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

122 02 30. Eyes DL Class Restrictions Endorsements 31. State 60. Eyes DL Class Restrictions Endorsements 61. State - - - - - - - - - - 10 - 123 105 32. Driver's License Number 33. DOB mm dd yy 34. Expires mm yy 62. Driver's License Number 63. DOB mm dd yy

mm dd yy 64. Expires mm yy - 03 -- -- -- - - - - - - - - - - 35. Owner's First Name Initial Last Name 65. Owner's First Name Initial Last Name 106 124 Same as Same as 02 Driver JEAN C ANTOINE Driver - - - 11 107 36. Number & Street

- 11 107 36. Number & Street 66. Number & Street 125 - 36 MITCHELL ST APT 2 Apt#2 - - 108 37. City State Zip 67. City State Zip 126a 01 WEST ORANGE NJ 07052 - - - 26 109 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 126b - TOYOTA AVALON GD 2000 D32DBW NJ - - - - - - - 110 44. VIN 45. Expires 74. VIN 75. Expires 126c 01 4 T 1 B F 2 8 B 3 Y U 0 2 9 9 4 0 04/19 - - - - - - - - - - - - - - - - - -- -- - 111

04/19 - - - - - - - - - - - - - - - - - -- -- - 111 126d 46. Vehicle Removed to: 76. Vehicle Removed to: - - - - 112 126e Driven Towed Disabled Towed Disabled & Impounded Driven Towed Disabled Towed Disabled & Impounded - Left at Scene Towed Impounded Left at Scene Towed Impounded 26 113 127a 47. Authority 77. Authority -

127a 47. Authority 77. Authority - Owner Driver Police Owner Driver Police - 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 - - - - - - - - - - - - 116 Results: 0. % Pending Hazard Class Placard No. Results: 0. % Pending Hazard Class Placard No. 127d 01 50. Carrier No.

Placard No. Results: 0. % Pending Hazard Class Placard No. 127d 01 50. Carrier No. 51. GVWR / GCWR (trucks & buses only) 80. Carrier No. 81. GVWR / GCWR (trucks & buses only) 10,000 lbs. 10,000 lbs. - 117 USDOT - - - - - - - None USDOT - - - - - - - None 127e 10,001 - 26,000 lbs. 10,001 - 26,000 lbs. - MC/MX - - - - - - - 26,001 lbs. MC/MX - - - - - - - 26,001 lbs. - 128 52. Motor Carrier or Government Entity

128 52. Motor Carrier or Government Entity 82. Motor Carrier or Government Entity - - 26 129 Number & Street Number & Street - - 08 130 City State Zip City State Zip - - - - - - 08

131 135. Damage to Other Property Yes (If Yes, describe) No - - 132 - Oper. 136. Charge 137. Summons No. Oper. 138. Charge 139. Summons No. 133 - - - - - - 02 Oper. 140. Charge 141. Summons No. Oper. 142. Charge 143. Summons No. 134 - - - - - - - 83 84 85 86

- - - 83 84 85 86 87 88 89 90 91 92 93 94 95 Names & Addresses of Occupants If Deceased, Date & Time of Death A B C D NJTR-1 (Rev. 01/17)

New Jersey Police Case Number Crash Investigation Report 18037240 3 4 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 While in the lobby of 549 Valley Rd (WOPD Traffic Bureau), I observed V1 attempt to proceed eastbound on Mitchell St through the intersection of Valley Rd. V1 then struck V2 which was travelling south on Valley Rd. The impact casued V2 to rotate 180 degrees striking V3 which was parked unoccupied on the east curbline of Valley Rd. D1 states that he stopped at the stop sign and then proceeded to travel through the intersection and did not see V2. D2 states that he was traveling south on Valley Rd when V1 came throuigh the intersection and struck V2. D1 was issued the following summonses: E18-9219 for 39:3-4 (Unregistered) and E18-9220 for 39:4-144 (Failure to stop or yield). V1 was impounded for expired registration. 146. Officer's Signature 147. Badge # 148. Reviewer Badge # 149. Case Status Pending Complete MATULLO,PATRICK 287 JACKSIC,CHRISTOPHER 137 NJTR-1 (Rev. 01/17)