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-9 Rev110805 DI 9 STATE OF UTAH INVESTIGATING OFFICER'S REPORT OF TRAFFIC CRASH DI 9 Mon:h Day EA X.2.3.4.5.6.7. Late of Day Military 02 28 21 Week SMT WTFS 05:58 Crasn Time 05 DLD Number PLACE WHERE Case Nurter 07 COUNTY Cily or Town of JurisdictonWELLINGTON CRASH OCCURRED: CODE b6 -4 N.S.E.W II crasr was ouside ctylimds ndirale 3larce Iom c Iy lmls or nearest Icwn Miles of La:itu3e Longitudo b7C -4 6 roaD.Street HWy Sr-6 Caly r T.y 39.542553 -110.687163 06 T CRASH OCCURRED REPORTABLE CRASH 03 4 Stree1 Narne or Hghway Number UDOT USE ONL . AT *HE INTERSEC*ION WITH X YES NO 14 2. IF VOT AT INTERSECTION 50 Fget Culvert NsE uDOt uSE M.S.EW Nearesl n:erseci cn stree1 house no. Iardnark 3 X . ol Mile Post 249 *enin ol amle Ee sure Io complete l rood nas rale posl 00 VEH # : : 4 5 1 5TDKZ3DC6JS958773 8FVH301 CA 09/21 GRY TOYT Sienna 2018 .00 #7 b6 -4 :v.: b7C - 4 96 AY 03 310703-3794 Airport Van 5235 West 140th Street, Los Angeles CA 90045 i6 COMMERCIAL VEHICLE NFO w: 00 A! 17a 04 ... ... VA. .. 173 01 12 A A: A. .....! SEQUENCE ... Yy MCST HARMFUL : S:: 50 80 40 OF CVENTS 01 62 41 58 EVENT For VEHICLE 58 W+r WAA Auedwon Anense nnnnn 11/01/2019 11/01/2020 CA07774954 AVA.: 12 X A. X: RMA Insurance Services, Inc. ie # 3 W YA: # 1 00 tA! I.va. A. A A: 00 20 COMMERCIAL VETCLE INTO ...: .. n.^: W ... Nw. VAAV A A 00 01 MOST HARMFUL SCOUENCC W OF EVENTS EVEAT Fot YEHICLE .. 96 AV 36 Work Zone? -otal # of Lanes on Rdway 2 ner tnan Vehcles Yes XNo : Unkncwn {9,n;0u a;js purc (a Q3 eweN} 96 Werke's Presen? #Vehic es 1 Neme and Address ol Phone { PRCPC RTY DANAGE ESTIMATE Involvec Owncr ol Ohocl Sluck Yes XNo .Unkncwn 1.0RR LE35 T|IANS1.000 WI INESSES 00 Name Address Prone 96 Aane Aas Phone Law Enforcamen: Actwily Tine Noliticd ol Crach ved al Seere Date Noblied i Crash Invecigalion Compleled 06:08 06:34 02 28 21 02 28 21 Field .Yes Video XNo XYes XDigital Diagram XNo :.No :.Film Use Mi tary Time inn cd 17 A WORiGINAL REPORt AddiTiOnAl pERsOns rEport SuppLementaL REport AMENDED REPORT State Law Requires a Reportable Crash Report to be Forwarded to Dept. of Public Safety Within 10 Days Following Completion of Investigation. Mail ORIG|NAL REPORT TO: Driver License Division.P.O.Box 144501, Sait Lake City. UT 84114-4501 22-cv-2152(FBI)-10143