2020 Police Report - Gore - PDF

562919 Drivers' Last Names MAGGITT, GORE, WALKER Page 1 of 18...

562919 Drivers' Last Names MAGGITT, GORE, WALKER Page 1 of 18 Juvenile Involved Yes No ARKANSAS MOTOR VEHICLE CRASH REPORT Severity Fatality Injury PDO Rev. 2019-1 # of Motor Vehicles 3 Crash Report # 6011203128 Automobiles, Motorcycles, etc. # of Non-Motorists 0 Investigating Agency STATE POLICE TROOP A Pedestrians, Bicyclists, etc. Signature Investigating Officer TRP Duncan Austin 417 Rank Last First Middle Suffix Badge # CRASH DATE AND TIME Date of Crash (MM/DD/YYYY) Time of Crash (HH:MM AM/PM) Date Police Notified Time Police Notified Date Police Arrived Time Police Arrived 11/24/2020 01:30 AM 11/24/2020 01:32 AM 11/24/2020 01:39 AM CRASH LOCATION County City Latitude Longitude Pulaski Little Rock 34.647718° N 92.421368° W Road/Street/Highway Section Log Mile At Intersection With INTERSTATE 30 (30) 23 127.703 py Not in City, but of the City Limits of Distance (feet or miles to two decimal places) Direction (N/S/E/W) City Not at Intersection, but of Distance (feet or miles to two decimal places) Direction (N/S/E/W) Reference point CRASH FACTORS AND CONDITIONS Co First Harmful Event 205 Location of First 100 School Bus 000 Roadway Surface 100 Weather Conditions Harmful Event Related Condition Non-Collision 100 Overturn/rollover Check all that apply: 101 Fire/explosion 100 On roadway 000 No, school bus 100 Dry 100 Clear 102 Immersion, full or partial 101 Shoulder not involved 101 Wet 103 Jackknife 102 Median 100 Yes, school bus 102 Snow 108 Freezing rain or 101 Cloudy 104 Cargo/equipment loss or shift 103 Roadside directly involved 103 Slush freezing drizzle 102 Fog 113 Fell/jumped from motor vehicle 104 Gore 101 Yes, school bus 104 Ice or frost 109 Snow 115 Object thrown or fallen 105 Separator indirectly involved 105 Water (standing or moving) 103 Smog on or near motor vehicle 106 In parking lane or zone 106 Sand 110 Blowing snow Type of 000 104 Smoke 198 Other non-collision 107 Off roadway, location unknown Intersection 107 Mud, dirt, or gravel 111 Severe crosswinds 105 Rain 108 Outside right-of-way (trafficway) 108 Oil Collision with Non-Fixed Object Collision with Fixed Object 200 Pedestrian 000 Not an intersection 112 Blowing sand, 999 Unknown d 198 Other 106 Sleet 201 Pedalcycle 100 Four-way intersection soil, or dirt 202 Other non-motorist Type of Collision 201 101 T-intersection 107 Hail 203 Railway vehicle (train, engine) 100 Single vehicle crash 102 Y-intersection 999 Unknown 198 Other 204 Animal (live) 103 L-intersection cte 200 Front to rear Light Condition 205 Motor vehicle in transport 201 Front to front 104 Traffic circle 104 206 Parked motor vehicle 202 Angle 105 Roundabout 100 Daylight 999 Unknown 207 Falling/shifting cargo or anything 203 Sideswipe, same direction 106 Five-point or more 101 Dawn set in motion by motor vehicle 204 Sideswipe, opposite direction 999 Unknown 102 Dusk Roadway Conditions 208 Work zone/maintenance equipment 205 Rear to side 103 Dark - lighted Road System 100 104 Dark - not lighted Check all that apply: 298 Other non-fixed object 206 Rear to rear 100 Interstate 105 Dark - unknown lighting 000 None 300 Impact attenuator/crash cushion 980 Other (describe below) 101 US highway 198 Other 100 Backup due to prior crash 301 Bridge overhead structure 102 State highway 101 Backup due to prior da 302 Bridge pier or support Relation to 103 County road 000 999 Unknown non-recurring incident 303 Bridge rail Junction 104 City street 304 Cable barrier 000 Non-junction 105 Frontage road Environmental Factors 102 Backup due to regular Check all that apply: congestion 305 Culvert 100 Intersection 106 Ramp 306 Curb 999 Unknown 000 None 101 Intersection related 103 Toll booth / plaza related 307 Ditch 102 Entrance or exit ramp 100 Weather conditions Property 100 104 Road surface condition 308 Embankment 103 Entrance or exit ramp related 101 Visual obstructions Classification (wet, icy, snow, slush, etc.) 309 Guardrail face 104 Railway grade crossing Re 310 Guardrail end 100 Public property 102 Glare 105 Debris 105 Crossover related 101 Private property 311 Concrete traffic barrier 106 Driveway access 103 Animals in roadway 106 Ruts, holes, or bumps 312 Other traffic barrier 107 Driveway access related 198 Other: 107 Work zone 313 Tree (standing) 108 Shared-use path or trail 314 Utility pole/light support 108 Worn, travel-polished surface 109 Acceleration or deceleration lane 315 Traffic sign support 999 Unknown 109 Obstruction in roadway 110 Through roadway 316 Traffic signal support 198 Other location within an Trafficway Classification 110 Traffic control device 100 317 Other post, pole, or support interchange area inoperative, missing, or obscured 100 Trafficway, on road 318 Fence (median, shoulder, and roadside) 111 Shoulders (none, low, soft, high) 101 Trafficway, not on road 319 Mailbox 102 Non-trafficway (describe below) 112 Non-highway work 320 Building 398 Other fixed object 999 Unknown 198 Other: 999 Unknown If 198, 298, or 398, describe: 999 Unknown WORK ZONE CRASH INFORMATION Work Zone 000 Location Relative 970 Work Zone Type 970 Worker(s) Present 970 Law Enforcement Present 970 000 No to Work Zone 100 Lane closure 000 No 000 No law enforcement presence 100 Yes 100 Before the first work zone warning sign 101 Lane shift or crossover 100 Yes 100 Officer present 999 Unknown 101 Advance warning area 102 Work on shoulder or median 970 Not applicable 101 Law enforcement vehicle only present 102 Transition area 103 Intermittent or moving work 999 Unknown 970 Not applicable 103 Activity area 198 Other 999 Unknown 104 Termination area 970 Not applicable 999 Unknown 970 Not applicable 999 Unknown CRASH REPORT - CRASH SUMMARY  562919 Crash Report # 6011203128 Page 2 of 18 Photos Taken ATTACHMENTS Yes Type Description No Alcohol test submission form Alcohol test submission form for Driver 1 Drug test submission form Drug test submission form for Driver 1 Witness statement Statement from Witness 1 Witness statement Statement from Witness 2 Witness statement Statement from Witness 3 py Co NON-VEHICULAR PROPERTY DAMAGE Damage Owner Address Description of Property Damage Estimate Contacted Name Street City State Postal Code Arkansas Department of Transportation - Concrete traffic barrier $500 P.O. Box 2261 Little Rock AR 72203 Legal Division d cte da Re WITNESSES' CONTACT INFORMATION Last Name First Name Middle Name Suffix Address City State Postal Code Traxer Megan 419 Willowbank St. Bellefonte PA 16823 Robinson-Hughes Jacob 508 Willowbank Street Apt. D Bellefonte PA 16823 BERNARD CHARLES ANTHONY 221 GLEN MEADOWS CIR BRUNSWICK GA 31523 CRASH REPORT - ATTACHMENTS / PROPERTY DAMAGE / WITNESSES  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 3 of 18 1 VEHICLE INFORMATION Crash Report # 6011203128 DESCRIPTION AND IDENTIFICATION Check if this vehicle Hit and Run Vehicle Body Type had no driver 000 100 000 No, did not leave the scene 100 Yes, vehicle & driver left the scene Passenger Vehicles 001 No, vehicle & driver left the scene 101 Yes, only driver left the scene 100 2-door 002 No, only driver left the scene 101 4-door VIN 1ZVBP8AM3B5162325 102 Hatchback 103 Convertible Vehicle Year, Make, and Model 104 Station wagon 2011 Ford Mustang/Mustang II 105 Pick-up Year Make Model 106 Mini-van License Plate 107 Passenger van (seats any number if personal; up to 8 if business) Missing 108 Cargo van (10,000 lbs or less) AR 103ZDL 2021 109 Sport utility vehicle Unknown (fill in all known details) State Number Year 110 Large utility vehicle Trailer #1 License Plate 111 Motor home/recreational vehicle Missing 198 Other passenger vehicle Unknown (fill in all known details) Truck (> 10,000 lbs) State Number Trailer #2 License Plate 200 Single unit truck (2 axles) Missing 201 Single unit truck (3 or more axles) py Unknown (fill in all known details) 202 Single unit truck with trailer State Number 203 Truck tractor only (bobtail) Owner Name Same as driver Unknown 204 Tractor/semi-trailer 205 Tractor/doubles KRISTOPHER MAGGITT 206 Construction/maintenance equipment Owner Address Same as driver Unknown 207 Farm equipment 3300 TYLER ST APT 8 CONWAY AR 72034-3336 298 Other heavy vehicle (GVWR/GCWR > 10,000 lbs) Co Bus / Van / Limo (9 or more seats, including driver) Street City State Postal Code Motor Carrier Type 300 School bus 000 Motor Carrier ID Numbers 301 Transit/city bus 000 Personal transportation USDOT # 302 Motor coach/intercity/cross-country bus 100 Interstate carrier 303 Limousine 101 Intrastate carrier MC/MX # 304 Van (seats 9-15, including driver) 102 Not in commerce - government 390 Other vehicle (seats 9-15, including driver) 103 Not in commerce - other truck State # State 391 Other vehicle (seats 16 or more, including driver) 999 Unknown Cycle / Low Speed Motor Carrier Name Unknown 400 Motorcycle d 401 Motor scooter 402 Moped Motor Carrier Address Unknown 403 ATV (3, 4, or 6 wheels) cte 404 Snowmobile 405 Golf cart Street City State Postal Code 406 Low speed vehicle Cargo Body Type 498 Other motorized cycle/low speed vehicle 000 000 No cargo body 104 Cargo tank 109 Dump 198 Other Unknown 100 Bus 105 Log 110 Concrete mixer 999 Unknown type of motor vehicle 101 Van / enclosed box 106 Intermodal container chassis 111 Auto transporter If 198, 298, 390, 391, or 498, describe below: 999 Unknown 102 Grain / chips / gravel 107 Vehicle towing another vehicle 112 Garbage / refuse da 103 Pole trailer 108 Flatbed GVWR/GCWR 970 Hazardous Materials Placard 000 Hazardous Material ID Hazardous Materials Released 970 (4-digit # or name from middle from Vehicle Cargo Compartment 100 10,000 lbs or less 000 Placard not required of diamond or rectangular box) 101 10,001 - 26,000 lbs 100 Placard displayed 000 No, hazardous materials not released 102 More than 26,000 lbs 200 Placard required but not displayed Hazardous Material Class 100 Yes, hazardous materials released (1-digit # from 970 Not applicable 999 Unknown bottom of diamond) 970 Not applicable (not carrying hazardous materials) Re INSURANCE DAMAGE Insurance Damage Severity 102 Initial Contact Point Damaged Areas Unknown Uninsured at time of crash 000 No damage (check 1) (check all that apply) (fill in any known details) 100 Minor damage 7 8 9 10 11 7 8 9 10 11 Insurance Company 101 Functional damage 102 Disabling damage STATE FARM MUTUAL AUTOMOBILE 999 Unknown 6 12 6 12 INSURANCE COMPANY Damage Estimate NAIC # $10,000 5 4 3 2 1 5 4 3 2 1 25178 Damage Prior to the Crash 000 Non-collision 097 No damage No prior damage 100 Cargo loss 113 Top Policy # Yes (describe below) 113 Top 114 Undercarriage 114 Undercarriage 0413538614 999 Unknown 999 Unknown TOWING Towed 101 Towed By 000 Not towed Walker Wrecker 100 Towed, but not due to disabling damage 101 Towed due to disabling damage Towed To 5703 Patterson Rd Little Rock AR 72209 Street City State Postal Code CRASH REPORT - MOTOR VEHICLE DESCRIPTION AND IDENTIFICATION  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 4 of 18 1 VEHICLE INFORMATION Crash Report # 6011203128 MOTOR VEHICLE CIRCUMSTANCES Vehicle Usage 000 Emergency Vehicle Usage 970 Vehicle Maneuver 100 000 No special function 100 Non-emergency, non-transport 100 Movement essentially straight ahead 100 Taxi 101 Non-emergency transport 101 Negotiating a curve 101 School bus/school transport 102 Emergency operation, emergency warning equipment not in use 102 Backing 102 Church bus 103 Emergency operation, emergency warning equipment in use 103 Changing lanes 103 Transit/commuter bus 970 Not applicable 104 Overtaking/passing 104 Intercity bus 999 Unknown 105 Turning right 105 Charter/tour bus 106 Turning left 106 Shuttle bus Travel Direction 107 Making U-turn 107 Military 103 108 Leaving traffic lane 108 Police 100 Northbound 109 Entering traffic lane 109 Ambulance 101 Southbound 110 Slowing 110 Fire truck 102 Eastbound 111 Parked 111 Non-transport emergency services vehicle 103 Westbound 112 Stopped in traffic 112 Incident response 104 Not on roadway 198 Other 999 Unknown 999 Unknown Vehicle Defects Check all that apply. 999 Unknown 000 None Traffic Control Device Types and Statuses py Check the box next to each traffic 100 Functioning properly 100 Brake 101 Exhaust system 102 Body or doors control device that was present at the location of the crash. 101 Functioning improperly 103 Steering 104 Power train 105 Suspension Use the codes to the right to record 102 Inoperative or missing 106 Tires 107 Wheels 108 Headlights the status of each traffic control 999 Unknown device present. 109 Tail lights 110 Turn signals 111 Windows or windshield 112 Mirrors 113 Wipers 114 Truck coupling, trailer Traffic Control Device Type Device Status Check all that apply. Use above codes. Co 115 Fuel system 116 Cruise control hitch, or safety chains 000 None 198 Other 100 Flashing traffic control signal 101 Traffic control signal 999 Unknown 102 Stop sign Trafficway Description 401 Roadway Surface 100 103 Yield sign 100 One-way trafficway 100 Concrete 104 Slow or warning sign 200 Two-way, not divided 101 Asphalt 201 Two-way, not divided, with a continuous left turn lane 102 Gravel d 105 Person (officer, flagman, crossing guard) 300 Two-way, divided, unprotected (painted >4 feet) median 103 Dirt 106 School zone sign/device 400 Two-way, divided, positive cable barrier 198 Other 401 Two-way, divided, positive concrete barrier cte 107 Pedestrian signal 498 Two-way, divided, other type of positive barrier 999 Unknown 108 No passing signal 999 Unknown 109 Words or symbols painted on roadway Roadway Grade 100 Roadway Alignment 200 110 Traffic lanes marked 100 100 Level 999 Unknown 100 Straight 101 Hillcrest 200 Curve left 111 Railway crossing with gate and signals 102 Uphill 201 Curve right 112 Railway crossing with flashing signals only da 103 Downhill 299 Curve, direction unknown 104 Sag (bottom) 999 Unknown 113 Railway crossing with crossbuck only Total # of Lanes Posted Speed Limit 198 Other: 6 Use the posted speed limit that applied 65 to this vehicle at the time of the crash. 999 Unknown MOTOR VEHICLE EVENTS Re Sequence of Events 1 205 2 3 4 5 6 7 8 9 10 Most Harmful Event 205 Non-Collision Collision with Non-Fixed Object Collision with Fixed Object Unknown 100 Overturn/rollover 200 Pedestrian 300 Impact attenuator/crash cushion 318 Fence 999 Unknown 101 Fire/explosion 201 Pedalcycle 301 Bridge overhead structure 319 Mailbox 102 Immersion, full or partial 202 Other non-motorist 302 Bridge pier or support 320 Building 103 Jackknife 203 Railway vehicle (train, engine) 303 Bridge rail 398 Other fixed object 104 Cargo/equipment loss or shift 204 Animal (live) 304 Cable barrier 105 Equipment failure 205 Motor vehicle in transport 305 Culvert If 198, 298, or 398 is used, describe below: (blown tire, brake failure, etc.) 206 Parked motor vehicle 306 Curb 106 Separation of units 207 Falling/shifting cargo or 307 Ditch 107 Ran off roadway right anything set in motion by motor vehicle 308 Embankment 108 Ran off roadway left 208 Work zone/maintenance equipment 309 Guardrail face 109 Deliberately crossed median 298 Other non-fixed object 310 Guardrail end 110 Unintentionally crossed median 311 Concrete traffic barrier 111 Crossed centerline 312 Other traffic barrier 112 Downhill runaway 313 Tree (standing) 113 Fell/jumped from motor vehicle 314 Utility pole/light support 114 Reentering roadway 315 Traffic sign support 115 Object thrown or fallen on or near motor vehicle 316 Traffic signal support 198 Other non-collision 317 Other post, pole, or support CRASH REPORT - MOTOR VEHICLE CIRCUMSTANCES AND EVENTS  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 5 of 18 1 DRIVER INFORMATION Crash Report # 6011203128 DRIVER INFORMATION Name Unknown Date of Birth/Age Sex Male Race 101 MAGGITT KRISTOPHER LE-SHON 03/23/1996 Female 100 White/Caucasian Age: 24 Unknown 101 Black/African-American Last First Middle Suffix 102 Hispanic Address Unknown 103 Asian/Pacific Islander 104 American Indian 3300 TYLER ST APT 8 CONWAY AR 72034 198 Other Street City State Postal Code 999 Unknown DRIVER LICENSE INFORMATION License Status 100 License Number Restrictions on License Check all that apply. Restrictions Violated Check all that apply. 000 Not licensed 935656669 100 Valid license 000 None 000 None 200 Suspended License State License Class 100 With licensed adult 100 With licensed adult 201 Revoked 202 Expired AR D 101 Corrective lenses 101 Corrective lenses 203 Cancelled or denied Is Commercial Driver License? 204 Disqualified 102 Mechanical aid 102 Mechanical aid 999 Unknown Yes No 103 Prosthetic aid 103 Prosthetic aid py Endorsements on License Endorsements Violated Check all that apply. Check all that apply. 104 Automatic transmission 104 Automatic transmission 000 None 000 None 105 Outside mirror 105 Outside mirror 100 Double/triple trailers 100 Double/triple trailers 106 Daylight only 106 Daylight only 101 Passenger 101 Passenger 107 Class B or C with passengers and class D 107 Class B or C with passengers and class D Co 102 Tank vehicle 102 Tank vehicle 108 Class C only with passengers 108 Class C only with passengers 103 Hazardous materials 103 Hazardous materials 109 Vehicles without airbrakes 109 Vehicles without airbrakes 104 Tank vehicle & hazardous materials 104 Tank vehicle & hazardous materials 110 Interlock device 110 Interlock device 105 School 105 School 111 School, church, or transit bus 111 School, church, or transit bus 106 Motorcycle 106 Motorcycle 112 Class D only with passengers 112 Class D only with passengers 107 Motor driven cycle 107 Motor driven cycle 113 Diesel fuel, fertilizer only 113 Diesel fuel, fertilizer only d 108 Valid without photo 108 Valid without photo 114 Seasonal farm service vehicle 114 Seasonal farm service vehicle 198 Other (describe below) 198 Other (describe below) 198 Other (describe below) 198 Other (describe below) cte DRIVER SEATING AND SAFETY INFORMATION Seating Position 110 Restraint Systems Used 000 Motorcycle Helmet Usage 000 000 None used - motor vehicle occupant 000 No helmet worn Standard Vehicle Seats Other Seating Positions da 100 Shoulder and lap belt used 100 DOT-compliant 101 Shoulder belt only used motorcycle helmet worn Front 800 Sleeper section of cab (truck) 102 Lap belt only used 101 Non-DOT-compliant Row Left Middle Right Other 801 Passenger section of bus 103 Restraint used - type unknown motorcycle helmet worn 802 Enclosed passenger/cargo area 1 110 120 130 180 104 Child restraint system - forward facing 102 Helmet worn, 803 Unenclosed passenger/cargo area 105 Child restraint system - rear facing unknown if DOT-compliant 2 210 220 230 280 804 Passenger/cargo area, 106 Booster seat 999 Unknown if helmet worn unknown if enclosed 107 Child restraint - type unknown Re 3 310 320 330 380 805 Trailing unit Eye Protection Usage 198 Other 806 Riding on motor vehicle exterior Yes 4 410 420 430 480 Unknown 970 Not applicable No 5 510 520 530 580 999 Unknown Unknown 999 Unknown Air Bags Deployed Ejection 000 Extrication 000 Bus Seating Position Check all that apply: 000 Not ejected 000 Not extricated 100 Ejected, partially 100 Extricated (Complete if 801 was selected for Seating Position above.) 000 Not deployed 101 Ejected, totally 999 Unknown 100 Deployed: front 970 Not applicable Front 101 Deployed: side 999 Unknown Driver 1A 1B 1C 1D 1E 1F 102 Deployed: curtain Ejection Path 000 2A 2B 2C 2D 2E 2F 198 Deployed: other 000 Not ejected 970 Not applicable 100 Side door opening 999 Unknown 3A 3B 3C 3D 3E 3F 101 Side window 4A 4B 4C 4D 4E 4F 970 Not applicable 102 Windshield 999 Unknown Aisle 5A 5B 5C 5D 5E 5F 103 Back window 104 Back door/tailgate opening 105 Roof opening (sun roof, convertible top down) ··· ··· ··· ··· ··· ··· 106 Roof (convertible top up) 198 Other (e.g., back of pickup truck, torn-off roof, car cut in half) ##A ##B ##C ##D ##E ##F CRASH REPORT - DRIVER INFORMATION  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 6 of 18 1 DRIVER INFORMATION Crash Report # 6011203128 MEDICAL INFORMATION Injury Status 3 Type of Medical Transportation 101 EMS Notified EMS Arrived 1 (K) Fatal injury 000 Not transported 11/24/2020 01:37 AM 11/24/2020 01:43 AM 2 (A) Suspected serious injury 100 EMS air Date Time Date Time 3 (B) Suspected minor injury 101 EMS ground Transported to Medical Facility By 4 (C) Possible injury 102 Law enforcement 5 (O) No apparent injury 198 Other MEMS - Pulaski Co Trauma Band # Medical Facility Transported To Unknown 199 Transported, but method unknown UAMS Medical Center, Little Rock, AR 999 Unknown if transported DRIVER CONDITION AND CIRCUMSTANCES Condition at Time of Crash Driver Distracted By 000 Driver Vision Obscured By 000 Check all that apply: 000 Apparently normal 000 Not distracted 000 No obstruction noted 106 Not in-transport motor vehicle 100 Manually operating an electronic 100 Rain, snow, fog, smoke, sand, or dust (parked, working) 100 Physically impaired communication device (texting, typing, dialing) 101 Reflected glare, bright sunlight, 107 Splash or spray of passing vehicle 101 Emotional (depressed, angry, disturbed, etc.) 101 Talking on hands-free electronic device or headlights 108 Inadequate defrost or defog system 102 Ill (sick) or fainted 102 Talking on hand-held electronic device 102 Curve, hill, or other roadway 109 Inadequate vehicle lighting system 103 Asleep or fatigued 103 Other activity with an electronic device design feature 110 Obstruction interior to the vehicle py 104 Passenger 103 Building, billboard, or other structure 111 External mirrors 104 Under the influence of medication or drugs 980 Other distraction inside the vehicle 104 Trees, crops, or vegetation 112 Broken or improperly cleaned windshield 105 Under the influence of alcohol 981 Other distraction outside the vehicle 105 In-transport motor vehicle 113 Obstructing angles on vehicle 198 Other 999 Unknown if distracted (including load) 199 Vision obscured - no details If 980 or 981, describe below: 980 Other visual obstruction (describe below) 999 Unknown Co Driver Suspected Alcohol Test Type Given 100 Alcohol Test Result Status 100 Blood Alcohol Content Speeding Related 000 of Alcohol Usage 000 No test given 100 Results pending 000 Not speeding 001 Test refused 101 Results received 100 Racing Yes 100 Blood test 970 Not applicable 101 Exceeded speed limit 101 Breath test 999 Unknown 102 Too fast for conditions No 102 Urine test 999 Unknown 198 Other type of test Unknown Result received from 999 Unknown if tested Crime Lab Driver Suspected Drug Test Type Given Drug Test Results Result received from Crime Lab Citations 100 d of Drug Usage 000 No test given Pending/Negative Not Applicable/Unknown Citation # Charges 001 Test refused 000 Results negative 970 Not applicable Yes 100 Blood test 100 Results pending 999 Unknown cte 101 Urine test No 102 Both blood and urine tests Positive Results (check all that apply) 198 Other type of test 200 Amphetamines 206 Methamphetamines Unknown 201 Barbiturates 207 Opiates 999 Unknown if tested 202 Benzodiazepines 208 Oxycodone 203 Cannabinoids 209 Propoxyphene 204 Cocaine 210 Phencyclidine (PCP) da 205 Methadone 298 Other positive result (describe below) DRIVER ACTIONS AT TIME OF CRASH Check all that apply: Re 000 No contributing action 999 Unknown Disregarded Traffic Signs or Controls Improper Maneuver Other Actions 100 Disregarded red light 300 Improper right turn 600 Impeding traffic 101 Disregarded other traffic signal 301 Improper left turn 601 Ran off roadway 102 Disregarded stop sign 302 Improper U-turn 602 Crowded off roadway 103 Disregarded yield sign 303 Improper backing 603 Crossing median 104 Disregarded other traffic sign 304 Improper passing 604 Failed to yield right-of-way 105 Disregarded other road markings 305 Improper lane change 605 Failed to keep in proper lane 106 Disregarded officer or flagman 306 Improperly parked 606 Wrong side of road Swerved or Avoided Improper Use of Lights or Signals 607 Wrong way 200 Swerved or avoided due to wind 400 Driving without lights 608 Followed too closely 201 Swerved or avoided due to slippery surface 401 Failed to dim headlights 609 Cutting in 202 Swerved or avoided due to motor vehicle 402 Failed to or improper signal 610 Over-correcting or over-steering 203 Swerved or avoided due to non-motorist in roadway 980 Other contributing action (describe below) Unsafe Operation 204 Swerved or avoided due to object in roadway 500 Reckless operation 205 Swerved or avoided due to animal in roadway 501 Aggressive operation 502 Inattentive, careless, negligent, or erratic operation 503 Under the influence of alcohol 504 Under the influence of drugs CRASH REPORT - DRIVER CONDITION AND CIRCUMSTANCES  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 7 of 18 2 VEHICLE INFORMATION Crash Report # 6011203128 DESCRIPTION AND IDENTIFICATION Check if this vehicle Hit and Run Vehicle Body Type had no driver 000 106 000 No, did not leave the scene 100 Yes, vehicle & driver left the scene Passenger Vehicles 001 No, vehicle & driver left the scene 101 Yes, only driver left the scene 100 2-door 002 No, only driver left the scene 101 4-door VIN 5TDYZ3DC9KS968905 102 Hatchback 103 Convertible Vehicle Year, Make, and Model 104 Station wagon 2019 Toyota Minivan/Previa 105 Pick-up Year Make Model 106 Mini-van License Plate 107 Passenger van (seats any number if personal; up to 8 if business) Missing 108 Cargo van (10,000 lbs or less) TX LRZ8576 2020 109 Sport utility vehicle Unknown (fill in all known details) State Number Year 110 Large utility vehicle Trailer #1 License Plate 111 Motor home/recreational vehicle Missing 198 Other passenger vehicle Unknown (fill in all known details) Truck (> 10,000 lbs) State Number Trailer #2 License Plate 200 Single unit truck (2 axles) Missing 201 Single unit truck (3 or more axles) py Unknown (fill in all known details) 202 Single unit truck with trailer State Number 203 Truck tractor only (bobtail) Owner Name Same as driver Unknown 204 Tractor/semi-trailer 205 Tractor/doubles STEVEN BARRY GORE 206 Construction/maintenance equipment Owner Address Same as driver Unknown 207 Farm equipment 2507 SANDY TRAIL KELLER TX 76248 298 Other heavy vehicle (GVWR/GCWR > 10,000 lbs) Co Bus / Van / Limo (9 or more seats, including driver) Street City State Postal Code Motor Carrier Type 300 School bus 000 Motor Carrier ID Numbers 301 Transit/city bus 000 Personal transportation USDOT # 302 Motor coach/intercity/cross-country bus 100 Interstate carrier 303 Limousine 101 Intrastate carrier MC/MX # 304 Van (seats 9-15, including driver) 102 Not in commerce - government 390 Other vehicle (seats 9-15, including driver) 103 Not in commerce - other truck State # State 391 Other vehicle (seats 16 or more, including driver) 999 Unknown Cycle / Low Speed Motor Carrier Name Unknown 400 Motorcycle d 401 Motor scooter 402 Moped Motor Carrier Address Unknown 403 ATV (3, 4, or 6 wheels) cte 404 Snowmobile 405 Golf cart Street City State Postal Code 406 Low speed vehicle Cargo Body Type 498 Other motorized cycle/low speed vehicle 000 000 No cargo body 104 Cargo tank 109 Dump 198 Other Unknown 100 Bus 105 Log 110 Concrete mixer 999 Unknown type of motor vehicle 101 Van / enclosed box 106 Intermodal container chassis 111 Auto transporter If 198, 298, 390, 391, or 498, describe below: 999 Unknown 102 Grain / chips / gravel 107 Vehicle towing another vehicle 112 Garbage / refuse da 103 Pole trailer 108 Flatbed GVWR/GCWR 970 Hazardous Materials Placard 000 Hazardous Material ID Hazardous Materials Released 970 (4-digit # or name from middle from Vehicle Cargo Compartment 100 10,000 lbs or less 000 Placard not required of diamond or rectangular box) 101 10,001 - 26,000 lbs 100 Placard displayed 000 No, hazardous materials not released 102 More than 26,000 lbs 200 Placard required but not displayed Hazardous Material Class 100 Yes, hazardous materials released (1-digit # from 970 Not applicable 999 Unknown bottom of diamond) 970 Not applicable (not carrying hazardous materials) Re INSURANCE DAMAGE Insurance Damage Severity 102 Initial Contact Point Damaged Areas Uninsured at time of crash Unknown 000 No damage (check 1) (check all that apply) (fill in any known details) 100 Minor damage 7 8 9 10 11 7 8 9 10 11 Insurance Company 101 Functional damage 102 Disabling damage 999 Unknown 6 12 6 12 Damage Estimate NAIC # $12,000 5 4 3 2 1 5 4 3 2 1 Damage Prior to the Crash 000 Non-collision 097 No damage No prior damage 100 Cargo loss 113 Top Policy # Yes (describe below) 113 Top 114 Undercarriage 114 Undercarriage 999 Unknown 999 Unknown TOWING Towed 101 Towed By 000 Not towed Metro Towing 100 Towed, but not due to disabling damage 101 Towed due to disabling damage Towed To 11710 Vimy Ridge Rd Alexander AR 72002 Street City State Postal Code CRASH REPORT - MOTOR VEHICLE DESCRIPTION AND IDENTIFICATION  562919 Motor Vehicle # ARKANSAS MOTOR VEHICLE CRASH REPORT Page 8 of 18 2 VEHICLE INFORMATION Crash Report # 6011203128 MOTOR VEHICLE CIRCUMSTANCES Vehicle Usage 000 Emergency Vehicle Usage 970 Vehicle Maneuver 100 000 No special function 100 Non-emergency, non-transport 100 Movement essentially straight ahead 100 Taxi 101 Non-emergency transport 101 Negotiating a curve 101 School bus/school transport 102 Emergency operation, emergency warning equipment not in use 102 Backing 102 Church bus 103 Emergency operation, emergency warning equipment in use 103 Changing lanes 103 Transit/commuter bus 970 Not applicable 104 Overtaking/passing 104 Intercity bus 999 Unknown 105 Turning right 105 Charter/tour bus 106 Turning left 106 Shuttle bus Travel Direction 107 Making U-turn 107 Military 102 108 Leaving traffic lane 108 Police 100 Northbound 109 Entering traffic lane 109 Ambulance 101 Southbound 110 Slowing 110 Fire truck