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

Police 26 114 127b 48. Alcohol Drug Test 49. Hazardous Material 78. Alcohol Drug Test 79. Hazardous Material - Given: No Yes Refused None On Board Spill Given: No Yes Refused None On Board Spill - 115 Type: Breath Blood Urine Type: Breath Blood Urine 127c - - - - - - - - - - - 26 116 Results: 0. - - % Pending Hazard Class Placard No. Results: 0. - - % Pending Hazard Class Placard No. 127d 03 50. Carrier No. 51. GVWR / GCWR (trucks & buses only) 80. Carrier No. 81. GVWR / GCWR (trucks & buses only) 10,000 lbs. 10,000

10,000 lbs. 10,000 lbs. - 117 USDOT - - - - - - - None USDOT - - - - - - - None 127e 10,001 - 26,000 lbs. 10,001 - 26,000 lbs. 03 MC/MX - - - - - - - 26,001 lbs. MC/MX - - - - - - - 26,001 lbs. - 128 52. Motor Carrier or Government Entity 82. Motor Carrier or Government Entity - - 26

26 129 Number & Street Number & Street - - 11 130 City State Zip City State Zip - - - - - - 11 131 135. Damage to Other Property Yes (If Yes, describe) No - 12

12 132 12 Oper. 136. Charge 137. Summons No. Oper. 138. Charge 139. Summons No. 133 - - - - - - 04 Oper. 140. Charge 141. Summons No. Oper. 142. Charge 143. Summons No. 134 - - - - - - 04 83 84 85 86 87 88 89 90 91 92 93 94 95 Names & Addresses of Occupants If Deceased, Date & Time of Death A 01 01 01 05 26 M 08 08 02 11 11 01

05 26 M 08 08 02 11 11 01 TIMOTHY F SULLIVAN 2 MORNINGSIDE AVE 5711 KEANSBURG NJ 07734 NANA OWUSU 138 MLK BLVD NEWARK NJ 07104 B 02 01 01 05 71 M - - - 11 04 - - C D NJTR-1 (Rev. 01/17)

New Jersey Police Case Number Crash Investigation Report 21027020 2 3 83 84 85 86 87 88 89 90 91 92 93 94 95 Names & Addresses of Occupants If Deceased, Date & Time of Death E F G H I J 144. Crash Diagram Show NORTH by Arrow (Not to Scale) SEE NJTR-1B 145. Crash Description/Narrative D1 stated V1 was going south on Valley Rd and as V1 was passing through the intersection of Mitchell Street and Valley Rd V1 was struck by V2. D2 stated V2 was going west on Mitchell Street and attempted to turn south onto Valley Rd when V2 was struck by V1. 146. Officer's Signature 147. Badge # 148. Reviewer Badge # 149. Case Status Pending Complete SMERALDO, CONNOR 372 SMARSH,SCOTT 161 NJTR-1 (Rev. 01/17)

Page 3 of 3 New Jersey Police Crash Investigation Report Police Dept: WEST ORANGE Code: 01 Motor Vehicle Crash Diagram Station: - Case No: 21027020 144 Crash Diagram (NOT TO SCALE) Indicate North SMERALDO, CONNOR 372 NJTR-1B (Rev. 01/17) Officer's Signature Badge Number

96 118a 05 Page 1 of 2 Fatal New Jersey Police Crash Investigation Report Reportable Non-Reportable Change Report 04 97 1. Case Number 11. Speed Limit 118b 10. Crash 01 2022-004921 Occurred On: VALLEY ROAD S 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 STREET -- 99

-- 99 119b -- Miles 17. Cross Road Name/Route No. 07 -- 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.) Code

01 01 mm dd yy (use 2400 hrs.) Code Killed Injured 21. Latitude 22. Longitude MON 100b 03/14/22 1648 0722 -- -- -- -- 120b 04 23. Veh. # 24. Policy No. 25. NJ Ins. Code 53 Veh. # 54. Policy No. 55. NJ Ins. Code -- 101 01 6091-69-16-07 148 02 6082-98-31-61 148 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 HENOK -- MENGSTAB M WELLINGTON