2834-24 Mitchell-Valley-All-Way-Stop-Report.pdf

96 118a 04 Page 1 of 2 Fatal New Jersey Police Crash Investigation Report Reportable Non-Reportable Change Report 09 97 1. Case Number 11. Speed Limit 118b 10. Crash 01 2022-007059 Occurred On: VALLEY ROAD N 25 -- -- -- 02 98 2. Police Dept. of Code Road Name Dir 12. Route No. Suffix 13. Milepost 119a 01 WEST ORANGE 01 At Intersection with 18. Speed Limit 25 3. Station/Precinct Feet N E Of : MITCHELL ST 25 99

25 99 119b -- Miles 17. Cross Road Name/Route No. 05 -- S W 19. -- To: -- NB EB 14. 15. 16. Ramp 100a From: 20. Route Name/Route No. SB WB 120a 4. Date of Crash 5. Day of Week 6. Time 7. Municipality 8. Total 9. Total 01 01 mm dd yy (use 2400 hrs.)

01 01 mm dd yy (use 2400 hrs.) Code Killed Injured 21. Latitude 22. Longitude FRI 100b 04/08/22 1542 0722 -- -- -- -- 120b 04 23. Veh. # 24. Policy No. 25. NJ Ins. Code 53 Veh. # 54. Policy No. 55. NJ Ins. Code -- 101 01 TCA00002029609 632 02 * * 121a 02 Parked Ped Pedalcyclist Resp. to Emergency Hit & Run Parked Ped Pedalcyclist Resp. to Emergency Hit & Run 01 26. Driver's First Name Initial Last Name 29. Sex 56. Driver's First Name Initial Last Name 59. Sex 102 121b JOHN -- EXIL

121b JOHN -- EXIL M JOHN D BIAMONTE M 01 -- 103 27. Number & Street 57. Number & Street 01 300 SMITHFIELD RD P5 - 55 38 BERRY PL 104 122 2 28. City State Zip 58 City State Zip 01 NORTH PROVIDENCE RI 02904 GLEN ROCK NJ 07452-3202 123 30. Eyes DL Class Restrictions Endorsements 31. State 60. Eyes

123 30. Eyes DL Class Restrictions Endorsements 31. State 60. Eyes DL Class Restrictions Endorsements 61. State 01 01 -- -- -- RI 02 -- -- -- NJ 105 32. Driver’s License Number 33. DOB 34. Expires 62. Driver’s License Number 63. DOB 64. Expires 01 40169661 mm dd yy mm yy B40114076403912 mm dd yy mm yy 02/08/99 02/23 03/01/91 03/24 124 35. Owner's First Name Initial Last Name 65. Owner's First Name Initial Last Name 03 Same As Same As

Same As 125 106 Driver CLAUDETTE EXIL Driver AAA FIRE PROTECTION INC -- -- 36. Number & Street 66. Number & Street 107 55 KINGSLEY STREET APT1L PO BOX 2294 126a -- 26 37. City State Zip 67. City State Zip WEST ORANGE NJ 07052-5242 MORRISTOWN NJ 07960 126b 108 01

NJ 07960 126b 108 01 -- 38. Make 39. Model 40. Color 41. Year 42. Plate No. 43. State 68. Make 69. Model 70. Color 71. Year 72. Plate No. 73. State TOYOTA COR WT 2017 T89MWE NJ CHEVROL TRA BK 2021 U63PES NJ 126c 109 01 -- 44. VIN 45. Expires 74. VIN 75. Expires 110 2T1BURHE3HC940280 10/21 KL7CJNSM4MB376831 09/25 126d 01 46. Vehicle Removed to: 76. Vehicle Removed to: -- 111 --

-- 111 -- -- 126e Driven Towed Disabled Towed Disabled & Impounded Driven Towed Disabled Towed Disabled & Impounded 26 02 Left at Scene Towed Impounded Left at Scene Towed Impounded 127a 112 26 -- 47. Authority 77. Authority Owner Driver Police Owner Driver Police 127b 113 -- -- 48. Alcohol Drug Test 49. Hazardous Material 78 Alcohol Drug Test 79. Hazardous Material Given : No

78 Alcohol Drug Test 79. Hazardous Material Given : No Yes Refused None On Board Spill Given : No Yes Refused None On Board Spill 127c 114 -- -- Type : Breath Blood Urine -- -- Type : Breath Blood Urine -- -- Hazard Class Placard No. 127d 115 Results: 0. -- % Pending Results: 0. -- % Pending Hazard Class Placard No. -- -- 50. Carrier No. 51. GVWR / GCWR (trucks & buses only) 80. Carrier No. 81. GVWR / GCWR (trucks & buses only)

81. GVWR / GCWR (trucks & buses only) 127e 116 USDOT -- None < 10,000 lbs. USDOT -- None < 10,000 lbs. 26 01 10,001 - 26,000 lbs. 10,001 - 26,000 lbs. MC/MX -- MC/MX -- 128 117 > 26,001 lbs. > 26,001 lbs. 26 01 52. Motor Carrier or Government Entity 82. Motor Carrier or Government Entity -- -- 129