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STATE OF CALIFORNIA DEPARTMENT OF CALItORNIA HIGHWAY PATROL TRAFFIC COLLISION CODING CHP 555 CARS PAGE2 (REV. 04-11) OPI 060 PAGE 2 0F 13 DATE OF COLLISION (MO. DAY YEAR) 08/14/2018 TIME(2400) 0710 NCIC # 9266 OFFICER I.D. 014808 NUMBER 9266-2018-01002 PROPERTY DAMAGE OWNER'S NAME OWNER ADDRESS NOTIFIED Il YES . NO DESCRIPTION OF DAMAGE SEATING (- A r POSITION SAFETY EQUIPMENT OCCUPANTS CHILD RESTRAINT AIR BAG B UNKNOWN - L -AIR BAG DEPLOYED RG NO T DEPLOYED N M : OTHER P - NOT REQUIRED INATTENTION CODES A - CELL PHONE HANDHELD B - CELL PHONE HANDSFREE C- ELECTRONIC EQUIPMENT D - RADIO / CD E - SMOKING F - EATING G H - ANIMALS I - PERSONAL HYGIENE J - READING K - OTHER A - NONE IN VEHICLE 0- IN VEHICLE USED B - R - IN VEHICLE NOT USED c_ LAP BELT USED S - IN VEHICLE USE UNKNOWN UNKNOWN D - LAP BELT NOT USED T - IN VEHICLE IMPROPER USE E - SHOULDER HARNESS USED U - NONE IN VEHICLE F - SHOULDER HARNESS NOT USED G - LAP/SHOULDER HARNESS USED M / C BICYCLE HELMET 1 2 3 4 5 6 _,,J 0 1_ DRIVER T 2 O 6 - PASSENGERS 7 - STATION WAGON REAR 8 - REAR. OCC TRK. OR VAN 9 - POSITION UNKNOWN - OTHER - CHILDREN EJECTED FROM VEHICLE 0 - NOT EJECTED 1 - FULLY EJECTED 2 - PARTIALLY EJECTED 3 - UNKNOWN H - LAP/SHOULDER HARNESS NOT USED DRIVER J -PASSIVE RESTRAINT USED VNO PASSENGER - K - PASSIVE RESTRAINT NOT USED W- YES Y - YES P - NOT REQUIRED ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK (1 SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY COLLISION FACTOR LIST NUMBER (#) OF PARTY AT FAULT • TRAFFIC CONTROL DEVICES 1 2 3 SPECIAL INFORMATION 1 2 3 MOVEMENT PRECEDING COLLISION 2 VC SECTION VIOLATED- CITED 0,E, A 22350 VC J 'O A CONTROLS FUNCTIONING A HAZARDOUS MATERIAL X A STOPPED g CONTROLS NOT FUNCTIONING* g CELL PHONE HANDHELD IN USE X g PROCEEDING STRAIGHT B OTHER IMPROPER DRIVING* C CONTROLS OBSCURED c CELL PHONE HANDSFREE IN USE C RAN OFF ROAD x D NO CONTROLS PRESENT / FACTOR* x x D CELL PHONE NOT IN USE D MAKING RIGHT TURN C OTHER THAN DRIVER* TYPE OF COLLISION E SCHOOL BUS RELATED E MAKING LEFT TURN D UNKNOWN* A HEAD - ON F 75 FT MOTORTRUCK COMBO F MAKING U TURN B SIDE SWIPE G 32 FT TRAILER COMBO G BACKING x c REAR END H SIDESHOW H SLOWING/STOPPING WEATHER (MARK 1 TO 2 ITEMS) D BROADSIDE I STREET RACING I PASSING OTHER VEHICLE x A CLEAR E HIT OBJECT J CELL PHONE USE UNKNOWN J CHANGING LANES B CLOUDY F OVERTURNED K K PARKING MANEUVER C RAINING G VEHICLE / PEDESTRIAN L L ENTERING TRAFFIC D SNOWING H OTHER': M NI OTHER UNSAFE TURNING E FOG! VISIBILITY FT. N N XING INTO OPPOSING LANE F OTHER:• MOTOR VEHICLE INVOLVED WITH 0 0 PARKED G WIND A NON-COLLISION p MERGING LIGHTING B PEDESTRIAN Q TRAVELING WRONG WAY x A DAYLIGHT x C OTHER MOTOR VEHICLE 1 2 3 OTHER ASSOCIATED FACTORS (MARK 1 TO 2 ITEMS) R OTHER*: B DUSK - DAWN D MOTOR VEHICLE ON OTHER ROADWAY C DARK - STREET LIGHTS E PARKED MOTOR VEHICLE A VC SECTION VIOLATED CITED 0 YES 0 No D DARK - NO STREET LIGHTS F TRAIN E DARK - STREET LIGHTS NOT FUNCTIONING* G BICYCLE B vc SECTION VIOLATED CITED ID YES O NO 1 2 3 PHYSICAL SOBRIETY - DRUG (MARK 1 TO 2 ITEMS) H ANIMAL: ROADWAY SURFACE c VC SECTION VIOLATED 'RED 11 DES D NO x A DRY I FIXED OBJECT: DI x x A HAD NOT BEEN DRINKING B WET C SNOWY - ICY j OTHER OBJECT: E VISION OBSCUREMENT: g HBD - UNDER INFLUENCE F INATTENTION*: c HBD - NOT UNDER INFLUENCE* D SLIPPERY (MUDDY, OILY, ETC.) ROADWAY CONDITION(S) (MARK 1 TO 2 ITEMS) G STOP & GO TRAFFIC D HBD - IMPAIRMENT UNKNOWN* PEDESTRIAN'S ACTIONS H ENTERING! LEAVING RAMP E UNDER DRUG INFLUENCE* A HOLES. DEEP RUT* x A NO PEDESTRIANS INVOLVED I PREVIOUS COLLISION F IMPAIRMENT - PHYSICAL` B LOOSE MATERIAL ON ROADWAY* B CROSSING IN CROSSWALK - AT INTERSECTION J UNFAMILIAR WITH ROAD G IMPAIRMENT NOT KNOWN K DEFECTIVE VEH. EQUIP CITED El YES 11 NO H NOT APPLICABLE C OBSTRUCTION ON ROADWAY* I SLEEPY / FATIGUED* D CONSTRUCTION - REPAIR ZONE C CROSSING IN CROSSWALK - NOT AT INTERSECTION E REDUCED ROADWAY WIDTH F FLOODED* D CROSSING - NOT IN CROSSWALK L UNINVOLVED VEHICLE G OTHER' E IN ROAD - INCLUDES SHOULDER IVI OTHER*. X H NO UNUSUAL CONDITIONS F NOT IN ROAD X X N NONE APPARENT G APPROACHING / LEAVING SCHOOL BUS 0 RUNAWAY VEHICLE SKETCH FOR SKETCH DIAGRAM, SEE PAGE 4 -. \ ) INDICATE NORTH MISCELLANEOUS V-1'S TRAILER OWNER: SANTIAGO MENDOZA, 547 REAL CT., NEWMAN, CA. 95360 V-2'S TRAILER OWNER: MARCOS SANTANA 2665 HONOLULU 4, MONTROSE, CA,. 91020 AN INTERNATIONALLY ACCREDITED AGENCY