Accident Report
Accident Number: l VI\IIPDw050430·0167
STATE OF NEVADA TRAFFIC ACCIDENT REPORT
Event Number: 05043(r.;Q167 Code Revision:
SCENE INFORMAnON SHEET Revise
Dprc1iminary Report b1Resubmission ~[]""iE-m-c-r-P;lc-n-c-y-"I"""ILI"""Q:ffi"'lc-c-R-e-ho-rt-iiP!Sl!!!j.:-l'1}itial R~ort DSupplcment Report Colllldon l)A~e: Time: Day: I Beat/Sector ~C(nlnty
I
Df,roperty l8IInjury UE~tal
J.,dl:Ht and Run DPrivate Property
Asency Name: l..AS VEGAS METROPOLITAN POLICE DEPARTMENi UCIt:v Surface Intt:rsectlon rAddlll'Mllirker 4/30/2005 010:3 SATURDAY S5 CLARK Ii!SlAsphalt ;;; Four YJ..ay JNone ~--""'---:'-+-~---IL.-_-~--:;-:L-~~------1~~---""'~----::-;-:---+-~~----:'--'~~--:--::--i-JFi~oncrcte _ > t'lour Way Side MU~ M"rkt.r #Vehlcl~ #Non Mororfsts #Occupant!i #Fntalltil:s #lnjllrtd #f.l.estrRined gOravel ~ I ~E.jght Side 1r---~--+-"'""'"='2--i~--~----=-O~------+-----::2=----+-----=-O---1---1:----t--"""'"':'""1 --"'-WIQirt =; Y d~oth Sides DQthcr _ ROUl'ldabo\l .JUnknown Occbrrcd On: (Hi!=tnway # or Street Name) DURANGO ~At lnterscctlon With: UApproximat• ....JOr: DFl!d DMIlf;!~ Of (Cro~.~ Street) PATRICK Access Control Df,al'kin,g Lot lII!J.rban DBural one U.E,ulI UE.srti~J T(ltlll All Lane8
I
Jlcft
I
ROAdway Character
I
fKJli
Roadway Conditions Dllnknown ~ .Qry DS!1Jsh
15
Total Thro Lane!'i AnraRe ROAdway WIdths RoadWAY Grade 12 f't.DNotDetet1'llinc:d Relative To: M8!in Road £ross ROi 0% Inside I Outside o Ft.1 0 Ft, Pnvemtnt Markin2S and TVDe U)'Jone JoJiehway DeserlDtjon Wellther Condltlons Ullnknown Edge Line,uft,Yeliow 4 CentCl"1inc,~rQken Yellow ~ !woNWay, Not Dividc-
YUKON
!YIN; IPlate #
=
!ComoJ lance LJRcstrlct UEndOtge R.estrictions 1SDced E~mate: I First Namc: MICHAEL. Mid IAccident Number: LVMPD·050430·0167
STATE OF NEVADA TRAFFIC ACCIDENT REPORT
NumOcr:OS0430·G-167
AtFl\l~It.l:!(l
Brlrl
T,"
-
-
I
At F:mlt [J Vehicf!;# 2
Revised 5/21/2003 J)riv~r Factors: Unl(nQwnO
=lJisrc:gard Control Device : Ioo FCtSt for Conditions
.....f:ail to Yield Right of Way
~Ban OffRoo1l0
:: gxceediJ1g Speed Limit ::: !Y.ronp; Way/DireetiQn
;; Object AvoidOlnce ~ DrivcrlC!l!l ychicle :::= l'ol1owi'llg Too Close ..... Unsafe Lane Changc ~ Made: Improper Tum DOver Correct SteerinR
I;PgDrivcr
Last Name:
I
j"te:lJ
Make:
Veh. Yr.:
1996
100DGE
Regi!ltcrcd Owner Name:
rrype
lModel:
IOAKOTA (Sam~ :IS
.QB.IVEB )
.
~ ~"ckln8
. ;::: Left Tum
;:: B.ight Tum ~IDongW:J'j
I..
Qther
Carrier Narn~:
jPll1tcIPermit 'Number:
IPK~PICKUP'I.._ p!n~Ured(COmpany:
~ folc
~tent of Onmltgc CI Minor 0 MOQerate
DamaKed
Arras'
ID.Right Front
CJ
Dn.ight:R&ar
DJ,£3Vintt P;:trkec1
EX
~ni\lry
irbae Swih;h
rapI'ed
UMLJE LJ Unk:
Restraints
Seatinl~
tn
.r3DDed
FJoliey Number: ITo:
LJlmiling Unit 3
,ULeft Fro!!t
1st 2nd
OtJndcr ~;'lITiage
DYnknown
3rd 4th
Collision with Fixed Object
u
MOiOR VEHICLE IN TRANS~ORT
u
o
o
Vehicle Confi~bratfon ;;;;; Irnctor Only ~!ractorISemi.Trailer ~ TmetOl;lTrailcr ~ Pass. Veh. <J;!.az-Mat)
;; Tractor/Doubles _ TractorITr,iplc!;
Light 1'n.J£k (HlIZ.Mat) ~ Qther He:..vy Vehicle ... Truck with Trnil~r ~
Ennt
u
U
5th
Most
Harm£ul
[J
u
[J
..... Comm. Yeh, .JSchool au~ Source;
bJ12river
DS.tate Reg.
tJiog BookOSicle .QfVehielc
O-Shipping J.:apert;lTrip Mnfs1
Power Unit GVWR;
O~ ),0,000 Lbg. 0] 0,00 1-2.6~OOO Lb!i. D:>:z~.ooO Lbs. lCity: IStatt::NV
lViolation
\irb~ Switch
vtN:
SequeOl:e of Events De.,crlption
CodeN
DLeft~cgr
DEnter Parked(,l)
Position
-f:::.:ln~i\"~I'YLoc~7at:.:..:io:.::t1:.....-
~icctco
jeolor. J8/31/20041WH ITE
Position Location
~eatinl:t
toQB:
!Person TYDe
IExp.:
DQther
----=::C=ar"..J:.rZt.:::.~()-=J,l;.;;:.Od=-IYl-r~rytlU;;.;:;'e.;;;lU~JlIa:..ln;;.;.k;.;.;n~QWTl~----,
L.IC.FR UCC/MC Dfcm.'ling 2} I nVl!stI2ntor~
ISta('Jtt
bJ ~(Jnc D !Ink. r8I Major 0 'total
o
~ending
~1:IRS
01
3.6
A.irba~s
DIop
UY:ln/Box UQrain~ Gravel Chips D~cmc:retc Mixer D~us,9"J5 Occupants ;:: flatbed DAut.o Carrier DBlls.>I.5 Occupants ~ ~\Imp DOarbage!B.cfuJlc ~ Qther ON-at Atlolicable ~ tiRS UCFR UCC/,Mt. lViolation I)
UM~EU Unk;
o
Ejected Suffix:
Middle:
I
~JN: Plate #
Vehicle Towed: LJ By; _ Removed To: ~INED BY DRIVER Vehicle Ac:tlon LJUnknQwn Ufarked WEnterint Lanc ~ .8us.2·15 Occupants OU-l:.um DLc:~ving Lane := Rus, :> t 5 Occupants OLanc Qangc Stopped ~ Singfe :z Axle & 6 Tire DP= 3 ~xlc DDrlvcrlcs8 Yeh OOthcr Tuming I - Any 4 tire Vehicle
;: lank
f-
DOB.
Tvoe OccuDant Restraints Injury Severity
Airbaes
o
ILieense St"tus: a v I Limit:35
IState; UNV TN
I To: 0
Pel'S(lr\
IVIN:
Carrier Street Addre~s: ~,.......,....
wOther: (1) Travel Lan~ T 1
IOLN:103227778
I From: 0 Suffix;
!Company Address;
Wlmiling Unit 2
~ _L~lt/
~ ~tralght
~ DONo ~ontrol!\ ,....,OD:Wamjn£ Sign
p1!nlcnown []Not Trans.
WEront r'-" (JJ\ight .side D~' IT \, .&_A h. /~m.. t·.,.· '., W ,-,~ft Side o Cl 0 l&l_Rear
DUnder Ride
; DONo Pa~!\ing
t>CCllD~nt
IVIN: IPlate #
D.Qvcrridc
I..
~; LJ~MS L...!Policc UQthcr 1-_ _~_ _+Tn"",JiU:~lTY~S..;.ev_e_ri...... ty_-+
NY
I{.O. Addrc!l!l: NV
ht Contact
~ DDR.R. Gat~s DDR.lt. SignaleD 18 DOM,3rked Lanes ~~OTire Chains/Snow Req
Signal
7
rrrllusported To:
WIrailing Unit I
c;J
'-. DD~ed.
c
U l::!ot Tran,.
~!ll1known OF,olice l-J.Dthcr First Name:
1
Last Name:
VALLEY
gy: ~gMS
~~P 9147
LASVEQAS
r-
rJ'r:tnsported To; S~RING
!City:
Ply:
~~OSch()Ql Zone
ISpel!d E!ltlmate: Middle:
First Name:
;:: DDR.R. Sign
~ DDFI~hing Light
Apparently fatigued/Sleep Oo~truete(j Yiew
!ComoHance URestnet DEndorlic
Restrictions
Str€ct Address: ~ - - . ..
Street Address:
:! DDS,peed Zone ~ DDSignal L.ight
IDURAN GO
I
FNFO ~ ODS!op Sisn ~ DDXield Sign
~NFO
~ Had Been Drinking ~ Drug Involvement
lDciver Il1/Injuretl ::::JQthcr Tmpropcr Driving :JDriver l!!attcntionl Distracted _ jphysictll Impairment IHigllway/Street Name:
:; Drove Left of Center ~ F,!i1 to Maintain Lane _ A,utregivc/ReckJess/CareJ~s Qirection ofTrllvcl: i81NorthDSouthDEal>tDWcst UtDL CiJ1License Valid
I
Trnmc Control LJ!J.nknown
(F-F\lnetionin~ Nr--Not Functioning O=Obstructcd)
~.6..pparently Nonnal
~Hjt and Rlm D'R~ad Defect
; M.echanica] Defect _
I
Agency Name; LAS VEGAS METROPOLItAN POLICE DEPARrrvU~NT
VEHICLE INFORMATrON SHEET
Vehicle Fnetors: UQnknown
Endorsements
Accident Number: LVMP 0·050430·0167
STATE OF NEVADA TRAfFIC ACCIDENT REPORT
Event 'N umber:050'430-0'1 £37
DICC Me ~~EJ~;!::!.Sjnglc State ~~SDOT
~PlaCBrd #:
1::-:-~~
Diamond #:
-INone
lZip:.
~AS
S;:tfety Report 1#
Number:
~:C"nada
INQe
00000
OMexico lCit"tion Number b,l.s.uapcetcd T1'r'lP:l.iTT11~T1t
I
C1Akohol
bJllnknown t:lRrll~s
Method of Dctcnninl'l.tion WDrivCT Admission ~~ield Sohriety Test ~,~rC1iminary Breath 00905 ~~videJ1tiary :arcatll J~Iood Test I LJUrine Test .~sl Rc~ults: 1m Nltmber: ---'j;::'ll)':":ot:":".c-:"----"l:!:" /R,e~v-;-'c-w-e-;-d";;;B:--v::- -.....r=::.,;~~~D~at':"'e-=R.=-ev"""':'"je-W-ed-=---~-~.c..:=.~I~=·~·- - - -
NOC
15597
14/30(2005
jeitation Number
12440 DAVID MOODY
5/5/20058;37:18 AM
J
STATE OF NEVADA TRAFFIC ACCIDENT REPORT
Event Number: 05043(r.;Q167 Code Revision:
SCENE INFORMAnON SHEET Revise
Dprc1iminary Report b1Resubmission ~[]""iE-m-c-r-P;lc-n-c-y-"I"""ILI"""Q:ffi"'lc-c-R-e-ho-rt-iiP!Sl!!!j.:-l'1}itial R~ort DSupplcment Report Colllldon l)A~e: Time: Day: I Beat/Sector ~C(nlnty
I
Df,roperty l8IInjury UE~tal
J.,dl:Ht and Run DPrivate Property
Asency Name: l..AS VEGAS METROPOLITAN POLICE DEPARTMENi UCIt:v Surface Intt:rsectlon rAddlll'Mllirker 4/30/2005 010:3 SATURDAY S5 CLARK Ii!SlAsphalt ;;; Four YJ..ay JNone ~--""'---:'-+-~---IL.-_-~--:;-:L-~~------1~~---""'~----::-;-:---+-~~----:'--'~~--:--::--i-JFi~oncrcte _ > t'lour Way Side MU~ M"rkt.r #Vehlcl~ #Non Mororfsts #Occupant!i #Fntalltil:s #lnjllrtd #f.l.estrRined gOravel ~ I ~E.jght Side 1r---~--+-"'""'"='2--i~--~----=-O~------+-----::2=----+-----=-O---1---1:----t--"""'"':'""1 --"'-WIQirt =; Y d~oth Sides DQthcr _ ROUl'ldabo\l .JUnknown Occbrrcd On: (Hi!=tnway # or Street Name) DURANGO ~At lnterscctlon With: UApproximat• ....JOr: DFl!d DMIlf;!~ Of (Cro~.~ Street) PATRICK Access Control Df,al'kin,g Lot lII!J.rban DBural one U.E,ulI UE.srti~J T(ltlll All Lane8
I
Jlcft
I
ROAdway Character
I
fKJli
Roadway Conditions Dllnknown ~ .Qry DS!1Jsh
15
Total Thro Lane!'i AnraRe ROAdway WIdths RoadWAY Grade 12 f't.DNotDetet1'llinc:d Relative To: M8!in Road £ross ROi 0% Inside I Outside o Ft.1 0 Ft, Pnvemtnt Markin2S and TVDe U)'Jone JoJiehway DeserlDtjon Wellther Condltlons Ullnknown Edge Line,uft,Yeliow 4 CentCl"1inc,~rQken Yellow ~ !woNWay, Not Dividc-
YUKON
!YIN; IPlate #
=
!ComoJ lance LJRcstrlct UEndOtge R.estrictions 1SDced E~mate: I First Namc: MICHAEL. Mid IAccident Number: LVMPD·050430·0167
STATE OF NEVADA TRAFFIC ACCIDENT REPORT
NumOcr:OS0430·G-167
AtFl\l~It.l:!(l
Brlrl
T,"
-
-
I
At F:mlt [J Vehicf!;# 2
Revised 5/21/2003 J)riv~r Factors: Unl(nQwnO
=lJisrc:gard Control Device : Ioo FCtSt for Conditions
.....f:ail to Yield Right of Way
~Ban OffRoo1l0
:: gxceediJ1g Speed Limit ::: !Y.ronp; Way/DireetiQn
;; Object AvoidOlnce ~ DrivcrlC!l!l ychicle :::= l'ol1owi'llg Too Close ..... Unsafe Lane Changc ~ Made: Improper Tum DOver Correct SteerinR
I;PgDrivcr
Last Name:
I
j"te:lJ
Make:
Veh. Yr.:
1996
100DGE
Regi!ltcrcd Owner Name:
rrype
lModel:
IOAKOTA (Sam~ :IS
.QB.IVEB )
.
~ ~"ckln8
. ;::: Left Tum
;:: B.ight Tum ~IDongW:J'j
I..
Qther
Carrier Narn~:
jPll1tcIPermit 'Number:
IPK~PICKUP'I.._ p!n~Ured(COmpany:
~ folc
~tent of Onmltgc CI Minor 0 MOQerate
DamaKed
Arras'
ID.Right Front
CJ
Dn.ight:R&ar
DJ,£3Vintt P;:trkec1
EX
~ni\lry
irbae Swih;h
rapI'ed
UMLJE LJ Unk:
Restraints
Seatinl~
tn
.r3DDed
FJoliey Number: ITo:
LJlmiling Unit 3
,ULeft Fro!!t
1st 2nd
OtJndcr ~;'lITiage
DYnknown
3rd 4th
Collision with Fixed Object
u
MOiOR VEHICLE IN TRANS~ORT
u
o
o
Vehicle Confi~bratfon ;;;;; Irnctor Only ~!ractorISemi.Trailer ~ TmetOl;lTrailcr ~ Pass. Veh. <J;!.az-Mat)
;; Tractor/Doubles _ TractorITr,iplc!;
Light 1'n.J£k (HlIZ.Mat) ~ Qther He:..vy Vehicle ... Truck with Trnil~r ~
Ennt
u
U
5th
Most
Harm£ul
[J
u
[J
..... Comm. Yeh, .JSchool au~ Source;
bJ12river
DS.tate Reg.
tJiog BookOSicle .QfVehielc
O-Shipping J.:apert;lTrip Mnfs1
Power Unit GVWR;
O~ ),0,000 Lbg. 0] 0,00 1-2.6~OOO Lb!i. D:>:z~.ooO Lbs. lCity: IStatt::NV
lViolation
\irb~ Switch
vtN:
SequeOl:e of Events De.,crlption
CodeN
DLeft~cgr
DEnter Parked(,l)
Position
-f:::.:ln~i\"~I'YLoc~7at:.:..:io:.::t1:.....-
~icctco
jeolor. J8/31/20041WH ITE
Position Location
~eatinl:t
toQB:
!Person TYDe
IExp.:
DQther
----=::C=ar"..J:.rZt.:::.~()-=J,l;.;;:.Od=-IYl-r~rytlU;;.;:;'e.;;;lU~JlIa:..ln;;.;.k;.;.;n~QWTl~----,
L.IC.FR UCC/MC Dfcm.'ling 2} I nVl!stI2ntor~
ISta('Jtt
bJ ~(Jnc D !Ink. r8I Major 0 'total
o
~ending
~1:IRS
01
3.6
A.irba~s
DIop
UY:ln/Box UQrain~ Gravel Chips D~cmc:retc Mixer D~us,9"J5 Occupants ;:: flatbed DAut.o Carrier DBlls.>I.5 Occupants ~ ~\Imp DOarbage!B.cfuJlc ~ Qther ON-at Atlolicable ~ tiRS UCFR UCC/,Mt. lViolation I)
UM~EU Unk;
o
Ejected Suffix:
Middle:
I
~JN: Plate #
Vehicle Towed: LJ By; _ Removed To: ~INED BY DRIVER Vehicle Ac:tlon LJUnknQwn Ufarked WEnterint Lanc ~ .8us.2·15 Occupants OU-l:.um DLc:~ving Lane := Rus, :> t 5 Occupants OLanc Qangc Stopped ~ Singfe :z Axle & 6 Tire DP= 3 ~xlc DDrlvcrlcs8 Yeh OOthcr Tuming I - Any 4 tire Vehicle
;: lank
f-
DOB.
Tvoe OccuDant Restraints Injury Severity
Airbaes
o
ILieense St"tus: a v I Limit:35
IState; UNV TN
I To: 0
Pel'S(lr\
IVIN:
Carrier Street Addre~s: ~,.......,....
wOther: (1) Travel Lan~ T 1
IOLN:103227778
I From: 0 Suffix;
!Company Address;
Wlmiling Unit 2
~ _L~lt/
~ ~tralght
~ DONo ~ontrol!\ ,....,OD:Wamjn£ Sign
p1!nlcnown []Not Trans.
WEront r'-" (JJ\ight .side D~' IT \, .&_A h. /~m.. t·.,.· '., W ,-,~ft Side o Cl 0 l&l_Rear
DUnder Ride
; DONo Pa~!\ing
t>CCllD~nt
IVIN: IPlate #
D.Qvcrridc
I..
~; LJ~MS L...!Policc UQthcr 1-_ _~_ _+Tn"",JiU:~lTY~S..;.ev_e_ri...... ty_-+
NY
I{.O. Addrc!l!l: NV
ht Contact
~ DDR.R. Gat~s DDR.lt. SignaleD 18 DOM,3rked Lanes ~~OTire Chains/Snow Req
Signal
7
rrrllusported To:
WIrailing Unit I
c;J
'-. DD~ed.
c
U l::!ot Tran,.
~!ll1known OF,olice l-J.Dthcr First Name:
1
Last Name:
VALLEY
gy: ~gMS
~~P 9147
LASVEQAS
r-
rJ'r:tnsported To; S~RING
!City:
Ply:
~~OSch()Ql Zone
ISpel!d E!ltlmate: Middle:
First Name:
;:: DDR.R. Sign
~ DDFI~hing Light
Apparently fatigued/Sleep Oo~truete(j Yiew
!ComoHance URestnet DEndorlic
Restrictions
Str€ct Address: ~ - - . ..
Street Address:
:! DDS,peed Zone ~ DDSignal L.ight
IDURAN GO
I
FNFO ~ ODS!op Sisn ~ DDXield Sign
~NFO
~ Had Been Drinking ~ Drug Involvement
lDciver Il1/Injuretl ::::JQthcr Tmpropcr Driving :JDriver l!!attcntionl Distracted _ jphysictll Impairment IHigllway/Street Name:
:; Drove Left of Center ~ F,!i1 to Maintain Lane _ A,utregivc/ReckJess/CareJ~s Qirection ofTrllvcl: i81NorthDSouthDEal>tDWcst UtDL CiJ1License Valid
I
Trnmc Control LJ!J.nknown
(F-F\lnetionin~ Nr--Not Functioning O=Obstructcd)
~.6..pparently Nonnal
~Hjt and Rlm D'R~ad Defect
; M.echanica] Defect _
I
Agency Name; LAS VEGAS METROPOLItAN POLICE DEPARrrvU~NT
VEHICLE INFORMATrON SHEET
Vehicle Fnetors: UQnknown
Endorsements
Accident Number: LVMP 0·050430·0167
STATE OF NEVADA TRAfFIC ACCIDENT REPORT
Event 'N umber:050'430-0'1 £37
DICC Me ~~EJ~;!::!.Sjnglc State ~~SDOT
~PlaCBrd #:
1::-:-~~
Diamond #:
-INone
lZip:.
~AS
S;:tfety Report 1#
Number:
~:C"nada
INQe
00000
OMexico lCit"tion Number b,l.s.uapcetcd T1'r'lP:l.iTT11~T1t
I
C1Akohol
bJllnknown t:lRrll~s
Method of Dctcnninl'l.tion WDrivCT Admission ~~ield Sohriety Test ~,~rC1iminary Breath 00905 ~~videJ1tiary :arcatll J~Iood Test I LJUrine Test .~sl Rc~ults: 1m Nltmber: ---'j;::'ll)':":ot:":".c-:"----"l:!:" /R,e~v-;-'c-w-e-;-d";;;B:--v::- -.....r=::.,;~~~D~at':"'e-=R.=-ev"""':'"je-W-ed-=---~-~.c..:=.~I~=·~·- - - -
NOC
15597
14/30(2005
jeitation Number
12440 DAVID MOODY
5/5/20058;37:18 AM
J
