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CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

CCN #21051273 – Traffic Crash Report


REPORT DATE / TIME DISTRICT / PSA EVENT START DATE / TIME - EVENT END DATE / TIME INCIDENT STATISTICS

Apr 22, 2021 23:53 Sixth District / 601 Apr 22, 2021 17:18 - Apr 22, 2021 20:23
RESPONDING OFFICER WEATHER

Jessica Reithmeyer (#10412) – MPD


ASSISTING OFFICER (ASSIST TYPE)

TELETYPE DATE / TIME TELETYPE # WHO NOTIFIED TELETYPE REPORTING PERSON (FIRST, MIDDLE LAST)

MAJOR CRASH NOTIFIED PERSON NOTIFIED DATE / TIME NOTIFIED


YES NO

MOTOR VEHICLES / NON-MOTORISTS INVOLVED


REFERENCE # NAME / DESCRIPTION # OF PERSONS (IN VEHICLE) VEHICLE TAG # OR PERSON DOB

VEH 2 FORD FORD (ALSO SEE ENGLISH, FRENCH) TAURUS 2


REFERENCE # NAME / DESCRIPTION # OF PERSONS (IN VEHICLE) VEHICLE TAG # OR PERSON DOB

VEH 1 FORD, TAU Ford Taurus 2

OBJECTS INVOLVED
REFERENCE # DESCRIPTION OBJECT TYPE

OBJ-1 Fence at 1439 Anacostia Avenue Northeast Other

CRASH DETAILS
REPORT TAKEN ON SCENE SCHOOL BUS RELATED # OF PHOTOS TAKEN
YES NO No 41
# OF VEHICLES INVOLVED # OF INJURED PERSONS # OF FATALITIES

2 4 0
CRASH LOCATION

1439 ANACOSTIA AVENUE NE, WASHINGTON, DC 20019 Type: Park/ Playground PSA: 601 District: Sixth District
TRAFFICWAY LOCATION INTERSECTION TYPE POSITION (BEHIND, FRONT, INSIDE, SIDE)

Trafficway, On Road T-Intersection Front


LOCATION DESCRIPTION

WORK ZONE-RELATED WORKERS PRESENT LOCATION WITHIN WORK ZONE


YES NO YES NO

WORK-ZONE TYPE LAW ENFORCEMENT PRESENCE

POSTED SPEED LIMIT TRAFFIC CONDITIONS STREET LIGHTS

25 Light Street Lights Off


LIGHTING CONDITIONS ROADWAY SURFACE CONDITIONS

Daylight Dry,
CONTRIBUTING CIRCUMSTANCES: ROAD CONTRIBUTING CIRCUMSTANCES: ENVIRONMENTAL

None, None
FIRST HARMFUL EVENT (WHERE DAMAGE OCCURRED) EVENT TYPE DETAILS

COLLISION_WITH_NON_FIXED Motor Vehicle In Transport


COLLISION IMPACT LOCATION RELATIVE TO TRAFFICWAY

Other On Roadway
WITHIN INTERCHANGE LOCATION WITHIN INTERCHANGE
YES NO

FULL SEQUENCE OF EVENTS


EVENT # VEH / NM / OBJ REFERENCE # EVENT TYPE EVENT SPECIFICS

1 FORD, TAU Ford Taurus COLLISION_WITH_NON_FIXED Motor Vehicle In Transport


COLLIDED WITH COLLISION IMPACT

FORD FORD (ALSO SEE ENGLISH, FRENCH) TAURUS Other

MOST HARMFUL EVENTS INSTRUCTIONS: LIST ONLY MOTOR VEHICLES FROM SEQUENCE OF EVENTS AND ITS CORRESPONDING MOST HARMFUL EVENT.

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 1 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

VEHICLE REFERENCE # EVENT #

VEH 2 Event #1 – COLLISION_WITH_NON_FIXED: Motor Vehicle In Transport


VEHICLE REFERENCE # EVENT #

VEH 1 Event #1 – COLLISION_WITH_NON_FIXED: Motor Vehicle In Transport

NARRATIVE

On April 22, 2021 at approximately 1720 hours Vehicle 1 and vehicle 2 were traveling southbound in the 1500 block of Anacostia Ave NE at a high rate
of speed. As they were driving Driver-2 attempted to make a left turn in front of vehicle 1 onto the 1400 block of Polk Street Northeast. Driver-1 was
unable to to stop in time causing Vehicle 1 to strike Vehicle 2 on the driver side door pushing the vehicle onto the sidewalk and into the fence at 1439
Anacostia Avenue Northeast. Vehicle 1 came to rest on the same sidewalk.

Driver 1, Driver 2, Passenger 1 and Passenger 2 did not make any statements on the scene.

Pending investigation

Both vehicles were disabled and towed by ANT Towing to the MPD shop on West Virginia Avenue Northeast.

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 2 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

Crash Diagram
CCN# EVENT START TIME / DATE – EVENT END DATE / TIME WEATHER

21051273 Apr 22, 2021 17:18 - Apr 22, 2021 20:23


LOCATION

1439 ANACOSTIA AVENUE NE, WASHINGTON, DC 20019 Type: Park/ Playground PSA: 601 District: Sixth District
COORDINATES

38.909454, -76.941708

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 3 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

TC Vehicle Addendum – VEH 2 2017 FORD (ALSO SEE ENGLISH, FRENCH) TAURUS
CCN# VEHICLE REFERENCE # HIT AND RUN CONTAINS HAZARDOUS MATERIALS HAZMAT SPILLED / RELEASED

21051273 VEH 2 YES NO YES NO YES NO

HAZMAT PLACARD HAZMAT PLACARD ID / NAME HAZMAT PLACARD CLASS #


YES NO

VEHICLE INVOLVED
MAKE OF VEHICLE MODEL OF VEHICLE YEAR MANUFACTURED VIN / HIN #

FORD (ALSO SEE ENGLISH, TAURUS 2017


FRENCH)
OWNER'S NAME (LAST, FIRST MIDDLE) OWNER PHONE TAG OR PLATE # / STATE

OWNER'S ADDRESS

OWNER TYPE (PRIVATE/COMMERCIAL/GOVT/UNKNOWN) MOTOR VEHICLE CLASSIFICATION

Government Motor Vehicle In Transport


VEHICLE WAS DRIVEN AWAY / TOWED DRIVEN AWAY BY / TOWING COMPANY TOWING CONTROL #

Towed Due To Disabling Damage ANT Towing TW32


TOWED TO LOCATION

West Virginia Ave NE

ACTIONS & DAMAGE


MOTOR VEHICLE ACTION

Turning Left
VEHICLE-RELATED CONTRIBUTING CIRCUMSTANCES INITIAL CONTACT POINT ON VEHICLE DAMAGED AREAS

10-point Clock Diagram 11-point Clock Diagram, 2-point Clock


EXTENT OF DAMAGE Diagram, 9-point Clock Diagram, 1-point
Disabling Damage Clock Diagram, 10-point Clock Diagram, 8-
point Clock Diagram, 12-point Clock
SKID MARKS BEFORE IMPACT (LENGTH IN FEET)

SKID MARKS AFTER IMPACT (LENGTH IN FEET)

DIRECTION OF TRAVEL BEFORE CRASH

Southbound

Diagram
TRAFFICWAY DESCRIPTION TOTAL LANES IN ROADWAY

Two-way, Not Divided 2


HORIZONTAL ALIGNMENT OF ROADWAY GRADE

Straight Level
TRAFFIC CONTROL DEVICE TYPE TRAFFIC CONTROL DEVICE FUNCTIONAL

No Controls YES NO

DRIVER
NAME (LAST, FIRST MIDDLE) DATE OF BIRTH / AGE RANGE PHONE DRIVERS LICENSE #

DL STATE DL TYPE / CLASS

DRIVER HAS INSURANCE INSURANCE COMPANY POLICY # EXPIRATION DATE

DRIVER DISTRACTIONS

Unknown
DRIVER ACTIONS AT TIME OF CRASH

Exceeded Post Speed Limit,

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 4 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

SPEEDING RELATED NOI #'S

Exceeded Speed Limit


DRIVER'S CONDITION AT THE SCENE

Apparently Normal,
RESTRAINTS HELMET EJECTION FROM VEHICLE

Other – no restrants No Helmet Not Ejected


AIRBAG

Deployed-combination
SUSPECTED OF
CONSUMING ALCOHOL USING DRUGS

PASSENGERS / OCCUPANTS
NAME (LAST, FIRST MIDDLE) DATE OF BIRTH / AGE RANGE PHONE

INVOLVEMENT TYPE

Passenger
POSITION: ROW POSITION: SEAT POSITION: OTHER

Front Right Not Applicable


PERSON'S CONDITION AT THE SCENE

Apparently Normal
RESTRAINTS HELMET EJECTION FROM VEHICLE

Other – no restraints No Helmet Not Ejected


AIRBAG

Deployed-combination
SUSPECTED OF
CONSUMING ALCOHOL USING DRUGS

OTHER VEHICLE ATTRIBUTES


VEHICLE INSURED INSURANCE COMPANY POLICY # EXPIRATION DATE
YES NO

SPECIAL FUNCTION VEHICLE USE AS EMERGENCY VEHICLE

Police Non-emergency, Non-transport


MOTOR CARRIER CARRIER NAME

CARRIER ADDRESS

TYPE OF CARRIER CARRIER ID TYPE CARRIER ID#

GROSS VEHICLE WEIGHT / GROSS COMBINATION WEIGHT RATING CONFIGURATION

CARGO BODY TYPE

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 5 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

TC Vehicle Addendum – VEH 1 2017 Ford Taurus


CCN# VEHICLE REFERENCE # HIT AND RUN CONTAINS HAZARDOUS MATERIALS HAZMAT SPILLED / RELEASED

21051273 VEH 1 YES NO YES NO YES NO

HAZMAT PLACARD HAZMAT PLACARD ID / NAME HAZMAT PLACARD CLASS #


YES NO

VEHICLE INVOLVED
MAKE OF VEHICLE MODEL OF VEHICLE YEAR MANUFACTURED VIN / HIN #

Ford Taurus 2017


OWNER'S NAME (LAST, FIRST MIDDLE) OWNER PHONE TAG OR PLATE # / STATE

OWNER'S ADDRESS

OWNER TYPE (PRIVATE/COMMERCIAL/GOVT/UNKNOWN) MOTOR VEHICLE CLASSIFICATION

Government Motor Vehicle In Transport


VEHICLE WAS DRIVEN AWAY / TOWED DRIVEN AWAY BY / TOWING COMPANY TOWING CONTROL #

Towed Due To Disabling Damage ANT Towing TW32


TOWED TO LOCATION

West Virginia Ave NE

ACTIONS & DAMAGE


MOTOR VEHICLE ACTION

Movements Essentially Straight Ahead


VEHICLE-RELATED CONTRIBUTING CIRCUMSTANCES INITIAL CONTACT POINT ON VEHICLE DAMAGED AREAS

Unknown, 12-point Clock Diagram 11-point Clock Diagram, 2-point Clock


EXTENT OF DAMAGE Diagram, 1-point Clock Diagram, 12-point
Disabling Damage Clock Diagram
SKID MARKS BEFORE IMPACT (LENGTH IN FEET)

SKID MARKS AFTER IMPACT (LENGTH IN FEET)

DIRECTION OF TRAVEL BEFORE CRASH

Southbound

TRAFFICWAY DESCRIPTION TOTAL LANES IN ROADWAY

Two-way, Not Divided 2


HORIZONTAL ALIGNMENT OF ROADWAY GRADE

Straight Level
TRAFFIC CONTROL DEVICE TYPE TRAFFIC CONTROL DEVICE FUNCTIONAL

No Controls YES NO

DRIVER
NAME (LAST, FIRST MIDDLE) DATE OF BIRTH / AGE RANGE PHONE DRIVERS LICENSE #

DL STATE DL TYPE / CLASS

DRIVER HAS INSURANCE INSURANCE COMPANY POLICY # EXPIRATION DATE

DRIVER DISTRACTIONS

Unknown,
DRIVER ACTIONS AT TIME OF CRASH

Exceeded Post Speed Limit,


SPEEDING RELATED NOI #'S

Exceeded Speed Limit

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 6 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

DRIVER'S CONDITION AT THE SCENE

Apparently Normal
RESTRAINTS HELMET EJECTION FROM VEHICLE

Other – No restraint No Helmet Not Ejected


AIRBAG

Deployed-combination
SUSPECTED OF
CONSUMING ALCOHOL USING DRUGS

PASSENGERS / OCCUPANTS
NAME (LAST, FIRST MIDDLE) DATE OF BIRTH / AGE RANGE PHONE

INVOLVEMENT TYPE

Passenger
POSITION: ROW POSITION: SEAT POSITION: OTHER

Front Right Not Applicable


PERSON'S CONDITION AT THE SCENE

Apparently Normal
RESTRAINTS HELMET EJECTION FROM VEHICLE

Other – no restraint No Helmet Not Ejected


AIRBAG

Deployed-combination
SUSPECTED OF
CONSUMING ALCOHOL USING DRUGS

OTHER VEHICLE ATTRIBUTES


VEHICLE INSURED INSURANCE COMPANY POLICY # EXPIRATION DATE
YES NO

SPECIAL FUNCTION VEHICLE USE AS EMERGENCY VEHICLE

Police Non-emergency, Non-transport


MOTOR CARRIER CARRIER NAME

CARRIER ADDRESS

TYPE OF CARRIER CARRIER ID TYPE CARRIER ID#

GROSS VEHICLE WEIGHT / GROSS COMBINATION WEIGHT RATING CONFIGURATION

CARGO BODY TYPE

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 7 of 8
CCN #21051273 – Event # 21051273 Public Traffic Packet - Non-Involved Persons Metropolitan Police Department

CCN #21051273 – NARRATIVE

On April 22, 2021 at approximately 1720 hours Vehicle 1 and vehicle 2 were traveling southbound in the 1500 block of Anacostia Ave NE at a high rate
of speed. As they were driving Driver-2 attempted to make a left turn in front of vehicle 1 onto the 1400 block of Polk Street Northeast. Driver-1 was
unable to to stop in time causing Vehicle 1 to strike Vehicle 2 on the driver side door pushing the vehicle onto the sidewalk and into the fence at 1439
Anacostia Avenue Northeast. Vehicle 1 came to rest on the same sidewalk.

Driver 1, Driver 2, Passenger 1 and Passenger 2 did not make any statements on the scene.

Pending investigation

Both vehicles were disabled and towed by ANT Towing to the MPD shop on West Virginia Avenue Northeast.

Printed by LISA ARCHIE-MILLS (#9610) – Cobalt Data Form v1.0 Generated at 04/26/2021 10:39 Pg. 8 of 8

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