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Fatal Crash Report

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Crash #2021410414 Crash #2021410414
Fatalities 2
State OREGON
County JOSEPHINE
City
Date Nov. 20, 2021
Time 8:52 p.m.
Google Maps(42.0646972, -123.6274667)
Street Name 1 CR-WALDO RD
Street Name 2 CR-ROCKYDALE RD
WeatherNot Reported
Number of Vehicles 1
Number of Vehicles in Transport 1
Number of Parked Vehicles 0
Number of Persons in Motor Vehicles 2
Number of Persons in Motor Vehicles in Transport 2
Number of Persons in Parked Vehicles 0
Number of Nonmotorists 0
Route Signing County
Rural / Urban Rural
Functional System Minor Collector
Road Owner County Highway Agency
National Highway System Not in the National Highway System
Special Jurisdiction No Special Jurisdiction (Includes National Forests Since 2008)
Milepoint 65
First Harmful Event Tree (Standing Only)
Manner of Collision First Harmful Event was Not a Collision with Motor Vehicle In-Transport
At Intersection No
Relation to Junction Intersection Related
Type of Intersection T-Intersection
Relation to Road On Roadside
Work Zone None
Light Condition Dark - Unknown Lighting
Atmospheric Condition Not Reported
School Bus Related False
Rail Grade Crossing ID 0000000
Arrived At Hospital Hour 88
Arrived at Hospital Minute 88
Crash Related FactorNone Noted
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Persons

Person #1 in Vehicle #1 Person #1 in Vehicle #1
Age 20 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityFatal Injury (K)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseNot Reported
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Reported
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
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 DeathNovember
Day of Death20
Year of Death2021
Hour of Death20
Minute of Death52
Lag Hours0
Lag Minutes0
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNo
HispanicMexican
Race White
Person Related Factor None Noted
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Person #2 in Vehicle #1 Person #2 in Vehicle #1
Age 19 year(s) old
SexMale
Person TypePassenger of a Motor Vehicle In-Transport
Injury SeverityFatal Injury (K)
Seating PositionNot Reported
Restraint System UseNot Reported
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Reported
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
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 DeathNovember
Day of Death20
Year of Death2021
Hour of Death20
Minute of Death52
Lag Hours0
Lag Minutes0
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNo
HispanicMexican
Race White
Person Related Factor None Noted
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Moving Vehicles

Vehicle #1 Vehicle #1
Fatalities 2
Number of Occupants 2
Hit and Run No Hit and Run
NCSA Make GMC
Body Type Large Utility (ANSI D-16 Utility Vehicle Categories “Full Size” and “Large”)
NCSA Model 421
Registration State California
Registered Vehicle Owner Driver (in This Crash) Not Registered Owner (Other Private Owner)
VIN 1GKEK63U12J1
Model Year 2002
VPIC Make ID 472
VPIC Model ID 1859
VPIC Body Class Sport Utility Vehicle (SUV)/Multi-Purpose Vehicle (MPV)
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 00000000000
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 Unknown
Travel Speed 90
Underride / Override Not Applicable
Rollover No Rollover
Rollover Location No Rollover
Initial Contact Point 12 O'Clock
Extent of Damage Not Reported
Vehicle Towed Towed
Most Harmful Event Tree (Standing Only)
Fire Occurence True
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 California
Driver Zip Code 93638
Non CDL License Type Unknown License Type
Non CDL License Status Unknown License Status
CDL License Status Unknown License Status
CDL Endorsements Unknown, if Required
License Compliance With Class of Vehicle Unknown
Compliance with LIcense Restrictions Unknown
Driver Height 999
Driver Weight 999
Previous Recorded Crashes 99
Previous BAC Suspensions (Underage) 99
Previous BAC Suspensions 99
Previous Other Suspensions 99
Previous DWI 99
Previous Speeding Convictions 99
Previous Other Moving Violations 99
Month of Oldest Violation Unknown
Year of Oldest Violation 9999
Month of Newest Violation Unknown
Year of Newest Violation 9999
Speeding Related Yes, Exceeded Speed Limit
Trafficway Description Two-Way, Not Divided
Total Lanes in Roadway Not Reported
Roadway Alignment Straight
Roadway Grade Not Reported
Roadway Surface Type Not Reported
Roadway Surface Condition Not Reported
Traffic Control Device Not Reported
Traffic Control Device Functioning Not Reported
Pre Event Movement Going Straight
Critical Precrash Event THIS VEHICLE TRAVELING Unknown Travel Direction
Attempted Avoidance Maneuver Unknown/Not Reported
Precrash Stability Precrash Stability Unknown
Pre-impact Location Departed Roadway
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 Not Reported
Vehicle Factors None Noted
Damaged Areas 12 O'Clock
Driver Distracted Not Reported
Driver Impaired Not Reported
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Crash Events

Event #1 Event #1
VehicleVehicle #1
Area Of ImpactNon-Harmful Event
Sequence of EventsRan off Roadway - Direction Unknown
Event #2 Event #2
VehicleVehicle #1
Area Of Impact12 O'Clock
Sequence of EventsTree (Standing Only)
Event #3 Event #3
VehicleVehicle #1
Area Of ImpactNon-Collision
Sequence of EventsFire/Explosion

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