Kindercare crash report

Page 4

Crash Date 4/9/2014

Time of Crash 3:05 PM

Date of Report 4/9/2014

Suspected Alcohol Use Alcohol Tested NO TEST NOT GIVEN Source of Transport to Medical Facility EMS

Alcohol Test Type

Reporting Agency FLORIDA HIGHWAY PATROL Alcohol Test Result

EMS Agency Name or ID OCFR`

Reporting Agency Case Number HSMV Crash Report Number FHPD14OFF030470 83773522-01

BAC

Suspected Drug Use Drug Tested Drug Test Type NO TEST NOT GIVEN EMS Run Number Medical Facility Transported To 030470 ARNOLD PALMER HOSPITAL

Drug Test Result

PERSON RECORD # Non-Motorist # Person Type Name Injury Severity 12 NM09 NON-MOTORIST / OTHER PEDESTRIAN MEKAYLA HEALY NONE Date of Birth Sex Address Phone Number 09/18/2008 F 4845 LAKE SHARP DR, ORLANDO FL 32817 Non Motorist action / Circumstance Prior To Crash Non Motorist Location at Time of Crash OTHER, EXPLAIN IN NARRATIVE OTHER, EXPLAIN IN NARRATIVE Non Motorist Action / Circumstance at Time of Crash 1 Non Motorist Action / Circumstance at Time of Crash 2 NO IMPROPER ACTION Non Motorist Safety Equipment 1 Non Motorist Safety Equipment 2 NONE Suspected Alcohol Use Alcohol Tested Alcohol Test Type Alcohol Test Result BAC Suspected Drug Use Drug Tested Drug Test Type Drug Test Result NO TEST NOT GIVEN NO TEST NOT GIVEN Source of Transport to Medical Facility EMS Agency Name or ID EMS Run Number Medical Facility Transported To EMS OCFR 030470 ARNOLD PALMER HOSPITAL

PERSON RECORD # Non-Motorist # Person Type Name Injury Severity 13 NM10 NON-MOTORIST / OTHER PEDESTRIAN ETHAN LOPEZ NON-INCAPACITATING Date of Birth Sex Address Phone Number 12/03/2009 M 402 BELVEDER WAY, SANFORD FL 32773 Non Motorist action / Circumstance Prior To Crash Non Motorist Location at Time of Crash OTHER, EXPLAIN IN NARRATIVE OTHER, EXPLAIN IN NARRATIVE Non Motorist Action / Circumstance at Time of Crash 1 Non Motorist Action / Circumstance at Time of Crash 2 NO IMPROPER ACTION Non Motorist Safety Equipment 1 Non Motorist Safety Equipment 2 NONE Suspected Alcohol Use Alcohol Tested Alcohol Test Type Alcohol Test Result BAC Suspected Drug Use Drug Tested Drug Test Type Drug Test Result NO TEST NOT GIVEN NO TEST NOT GIVEN Source of Transport to Medical Facility EMS Agency Name or ID EMS Run Number Medical Facility Transported To EMS OCFR 030470 ARNOLD PALMER HOSPITAL

PERSON RECORD # Non-Motorist # Person Type Name Injury Severity 14 NM11 NON-MOTORIST / OTHER PEDESTRIAN ISIBELLE STRUBE NON-INCAPACITATING Date of Birth Sex Address Phone Number 08/21/2009 F 2831 DELCREST CT, WINTER PARK FL 32817 Non Motorist action / Circumstance Prior To Crash Non Motorist Location at Time of Crash OTHER, EXPLAIN IN NARRATIVE OTHER, EXPLAIN IN NARRATIVE Non Motorist Action / Circumstance at Time of Crash 1 Non Motorist Action / Circumstance at Time of Crash 2 NO IMPROPER ACTION Non Motorist Safety Equipment 1 Non Motorist Safety Equipment 2 NONE Suspected Alcohol Use Alcohol Tested Alcohol Test Type Alcohol Test Result BAC Suspected Drug Use Drug Tested Drug Test Type Drug Test Result NO TEST NOT GIVEN NO TEST NOT GIVEN Source of Transport to Medical Facility EMS Agency Name or ID EMS Run Number Medical Facility Transported To EMS OCFR 030470 ARNOLD PALMER HOSPITAL

PERSON RECORD # Non-Motorist # Person Type Name Injury Severity 15 NM12 NON-MOTORIST / OTHER PEDESTRIAN XAVIER VALEZ NON-INCAPACITATING Date of Birth Sex Address Phone Number 11/22/2008 M 3733 N GOLDENROD ROAD, WINTER PARK FL 32792 Non Motorist action / Circumstance Prior To Crash Non Motorist Location at Time of Crash OTHER, EXPLAIN IN NARRATIVE OTHER, EXPLAIN IN NARRATIVE Non Motorist Action / Circumstance at Time of Crash 1 Non Motorist Action / Circumstance at Time of Crash 2 NO IMPROPER ACTION Non Motorist Safety Equipment 1 Non Motorist Safety Equipment 2 NONE Suspected Alcohol Use Alcohol Tested Alcohol Test Type Alcohol Test Result BAC Suspected Drug Use Drug Tested Drug Test Type Drug Test Result NO TEST NOT GIVEN NO TEST NOT GIVEN Source of Transport to Medical Facility EMS Agency Name or ID EMS Run Number Medical Facility Transported To OTHER, EXPLAIN IN NARRATIVE ARNOLD PARMER HOSPITAL

PERSON RECORD # Non-Motorist # Person Type Name Injury Severity 16 NM13 NON-MOTORIST / OTHER PEDESTRIAN DONNA BRASHEARS INCAPACITATING Date of Birth Sex Address Phone Number 09/12/1971 F 3023 CENTER AVE, ORLANDO FL 32806 Non Motorist action / Circumstance Prior To Crash Non Motorist Location at Time of Crash OTHER, EXPLAIN IN NARRATIVE OTHER, EXPLAIN IN NARRATIVE Non Motorist Action / Circumstance at Time of Crash 1 Non Motorist Action / Circumstance at Time of Crash 2 NO IMPROPER ACTION Non Motorist Safety Equipment 1 Non Motorist Safety Equipment 2 NONE Suspected Alcohol Use Alcohol Tested Alcohol Test Type Alcohol Test Result BAC Suspected Drug Use Drug Tested Drug Test Type Drug Test Result NO TEST NOT GIVEN NO TEST NOT GIVEN Source of Transport to Medical Facility EMS Agency Name or ID EMS Run Number Medical Facility Transported To EMS OCFR 030470 ORLANDO REGIONAL MEDICAL

WITNESS RECORD # 17

Name ALAN B ROOT

Address 8412 ALVERON AVE, ORLANDO FL 32817

Phone Number

Address 8412 ALVERON AVE, ORLANDO FL 32817

Phone Number

Address 1705 NORTHEAST 4TH PLACE, CAPE CORAL FL 33901

Phone Number

Address 702 SOLANDERA DRIVE, ORLANDO FL 32807

Phone Number

WITNESS RECORD # 18

Name DENNIS A DICKQUIST

WITNESS RECORD # 19

Name RONNEY AVELLAN

WITNESS RECORD # 20

Name JOEL ROSADO

NON VEHICLE PROPERTY DAMAGE Property Damage (Other than Vehicle) WATER SPRINKLER AND BUILDING WALLS

Page 4 of 6

Est. Damage Business Person# Property Owner 5,000 YES KINDERCARE LEARNING CENTER (4035 Goldenrod Road, Orlando, Fl 32817)

OFFICIAL COPY


Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.