001?

1'0!me School El unm?wn

NA MA

Police [3 Ambulance l] Run GnnunallnnAllnad If] 

[j B. Slnliunmry GmnhAhnnd Unknown (Elenln)

YUNEHIOLE DF EENTE GDDEB Danna Llama In In annular; n) ALCOHDLUSE
I25 1] Unknown lAMIMAugnn?i?m?-PHOHAHLE GIRGUMQTANCEH Nona

Vltlon Dbalruclad Fullud Tu In Roadway
BpaIdnExcuadud lell:  IJrlvarFmIaunIMIonp Tn Una Lighlu Imprupurly Slapan On Roadway Type}
Slu??l Tun Clone [w?wl Unknown (Expluln)

Elnnall?lan Impmpar?anklnu El Wrong aldanIPnnulnu} thur (Explain) 

Fallad To Turn (Dun-Way) Ti! Vll?l- EXl?l?iN got-lag) NA

Alcohol imprupnrr?uulnu Plnyuluul (Explain) Oman.? Emu? a)

[1 Drugs Improperly Furknd Impropnr?lurlIV-?mml?alk In Huntlan i I 
wildcat-m El Liam..- 
Maw n1: . J: mam mum. ?1 memes.  

Wm"!  CI 310;) Blun  Nu Panaan Zane Turn Rnul?ulnd Omcarf Hag;an 'Dn Burma] Gun a Suva-mm")  

Van  No unknuwn comma: Warning ?lnnl?avlcu Ll RalleyC-rulinlnn Cl man [3 (Explain) 

H, I DATE. an): BEAT AIR SAFETY PI-IDNENUMBEH
I   guy'mum? mp) LDC PQHT TIUN BAG UEVIGEB
ll" I - unu- 'l I
316? 4/2 nanny 7133M IE: .4 af?x/13% Af?ne? ?2 M. ann??n?mnw
VB. NA RquIlI'Hd an Whlu'lu  l"Vm "wnn ?l'lle?l'?GMV and olthn three nrltarln ln pnnz.
MGTOR [:11an PHONEMUMBER am
C?fl'lur Hal In MGIMXIICG NO. UBDDT MD.
Barriur Na! In Vahlnla
 El ?ux Fl?lb?d  Cu??mlu Mim? Gurhugnlliofuun Palm Tr?ll?l? Vulilnlu Twins [3 Inl?rmudnl NMND 
TYPE Cargn Tank [fl Dump Aulo'l'rnnupmlur L69 g?gm'l'i?  [fl] Unknown

PLACJARID dim?l'l' ND. CLASH HM CARGO PRESENT HM CARGO HAMHIJOUB 
Hm?? I. 
REP-3111 rim PAGE Ortiz-.-


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VEHIGLE Ac'nnu i SEQUENCE DP EVENW (Heme with dwihin-uewrlek require eddlliunal ending}

1. Going 811111911! 10, 913nm.? Fame 19. Airborne ea, Geperelinn?fUnIle Cuiliniun 44. ThrowniFeIIinu Want

2. Overleidng 11. emu." an. 29. Rummau?ro Ruadwuy an. 45. Faiilnii. mainecnm?.
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ANIMAL cones Fun val-I113?; ACTION i BEQUENCE or: EVENW

30. Deer 61. FermAnin-iel 82. Dog 33, am" U. Unlimer

FIXEI: GBJEGT GDDES FCIR VEHIGLE i' OF EVENTS

an. Tmi?lum??lunding) 23. Culven 32. Building 33. nriduu Reii 4-1. Well

21. Bluff Tiu?in $ 0I1anli?upp?ll 33. Traf?c Slgn?l-?Supp?rl 3'3. Guardrail End ?113. Gable Berna:

22. niuardreil Feet: 28. Bridge 34. impact Altanueioricreeh ?uehlnn 41:. Other Truffle Hauler 411. Bridge trueiure
21$. Ullilw F'nle 1111. Curb 35. Fire Hydrant 41. Overhead Sign Buppon I17. Overhead Lii-ieicmie

2:1. Flame 1m. Muil?nk 31.1. Oiheri?eplein) 42. Ditch U. Unknown

213. SireuiLiuhtSuppen 31. Conereie?rre?lc 11111111? Bridge Fempnl End 43. 

CODES

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ii. a. Communication novice- Hands Free 10- ??nding 11- Miuwilhe Whi?l? 51311110?

3. Equipment 7. Communlceilnn DwicmTexllneiE-melline 11- TDDMED 15- WW (EMPIRIM

A. Navigatinn Davina a. Demmunlceilen Devlee Web Brewing 19- Gf??i'nln?

VEH ICLE TYPE GGDEB

1. Meier Vehicle 1n Tienapen 3. Workan Meter Vehiaie e. Drawn Vehlnla i Animal Hidden For Putnam

2. Parked MolorVehlcle 4. Fudeleyole U. Unmewn

OTHER VEHIGLE IGODEB

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From: I Thompson. Kari 

Sent: Tuesday, September 01, 2015 10:21 AM 

To: Frank, Tom 3 

Subject: RE: USA Today query  6, yak?)
?p 

Good Morning Torn.

Please see the narrative of the report you requested.

On Friday 08/09f2013, at approximately 012?? hours, the listed witness PO Simbro, a
uniformed member of the Kansas City Missouri. Police Department who was on duty in a
marked patrol unit observed Vehicle 1 traveling the wrong way on a one way street in the
area of 1. 1th and Lydia. Vehicle 1 was traveling eastbound on 11th Street,?which is a one
way westbound only street between Broadway and Woodland. 
of 11th Street and Woodland. 
stopped the vehicle and as the witness was walking up to the driver's window Driver 1
accelerated and. the vehicle took off at a high rate of speed. Vehicle I. traveled east on
12th Street and then south on Chestnut at a high rate of 
on. Chestnut. For additional information. see Progressive
Investigation Report by P0 Simbro #4567. I

At approximately 013 1 hours, the driver loses control of the vehicle on Chestnut,
approximately mid-block between 24th Street and 25th Street. The vehicle strikes parked
Vehicle #2 and parked Vehicle #3 as it continues sliding towards the south. Debris and
parts from Vehicle #1 strike parked Vehicle causing damage to the rear of the vehicle
and breaking its windshield. Vehicle #1 brie?y leaves the roadway along the northwest
corner of 25th and Chestnut and strikes a stop sign. The stop sign and its support post
were broken. and detached from the base in the ground. The stop sign with post attached
were found south. of 25th Street in. the front yard of 2500 Chestnut. Vehicle #1 returned. to
the roadway and continued to slide towards the south where it struck. parked Vehicle #5
with enough energy to push Vehicle #5 forward into parked Vehicle and parked
Vehicle #6 forward into parked Vehicle Vehicle #1 came to rest facing north in the
middle of the roadway on Chestnut, south of 25th Street. The unrestrained driver was
partially ejected from the vehicle at the driver's door, with the lower portion of his body
pinned in the vehicle between the now damaged driver's side door and the center console.
The driver's front and side airbags were deployed in the collision. Driver #1 was
transported to St. Luke's Hospital by KCFD EMS where he died from injuries sustained
in the collision.

 

This report has been redacted to provont the dloolooure of personally Identi?ablo InformationI15 NINTH Of

47 Inluroo Token

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Form 1 1 tom NM: P13033409
49 POINTS CIF IMTIAL 1 1 2 3 INFD. ROADWAY INFD. . RELATED
Veh 1 Von II 2
CONTACT 
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DENNIS LYDN 5716 SIX FORKS FID, RALEIGH NC 27615 ?mm (919) SHE-3335
Nun! Mdron when. No.

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THE INFORMATIGN IE FOR ALL ACGIHENTE


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2013 News Releases
October 21, 2013

Update to fatal accident from 10f13X13

The Dutchess County Sheriff?s Office reports updated information in the fatal
accident which occurred on Route 9G in the Town of Poughkeepsie during the early
morning hours of 10/ 13f 13. The accident is still under investigation, however preliminary
information has indicated that excessive speed and reckless driving are significant factors in the
crash.

Investigation has shown that during the early morning hours of 10X 13! 13 
riding his with another person, who has been identified as Anthony Derienzo (age 22. of
I?oughkeepsie). The two were riding together but on separate Eyewitness accounts
indicate that the two men were riding together in the Poughkeepsie area, and were riding recklessly
and extremely excessive speeds. At a point in time after the men were observed. driving in this
manner they were approached at a red light by two (2) Sheriff?s Office Deputies, who attempted to
identify and stop them 
they ignored the Deputies? lawful directives to stop by driving away, once again recklessly and at
excessive speeds. As they were driving in this manner and failing to comply, Mr. Bohlmami lost
control of his and crashed on Route 90?- in the area of Cottage Street. Further
investigation has also shown that Mr. Bohlmann was operating the with only a learner?s
permit and not a license.

Mr. Derienao split offend took another route during the incident, so he wasn?t involved in the
crash. Through further investigation he was identified and interviewedwas
arrested for his alleged actions during this incident. At this time Mr. Derieneo has been charged
with the following:

1. A Misdemeanor

2. Reckless driving: Misdemeanor

3. Excessive speed: Traffic infraction
Mr. Derienzo was released on appearance tickets after being processed, and is due to appear before
the Town of Poughkeepsie Court on 11/25/13. As with any other criminal case, the charges
described above are merely accusations and the defendant is presumed innocent until proven guilty

in a court of law. The investigation is continuing, and more information may be released as it
becomes available.



 

Um<ro<z?

Page 1 of 2 Pages


13-?31094

 

 

{213101000110

 

 

 

10 2013

I: .
Llcanaa ID Numaar 519430700
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Show: 1l' involved vahlata Ia:

moro than 95 inches wide;
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operated wilhan ovarwalghl

Baa-<1 - Point at Irn aat
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Enter up to Ihroa
mom codoa
1W:
To:

VEHICLE DAMAGE CODING:

1.13 BEE DIAGRAM ON RIGHT.
14. 17. OEMOLIBHED
16. TRAILER 13. NO 
15. OVERTURNED 1B. OTHER





Raforonoa Marker
9 Lauitudomoruuno:

I01

Longitudal?aa?ng:

4

HOME

AMENDED mamm-

Sunday

New York State Dopadmont of Motor Vahlclaa

POLICE ACCIDENT REPORT
-

  

03:02

NO.
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Fla?aa Whom Accident

?3 Olly Wlaga
Read on which umldantomurrad ROUTE 9?3

at 1) alraat MILLER PL

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EIN 133
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ACCIDENT DIAGRAM

Boo tho 1am; page: of tho adv-1.042; for tho
aooidant diagram,

2

9.

Cost of ropalra to any ono vohIolo Mil bo mow than 510W.
la datarmlna Yam No

a Tm of 

Number or Street Home.)
(Rania Humbor or Elma! Mama)

of

V1 WHILE TRAVELING SOUTH IN BOUND LANE ON STATE ROUTE 9G IN THE TOWN 
POUGHKEEPSIE LOST CONTROL AT A HIGH RATE OF SSEED. V1 OFF THE ROADWAY ON THE EAST BOUND
SIDE THE ROAD STRIKING A SIGN POST. BITTER. STEIKING THE SIGN POST OONTINUEIJ OFF THE

ROADWAY INTO A UTILITY POLE.

 

 

 

 

   
   

 

   
      

 

  
 
 

       
        

 
  

  
 
  
 
  

   
   
  
   

     

 

 

     
 

     

     
 
 

    

 

    

 

 

 

   
  

    

 

   

    

 
 

 

 

 
 
  

   
 
  
 
  
 
  

    
     

      

 
    
  

  
 
 

 
 

  

 

        

PROPERTY DAMAGE BY VEHICLE NYS DOT SIGN, NEW YORK STATE Namun a! all lnvolvad Data of Death Only
   23- 01 03 1 9994 130"} BOHLHANN, JOSHUA 10/13/2013
.. 'Oggcsair?: 511:3: Daputy I Badaa?D Na. NCIG No. gigli?czag?gat 32:24:25} Olga: 

?0113'?? 931 01300 I 01:14 

 

 

 

MV-iDdi?iH) A

You must report within 10 days any accident occurring in New York Stare ceasing a fatality),
pit-mono! injury or damage over $1,000 to the property of any one person. Failure to do as
within it) drips is a misdemeanor. Your license end/or registration may be suspended until a
airport is ?led. Check the box at the top ofpnge i lfycar license is suspendedfar
failure to report this accident on time. You must fill in all information requested on the report.

Then fill In the boxes numbered and 23-30 In the right margin on page enterlng the
number of the Item from Section EI that best describes the circumstances the accident.
If a mention does not a I

enter a dash . If I on do not know an answer enter an 
INSTRUCTIONS - PLEASE PRINT OR TYPE ALL WON USE OLA CK 

    

First unfold along this shaded. dotted line.? 

Don't fold form. instead, piece age 2 over page 1, with the arrows on
page 2 pointing to the boxes on i rig edge of page i.

VEHICLE INVOLVEMENT - If you were in an accident involving:

two-care, 1 section and the other driver?s
information in the VEHICLE 2 section.

I a pedestrian, bicyclist or other pedestrian (a person using a non-motorized conveyance such
as inaline skates. etc), enter the infant-ration in the "Driver" spaces provided

- for Vehicle 2, and check the PEDESTRIAN, BICYCLIST or OTHER PEDESTRIAN box.

In a vehicle other than a motor vehicle (such as a snowmobile, minimbike, 
alluterrain vehicle, trail bike, or other ilOileCtCi' vehicle), enter the driver, registrant and
Vehicle information in the space provided for VEHICLE 2.

an unoccupied vehlcte, enter all available information. Be sure to enter the correct
vehicle Plato Number and Vehicle Type in the VEHICLE 2 block.

I more than two vehicles, ?ll. out additional accident re orts. On these to arts, place the
information for the third vehicle in the space marked Willi 1 and mark. 3. Use the
space marked Wit-11(2th 2 for the touch vehicle, and marl: it it 4 and so on. Additional femis
are available at any Motor Vehicles cities or from the DMV website: W.

0 DRIVER Enter the information 1hr each driver EKACILY as it: appetite on driver license.

9 RECISTRANT Enter registrant infonnation EXACTLY as it appears on the registration of
each vehicle involved in the accident.

VEHICLE DAMAGE - Indicate if the accident exceeds the $1,000 threshold for property damage
to any one vehicle or property caused by the accident, and describe the vehicle antage.

9 ACCIDENT LOCATION Enter the county, locality and street(s) where the accident
occurred. Check the box if there is an intersecting street. If available, identify a permanent
landmark nearby, such as a business, school, shopping mall, parking lot, water tower,
railroad, mountain or cell tower.

ALL INVOLVED - List the names of all persons involved in the accident, and provide the
date of death if anyone was killed in, or as a result of, the accident. If more than four
people are involved, complete another report. in the ALL INVOLVED section of that
report. provide the required information for everyone else involved in the accident. Enter
the following codes in the appropriate columns:

WHICH VEHICLE OCCUPIED (Column ll) - Enter the appropriate number or letter.
I 1. Vehicle 1 2. Vehicle B. Bicyclist P. Pedestrian O. Other Pedestrian

thON VEHICLE (Column 9) - Enter the number item this

 

 

 

 

 

 

 

 

diagram which corresponds to each person's position. .,

1. Driver 2-7. Passengers 8. Riding?-langing on Outside I 7 a It
SAFETY EQUIPMENT USED {Column 1'0) '5

1. None 7. Air Bag Deployed 
2. Lap Belt 8. Air Bag Deployedflalp Belt

3. Shoulder Restraint 9. Air Bag Deployed/Shoulder Restraint C-Hclmel 0111!?

4. Lap Belt Restraint A. Air Bag Deployed! Lap Belt/Restraint 

s. can Rostraint Only a. Air Bag Deployed/Child Restraint 13- Pads Only

6. Helmet Only) O. Other 53101113313 Only

INJURY (Columns ran-c) Check all COlUil?lIl(tI) that apply and DESCRIBE INJURIES:

A - Severe lacerations, broken or distorted limbs, skull fracture, crushed chest. internal
injuries, lurconselous when taken from the accident scene, unable to leave accident
scene without assistance.

13 - Lump on head, abrasions, minor lacerations.

a Momentary unconsciousness, limping, nausea, hysteria, complaint of pain (no visible
injury), whiplash (complaint of neck and head pain).

INSURANCE - Enter damage to private property, if any, hisurancc policy information and VIN.
Attach additional reports to page one. Each page of the report must be numbered in the upper
left corner. Mark additional sheets etcTHE REPORT BE SIGNED RIVER. to 
DR 3H5 I5 UNABLE T13 BEGAUEBE l$ INJUREU QR 

to: CRASH RECORDS CENTER
6 EMPIRE STATE PLAKA
PO BOX 2925
ALBANY NY 12220-0925

    
 
    

  

-: I. I

  

     
   
 

  

Ho euro your
are marked
MERE 

SECTION 

USE TO COMPLETE
BOXES 1-7 and 23?30 0N PAGE 1
FEDESTRIANIBICYCLISTIOTHER FEDESTRIAN LOCATION Bag-E

1. Pedestrian at Intersection 1
2. Podoslrlani?lcyelisti?thor Pedestrian Not at intersection

PEDEETRMN ACTION

 

1. Crossing, Signal
2. Crossing. Agalnst Signal
3, Crossing, No Signal, Marked Crosswalk
c1. Crossing. No Signal or Crosswalk
t5. Along With Traf?c
8. RidingNVaIking iSkatIng Along Highway Against Trellis
from In Front otlSahlnd Parked Vehicle
3. Going tori-?rem Stepped School Bus
9. OnlDI?i Vehicle Other Than School Bus
11, Working In Roadway
12. Playlng In Roadway
13, Other Actions to Roadway
14. Not In Roadway
TRAFFIC CONTROL
1, Mono til. RR Crossing Cotes
2, Traf?c 11. Stopped School Bus-Rod
3. Stop Lights 
4, Flashing 12. Construction Work Area
5, Yield Sign '13. Maintenance Work Area
ti, Ot?ceriC-uord 14. Utility Work Area
7, No Passing Zone 15. Emergency
B. RR Crossing Sign 16. School zone
9. RR Crossing Flashing Light 20. Other

 

 

Ll HT CONDITIONS

 

1. Daylight s. Dusk ??urk-Rood 4
2. Dawn 4.Dark-Road nghted
ROADWAY CHARACTER

1. Straight and Level Curtis and Lovol
2. Straight and Grade ti. Curve and Credo

3. Straight at I3. Curve at Hillerost
ROADWAY SURFACE CONDITION

 

 

1. Dry 3. Mudd El. Slush 0. Other 6
2. wet 4. Snow Ice 6. Flooded
WEATHER 2, Cloudy 6. SIeetiHaIliF-?roeclng Rain
1 mm 3. Rain 
4. Snow 0. Other
DIRECTION OF TRAVEL
I1
1. North 5. South 2
2. Northeast 6. Southwest
3. East 7. West
4, Southeast 3, ah

Northwest 



 

 

 

VEHICLE ACTION

 

 
  

 

1. Colng 11. Avoiding Object to Roadway

2. Making Right Turn 12. Changing Lanes

3. Making Lott Turn 13. Passing

Making Turn 14. 

6. Starting from Parkan 15. Backing

Ii. Starting In Traitic 16. Maklng Right Turn on Red

T, Slowing or Making lettlTum on Red Volt
a. Stunned in Traf?c: sitar-Eal.eazr' - a 2?3
it. Entering Parked Position 

. ed

LOCATION OF FIRST EVENT

1. On Roadway

TYPE OF ACCIDENT
Wt TH

2. Off Roadway



     
 

1, Other Motor Vehicle  'Bg-al?? 5km? Plot
3? $3233?" e. Other Pedestrian Font
4: Animal 10. OlhorObloct(NotFIxed)
ti. Rallread 'l'raln
COLLISION WITH OBJECT
11. Light Pole 21. Median NotAt End
12. Golds Roll - Mot At End 22. Snow Embankment
13. Crash Cushion 23. Eath Embankmonb' rm} Volta
1d. Post Rock CuthItcl't 1
1n, Tree 24. Flro hydrant swung
13. 25- Rail "End Event
'17. Curbing 26. Medlen-End
13. Fence 27, Barrier 
19. Bridge Structure 30. Other leed Object
20. CulvertJHoad 
NU 
31, Overturned 33. Suhmerslon
32. FIrolEprosIon 34. Ran Cit Roadway Only

40. Other

 

  
  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LHHIIncident Report 21 
1 Investigation I pr:
1 OFFICIAL OKLAHOMA TRAFFIC COLLIEION REPORT ?1111121111 I Fatality 
mm I HitSnd 
Rnp?m?? AgnncIy COCO Numbnr (Agunuy Um) I
1 - Nu bn
OKLAHOMA HIGHWAY PATROL 300727213 01 00 01
[mm of 11nd Name MOI-11331 any or Town Numlmr 
I
11222013 0303 47 MAJOR  00 ORISNTA
?2131 
MI. . -
m. I 0002 2.1% @511 23 00 033 1 023  0 300173332
Id) 3022!. Road or Intersectan E?Irnnt. Rand UNITED STATES 112 I 1 0001  CR 2311
HM FIISI 3111111 Data 5211
Run

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(23) InvnsIlgnlInn 

[131an 

?I?rp??lv. 

0A 01 M, 
MOI-11311 my Siam alp Tuluphc-nu (Use Area Dada)
.r 73T17
$13111 $1211. Typo of DmrPad?Ond. OP U113
OR 0 01 04
T351 by Tn Mcdlunl 0th Numbnr 301110 Month Your

SHE IQ 0. OR 12 [2013
VIN Yum Color 2nd Mum Modal G?nfl.
2111:1111 Of
2S3AA4-CT3AH23311T 2010 SLR 0 CHAR 02 WW 0
(1m Nun-In PO 119 Number Innurnnm Tuluphnnu (Una Arnuu C311an
I
er?mtian 4
(11) anuwd by Ownnr?: L221 Name Film $111101
ma 5
Drlvorr"    SAFEW
Mdm?u Clty SI.qu le Vnh. Tde
Ovamlmd 
PO  1  5     1  Lan Bun-Ind Film-m mm 
(13) 
Numbar Numbnr Numbnr 
UnlI 033113111113 a Lnul Nun-In - Sul?k Duh!  
Run
01 01  *1 IM
{15) Addrm: (my 51313 le TnIanIunu (Una A1133 
73114 9
(16} 1.2131123 Nun-Ibm' 51303 0331113 Enduraamamm In]. Sev? Typ? (If Injury OP Una
00031717 TX 3 ?g 32 01
(1 Ejnulnd HAG) by T11 Mndinnl SIS Numan Stale Year
All?
In? 11E   0. FAIRVIEW RONSR MEOICAI. EXAMINER SC34333 TX 07 2013
WIT Color and GOIOI Mnku MCIJHI VHII. CCIIL 
Eklunl uf
2004- WHI 0 FORD F350 04 9mm" '4
(19) Insurancn Pollcy Number Inuumnm (U31: Amu Cudu) 
Insurance ..
AMERICA FIRST INSURANCE SA0730371 0773133002
{20} 11311130311 by Owner': Lunl Numa Sumx
3mm: 21;
FAIRVI EW AUTO SALVAGE 1311031 TEXAS ENVIRONMENTAL PLASTICS
Owuar?n Addfunn Olly 61313 Zip 'I?ownd Voh. Typo
.. OvursIzad Round I?r?hona 
2500 FARRELL. ROAD HOUSTON TX 77073 Land IE 00 Burned a Phnnu In um: 
(22) 
Numbnr Numhnr Numhnr
W012. anluwm Reviewer Nada? humbnr Data of Ralph? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BILL REITE 76 .J AL. 106 
Inlury 521121111; Type 01' Injury (DP) 
II Omar 2. Omnr IN 11 MIA 4 nnlInIIn MIA 3 Trump no Ni 00 N01 ?5 liq-11111an211111
Pudnnu'Inn *nr I "12mg"? E1 F212 0 1 ?and In?unnm DIDD n? ?lnl 01 Natlde 3'3 a; on?:
Fnunulrhm Impulrod mm! 01? lle 5 !!an Un awn
1' mm a Nun? ExInmnI II Ln 1: 0:1 (211an 31111011102 02 WII 11m:I 1?1 0: Should" ?My 
ISA-1111311 II mm 3-1 11.3.2211.? 21 SIcnpy LInImner D-I Shnuldnr 11111: 1.101 8le DD Huulrulnlv Roar Fudnn
Alr ling Dupluym?l maul?! muman 'I?m Insurance VerlI?Iuallun Lulu-I TOWN 
11111 II hl In. .I'hOlh I1n . In II 1:1 :1 I: 111211. 11 MIA 11 11121 A I1 0 NA 3 Funnilunnl 0 NM 3 Dmrulur 0 HM (KI I35 
1 H21 WISH 1 I131 0513:] newly 1 53 1 11133.1 11715.1. 31an 1mm 1 1 H11 II 2113mm 0.1 In 
2 D21: am I anI I5 anInIInu- omnInnunn 2 11111112. Unknown 2 on 2 2111th um WM 2 Unknown 5? I?arrnluu   D7 gum 
3 v?ldn 9 {Dnr?uvmrn'lUnknuwn I arIJnIIy II Hum Tran? a? Trail? Unknw?
WARNING - STATE LAW Use Of contents fOr IS unlawful

 

 

DPS: 0192?01 REV 0107

one Member J00727-13



 

 



 

 

 

 

 

 

 

 



EVENTS

Ldligllude

 

 

 

 

 

 

4 5
I'Inllruud Number Reeawev (brlentellon Pg ?Df 
Unll IE Unl'l. 
Nunmer Number 01 EJ

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unlt Final Event :aeend Event ll'lrlrIIl Event Fau?ll Evml
0A 00 00 00 00

Hall I-?lral Event ?aeand Event Thlru Event Fourth Event
01 17? '19 18 10
(30 Nompplieabla 21
10 Overturniliellever 22
1?1 23
12 
?13 
14 Carem?Equl ment LESS I10
15 Equ parent :eliure (Blown Tire. Brake 31

Failure. etc.) 32

16 Separatlen ernlle 33
Departed?earl Right 31%
18 [Smearlml Fiend Len 
19 Cress MedianI?Centerllne 36
20 Downhill Runaway



Reill'l?fkii

 

 

 

 

 

 

 

 

M?hl Harmful Hr? Hun-Mm
i'er 
0 Entire
Celilelen
Meal Event 

 

 

 

 

 

 

 

 

 

Fellrdurn rat From Meter Vehicle
'i'hrewn Falling Object
Other Non-Callie an

PERSDN VEHICLE. on 
FIXED 

lJedeStrlen

Pedal Gy?le

Railway Vehicle (train. engine)

Animal

Molor Vehicle in 'l'reneborl

Parked Meier Vehlcle

Struck by Fellin . Cargo or
Anything Bel lrI ellen by Motor Vehicle

37'

38
FIX
40

 

 

Werk ZanaiMalntanance
lit ulpment I
or Ier (Jolene!

ED DBJECT:

Barrier Concrete}

Harrier Ollrer)

Barrlarfable)

Fence ele

Fence

?l'ral'ile Blgnel Buppari

'l'railit: Si?" Support
Utility F?e elLluiIl Guppert
Other PeatiF?elGiEupport
l-aee
Guardrail End

Culvert

Curb

leiand

53nd Barrela

impact Attenuated Crunh
Guelrirm

 

 

 

 

 

lndlea'la Narth
by Arrew

Pavement Drop-Off
Diloh

Embankment

Tree (Elendlne)
Dividing Girl)

liietainrn all

Bridge A utmem
Bridge l-?ler er Supper!
Bridge Rail

Bridge Peel

Bridge Garb

Bridge Super Structure (Beanie)
Bridge Overhead tilrueture
Delinealor

Malibu);

Other l-lxod Object

Ollrer l'liuhway Structure
Ground

Unknown

 

 

 UNIT 1 HAD STRUDE STDR STICKS THAT WERE
DEPLDYED BY DHR UNIT .I-SID. UNIT 1 THEN DERARTED THE RDADWAY To THE RIGHT AND TRAVELED
14.10 FEET BEFORE STRIHING A ON THE WEST EDGE DF DR 254. UNIT 1 THEN
TRAVELED APPROXIMATELY 230' EEFDRE REENTERING THE ROADWAY. UNIT 1 THEN ENTERED A SRDAD SLIDE.
UNIT 1 THE RDADWAY IN A SRDAD SLIDE TRAVELING 155 FEET EEFGRE DERARTING
THE NORTH SIDE DE THE ROADWAY AND ROLLING. UNIT 1 THEN RDLLED 3 TIMES SEFDRE GDMINS TD REST DN
ITS WHEELS. ADI WAS APPROXIMATELY 32 FEET DF THE EDGE OF US 412 AND APPROXIMATELY
FEET EAST DF DR 254. ADR WAS APPROXIMATELY 130 FEET EAST AND 72 FEET NORTH OF ADI. DURING THE
THE DRIVER WAS EJEDTED FRDM THE UNIT 1. ADR OF THE DRIVER WAS 30 FEET
WEST OF THE ADR OF UNIT 1 AND 97 FEET DF THE EDGE OF US 412.

 

 

This report is based on the officer's lnvestlgatlon collision. This repDrt may contain the opinion of the of?cer.

DPS: 0192?04 REV 0107

"Print CR8 W0338497 page I 0ft)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I commonweaarn or I
PDMCIE CRASH IRIEIPIDIIRTIING FDIRIMI a Crash Number
Case Closer! Reportable Crash ?(0333497
 500 - Yes No I Yes No
Incident Member Police Agency Petrol Zone
I I moat-2013 I W305 I I 3 
Agency Name Precinct Investigation Date 
I New Remington City Dispatch Time (mil) Arrival Time (mil) investigator Hedge Number
lg [1547 I 1550 ISGT I I 1.9 I
Reviewer Badge Number ApprovaiDate 
ISGT. STEPHEN GRDARK SR. I 32 I 04  09  2013 I
 Countyd ulceenty Name Municipality Municipality Name I-   
I64 I IWestmol?eiand I I305 I INow Kauailtgton City I :3 
[i
?3 Crash Crash Timet?mii) itie of Units People Injured ttilierit *liatitl CD Man I 
2 complete CD 55"
or 13 2013 1550 meme tea-1057a are) I No teat?? :1 res- - tagger? 1:1 res In No 
madman: 4 Way Intersection "w Intersection (I) Mimi-Err?an on Ramp Railroad Crossing IE
:1  I Interseclien gag/t On Ramp Ci Crossover tlther i 5m Dummy
Route Number Segment (Optimal) Travel Lanes 5 eed Limit I Nonh MOI-150 Number (if applicable1:1 sent 631
.. Street Name sweet Enc?ng 3 East For Mid-block crashes only. Use
4 .I I C: We? postal Hausa Number and make sure
IE I ORANGL interstate CD CD CD State County Local Road CD Private Other!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Not Turnpike) (Eaisest) Spur Highway Road or Street Read Unknown
?eute Number SegmenHOptIOrlali Travel Lanes Speed Limit North
Street Name Street Ending 5 ?51
I i Wis"
C) Unknown
mm Interstate Turn ike Turn the State County Local Road Private Otherl
CD (NotTurnolkei c3 (East'lee-st) Spurp C: Highway CD Road a or Street C3 Road E) Unknown
intersecting at were or Mile Post or Segment, Marker South
meme Dr intersecting Street Name St Ending in (3 East Dr miles
:2 Enter I I I West
Information a
I.  1? forBDi?H -
-. at more or ltlliie Past 0r Segment llilerirer CD North Distance From Crash
This Option Scene to Landmark?l
Or intersecting Street Name i St Endin (For Cram 
1 lg - Ea? Landmark i and
I I 5 '5 W935i Landmark 2}
 Degrees Seconds  Degrees Minutes Seconds 
7 Letitude:I I I I LongitudeWami?ewm new 5'9" amine Officer or teammate I I i Emergency
a men . av ce 
a DIM Traffic Signal ?gtri?lIIruER Crossing ml?? Type TCD Ne Centrnis CD Improperly Eggs-flint.?
?Wing i? . Device Not Davice Fenctiunin
CD C) 5m? Sign IZientrols C3 unknown Functioning Property 9 unkr?ow"

 

 

Not Applicable Partially Fully Unknewn Directiaa 5mm  West East and Wrest 

Yes I No (23
Unknown 

 

 

 

 

 

 


skip rest of me Lane crmure sectianj mm CZ) North CD East I North and South C) All

 

55% "mm! C) -r 30 Min. I 30-60 Min. 1.31115 Chours C3 Unknown

 .. -

 

.-11-

3037981201 50910103123 9H OXBOI 5

'Prinl CR8 W0338497

_l

eereeae?irwetieia
[melee melee relates!

 

 

Page. 2 of 9



 

 

 

 

Page: I
AA 500 2 ?will  
2 W0338497
jig-l arm!? - CZ) l'iitdl RunVehlcie CD Illegally Parked CD Legally Parked CD Man a Melerizecl which
- r- 
#2 Pedesuian C) Pldem?rimml?smws' CD [MB-bled hm.? CD Train CD Phantom Vehicle C: as I 
In Wheelchair. etc Prewous Crash Yes Campfete Form C.)
"Pedestrian" or ?Peels-scrim on Skates, in Wheelchair, ere". Com lere Form Secrion 28} 
 amen m? \l ..
Unit No First Name MI Date of Birth 
I IDEVANTE I I07 I I03 I I1993 I

Mate? est-Name. I Telephone Number
5 I I

 

 

 

 

 

 

Address I City 1 State

 

I 14-17 ALCOA DR ARNOLD PA

II
I Iisoee

 

 

 

 

 

 

 

 

 

 

 

Driver License Number State Class
I30807951 I I

?iwhei/Dmgs Susgeeted Driver or Pedesrrlan Physical Condition
No C) illegal [lines Medication ?gl?a?mly Dim-l :3 Fatigue Medication
C.) Alcohol Cl Alcohol and Drugs I Unknown C) Ha?kliaggn C) sick C: Asleep I Unknown
I. ?lfahoi [est . . .
- Tam Nm Given a Bream CH.) Other Primary Vehicle Cede Vrol'eiren Chmged?
. .. Yes No
:3 Blood (3. mm gain DRIVING I
an Aicohoi Test Results (I) Test Refused C3  MW leDriver Operated Beuriver Flecl Scene
I  3 Test Given, Vehicle 11le and Ron I
- Contaminated Results anO Driver Q=Urlknawn

 

 

Ownelvbriver Applicable

Vehicle Owned!
Leased by Driver

Dszrivate Vehicle Not
Owned/Leased by Driver

Orieliented Vehicle

D4m5tate Police Vehicle
DSNPENNDOT Vehicle
??eother State Gov Veh

07wMunicipal Police Veh
OBthher Municipal
Government Vehicle

ngFecleral Gov Veh
Qanother
QQnUnknown

 

Same as

 

Driver (1) I

Owner First Name



Owner Last Name or Business Name (if Pedestrian, skip this Section)

I I HARRISON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address I City I State I Zip Vehicle Make *illieile Code
I 16 HELEN ST ROCKS PA 15136 I I Dodge I I07 I
\llN Model Year Vehicle Model (569 overlay)
I 2134GP44GGYR317609 I I I CARAVAN I
License Plate Reg. State Est. Speed Kenya Towed Towed By
I HZFOWZ I IPA I035 I I Yes to No I HAWK ?rowmo I
Insurance Company Policy No
. I: Yes No C) Egg? I BRISTOL weer INS co I I (300 4944396 02 I
all a leiowing Pass. Vein eelMohllelModular Home ?leSemI-Tlailer Tag No The Year Tag St
"sin: Ila-19f ZeTowing Truck SuCampel {leather I I I I
BuTowirlg Utility Trailer ?uFull Trailer BeUnknown
3g
reel on We n: a Palm on euremeni? Eularev Overlay
MM 5 I 05=Large Truck 20=Unieyrile Bicycle, muggiggegrgal
0 01 Automob'lu OEKSUV Till;ch I -
D7e5iivel 02:Mmorcy?ie D7n=Varl EluOther Peliaicycle  $?Ehcable tamer
Dielilue D?mBlown 04=Sltiall Truck lleFMm EQUIP Bellini? 3* Rider 03=Pa ice 22=Twirl Trailer
Ohm- lom?me l? I?ll? ?z?conmud ?Mal? 08=Other rmerqency P3=Tripie Trailer
M, Sectional 3:3? 5 gg=gi?ley Which; eluMadmad Veil
en 4: er 4? =terypepece mler 
ospmack ggzUnkann osr??gz, gg?mplere 193Unk- Mm SPEC Veh ill-Pupil Transpolt BQHUnllnown
er in Damage indicator Gradient swownhm MW
DO=Non-Colli' 14:11 a Darlene Saul?unctionel 44aollom of Hill l=straighl
IE Palm 15mT?w??iIL?le luminor seTop of Hill 2=Curvecl
1 EHTDI) germanknown 9=Unknewn - 9=Unknowrl ElmUnknown
mew melee: PENNHOT COPY

1 303793 233 

 

9/10/2015

 Print CRS W03 3 8497

.J

AA  3 1 Police Use only

0i}: 
POMCE CRASH 

Page



Page 3 of 9



W03384197

 

Pawnee.
A in?river
2=Passen er
'IaPodostr an
BeOther


Sear

=Pernale
MmMaie

?Unknown


gaR%t 
In aortn ury
BuModerate
In dry
4- innr Injury
Uni:
Severity
9=Unknown if
Injury

 



Seminar
A Passengifrl?ccupant

Oio?river - Ail Ve Icles

D2=From Seat Middle Position

03=Pront Seat Right Side

UdeSecond iiow - Lott Side Gr
Passen er

USuSedOnd Row - Mi die Position

UGmSocond Row - Right Side

We'rhird how 0r (Heater -
Left Side

DBuTi'lirr?I Raw Cir Greater -
Middle Position

DQe'ihird Row Or Greater -
Right Side

10=Sleeoer Section oi Trucitcah

ii=ln Other Enclosed
Passenger Or Cargo Area

122m 0 an Area
(Bat: 01 Picitup. Etc.)

13==Trailln9 Unit

14=Ridln On Vehicle Exterior

15u13us essenger

seaouwr







O?e?one Used 9 Not Applicable
01=Shau der Belt Used

Mateo Belt Used

UBoLap And Shoulder Belt Used
Safety Seat Used
05=Motore cle Helmet Used
O?wBic cle lelmet Used

10e5a ety Belt Used improperiy
11mChild Safety Seat Used improperly
izaHelntet Used irn roperly 
Eduiiestroint Used. 'ype Unknown
99mUnl<nown

Saidwt?utesw Item
anemone Use I Not Applicable
[Ha-Front Air Bag Defloyed (For This Seat)
OZuSide Air Bag De eyed (For This Seat)
OBwUther Type Air ad Deployed
DanMulttpio Air Bags Deployed
Protection
Wearing EIbothnee/Pads
1D=Alr Bag Not Deployed. Switch On
11=Air Bag Net Deployed. Switch on
12=A r Beg Not Deployed.

Unis Switch Settin
13wAir Bag Removed TPrior To Crash)
Ii Air Bag Deployed
EiEluUnitnown

5mm Applicable

1=Nut Eiectecl
zeTotellr Elected
BoPartiely -jected
9=Unknown

I.
{inner Eg'eoed I Not ergalicabie

1=Through Side Door pening
Side Window

BeThrough 

4wThrough Back Door 

5=Thrpugh Back Door Tall ate Opening
t5=Through Root 0%enin SunrootI

 

Top Up)
Re?stricated By Mechanical Means

Convertible Top own
'Io'l'hrough Opening (Convertible
QwUnlsnown
gradation: 

ot Applicable
i=i\iot Patricated
BmFreed By Nan - Mechanical Means
Brother
timUnlsnown

 

 

 

smur-

 

sets Agency: INEW tsensmoron EMSIL were: Facility: ALLEGHENY GENERAL1-103PITAL 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unltno Person No balm? Date of Birth (MM-Deva A i) 1 
.. s3 ["103 Hi9? ll?lm ?99 ll"4 
Home I Address I Phone EMS Trauma?
31333;?; IDEVANTE D. BROADEN 1417 ALCOA DR. ARNOLD PA 15063 :3 Yes I Na
Unit No Person No Dale?? Data at Birth A I
[as  03 H11 l-llaee iEElee H99 H04 
Name I Address I Phone EMS 
El gi?gfai'; R. 8120 ST VERONA PA 15147 Yes i No
Unit No Person No balm? taste of Birth A 1
i H31 H1991 1E199 ilOD HP1 
Name I Address I Phone EMS Transport
mm, IMARQUIS HUGHES 1920 VICTORIA AVE ARNOLD PA 15068 (3 ND
UnitNo Parson Ne Wat?? Date of Birth A I
on 1 Pi:22 111994 iEiiss Ilse ll04 NEE
Name I Address I Phone EMS Transport
gapng?nfgr IEDWARD R. GREEN 1370 5TH AVE. ARNOLD PA 15063 YES NO
unit No Person No ?Glam? Date of Birth (MM-DD-YYW) A 1
co  oe Hoe  - 1992   oe Hoe ] o4 
Name I Address I Phone EMS Transport
El g?f?gr D. SCOTT 1729 BELLEAU ST APT 35 PITTSBURGH PA 1521 We; :3 No
Unit No Person No mm?? Data of Birth A I
on 09 He? 1990   99 H99 H04 la

 

 

 

Name I Address I Phone
Same as JACKSON 8120 CIHIASRE ST VERONA PA 15147
Operator

 

EMS Transport
(:31 Yes I No

 

 

 

 

AIM-6M "was;

COPY

9I10I2015

 Print CRE- W0338497 Page 4 of 9

 

 

 

 

 

 

 

 

.. i 'i
PDUEE cease: FORM Page 
AA see 3 I or" ?rm? I 4 I w0338497
rr . m. 'di
Jane: I ?ame:
A in rwer DDmNot A P. ssen 0 is one sed I Not Applienhie (3 Damn Applicable
2mi?assenger - All valicles dimShoulrler Belt Used toilet Eiected
i 7ePedestrran warrant Seat Middle Position UZoiap Belt Used ;=Tetallr Eteded
Boomer DEHFront Seat Right Side OSuLao And Shoulder Belt Used 3=P?iti? 'Jected
QmUnknown 04a5econd Row - Left Side 0r Safety Seat UsEd QHUHRHOWH
Passenger 05=MotorcIcle Helmet Used
05=Second Row - Middle Position cle ieirnet Used 
593. OBoSecond Row - Right Side ids-5a ety Beit Used improperly SIENM I Nm Applicable
E'Female O'IwThird Row 0r Greater - ?iiuChild Safety Seat Used Irhprepedy WThmugh Side Dam Opening
Left Side 12=Hoimet Used im roperly 25thqu we Window
. Hunknown DaoThird Row 0r Greater ddaitestraint Used. ype UnknoWH 3H1-Iwugh Windshield
Middle Position QEJuUnisnown Ina-?rough 3m: Dom
OBarhird Row Or Greater - . I Sm'l'hrough Bark Dom Tail ate Opening
.E Will? .  Rool Openln ?Sunroof/
E1 . 10::Sieeper SecirIen oil Truckeah Ulse I Neat Convertibm Tap Down
"?lm midml? 11min Dlher Em: also im ront ?mums Passenger Or Cargo Area DZuSide Air Bag Deg eyed (For This Seat) Maytag; Rom Opel-"n9 
2=Major injury 12min 0 on Area OBthher Type Air ae Deployed 
3=Maderm (Bar; or Pickup. Etc.) DanMuliinla Air Bags Deployed
In my 13nTraiIing unit Protection
Inm' Injury ids-Riding 0n Vehicle Exterior D?ualpyciist Wearing iilhowIKneeIPads Miami-M;
guinjury, Uni: i?oaus Passenger iOnAh? ?an Not Deployed, Swneh On I OENDI Applicable
severity Q?wother 11=Arr Beg No1 Deployed, Switch Ofi 13ml Extricamd
BaUnknewn ii 12=Alf ?9 N01 DOPIWW- Zo?xtricated By Mechanical Means
iniury ?Pk . {satire-ed By Nan - Mechanimi Means
13-:Arr Bag Removed Prior TO Crash) 3,?th
iSi=Unknown ii Air Bag Deployed 
BQnUnltnown
- 5 e' 
12 EMS Agency: INEW IMedical Facility: GENERAL I AL I

 

 

 

Unit No Person No date of Birth (MM-DD-WW)

A a r;  
 Hum renew We met]

Name I Address I Phone EMS Transport
Same as IDEVIAN M. rarer-roman 3193 ST VERONA PA 15147 Yes No

Operator

 

 

am

Date of Birth 

ah si??i

Unit No Person No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name I Address I Phone EMS Transport
Same as I
Operator Yes C.) No
Unit No Person no am of Birth (MM-oeva EDEN il 
Home I Address I Phone EMS Transport
Same as I 
Operator (D Yes No
- C. I
unlt No Person No Dale?? Date of Birth (Name I Address I Phone EMS Transport
Same as I
Operator Unit No Person No Dale?? Date of Birth (Name I Address I Phone EMS Transport
Same as I
Operator Yes C) No

 

 

 

I onto aroma (MM-DD-YWY) A i
i iElElEi
Name I Address I Phone ems Transport
E1 sissisi 

PENNDOT r:on

Unit No Person No

 

 

 

 

1 303798 233  9I10I2015

 Print CR3 W0338497 Page. 5 of9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dr  it I
FDUCE NEPUNWNG FORM Page cm "m 
  4 I Police Use Only . I I 5 I ?(0338497 I
- Hw?oao 0n dunnole Be?ideawi ti Hlet Pedeatrlan
.
 cram "an 7 1=Fieor End 3nFISier Roar (opgos?u 
I  I  I link no) time motion) 7=Hll ?ied Oblacl He?llh?d?l??g??:
 ?1 Relation gig 395ml; 5 1=0n Travel Leone EuModlon lie-Dottilde ?l'etGore (Homo Intersection)
I EmBhouldor daFtoedeldo ?wli'l Parking L803 QfUl'lk?DW?
15 Jg  sugar-?t,  . .. 
- 2: nrlt- 9 5 t3: urk-Un now
g; 
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Ind?M".  
 4 Stun? ?wlce Patches: homer
Written; 0 
1=Wet eegIIet-r cogent! ..  
Utility?e613 one it moms Even? soengt Fence orwail
1 :3 lanes) i met in smitten
.
Unit are SEZHII WI 3 33min llridoe oer 0r Abutment
2 mi I ?rent soonest?
. 05rd! I?il . .
ots=tiit Other Traffic Unit Bou Or Obstacle
Heme PM 07=Hit beer Road?
3 I C) I I 03=l-lit Other Animal ttenoolor
Mn? '1 . With Other Nan 3?nl'litF'reHrdrarIl .
So uontlel - 
in 1  renninILEIISCR a; diet-liti:refliclsland
?5 13=5lwck ?nil 3  
Harm Event un Most? Utility Pole Number    Bum? 
I 16=5trueh By Other Traffic Unit 43ml!" Other Fixed?b en,
CD 2mm rice 0r Sittubhe Alt-leHiI Unknown Fore Detect
I ?l
No 22mllit Embankment SDoDveriuranoll Over 
to 1 (D I I ZHwHit gote Bugatti: By Thrown 0r Falling
24 H'tTa -
{g Gruar'd 52oPot Holes Or Other
Please For I I ggwI'IIt Enuogd Rail End 53 Igg?mgnl "regurmmes
. . or 
Em? 3 C3 Concrete 0r 54:0"! In Vehicle
5" Lon 'itudlnai Barrier Non-Colliers"
rder 4 I I 29m" Itch goeunttnown Hermlui Event
1' - Fun? human?,1 .twcy- .
I Unit No Harm Event ltil'ostif I Unit No Harm Event SI 
gar-'11 Harm 00 No Contributin Action . i
1? van :1 Event In minnow was {3553mm ie=ortwno 0h The Wrong
the Crash mentoring Using Hand Held Phone 303?
he not rent-tit titit intonation on Multiple ll??tii 03u0rivino Using Hoods Free 19=Makln9 Imp?). er
"legal uqum Entrence To Iohwoy
  1=Careless Perltn z?Un erkln
uo=None Road Conditions liceiSnow) ?2=0oermnder I 
01=winrly Conditions stance 0n Roadway Dsgkunning Sto 5: Compensation At Curve
02=Sodden Weather Conditions iBnPotholes Deenunnin lie no it 
0320mm Weather Conditions MnBroken Or Cracked Pavement tDmFallure 0 Res and To gonorivin goo Feel for. Conditions
Downeer In Roadway ise?rcn Obstructed Other Traffic 'ontrol Device 25mm?: 
05=ooetaiole On Roedwe 'i?wSoft Shoulder Or Drop Ci" 11n?l'eil atln i   ?t Item I
ce.  sse
Donether In Roe way 20=0ther Roadway Factor den '0 
07u0lero 29=Other Environmental Factor 13=I  egeily Sitier 0n oa ZBHFailum To Isa SPEciaIized Eqqu
oeewieric Zone Retated Boeunicnown mam? Pass-mg gMiteetee By Physical Condition
- . . - QBtOther improper [Driving Actions
If saga Mg 1;:Wl en.? 15=Pesstn in No Pessin Zone.
Ug?Noi?e 0 mm Igg?thm Hubr?er heotInQICantrol l?nDrWing The Wrong ny On 
D7=Headlil I-m I. Dl'il?l?i, 1-Way Street
oz=Broke System oeen net ighe Unl 
03e5teerlng System oeeot er Lights Not I01 I MannieIona?? - Ig?rlel?ggs?verloeded  
:ETI'ower ram 1: note 'ieier Ztm?bstructed Win shield ad I A og?wDrkIng
I 1 I I I I QQmUnltnown Ohm? gge?uslsino Keith? I hi I
- pproac mg i no no co
Oimgg??d?ogg?rg 0n Vehicle

 

- 0?w$tending

Wm Unit No Factor Code oquttiittno, Running, Jogging. 93=mher
19 Inwm?m an I 26 I or playing EIB=Unltnown
Elli? 0 

 
:3 :3 iron is the Prime Factor 

Typo, leave Unit No blank

 

 

 

 

 

 

 

 

 



l'??lil ll 6053?!

3 9/10/2015

 Print CR3 W0338497 Page 6 of 9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.J ?l
POLICE CRASH REPORTING FORM Page Cf?ih Number
Police Use (Jnly
500 witness Name Phone
Address
2 Witness Name Phone
Addrea:
Narrative and additional witnesses: Accident Investigation Notification Issued? Property Damage 

 

Sgt. Samuel Long #19

On 01i1ai2013 at 1547 hrs. NKPD units were assisting Arnold PD with a call for a silver minivan occupied by
multiple placlt males who had pointed a ?rearm at another male who was walking along the street.

County 911 advised that the vehicle. unit was last seen travelling south on 51h Ave towards 11th St. This
officer and Film Grille were travelling west on 11th St when this ef?cer observed unit #1 stop at the intersection
of 5th Ave and 11th St. Unit a silver Dodge Caravan bearing PA registration HZF 0972. turned east on 11th
St towards this officer's position. I activated my overhead lights in order to stop unit Unit #1 did not stop and
drove around my vehicle. police units proceeded to pursue unit Police units involved in the pursuit had
overhead lights and sirens activated for the duration of the pursuit. County 911 advised that unit #1 was listed
as stolen.

?ii The pursuit of unit #1 led east on Locust St where it turned onto Taylor Ave and then onto Orange Ailey. The
intersection of Orange Ailey and Taylor Ave is where the ?rst occupant jumped from unit #1 as it slowed to
negotiate the right turn. A short distance later unit #1 slowed again where two more occupants exited the
vehicle. one of which was holding a pistol in his right hand. That male was later identi?ed as Devian Nicholson.
Grille stopped and pursued Mr. Nicholson on feet at that point.

?rm atsl Email-re

Unit #1 continued on Orange Alley crossing over Catalpa

 

 

 

 

roan ll MSW (11M) COPY



 



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Mm INVESTIGATION DIAGRAM . .  unm?maymvemagunmannmuyugns 
INVESTIGATOR: mom. .J. 0. swim. ..
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FF THE SIDE DF THE ROADWAY BTRIKINB A SIGN.
TRAVELED OFF THE LEFT SIDE OF THE
RDADWAYI. AND 5. RUCHA UTILITY PD LE. 

woman a mum
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5 MPH.

 

 

   

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3:29.11. 2015 140.5731 F. 4/17 
.II I Page 1
Mugsvi?e Pallceihe meat
Rn: 
incident No. 1000007403. I 
Incident 
cm Nu. mum. Tm Criminal m1. 23:10
aulun Dpen clear. 0th By: mum.
El?lul M060 HwAIomun. leur Mwa- W1 Allin. William 3 0319111013
Pam. VIM. Nu Nan-um lnuanlfpalm Dam-law? 
Duno?p?un
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Drug Enlist! Gang Roland Hl-Epud Mmuil Weapon! Uind
mum Gm {SM-lumm U0 Fa Mam EVADING ARREST DETENTION CAUSING DEATH Nu. Premiere
at? Mailvatim Aug Alum-lamb. Chum". ?upp?mgnt: 
Mr. Gnnuml Canaan Bivd Lao-W 
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Off. Baum Dill ?szMO? 23:10 DH. End Blf?fz?? 20:10 Emy'mthw 
DINO Him! 0mm Karma Hi-Spnd Pumull Wuhan: Uud
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lunlnm?m m: Elm: Miran I
But: a: min Victim 1m :3 King Aw: . Kin?willm 7m:

 

Vehicle:

RELEASED UNDER. (WEN RECORDS

Stall. 20H No.573i P. 6/1?

POLICE DEPARTMENT

- Narrative
Date of report: Dam/2013 Case Number: 1300007492

 

incident Number :1300007492 .

On Wednesday. March 20. Stile Corporalv. Murray #64 called out overthe police radio that 
he was attempting to stop a vehicle that was oVading him. corporal Murray-described the
suspect vehicle as an Extended Cais?hevy Pick Up. - -

Corporal Marray stated that the vehicle Was traveling eastbound on General Savazos
headed towards the Naval Base. advised dispatch that i was in route to his location as a-
backup silicon A short time later Corporal Murray advised thatthe vehicle attempted to ram
the Gate resulting in a major accident. Corporal Murray immediately requested EMS to his
. location. .

Upon arrival 1 observed a Grey Chevrolet 1500 Extended Cab Filoltup stopped in the
middle of the street in the opposite lane of traffic. The vehicle had cross theoenter of the lane
and drove against traffic and attempted to ram the security gate. "the security gate appeared to
have stopped the vehicle at the point at impact and prevented the vehicle trorn entering the



There were several occupants in the bed of the pick that sustained various inlurles. I
along with other Police Of?cers, Boarder Patrol. Naval Security and Naval Police
(WI-?tit removed the occupants from the vehicle that were able to stand. They-were
placed do against a cement barrier where they could be triaged by EMS. I observed four
occupants in the bed of the pickup. The subjects in the had identified theMselves as Felipe
Castillo. male from Honduras. Santos Perez Nalera 23yrs old male from Guatemala. Jacobo
Pirlr 18yrs old lrorn Guatemala, and Ohando Perez 22yrs old from (automate. Once EMS was
on scene they began gradually removing people tram the CAB of the Vehicle and as they were
placed in the triage area was able to get some names others were unconscious and they
could not preside their information. - I

 

Officer: Alaman. Javier I Approving Supervisor: Allen. William 

transit oped needless
Page I of 2

i

JUVENILE EYES ENG PRIVATE 

 

 

 

 

  

 

 

  
  

PAGE

 

OI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL CENTER

By:
MED 7. 13

- mite Agency NO. .3130me umaonm Gaunt! Data UMVH
130052533 MOTOR VEHISMS ACCIDENT REPORT 
ft. A nv ct Total Number of: lnotdo City of:
Dam Dmat?] TM 0 vantctaa Irtjurlea 
Igun Th 3' 1518 1518 3 . 3 1
Rand of PEAONTREE INDUSTRIAL BOULEVARD IE EEAOHTREE OREST DRIVE Cortootod Roport?? [it]
Occurrence Intersection With 
1m tnteratate EDLOweat St. Rt. 3% Go. Read am Otty St. Intaratalo Lowest St. Rt. 3 Ga. Road Cally 3t. Suppl to DnolnalI?Iun Yoo IE
EJWW ?Immeretate o?Lowoot St. Rt. BEICounty Ra. St. am So. Lino City DULUTH
And continuing In tho ctlrocllon Shocked above. the God
Noxt Rotoronoo Point to 1D Lowest 3L Rt. 3 c9, [Toad City at. SCI Ce. Lino 313007
.  FIRST I I I INITIAL '5 LAST NAME MIDDLE INITIAL
Katmai; ..     ?It: "w DAWN
-. . . ..I 
Addreaa Aadt'eea
1? r1621 HOUSE ROAO 3955 STONSSRIAR LANE
City atato th DOS Ctty State Zip II 
FLOWERY BRANC GA aorta DULUTH SA 30097 foot-14
Crtvot?a Lloanao No. Ctaao State Mata Female Driver?o Lloonoo No. State Male Female
050723160 GA 058695945 GA
Posted tnouronoo Co. Policy No. Pootod I Inaumnoa Go. Follay No.
39%? 55 TRAVOO OO 55 METROPOLITAN GROUP
Year Matte Model Telephone No. Year Make Model Telephone NO.
1995 N155 2005 CHIEV EQUINCX
VIN Vortloto Color VIN Vohtolo Cotor
JN10A21DOST057925 - ELK WHI
Tan 1! Stata County Month I Year Tag at 31am County Mogth Toar
PILBRTE OA SWINNETT 09 2013 GA GWINNETT 0/ 2014
Trotter Tag a $tato County Month Yoar Trollar Tag State County Month I Year
I I
mama Cwnat?a Name (laat tirot middle initial) I mm 55 Drivm Cwnar?a Narno (toot ?rst tnltiot)

City Stan zip City State zip
Rornovott toy Hammad Fto uoat Llat
STATEWIDE WRECKER SERVICE ?mm? STATEWIDE WREOKER SERVIOE - 
Alootiol Toot Typo Raoulto 13mg Toot Typo Ftoautto Alcohol Toot Typo Rooulto Crag Toot Typo Reaulta
2 2 2 2t .
Drtvor Conn Dtrootton of Trovot Vtolon Factora Drlvor Cond tl?ilraotlon of Travel Vlalrm Contributing Faalaro
. 3 1 Dbaouwd 1 - 013mm? '1 01 
Volt Cone Veh Monouvor Pad Monomer 
Veh CItIond Von Mogouyor Pact Manauvar 3g 1 10 
Moat Harmtul Event Glaae: II I Voh Typo: 1 Meat HanI'nfuI Evont I I Veh I Voh Typo: 
Trat?o Ctr! 7 'Dovioo Inoporatlvo? Yoo No Ibavloa Inoparattvo? Yao No 
Inturoot Tatton To:

 

EMS Notitloo Tima

EMS Arrtval TIn?te

Hoopttol Arrivat 't?lmo

Phetaa Taken - Yaa  Na. 

By: .
INV. DR. ARRENDALE #874

 

 

 

 

51 3 524 1 
Raped By:  my I a Badge It Report Date Chokad By: Um Clt?Ck?d
Ceanty Potloe Dept. 07434013 3533 marine a'rhtoaata
Witneaatea): NAME (loot tirSt middle Inlttal) Straat City 

NAME (teat {trot middle Inittal) Street Addreaa City State ZIP Tataphana ND. 
9 .

 

MIGRDFILM NUMBER (DD NDT WRITE IN SPACE)

   

 

 

 

 

 

 

 

Corner Home I Carrtar Mama
Wm? vm?
AddroSS City - . - - ,Stale zip Addreaa Clty State 
No. ot Axloo G.V.W.R. a. Re Cargo ?atly Type No. of Axloa G.V.W.R. t1. Ra ablo Cargo Body Typo
Yoo No Yea No
Vehtele Gonna. Interstate Intrastate El Vehlete Oontig. t.c.O.M.O.tt Intaratale tntreotatelj

 

 

 

o.o.t..1 2mm:
Vehlete Ptooaraod? 1.I:lYoo szo
Reteaeed? 

C.D.L.Suapendad? 

If YES. Narno or 4 DIQII Numuortrom Dlantund or Box:
'1 Digit Number tram Bottom of Diamond:

Hazardous Matartala? 2.l:INo

mm?an GII Read Runaway _Carge Leaai?Shitt _Eeparetlett OI Unite

 

tm?t?aa 

 

at] No

It YES, Name or :1 Digit Number from Diamond or Box:
1 Digtt Number from Bottam Of Diornona: 

_I_Ren fo Rood

o.O.L.Suoponooa? 
Vettlale thtaearded'? SEEM: Hazaraaua Materlala?? 1.m?t?aa 2mm

?own Hill Runaway F?arge ?Separation of Units



 

 

DMVS - 523 [12103)

MAIL TO: GEORGIA DEPT. VEHICLE SAFETY. ACCIDENT REPORTING UNIT HERON HIM-1W. CDNYEREEA 30013-3447

AaaIgnmentIt-Tihltt AIU

Accident Number: 130032633

DI Call: 5102

F-?mm 1513. u'

- Data From: 07-13-2013

 

REMARKS:

.a

 

 

VEHICLE TRAVELING NORTH ON REACI-ITREE INDUSTRIAL BOULEVARD IN THE SCUT-HSOUNO LANES.
VEHICLE OF VEHICLE AND SOTH WERE TRAVELING SOUTH ON REACHTREE INDUSTRIAL ECLILEVARO ON THE CORRECT
SIDE OF THE ROAD. VEHICLE STRUCR VEHICLE SS HEADFDN AND EOTH VEHICLES TRAVELEO TO EINAL REST ASAINST THE SUARDRAIL ON
THE RIGHT SHOULDER OF THE SOUTHSOUND LANES. VEHICLE WAS OVERTURNED IN ITS FINAL FOSITIUN. VEHICLE #3 STRUCR VEHICLE
#2 AS IT MOVED TO FINAL REST. DRIVER #1 WAS FOUND TO SE LIEELESS AT THE SCENE EW FIRST RESRONDINS UNITS. DRIVER DRIVER
IIS. AND THE RASSENCER IN VEHICLE IIS WERE TRANSPORTED TO SWINNETT MEDICAL CENTER WITH MINOR INJURIES. ALL THREE VEHICLES
WERE IMROUNDEO AND TRANSPORTED TC PCILICE HEADQUARTERS WHERE THEY WERE SECURED IN THE ACCIDENT INVESTIGATION UNIT
IMPDUND LOT. PENDING POST-CRASH VEHICLE INSPECTIONS. NOTIFICATION WAS IVIADE TO DRIVER MOTHER. TANA LOEAN. SREED IS A

FACTQR THIS COLLISIDN. THIS INVESTIGATION I5 

 

 

INDICATE ON THIE DIAGRAM WHAT HAPPENED

INDICATE

NORTH

 

Citations a Vehicle 

 

 

 

- Vuhlcla 2

 

 

I I. IZI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I I CitattCn mm I
Harmful . Weather Su?sm Cond. . Light Gn'nd. - Mannm Sf Lowtl?n at Rvad Cumri- Road DGI- Rand 
Event F?th AISS Cf Impact Charactar 
- 2 $3 2 2 5 
"VehDiatanw - AFTER Width Of Road
Numhnr of Occupants Imam; Van 1

?3 12 9 AFTER 0 72
2 2
I'l?mnga IO 5 5 mm Yeh 
Dnmaga OthSr Than Ownar: TAKEN SAFE AIR
Audra?; SEX VEHN P05 - INJURY EJEET Em": ENTRIC BAG
. GUARDRAIL . . . - - - - 
Qccupanm (LIE: BaluwLaaINamu FINI Addrum .Clty SISIS ZIP 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I12I03I

MAIL TO: GEORGIA DEPT. OF MOTOR VEHICLE SAFETY. ACCIDENT REPORTING UNIT FD. BOX GA 3001343447

 

ASElnnmonUGhI?l FAIU I

  N9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aggliagfgzit; GEORGIA UNIFORM MOTOR VEHICLE REPORT CONTINUATION
Occupants {List Below): AGE SEX. F05 T331591 EJEQT  Emmi: 
Last Name Firm City 5mm 21:: 
Injurad Taken m: Hy:
Flrm, Ml Adams: Clty. smzc.zlp) Phona: (Hamml?ualnuaa?all)








REMARKS:

 

 

 

 

 

Hanan By: ARRENDALEDR
Badge: 3874
Attach 10 3 I lug?! I

 

 

 

 

 

NU

AunignmunUEhHl 

0!

PAGE

 

 

JUVENILE DYee ENG PRIVATE 

 

      

 

 

 



 

  
  
  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I Agency D. GEDRGIA UNIFQRM Dale HEB HY DMVE
130052533 I Gaeernene MOTOR vsHIeLe REPORT 
Date a TI DH. Arrlved Tetel Number OI: Inside City Of:
aw T: Vehlelee Injurlea 
ems-2013 11. 3 151s rare 3 1
Reed 0mm? FLASH reLL INDUSTRIAL BOULEVARD Wim CREST DRIVI: Corrected Report? Yap IE
Interstate 2mmweet St. Rt. 9% Ge. Read City St. Interstate Leweat St. Rt. amps. ease Olly Suppl IO v.FILM Yes 
F991 WW r?lnrereats EmLewest er. re. amoeunty as. St. em Os. Llne Glty DULUTH
And eentlnulng In the directlan checked sleeve. the as
NM Remnant?? Pall? I5 1D Interstate EDLewest St. Rt. 3 CO. Read Clty St. Ce. Llne 313007
. LAST NAME FIRST MIDDLE INITIAL . LAST NAME FIRST MIDDLE INITIAL
JOSE 
Address Address
2144 MARSHES GLENN earl/E 
State le Glly Stale 
GA 30071 992
Driver's License Ne. 'Slass State Male . Female Drivers Lleenaa NO. Clean Stale Male Female
Posted Insuranee Ce. Pulley Ne. Feated Insurance Ce. Pettey Ne.
59m 55 unrree AUTCI 
Year Make Medal Telephone Ne. Year Malta Medal Telephene NO.
1995 FDRD RANGER
VIN Vehlcle Celer VIN Vehlele Geler
RED
Tee It State County Menth I Year Tau State Geunty Menth I Year
PCIA2725 GA '11 I 2013 I
'l'ralter Tap II State GOUnty Menth I Year 'l'raller Tap II State County I Year
I I
Egan?, 5.5 Drive,- Nan?! (last first InltlaI) I Sam as urmr Dwnar?a Name (teat ?rst Initlsl)
Address Address
Olly Slate le Olly Stale Zip
- 
emeve If I LISI
STATEWIDE SERVICE I: ?mm ?m 
Aleeltel Teal Type Results Test Type Results Aleeltel Teal Type Reaulta Drug Test Type Results
2 2 .
Driver Send Dlreetlen ef Travel Visten Centrleutlng Peelers Driver Cane Dlrsetlen of Travel Vlslen Fecters
1 2 Obseured 1 01 - ?lial-tum!
Veh Siend Veh Mfgeuver Pee Maneuver . Vehl?end Veh Maneuver Pad Maneuver
Mast Harmful Event Veh Class: Van Type: Meet Harmful Event I Veh Class: I Veh Type:
Traflte 7 Device lneperstive?l" Yes NO Trams Set I Davlee Ineparatlve'? Yea Ne
Injured Tel-ten Te: 'Ey:
GWINNETT MEDICAL CENTER GGFD MED 7. 13 
EMS Netirlae Tlma Arrlval 'l?lme Hea Ital Arrlvel ?I?lme Plt'etes Taken  V09 N0 -- EV: - .
151a 1524 1:556 '3 INV. DR. earn
Report gem I r- Badge Department Repert Sate Checked By: - Date Gheekad
ARRENDNMEIDR County Pellea Dept. E1833 HYDECS 071132013
Wllneea{ea): NAME (last ?rst mlaslle Street Address Olly Stale ZIP - Telephone NO.
1
NAME (teat Ilret mIrIdle Street Address State zip Telephone No.
a
DMVS MICRUFILM NUMBER (DID NOT WRITE IN THIS SPACE)
 H?mm
career Marne . center Name 
mm It. - trample ll
Adereae Glly . State ZIP Addrees Clty State 
Ma. et Axles S.V.W.R. cl.. Re Game Electy Type NO. Of Axles. G.V.W.R. a. Re able Cargo Body Type
Yea Vehicle Gen?g. I.C.C.M.C.II Interetete Intrastate LJ Vehtele Genllg. LJ.S.D.O.T.II InlOI'Btme Intr'aetetem
11:] Yes ammo O.O.L. Sunpended? Yea amen cam Yea 21:! Ne 0.0.L. Suspended? Yes 211%
Vehlele Yes Hazardous Materials? Yea amass Vehicle IHYOB 2mm Hezerdeue Materlele? TD Yes SUMO
Released? Yea ammo Released? Yes 
lt YES, Name er 4 Member from Slamend Or Bax: If YES. Name or 4 Number Item Diamond er Box:
Dlgit Number from OI Diemend: 1 Digit Number GI Dt?l??ndi 
m?an Reap mbown Runaway _Gerge LeaalSltift _Separatlen OI Unlte ?Han OII Reed MCWSO 

 

 

 

DMVS -- 523 (1303)

MAIL TO: GEORGIA DEFT. VEHICLE SAFETY. REPORTING UNIT RUBEN. 90447. 3001343447

FNU

Acclumn Numbar; 130062333 Nature: 5102 From Timo: 1513 Data From: 0743-2013

 

 

 

 

 

 

REMARKS:
ON THIS DIAGRAM WHAT HAPPENED - .  INDICATE

Citations a Vnhlolcr jig? Citations - Vahlcla 

 

 

 

 

Vah1Vi0lallon:1 [3:313:11an I Citation 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Harn?ul TrafflcaWay Wmlhor SUHHGB Cand. Lluhl Cond. . Manner of Location at Hand Camp. Ram Daf- .Gnn?lructlonl
Event Flow .- Charm'Vah? 5km
- . Dl?t?nc? Width 0" Road
NumbBerDccup?nta 2 I Befqm - Vah 3 Veh 3 . I
Impact I I
Contact ?a AFTER . 7?2
Dnm?ga to Vahiclas 3 - 3mm
Danmgn Other Than Vahlcio Dwnar: Nan?: . TAKEN NR
Addrann: AGE 33): vEHn PDS INJURY EJI-zc?r EQUIP metc- BAG
Driver 3 or Fadaat?an 3 '1 1 3 '2 
Occupants (List Below}: Drivar or Pedestrian 
Ln'LilNun'la Firm City State? ZIP 
Momma mm:th MANUEL GLENN nnwa NORCROSS GA 30071 DMVS-EES {12103} MAIL GEORGIA. DEPT: (3F SAFETY, ACCIDENT UNIT 9.0. EOX 30447. CDNYERE. GA 300133447 A?al?nmmus'lml FNU I

 YES NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$333222?? anSE-Efglgoogm Agiliag?g GEORGIA MOTOR VEHICLE REPORT CONTINUATION
Dmupanm (Llal Below): AGE EEK VEW P05 Emm-l?i?g?g m;ng $133
Last! Name First Address City State ZIP 
Injured Taken la: By:
Wilnass-Namaimst. First. MI Inlual) - Address: (Strum Admss. City. State, Zip) (Hamm?usln?a??ell)
I 














REMARKS:

 

 

 

 

 

Raparl my: ARRENDALELH

Budge E3374
Attach to BMW-523 Aaalunmanmhm I Ea?! I

 

 

 

 

 

FAiu

DI

FAG 

 

 

 

   

 

   
   

 

 

 

 

    
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

JUVENILE Yee No PRIVATE: I I 
Aeoleent Nuntlter IAgenoy NUIU No. GEQHGIA UNIFORM GDUHIY Dam H93 WVE
130959533 VEHICLE ACCIDENT REPORT GWIN NFTT
Dete - Time on. Arrlved Total Number of: Inside Clty of:
[j [j Vehlolee Injuries Fetelltlee
07-13-2013 gun 1- Th 5 151 El 1518 3 . 3 1
Reed of INDUSTRIAL BOULEVARD At Ite PEACHTREE CHEST DRIVE Cormoted Report? Yee 
Deeurrenoe lotereoetlen With 
Interstate HUI?aware er. Rt. Ce. Reed all] City er. 1 lnteretete Lowest amen. Road 3L Suppl to Drielnel? Yee IE1
Not at lit; -:
But Mum I'm? . 3? Wm Yee IEI
I:IFeet 2E]me 3L Rt. amCoumy Rd. dainty or. 6D Ge. Line City 
And oenllnuine in the dlrootion checker: above. the Grid
Next Reterenee Is 5L RL 3 Cu, Rand .413 City St. 5m Ge. Llne 313007
. LAST NAME FIRST MIDDLE INITIAL . LAST moor MIDDLE INITIAL
me. {m KELLY JEREMY (3 mm SMITH DAWN
Address
:33 more t. 
City $tete le one City State ZIP DOE
envere Lloenee Ne. Stale Merlo Pemete I?Jrlver'e Lleenee No. Glues - etete Male Pemete
PDeted Ineurenoe Ge. Policy No. Footed lneurenee GD. POIIW NU-
Speed NUNE Speed -.-
?r?eer Motto Model Telephone No. Year Matte Model I Tole mono Ne.
VIN Vehicle Color VIN Vehicle color
Tag at! State County Month I Year Tag State Mum? I Yam"
I
Treller Tee It etete County Month I Year Traller Tag it. State County Month I Year
I I
I 
maama mm". Dwnere Meme (Ieet IIret Initlel) as Drivur Owner El Dn'le eat e)

City State are Glty State Zip
Removed {By Request ?at Removed By Raquu?t 
Aleoltol Teet Type Reeulte Drug Teet Type Results Alcohol Teet Type Reeulte [Bren 'l?eot Type Reeutm
Drlver Gend Direetlen ofTreveI Vlelen Contr'leutlne Feetore Driver Gent! Dlrecll?n V'Bl?n conmbmin? Fad?
Obeourecl Obscured
Veh Cond VIeh Meneuver I Pee Meneuver Ven Gone Veh Maneuver Pad Maneuver mm
Most Hermie! Event Veh I Veh Type: Moot I-IlenTIIful Event I Vol; Veh Type:
Treme om Device lneperellve? Yer. I [Help Traf?c: Device Inoparatlvo? Yea No
I Injured Token To: By:
- EMS Notl?ed Time EMS Arnvel Tlrne Heepltel Arrive! Time Photos Taken Yes No - 13y:
Report By:l mm]. - Badge Department Report Date 'Gneokee By: Data Chockud

 

 

 

ARRENDALEIDR County Pelloe Dept. 1144-2013 BEBE- 
NAME. (loot ?ret mlodle Initlol) Etreet Glty State Zip Telephone No.
.1

NAME (last ?rst Inltlel) Street Address City I 51m z'P Telephone ND.
9

 

DMVS MIGRDFILM-NUMBER (DC) NOT WRITE IN THIS SPACE.)

 

 

 

 

 

 

Carrier Name  I Carrier Home
I  Vehicle 
Clty - - State le Address ?it! 5113?! 
No.efolee e.v.w.R. - d.Re I bte Ger-go Body Type ND.Dfolee G.V.W.R. - c1. Re able Caren Body Type
Yee No Yes ND
Vehlcle Gentle. lnteretete Intreelete Ll Venlole Con?g. lnloratelot] tntreetetem

 

 

 

 

 

one}? mares 2.I:Ine C.D.L.3uepended? 1.mYee 
Vehlele FIeoerdeo? Hexentoeo Meteriele'? 1m?fee 
Released? 2mm)

If YES. Home or 4 Well Number Item Dlelnoncl or Box:
1 Digit Numeertrom Bottom otDlernond: m,

mn-

HWIRenOffRoeo Runaway _Cel'oo ?Seperetlon 

 

2mm G.D.L.$uepended? tmwe 2mm,
Vehiole Plecerded? 2mm Hezerdeue Meteriele? Llj?l'ee 
2mm: 

It wee, Name or 4 Dleit Number Item L?llemond or Box:
1 Number from [tottern of Diamond: 

I_I_?en Off Reed mmCergD _Seperellen DI Unite

 

 

 

owe - 523 (meet

MAIL. TO: GEDRGIA DEPT. OF VEHICLE SAFETY, ACCIDENT UNIT P.D.EICIX 30447, 30013r?447

Aaeignntonutsnitl 

 

130062633 Nature DICSII: 5102 From TIME: 1513'?: .DISIIDI Emmi 07-13-2013

REMARKS:
THIS IS A SUPPLEMENT TO THE ORIGINAL. REPORT

 

IT IS THE CONCLUSION OF THIS INVESTIGATION THAT JEREMY DEATH WAS CAUSED Ev THE INJURIES HE SUSTAINED IN THE
COLLISION, AND WAS THE DIRECT RESULT OF HIS OWN DECISIONS AND ACTIONS. KELLY WAS IMPAIRED BY MULTIPLE SUBSTANCES AND
WAS DRIVING A VEHICLE WITH NO RESISTRATION. NO VALID INSURANCE, AND DISPLATINCA STOLEN 
WAS SUSPENDED AND HE HAD AN ACTIVE WARRANT FOR HIS ARREST.  
.EELLY MADE A CONSCIOUS DECISION TO ENDANCER THE SAFETY OF
BY ENOAOINO IN NUMEROUS DRIVING SEHAVIORS IN HIS ATTEMPT TO FLEE. INCLUDING DRIVINO IN
EXCESS OF 100 MPH ON THE WRONG SIDE OF THE ROADWAY INTO ONCOIVIINS TRAFFIC. IF KELLY HAD PULLED OVER WHEN OFFICER

. THAXTON INITIATEO THE TRAFFICSTOP. THE COLLISION WOULD NOT HAVE HAPPENED. - -

SEE REPORT FOR ADDITIONAL INFORMATION.

CASE EXCEPTICINALW SLEARED a ADULT (EA)

 

 

 

INDICATE ON THIS DIAORAM WHAT HAPPENED - I - INDICATE
- - NORTH

 

Citations . II .1 Citations Vehicle II 

I I I 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Harmful Tram-Way Weather .SurquS nghI GORE. . MannSer St ROSE cOmp. ROSS . . 
Event AIDS OI Impact Gh?r??tDistance AFTER Width ofRoad
Impact - 
Palm 0! Initial GOntact AFTER
Vah vah'. I.I-

 

 

 

 

 

Damage I OwnSr: Name I I . TAKEN AIR

 

 

 

DIIVSI OI Pedestrian 

 

 

Occupants (List DIIVOI II. or 

 

 

 

 

LastNamu FirSl State ZIP 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(12(03) MAIL GEDRGIA DI: VEHICLE SAFETY. ACCIDENT REPORTING UNIT BOX CUNYERS. GA 309134447 FAIL-I I

gym-mm- :mm-gz El No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I Amldm? Nun?lb?f Agency NCIG ND. Accident Dam
130062533 GADBTOEOO 07-134013 GEORGIA UNIFORM MOTOR VEHICLE REPORT CONTINUATION
I Li IE I TAKEN
mum" at 5 MW) AGE 3m: POE NJURY FDR EEK EXTRIC 3133
Last Name First Adams: City State. 2913 TREAT ..
Injured Taken to: By:

 

 

Wunass Mama (Lam. First. MI lnItIal)

Address: (Street Admm. City. 51m. le)

Phano: (Harm. Buslnass. Ca?)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 








'l
REMARKS:
Report By: ARRENDALEDR
f?udga 3374
Attach to I 1-51? I

 

 

   

Aniynmunlf?Slli?

Of

PAGE

 

 

STATE OF GEORGIA TRAFFIC CRASH REPORT
Georgia State Patrol

Georgia Department of Public Safuty

PD. Box 1-456

Atlanta. Georgia 30371-1456

mmuumnr curiln Auun anoninamencycase Numer 9 mil A an -TI umber
CHEM PUBLIC SAFETY 27434

CRASH IDENTIFIERS

I I I. Ru one atuffimu Din 919999 ninrrimu
999 r? 99514991992949 99 19291902199999

'rilnvoail niinn Iut Scum I Immiinn I
Ema-173913 32:3? PM him Io?Tf?ma um'i?a??IPM I 9? WI LAW ENECRCEMEINT AGENCY

 

  
  

 
 
 
 

    
 

 
 
 

   

   

     

Cr??Crash Plclurlaa Taken

OBJECT

I la Buainmima
TOIBICDUMB VEHICLE V01 

.. a or on 9 919 99 name umar - an a pm I'r?annamn
901139 VEI ICLE IN TRANSPEIIRTI CA 9591992 6 to 091391: 9 r: 9 - - 

BET Makeagoty
2012 IGDROLIEA Idg CRY FAESEINGER 
3 niai I-unni. on at Motor Vehicle in Trans on  Mam Which Use 9 50

a SPECIAL FUNCTION 9 INC WM ?51" A 9%
Bwnar?mmamu IDimurMIddia Harm Dwnor L991 l?wnursm uInMHII'nanurBun) .

AUTO CASH INCORPORATED
Address . Minimal; 99m . - I I99 ?19m 2i Coda
9999 E'ExF?EsswAv a Inmnm ?mm 
awn Irma umber war a bar OI 19 Insumnm 13m EMPIRE FIRE gun MARINE IVALID (99:0

Vnhluio Ran-naval Vnhialn-?wad By [Wrecker Selection Mamud
TCWED DUE T0 DISABLING DAMAGE . WELIBORNE RDTATIDN

 

 

 

 

Eman [Rondwa 1' pa IToiuILnnea Roadwn E999m Gracia
$9999: 70 4 STRAI 
I?a 

cw? n?mrlpum I - Duvim pa . - Wurkirru Properly
MEDIAN HARRIER NC 
?dein can? than or a ?Travel Maneuver Acl volume) Damn Imam {for this which)
MOVEMENTS STEAIGHT AHEAC INC DID CT-LEAVE-SCENE- i - - - . DISA 
ml 59 name or BMW HE iihla which) ??i?au uunm E.an Detail "Illa Whl?l?)
I CCLL SIGN NON-FIX BJECT - MDT VEHICLE IN TRA SPORT
nu we Hanna 0 -wn pa 9 v9 2 LIan I: EWHIB In 
I DLLISICN RAN FF RIB 
and :99 manna uI? Izvunia ?9 (Ihls vehicle) and human: 919991193 5319? (this which!)
I CCLL SIGN WITH OBJECT TREE (STANDING
4m 59 minus at EvanE Type [1319 which) 419 8 mum at Events Data?ill (this whi?i?)
NCN- OLLISICN DVE 
Man! Harm? Event 9 Ehia Yahluid? Mast HurmM EVEN 591911 thin whim
COLLISION NCINHEIX CBJE MOTOR VEHICLE IN 
contributing Eircumaianms 1 (this which) ConlriEuunu Circumstant 5 999 whim)
NONE DNE
Arm of Initial Impact  Maul Damaged Am:
Nun Collision Ii", Nun contusion
Tm, I. I - Top
Undomn?lnga
Unknnum I I  I ?Ela IQ I unknown
. . 

   

 

 

 
   
   
   

I I WEEK: "9999

I 999.999 .

9299999199999 FATAL INJURY (K)
RELPHEAL mowime NDN FATAL INJURY

 

PASSENGER

     

           
        

      

         

 

 

 

 

Molar a GB 9 9 9mm? Formation!
V02 IOTQR VF. ?91 9 9: TRANSPORT GA 193999999 Cl 999919199 mam-199599199994
Year Make Mudul 5 In Gnior Bud 99 ?9_i999w
2999 CHARGER ISTEDAN EILU NGER GAR

 

 

 

P990 1 of 4 OFFICIAL cow V9r9i9n 9.9.9.9

      
  

    

     
  
   
    
    

    

      

 

 

 

 

 

 

 

 

 

 

 

ran-Ii Number Ra oriln on Ronoriiog Agency Nemhor Re min on um or
1300017130041 OREIA DEEARTMENT OF PUBLIC SAFETY 
I.
5 ooluI Funeilon oi Molor Voliiolo In oi Bun Ulio 
SPECIAL FUNCTION NO A BUS
or First Name LnoI Nome Ovmar lower oualnooe (If nel Pomon 
OEPAR 

K?dm?a Meme Ollie39010
Own 0i? I I naurn ior) Magman 141 mam-AM 1413
Voi'iicio Rommol Vehicle Tomi] Ely Method
DRIVEN - NOT DISAELEO .

 

 

 

Dlmoi on of mwl?efeio roan Eeiimn Fooled ioadwn po ToiolLanoo oadwn Randi-VB Grade
loom: IDIVIOEDI-IIGHWAY [5 mi? 
TioI'Iio oniro oo Properly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

own on piion ype
DIVIDED POSITIVE MEDIAN BARRIER NO CONTROLS
Roadway Boson lion for Vehicle Timon!
IEIS NB 
Vonioio Maneuver Action (I: ihio whlolo non? Demo Extent Iorihlii vehicle)
MOVEMENTS ESSENTIALLY S?i? AIGHT AHEAD NO DID CT LEAVE SCENE MIN DAM GE
ini uonoo Evonio 1' this vehicle) in uonoo .Venin Dololl 
COLL. SION NON-FIX SJECT MOTEIR VEHICLE IN TBA SPORT
Mani Ii?o WHORE Moot Hamifui Ewni Deinii lhlii which)
COLLISION IXED OBJE MOTOR VEHICLE IN 
Ciroumioneeo 1 (ihii: veiiloie) Coniiloullng Clroumalanoea 2 (this which!)
NONE NONE
Aron oi Inlilol Impooi Moai'oomogoe Avon
Non Coilielen Neri Collision
El Tap . El Too
El Undoronningo [j Undercarriage

Occupant Typo Person Home (First Middlo Last Suffix) Injury Sioius
DRIVER DLER 

 
 
 
    

DRIVER V01

   

 

 

 

 

 

 

 

 

 

 

onion
1: If Dnie oi??IniI 
rel time orno Lani am ?e -. on:
THANQUARIIJS I I CALHOUN I 391 IM
M?m?o Adore? Oliver 3 END
?14 ST ITIICOONOUGH 3 253
Poona Number FFiono Number (eihei) Condition oi Tim Crash
AFFARENTLY NORMAL
Orivor Lioonao Number Ex Iroo Sieio Jurleeiollen Siam
05641?I'0Iili I 0EI20I201S IGA 02 JEN-COL LICENSE SUSPENDED
Driven: Uoonoo 1 Driven: Lieenee ?esI?Eono rivere ,ieeniio Restrictions 0
NONE . I I NONE
Driver Elairocled SF Driver Vision Oeetmmleno
NOT DISTRAC ED - VISION NOT OBSCURED -

 

Driver Won: aI 'I'Imo oi Crush 1 (based on Lid emeni of inveell eilen emee Bower at Time oI Eras? 2 based on ad oI InveoII olion o?Ioe?
CEEDED POSTED SPEE LIMIT1 5' 0 OPERATED MOTOR VEHICLE IN EFIRETIC RECKLEEISS CARE ESS NEGLIGENT I:
Timon; oI I?Imo oI Croe? 5 on IWgemenI 3? Invoeilgoilon Driver at Time DI EMF 3 Ihesod an IEIIBMBHI a Inmuiimlon DRIED .

 

 

 

 

 

 

       
 

 

 

 

 

 

 

 

 

 

 

 



FA LED TO KEEP IN FROP LAN EITHER ACTION

Molor on no lion: ow Nor is ole Poeliion: Seei MolDrVahl eiin Pee i on: Dir-er

FRONT - - LEFT - ?9 NOT APPLICABLE - - I Emmi! 
Roslraini 8 tom: lJee

NONE ED a MOTOR VEHICLE OCCUPANT

Air BEE - -, Eamon

DEF COMBINATION JECTED TOTAE
Wodmnon?on - -. .

TTRAFFED .

I u: Lava um? mm um? Fl?lma or MOSI DDUIOLIE CI 3 I unoci 

I (A) UNSEECIFIED I 9

Jouroo or I EMS Run Number Medlo?i Facililv fans Mild TD . -

EMS AIR COUNTY EMS 20134047 GREENVILLE ME ICAL CEN TER

Low Snioroemeni Suspected Aleenel er Aleenei Teelwiie Aleehol?roolod ea 

UNKNOWN BLOOD TEST GIVEN PENDING

Law Enforcement Sue niod Dru . Em TIMI Ty Tome 5 Tool 

YES BLOOD TE GIVEN PENDING

Violation Type leeuod Number Violation 

UNIFORM TRAFFIC CITATION E01143596 SAFETY RESTRAINT VIOLATION (0 YEARS OF AGE OR OLDER)

UNIFORM TRAFFIC CITATION 4043-181 SFEEDINC IN EXCESS OF MAXIMUM LIMITS

UNIFORM TRAFFIC CITATION E01143590 40-43-395 FLEEINO OR ATTEMFTING TO ELUOE POLICE OFFICER

UNIFORM TRAFFIC CITATION E01143509 4043-395 FLEEINO OR ATTEMFTING TO ELLI DE POLICE OFFICER

UNIFORM TRAFFIC CITATION E01143900 40-6-3434 SERIOUS BY VEHICLE

UNIFORM TRAFFIC CITATION E01143601 4043-30300 HOMIOIDE BY VEHICLE IIST DEGREE)

UNIFORM TRAFFIC CITATION E01143602 DUI I DRUGS I LESS SAFE

UNIFORM TRAFFIC CITATION 301143603 DRIVING WHILE LICENSE SUSPENDED OR REVORED

UNIFORM TRAFFIC CITATION E01143i30-1 40-64590 RECKLESS DRIVING

UNIFORM TRAFFIC CITATION E01 1413605 40-643 FAILURE TO MAINTAIN LANE

 

I3 Sealing Pooiilon Unknown

 

Fags 2 of 4 OFFICIAL COPY Version 9.9.9.9

 ARTMENT OF PUBLIC SAFETY

Seating Poeition Unknown

Sutton Unknown

 

   

NARRATIVE: 00001?! 383 I

Wehioie 2, marked Georgia State Patrol vehicle. woo attempting to stop vehicle 1. Vehlete 2

he?d?eil 'hle'emergancy tights and storm activated. The driver of vohieio 2 initiate ?the FIT maneuver. vehicle 2 made contact with the right rear at which! 1 with the left front of
vehioie 2. Mar contact. vehicle '1 started to rotate in a clockwise rotation. Vehicle 1 traveled off the right edge of the roadway as it rotated and entered a ditch. Vehicle 1 then
struck a tree and otortod to ovortum. Vehicle 1 came to en uncontrolled rent oftthe shoulder of the roadway. Vohiolo 2 was driven to oontroIied reei.

Note: Thie incident was video recorded by TFC D. Saddler #129. with hie In oer Video.

Vehleie 2 information:

Perm it 3091

Odometer 124741 I

An Independent inventigatldn lo being conducted by the Specialized Gollioion Team Tr??p 9-

Page 3 of 4 I I DFFIGIAL CDPY Version 9.9.9.9

 umr 

7434 

  

REPDRTING DFFICER

 
   

{in mm O?'ldurNama Elgnmum Duh-Br Nam: Slanatura

A. . Waawu. 

ID Number Rank '10 Nuwmgr Rank 

M13 BERGEANT I  I   #1?ij can LIEUTENANT  - 
afghunll - pmmnit 
B- . . 

 

DIAGRAM OF ACCIDENT

 

mum-himmil-ills UH WW m'
I

 

 

..1 593999950": I .

 

 

 

 

Page 4 of 4 GFFICIAL COPY Version 9.9.9.9