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CO0047244 (2)
Environmental Health - Public
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2500 – Emergency Response Program
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CO0047244 (2)
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Entry Properties
Last modified
6/30/2021 1:59:37 PM
Creation date
6/30/2021 1:54:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0047244
PE
2546
STREET_NUMBER
0
Direction
W
STREET_NAME
HWY 580
City
TRACY
Zip
95304
APN
NEAR 25327028
ENTERED_DATE
8/14/2018 12:00:00 AM
RECEIVED_DATE
8/14/2018 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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STATE OF CALIFORNIA <br />DEPARTMENT OF CALIFORNIA HIGHWAY PATROL <br />INJURED/WITNESSES/PASSENGERS" <br />PAGE 3 OF 13 <br />E 3 REV 11-16 OPI 060 <br />DATE OF COLLISION (MO. DAY YEAR) <br />08/14/2018 <br />TIME(2400) <br />0710 <br />NCIC # <br />9266 <br />OFFICER ID. <br />014808 <br />NUMBER <br />9266-2018-01002 <br />WITNESS <br />ONLY <br />PASSENGER <br />ONLY <br />AGE SEX EXTENT OF INJURY('X' ONE) INJURED WAS (r ONE) PARTY <br />NUMBER <br />SEAT <br />POS. <br />AIR <br />BAG <br />SAFETY <br />EQUIP. <br />EJECTED <br />FATAL <br />INJURY <br />SUSPECTED SERIOUS <br />INJURY <br />SUSPECTED MINOR <br />INJURY <br />POSSIBLE <br />INJURY <br />0 <br />DRIVER PASS. FED. BICYCLIST OTHER <br /># 62 Mb X xEEEH 2 1 P G 0 <br />NAME! D.O.B. I ADDRESS <br />JOSE (NMN) HERNANDEZ (03/08/1956) 2174 FOX GROVE RD TUSTIN CA 92780 <br />TELEPHONE <br />(714)206-6855 <br />(INJURED ONLY) TRANSPORTED BY: <br />AMR <br />EMS RUN NUMBER <br />07248423 <br />TAKEN <br />SUTTER <br />TO: <br />TRACY COMMUNITY <br />DESCRIBE INJURIES: VISIBLE LACERATIONS <br />LACERATION TO LEFT FOOT. <br />TO MULTIPLE AREAS OF LEGS AND HANDS. <br />ri VICTIM OF VIOLENT CRIME NOTIFIED <br />X <br /># I 41 n H <br />NAME! D.O.B. / ADDRESS <br />DANIEL GARCIA (08/12/1977) 7095 N DEVLAN AVE FRESNO CA 93722 <br />TELEPHONE <br />. (559)614-5669 <br />(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER TAKEN TO: <br />DESCRIBE INJURIES: <br />I I VICTIM OF VIOLENT CRIME NOTIFIED <br />54 NI LI 5 IA 1 I l' C 0 <br />NAME / D.O.B. (ADDRESS <br />SANTIAGO MENDOZA MADRIGAL (05/12/1964) 1021 EUCALYPTUS AVE NEWMAN CA 95360 <br />TELEPHONE <br />(209)247-3639 <br />(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER TAKEN TO: <br />DESCRIBE INJURIES: COMPLAINT OF <br />WILL SEEK OWN AID. <br />PAIN TO NECK AND BACK. REFUSED TRANSPORT. <br />1 1 VICTIM OF VIOLENT CRIME NOTIFIED <br />n# <br />, <br />_ ri I I <br />NAME) D.O.B. / ADDRESS TELEPHONE <br />(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER TAKEN TO: <br />DESCRIBE INJURIES: <br />VICTIM OF VIOLENT CRIME NOTIFIED <br /># <br />1 <br />1 EL 1 LI E I-1 HIP ri <br />NAME! D.O.B. (ADDRESS TELEPHONE <br />(INJURED ONLY) TRANSPORTED BY: EMS RUN. NUMBER TAKEN TO: <br />DESCRIBE INJURIES: <br />L VICTIM OF VIOLENT CRIME NOTIFIED <br />n 1-1 I LILI <br />NAME / D.O.B. / ADDRESS TELEPHONE <br />(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER TAKEN TO: <br />DESCRIBE INJURIES: <br />VICTIM OF VIOLENT CRIME NOTIFIED <br />PREPARER'S NAME <br />C A DUNCAN <br />ID. NUMBER <br />014808 <br />MO. DAY YEAR <br />08/14/2018 <br />REVIEWER'S NAME <br />S. A. MC CRARY 013652 <br />MO. DAY YEAR <br />0S/17/2018 <br />AN INTERNATIONALLY ACCREDITED AGENCY
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