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STATE OF CALIFORNIA DEPARTMENT OP CALIFORNIA HIGHWAY PATROL TRAFFIC COLLISION REPORT CHP 555 PAGE 1 (REV. 04-11) OPI 060 PAGE 1 OF 13 SPECIAL CONDITIONS NUMBER INJURED 2 HIT & RUN FELONY crry JUDICIAL DISTRICT UNINCORPORATED STOCKTON SUPERIOR LOCAL REPORT NUMBER 9266-2018-01002 NUMBER KILLED 0 HIT & RUN MISDEMEANOR • COUNTY REPORTING DISTRICT BEAT SAN JOAQUIN 021 DAY OF WEEK TUESDAY TOW r AWAY YES NO LOCATION COLUSION OCCURRED ON: 1-580 W/B 0 MO DAY YEAR 08/14/2018 TIME (2400) 0710 NCIC # 9266 OFFICER I.D. 014808 MILEPOST INFORMATION: 1.0 MILE(S) EAST OF 580-SJ-4.05 GPS COORDINATES LATITUDE 37.66710° LONGITUDE - 121.4492680 PHOTOGRAPHS BY: ri NONE r AT INTERSECTION WITH: OR: 1 MILE(S) EAST OF CHRISMAN RD. 0/C STATE 11 HWY REL YES NO PARTY 1 DRIVER'S LICENSE NUMBER C5429755 STATE CA CLASS A AIR BAG P SAFETY EQUIP. G VEH. YEAR 2013 MAKE (MODEL KENW 3 AXLE / COLOR GRY LICENSE NUMBER WP33811 STATE CA DRIVER r NAMEIFIRST, MIDDLE, LAST) SANTIAGO MENDOZA MADRIGAL 1988 EAST 2AXLE SIL 4LY7367 CA OWNER'S NAME In SAME AS DRIVER PEDES- TRIAN STREET ADDRESS 1021 EUCALYPTUS AVE OWNERS ADDRESS r SAME AS DRIVER PARKED VEHICLE CITY / STATE / ZIP NEWMAN CA 95360 DISPOSITION SUPER TOWING OF VEHICLE - ON ORDERS (209)409-1581 OF: OFFICER 19 DRIVER OTHER BICY- CLIST SEX M HAIR BLK EYES GRN HEIGHT 5-6 WEIGHT 175 BIRTHDATE DAY MO YEAR 05/12/1964 RACE H PRIOR MECH. DEFECTS lij NONE APP. u REFER TO NARRATIVE OTHER HOME PHONE (209)247-3639 BUSINESS PHONE (209)247-3639 VEHICLE IDENTIFICATION NUMBER: 1XKAD49X4DJ365396 VEHICLE TYPE DESCRIBE VEHICLE DAMAGE UNK NONE MINOR SHADE IN DAMAGED WWI AREA INSURANCE SCOTTSDALE CARRIER IDEMNITY L010000098 POLICY NUMBER 25 I 32 r MOD MAJOR ROLL-OVER DIR OF TRAVEI W ON STREET 1-580 OR HIGHWAY SPEED LIMIT 70 CA 433667 DOT CAL-T TCP/PSC MC/MX PARTY 2 DRIVER'S A5448828 LICENSE NUMBER STATE CA CLASS A AIR BAG P SAFETY EQUIP, G VEH. YEAR 2001 MAKE / MODEL INTE 3AXLE / COLOR WHT LICENSE NUMBER 9C43487 STATE CA DRIVER 111 NAME(FIRST, JOSE (NMN) SIIDDLE, LAST) HERNANDEZ 1998 COMM 2AXLE WHT 4ND7159 C 1 OWNER'S NAME r SAME AS DRIVER PEDES- TRIAN STREET ADDRESS 2174 FOX GROVE RD OWNER'S ADDRESS ri SAME AS DRIVER PARKED VEHICLE CITY / STATE TUSTIN / ZIP CA 92780 DISPOSITION SALAZAR OF VEHICLE TOWING ON ORDERS OF: OFFICER - (209)463-8500 • 111 DRIVER OTHER MY' CLIST LI M SEX HAIR BLK EYES BRN HEIGHT 5-7 WEIGHT 187 BIRTHDATE MO DAY 03/08/1956 YEAR RACE H PRIOR MECHANICAL DEFECTS pi NONE APP. REFER TO NARRATIVE OTHER HOME PHONE (714 206-6855 BUSINESS PHONE (714)206-6855 VEHICLE IDENTIFICATION NUMBER: 2HSCEAMR01CO20554 VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE UNK NONE MINOR IN DAMAGED AREA SCM-TIVIER•LEFt INSURANCE CARRIER NONE POUCY NUMBER 25 I 31 MOD r MAJOR LIROLL.OVER ;II DIR OF TRAVEL W ON STREET OR HIGHWAY 1-580 SPEED LIMIT 55 401942 :'.:., CA CAL-T DOT TCPIPSC MC/MX ' tr4"10 0 el PARTY 3 DRIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY EQUIP, VEH. YEAR MAKE / MODEL / COLOR LICENSE NUMBER STATE DRIVER NAME(FIRST, MIDDLE, LAST) OWNERS NAME SAME AS DRIVER PEDES- LI TRIAN STREET ADDRESS OWNER'S ADDRESS SAME AS DRIVER PARKED VEHICLE CITY/STATE I ZIP DISPOSITION OF VEHICLE ON ORDERS OF: LI OFFICER DRIVER OTHER MY' CLIST SEX HAIR EYES HEIGHT LI PRIOR WEIGHT BIRTHDATE MO DAY YEAR RACE MECHANCIAL DEFECTS LI NONE APP. LI REFER TO NARRATIVE OTHER HOME PHONE LI VEHICLE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: TYPE I MOD DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA LII UNK LI NONE LIMINOR MAJOR ROLL-OVER INSURANCE CARRIER POUCY NUMBER DIR OF TRAVEL ON STREET OR HIGHWAY SPEED LIMIT CA DOT CAL-T TCP/PSC MC/MX PREPARER'S NAME CA DUNCAN 014808 i DISPATCH r LI NOTIFIED YES NO NIA LI REVIEWER'S NAME S. A. MC CRARY 013652 DATE REVIEWED 08/17/2018 AN INTERNATIONALLY ACCREDITED AGENCY