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Fatal Crash Report

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Crash #2021040629 Crash #2021040629
Fatalities 1
State ARIZONA
County YAVAPAI
City CAMP VERDE
Date Sept. 29, 2021
Time 2:37 p.m.
Location(34.5766972, -111.8834167) - Fatality Map - Google Maps
Street Name 1 SR-260
Street Name 2 I-17 RAMP
WeatherCloudy
Number of Vehicles 3
Number of Vehicles in Transport 3
Number of Parked Vehicles 0
Number of Persons in Motor Vehicles 4
Number of Persons in Motor Vehicles in Transport 4
Number of Persons in Parked Vehicles 0
Number of Nonmotorists 0
Route Signing State Highway
Rural / Urban Urban
Functional System Minor Arterial
Road Owner State Highway Agency
National Highway System Not in the National Highway System
Special Jurisdiction No Special Jurisdiction (Includes National Forests Since 2008)
Milepoint 124
First Harmful Event Motor Vehicle In-Transport
Manner of Collision Angle
At Intersection No
Relation to Junction Intersection
Type of Intersection Four-Way Intersection
Relation to Road On Roadway
Work Zone None
Light Condition Daylight
Atmospheric Condition Cloudy
School Bus Related False
Rail Grade Crossing ID 0000000
EMS Notified Hour 14
EMS Notified Minute 41
EMS Arrived Hour 14
EMS Arrived Minute 44
Crash Related FactorMotor Vehicle Struck by Falling Cargo or Something That Came Loose From or Something That Was Set in Motion by a Vehicle
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Persons

Person #1 in Vehicle #1 Person #1 in Vehicle #1
Age 48 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeveritySuspected Minor Injury (B)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseShoulder and Lap Belt Used
Restraint System MisuseNo Indication of Misuse
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenTest Not Given
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedTest Not Given
Transported To Medical Facility ByEMS Ground
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
Person Related Factor None Noted
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Person #1 in Vehicle #2 Person #1 in Vehicle #2
Age 28 year(s) old
SexFemale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityPossible Injury (C)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseShoulder and Lap Belt Used
Restraint System MisuseNo Indication of Misuse
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenTest Not Given
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedTest Not Given
Transported To Medical Facility ByNot Transported for Treatment
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
Person Related Factor None Noted
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Person #1 in Vehicle #3 Person #1 in Vehicle #3
Age 79 year(s) old
SexFemale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeveritySuspected Minor Injury (B)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseShoulder and Lap Belt Used
Restraint System MisuseNo Indication of Misuse
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationExtricated
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenTest Not Given
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedTest Not Given
Transported To Medical Facility ByEMS Air
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
Person Related Factor None Noted
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Person #2 in Vehicle #3 Person #2 in Vehicle #3
Age 79 year(s) old
SexMale
Person TypePassenger of a Motor Vehicle In-Transport
Injury SeverityFatal Injury (K)
Seating PositionFront Seat, Right Side
Restraint System UseShoulder and Lap Belt Used
Restraint System MisuseNo Indication of Misuse
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationExtricated
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Reported
Alcohol Test ResultNot Reported
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByNot Transported for Treatment
Died En RouteDied at Scene
Month of DeathSeptember
Day of Death29
Year of Death2021
Hour of Death15
Minute of Death47
Lag Hours1
Lag Minutes10
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNo
HispanicMexican
Race Unknown
Person Related Factor None Noted
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Moving Vehicles

Vehicle #1 Vehicle #1
Fatalities 0
Number of Occupants 1
Hit and Run No Hit and Run
NCSA Make Kenworth
Body Type Truck/Tractor (Cab Only, or With Any Number of Trailing Units: Any Weight)
NCSA Model 881
Registration State Arizona
Registered Vehicle Owner Vehicle Registered as Commercial/Business/Company/Government
VIN 1XKWD29X6JS5
Model Year 2018
VPIC Make ID 532
VPIC Model ID 2732
VPIC Body Class Truck-Tractor
Body Class Not Applicable
Lower Weight Rating Class 8: 33,001 lbs and above (14,969 kg and above)
Upper Weight Rating Class 8: 33,001 lbs and above (14,969 kg and above)
Vehicle Trailing One Trailer
Trailer VIN 1 1PTF71TH6D90
Trailer VIN 2 777777777777
Trailer VIN 3 777777777777
Trailer Weight Rating 1 Not Reported
Trailer Weight Rating 2 No Trailing Units
Trailer Weight Rating 3 No Trailing Units
Jackknife No
Motor Carrier ID 571420572
Vehicle Configuration Truck Tractor/Semi-Trailer
Cargo Body Type Flatbed
Bus Use Not a Bus
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit 40
Travel Speed Unknown
Underride / Override No Underride or Override
Rollover Rollover
Rollover Location On Roadway
Initial Contact Point 12 O'Clock
Extent of Damage Disabling Damage
Vehicle Towed Towed
Most Harmful Event MotorMotor Vehicle In-Transport Strikes or Is Struck by Cargo, Persons or Objects Setin-Motion From/by Another Motor Vehicle In-Transport
Fire Occurence False
Automated Driving System Present Not Reported
Automated Driving System Level Not Reported
Automated Driving System Engaged Not Reported
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Colorado
Driver Zip Code 81505
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status Valid
CDL Endorsements Endorsements Required, Complied With
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions Restrictions, Compliance Unknown
Driver Height 71
Driver Weight 220
Previous Recorded Crashes 0
Previous BAC Suspensions (Underage) 0
Previous BAC Suspensions 0
Previous Other Suspensions 0
Previous DWI 0
Previous Speeding Convictions 1
Previous Other Moving Violations 0
Month of Oldest Violation September
Year of Oldest Violation 2018
Month of Newest Violation September
Year of Newest Violation 2018
Speeding Related Yes, Too Fast for Conditions
Trafficway Description Entrance/Exit Ramp
Total Lanes in Roadway One Lane
Roadway Alignment Curve Right
Roadway Grade Uphill
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Traffic Control Signal (on Colors) With Pedestrian Signal
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Turning Right
Critical Precrash Event THIS VEHICLE TRAVELING Turning Right
Attempted Avoidance Maneuver Braking and Steering Right
Precrash Stability Tracking
Pre-impact Location Stayed on Roadway, Not Known if Left Original Travel Lane
Crash Type CATEGORY IV: CHANGING TRAFFICWAY, VEHICLE TURNING - Turn Into Path, Turn into Same Direction [Turning Right]
Vehicle Related Factor None Noted
Driver Related Factor None Noted
Visibility Obstructions No Obstruction Noted
Moving Violations None
Driver Maneuvered to Avoid Contact Motor Vehicle (in This Crash)
Vehicle Factors Brake System
Damaged Areas 7 O'Clock
Damaged Areas 8 O'Clock
Damaged Areas 9 O'Clock
Damaged Areas 10 O'Clock
Damaged Areas 11 O'Clock
Damaged Areas 12 O'Clock
Damaged Areas Top
Driver Distracted Not Distracted
Driver Impaired None/Apparently Normal
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Vehicle #2 Vehicle #2
Fatalities 0
Number of Occupants 1
Hit and Run No Hit and Run
NCSA Make Chevrolet
Body Type Light Pickup
NCSA Model 473
Registration State Arizona
Registered Vehicle Owner Driver (in This Crash) Not Registered Owner (Other Private Owner)
VIN 1GCGTDEN2J12
Model Year 2018
VPIC Make ID 467
VPIC Model ID 4086
VPIC Body Class Pickup
Body Class Not Applicable
Lower Weight Rating Class 1: 6,000 lbs or less (2,722 kg or less)
Upper Weight Rating Class 1: 6,000 lbs or less (2,722 kg or less)
Vehicle Trailing No Trailers
Jackknife Not an Articulated Vehicle
Motor Carrier ID 0
Vehicle Configuration Not Applicable
Cargo Body Type Not Applicable
Bus Use Not a Bus
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit 35
Travel Speed 33
Underride / Override No Underride or Override
Rollover No Rollover
Rollover Location No Rollover
Initial Contact Point Right
Extent of Damage Disabling Damage
Vehicle Towed Towed
Most Harmful Event Motor Vehicle In-Transport
Fire Occurence False
Automated Driving System Present Not Reported
Automated Driving System Level Not Reported
Automated Driving System Engaged Not Reported
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Arizona
Driver Zip Code 86326
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status No Commercial Driver's License (CDL)
CDL Endorsements No Endorsements Required for This Vehicle
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions No Restrictions or Not Applicable
Driver Height 69
Driver Weight 215
Previous Recorded Crashes 0
Previous BAC Suspensions (Underage) 0
Previous BAC Suspensions 0
Previous Other Suspensions 0
Previous DWI 0
Previous Speeding Convictions 0
Previous Other Moving Violations 0
Month of Oldest Violation No Record
Year of Oldest Violation 0
Month of Newest Violation No Record
Year of Newest Violation 0
Speeding Related No
Trafficway Description Two-Way, Divided, Unprotected Median
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Downhill
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Traffic Control Signal (on Colors) With Pedestrian Signal
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Going Straight
Critical Precrash Event OTHER MOTOR VEHICLE ENCROACHING INTO LANE From Crossing Street, Turning Into Same Direction
Attempted Avoidance Maneuver No Avoidance Maneuver
Precrash Stability Tracking
Pre-impact Location Stayed in Original Travel Lane
Crash Type CATEGORY IV: CHANGING TRAFFICWAY, VEHICLE TURNING - Turn Into Path, Turn into Same Direction [Going Straight]
Vehicle Related Factor None Noted
Driver Related Factor None Noted
Visibility Obstructions No Obstruction Noted
Moving Violations None
Driver Maneuvered to Avoid Driver Did Not Maneuver to Avoid
Vehicle Factors None Noted
Damaged Areas 1 O'Clock
Damaged Areas 2 O'Clock
Damaged Areas 3 O'Clock
Damaged Areas 4 O'Clock
Damaged Areas 5 O'Clock
Damaged Areas 6 O'Clock
Driver Distracted Not Distracted
Driver Impaired None/Apparently Normal
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Vehicle #3 Vehicle #3
Fatalities 1
Number of Occupants 2
Hit and Run No Hit and Run
NCSA Make Dodge
Body Type Minivan
NCSA Model 442
Registration State Arizona
Registered Vehicle Owner Driver (in This Crash) Was Registered Owner
VIN 2C4RDGBG2LR2
Model Year 2020
VPIC Make ID 476
VPIC Model ID 14832
VPIC Body Class Minivan
Body Class Not Applicable
Lower Weight Rating Class 2: 6,001 - 10,000 lbs (2,722 - 4,536 kg)
Upper Weight Rating Class 2: 6,001 - 10,000 lbs (2,722 - 4,536 kg)
Vehicle Trailing No Trailers
Jackknife Not an Articulated Vehicle
Motor Carrier ID 0
Vehicle Configuration Not Applicable
Cargo Body Type Not Applicable
Bus Use Not a Bus
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit 35
Travel Speed Unknown
Underride / Override Not Applicable
Rollover No Rollover
Rollover Location No Rollover
Initial Contact Point Top
Extent of Damage Disabling Damage
Vehicle Towed Towed
Most Harmful Event MotorMotor Vehicle In-Transport Strikes or Is Struck by Cargo, Persons or Objects Setin-Motion From/by Another Motor Vehicle In-Transport
Fire Occurence False
Automated Driving System Present Not Reported
Automated Driving System Level Not Reported
Automated Driving System Engaged Not Reported
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Arizona
Driver Zip Code 86322
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status No Commercial Driver's License (CDL)
CDL Endorsements No Endorsements Required for This Vehicle
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions No Restrictions or Not Applicable
Driver Height 49
Driver Weight 175
Previous Recorded Crashes 0
Previous BAC Suspensions (Underage) 0
Previous BAC Suspensions 0
Previous Other Suspensions 0
Previous DWI 0
Previous Speeding Convictions 0
Previous Other Moving Violations 0
Month of Oldest Violation No Record
Year of Oldest Violation 0
Month of Newest Violation No Record
Year of Newest Violation 0
Speeding Related No
Trafficway Description Two-Way, Divided, Unprotected Median
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Downhill
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Traffic Control Signal (on Colors) With Pedestrian Signal
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Going Straight
Critical Precrash Event OTHER MOTOR VEHICLE ENCROACHING INTO LANE From Crossing Street, Turning Into Same Direction
Attempted Avoidance Maneuver No Avoidance Maneuver
Precrash Stability Tracking
Pre-impact Location Stayed in Original Travel Lane
Crash Type CATEGORY VI: MISCELLANEOUS - Other Crash Type
Vehicle Related Factor None Noted
Driver Related Factor None Noted
Visibility Obstructions No Obstruction Noted
Moving Violations None
Driver Maneuvered to Avoid Driver Did Not Maneuver to Avoid
Vehicle Factors None Noted
Damaged Areas 1 O'Clock
Damaged Areas 2 O'Clock
Damaged Areas 3 O'Clock
Damaged Areas 4 O'Clock
Damaged Areas 5 O'Clock
Damaged Areas 6 O'Clock
Damaged Areas 9 O'Clock
Damaged Areas 12 O'Clock
Damaged Areas Top
Driver Distracted Not Distracted
Driver Impaired None/Apparently Normal
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Crash Events

Event #1 Event #1
VehicleVehicle #1
Area Of Impact12 O'Clock
Sequence of EventsMotor Vehicle In-Transport
Vehicle Vehicle #2
Area Of ImpactRight
Event #2 Event #2
VehicleVehicle #1
Area Of ImpactNon-Harmful Event
Sequence of EventsCargo/Equipment Loss or Shift (Non-Harmful)
Event #3 Event #3
VehicleVehicle #1
Area Of ImpactNon-Collision
Sequence of EventsRollover/Overturn
Event #4 Event #4
VehicleVehicle #1
Area Of ImpactCargo/Vehicle Parts Set-in-Motion
Sequence of EventsMotor Vehicle In-Transport Strikes or Is Struck by Cargo, Persons or Objects Set-in-Motion From/by Another Motor Vehicle In-Transport
Vehicle Vehicle #3
Area Of ImpactTop

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