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1 Luke A. Foster (SBN 166560)
CARBONE, SMITH & KOYAMA
2 1610 Arden Way, Suite 190
3 Sacramento, CA 95815-4035
Telephone: (916) 480-1075
4 Facsimile: (916) 481-0990
5 Attorneys for Defendant
PEDRO CAVIZO, JR.
6
7
8 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA
9 UNLIMITED CIVIL JURISDICTION
10
11 ANGELA MCGANTY, an Individual; Case No. SCV-269974
BENJAMIN PEREZ, an Individual,
12 NOTICE OF MOTION AND MOTION
Plaintiffs, TO TRANSFER VENUE;
13 MEMORANDUM OF POINTS AND
v. AUTHORITIES; DECLARATION IN
14 SUPPORT THEREOF
PEDRO CAVIZO, JR., an Individual and
15 DOES 1 to 25, Inclusive, REMOTE APPEARANCE
16 Defendants. Date: _____________, 2022
17 Time: __________
Department 16
18 Hon. Patrick Broderick
19 Complaint Filed: January 12, 2022
20
21 TO ALL PARTIES AND TO THEIR ATTORNEYS OF RECORD:
22 PLEASE TAKE NOTICE that on _______________, 2022 at ____________or as soon
23 thereafter as the matter can be heard in Department 16 of the above-titled court located at 3035
24 Cleveland Avenue, #200 Santa Rosa, California 95403, Defendant PEDRO CAVIZO, JR. will
25 and hereby does move the Court for an order pursuant to Code of Civil Procedure section 395(a)
26 to transfer venue of the above-captioned action to the Superior Court of California, in and for
27 the County of Solano for further proceedings and trial.
28 ///
________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
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1 This motion will be made on the grounds that under Code of Civil Procedure section
2 395(a), Sonoma County Superior Court is not a proper venue as the incident giving rise to this
3 action occurred in Fairfield, California, County of Solano. Additionally, Defendant PEDRO
4 CAVIZO, JR. has resided in Vallejo, California, County of Solano since the commencement of
5 this action. [Code of Civil Procedure §§395, 396(b), 397(c)].
6 This motion will be based on this notice of motion, the supporting memorandum of
7 points and authorities, the supporting declaration of Luke A. Foster, the signed stipulation
8 between the parties, the complete records and files herein, and on such further evidence and/or
9 oral argument as may properly be presented at the hearing of this motion.
10 Pursuant to Local Rule 5.5(A), “[d]uring the court day preceding each law and motion
11 calendar, by 2:00 p.m., the Court will issue a tentative ruling for each matter noticed on such
12 calendar. Tentative rulings may be obtained online between the hours of 2:00 p.m. and 4:00 p.m.
13 on the day before the hearing on the Court’s website at www.sonoma.courts.ca.gov (Click on
14 the “Online Services” tab on the home page, select “Tentative Rulings” in the drop-down menu,
15 and the click on the link to “Civil”). A copy of the tentative ruling will also be posted at the
16 Assigned Judge’s courtroom. For tentative rulings by phone, please call (707) 521-6606. Where
17 appearance has been required or invited by the court, then oral argument may be presented.
18 Appearance is always required on small claims law and motion matters and on all claims of
19 exemption, unless otherwise stated on the tentative ruling.”
20 DATED: February 11, 2022 CARBONE, SMITH & KOYAMA
21
_______________________________
22 Luke A. Foster
23 Attorneys for Defendant
PEDRO CAVIZO, JR.
24
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________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
-2-
1 MEMORANDUM OF POINTS AND AUTHORITIES
2 I. FACTUAL BACKGROUND
3 This action arises from a motor vehicle collision that occurred on December 16, 2020 in
4 Fairfield, California, County of Solano, State of California eastbound on State Route 12,
5 approximately 300 feet west of Beck Avenue. (A true and correct copy of the Traffic Collision
6 Report is attached hereto as EXHIBIT A).
7 As a result of the incident, Plaintiffs ANGELA MCGANTY and BENJAMIN PEREZ
8 filed an unlimited civil action in Sonoma County Superior Court on January 12, 2022 alleging
9 personal injuries and damages. (A true and correct copy of Plaintiffs’ Complaint is attached
10 hereto as EXHIBIT B).
11 Defendant PEDRO CAVIO, JR. is currently a resident of the County of Solano and has
12 been since the commencement of this action and service of the Summons and Complaint. (A
13 true and correct copy of Defendant’s signed declaration is attached hereto as EXHIBIT C).
14 Counsel for Plaintiffs has stipulated to the transfer of the matter from Sonoma County
15 Superior Court to Solano County Superior Court. (A true and correct copy of the stipulation
16 between the parties is attached hereto as EXHIBIT D).
17 In light of the foregoing, Defendant respectfully requests this matter be transferred to
18 Solano County Superior Court for further proceedings and trial. Counsel for Plaintiffs has
19 stipulated to the change of venue.
20 II. LEGAL ARGUMENT
21 Section 395(a) of the Code of Civil Procedure provides in pertinent part, as follows:
22 “(a) Except as otherwise provided by law and subject to the power
of the court to transfer actions or proceedings as provided in this
23 title, the superior court in the county where the Defendant or some
24 of them reside at the commencement of the action is the proper
court for the trial of the action. If the action is for injury to person
25 or personal property or for the death from wrongful act or
26 negligence, the superior court in either the county where the injury
occurs or the injury causing death occurs or the county where the
27 Defendant, or some of them reside at the commencement of the
action, is a proper court for the trial of the action.”
28
________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
-3-
1 Section 396b of the Code of Civil Procedure provides, in pertinent part, as follows:
2 “(a) Except as otherwise provided in Section 396a, if an action or
proceeding is commenced in a court having jurisdiction of the
3 subject matter thereof, other than the court designated as the
4 proper court for the trial thereof, under this title, the action may,
notwithstanding, be tried in the court where commenced, unless
5 the defendant, at the time he or she answers, demurs, or moves to
strike, or, at his or her option, without answering, demurring, or
6
moving to strike and within the time otherwise allowed to respond
7 to the complaint, files with the clerk, a notice of motion for an
order transferring the action or proceeding to the proper court,
8 together with proof of service, upon the adverse party, of a copy
9 of those papers. Upon the hearing of the motion the court shall, if
it appears that the action or proceeding was not commenced in the
10 proper court, order the action or proceeding transferred to the
proper court.”
11
12 The incident giving rise to this action occurred in Fairfield, California, County of Solano,
13 on eastbound State Route 12, approximately 300 feet west of Beck Avenue. At the time of the
14 commencement of this action by filing of the Complaint on January 12, 2022, Defendant
15 PEDRO CAVIZO, JR. was at all times a resident of the County of Solano.
16 Section 399(a) of the Code of Civil Procedure provides, in pertinent part, as follows:
17
(a) When an order is made transferring an action or proceeding
18 under any of the provisions of this title, the clerk shall, after
expiration of the time within which a petition for writ of mandate
19 could have been filed pursuant to Section 400, or if a writ petition
20 is filed after judgment denying the writ becomes final, and upon
payment of the costs and fees, transmit the pleadings and papers
21 therein (or if the pleadings be oral a transcript of the same) to the
clerk of the court to which the same is transferred. When the
22
transfer is sought on any ground specified in subdivision (b), (c),
23 (d), or (e) of Section 397, the costs and fees thereof, and of filing
the papers in the court to which the transfer is ordered, shall be
24 paid at the time the notice of motion is filed, by the party making
25 the motion for the transfer. If the transfer is sought solely, or is
ordered, because the action or proceeding was commenced in a
26 court other than that designated as proper by this title, those
costs and fees, including any expenses and attorney’s fees
27
awarded to the defendant pursuant to Section 396b, shall be paid
28 by the plaintiff before the transfer is made. [Emphasis added]
________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
-4-
1 In this instance, Defendant requests that Plaintiff be required to pay for the transfer
2 before the pleadings and papers are transferred to the clerk of Solano County Superior Court.
3 III. CONCLUSION
4 In light of the foregoing, but not expressly limited thereto, Defendant PEDRO CAVIZO,
5 JR. respectfully requests the Court grant Defendant’s motion and transfer this matter to Solano
6 County Superior Court for all purposes including discovery and trial.
7 DATED: February 11, 2022 CARBONE, SMITH & KOYAMA
8
9 _______________________________
Luke A. Foster
10 Attorneys for Defendant
11 PEDRO CAVIZO, JR.
12
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________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
-5-
1 DECLARATION OF LUKE A. FOSTER
2 I, Luke A. Foster, declare:
3 1. I am an attorney at law duly licensed to practice before all the courts in the State
4 of California and am an attorney in the law firm Carbone, Smith & Koyama, and will be the
5 attorney of record for Defendant PEDRO CAVIZO, JR. in this action. I have personal
6 knowledge of the matters stated in this declaration and if called as a witness I could and would
7 competently testify thereto.
8 2. The accident giving rise to this action occurred in Fairfield, California, County
9 of Solano. (A true and correct copy of the Traffic Collision Report is attached hereto as
10 EXHIBIT A).
11 3. Plaintiffs ANGELA MCGANTY and BENJAMIN PEREZ filed this action in
12 Sonoma County Superior Court on January 12, 2022. (A true and correct copy of Plaintiffs’
13 Complaint is attached hereto as EXHIBIT B).
14 4. Upon information and belief, at the time Plaintiffs’ Complaint was filed
15 Defendant PEDRO CAVIZO, JR. was a resident of the County of Solano. (A true and correct
16 copy of Defendant’s signed declaration is attached hereto as EXHIBIT C).
17 5. Sonoma County is not a proper venue for this matter as Defendant PEDRO
18 CAVIZO, JR. did not reside in Sonoma County at the time of the commencement of the action,
19 nor did the accident occur in Sonoma County.
20 6. Counsel for Plaintiffs has signed a stipulation to transfer venue of this matter. (A
21 true and correct copy of the stipulation between the parties is attached hereto as EXHIBIT D).
22 I declare under penalty of perjury under the laws of the State of California that the
23 foregoing is true and correct, except as to those matters stated on information and belief, and as
24 to those matters, I believe them to be true, and that this declaration was executed at Sacramento,
25 California on February 11, 2022.
26 ___________________________
Luke A. Foster
27
28
________________________________________________________________________________
NOTICE OF MOTION AND MOTION TO TRANSFER VENUE;
MEMORANDUM OF POINTS AND AUTHORITIES; DECLARATION IN SUPPORT THEREOF
-6-
EXHIBIT A
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC COLLISION REPORT
CHP 555 PAGE 1 (REV 04-11) CPI 060 PAGE 1 OF 7
SPECIAL CONOITIONS
.. NUMBER HIT &RUNCITY JUDICIAL DISTRICT LOCAL REPORT ~UMBER
L"JURED FELONY
FAIRFIELD
□
0 NORTHER~SOLANO 9365-2020-01888
0
HtT&RUN
NUMBER JW.UI COUNTY
MISOEl.l£ANOR
SOLANO
REPORTING DISTRICT BEAT
122
DAY OF WEEK
WEDNESDAY
I[xj
TOWAWAY
D
□
YES NO
COLLISION OCCURRED ON:
SR-12
MO DAY
12/ 16/2020
YEAR TIME (24001
08 10
NCIC# I OFFICER I.D.
z 9365 014948
0
f'.=
MILEPOST INFORMATION: IGPS COORDINATES
. PHOTOGRAPHS BY: [xI NONE
<( 38.2402°
LATITUDE 122.0677°
LONGITUDE -
<..)
0_J LJ AT INTERSECTION WIT H: STATE HWY REL
[xlOR: 300 FEET WEST OF BECK AVE [x] YES
□ NO
PARTYDRIVER'S LICENSE NUMBER
S0275924 (ID)
ISTATE
CA
Ic~s I AIR BAO
M
ISAFETY~QUIP.
VE>t. YEAR
05
MAKE I MODEL I COLOR
TOYOTA HIGHLANDER RED
LICENSE NUMBER
7AFP119
STATE
CA
1
DRIVER NAME(FIRST, MIDDLE, LAST)
[xI PEDRO AB LEN CAVIZO JR OWNER"S NAME [i] SAME AS DRIVER
PEDES-, STREET ADDRESS
TRIAN
200 EMILY ST Lxl
□
OWNER'S ADDRESS SAME AS DRIVER
PARKEDCITY I STATE I ZIP
VEHICLE
n VALLEJO CA 94589
□ [x] DRIVER□
I
DISPOSITION OF VEHICLE ON ORDERS OF:
OFFICER OTHER
BICY- SEX
I HEIGHT WEIGHT BIRTHDATE
I
rr
OTHER
M
HAIR
GRY
HOME PHONE
EYES
GRY 5-06 230
MO DAY
06/ 12/1948
BUSINESS PHONE
YEAR RACE
A
AAA CLUB FLEET
PRIOR MECH. DEFECTS LxJ NONE APP.
VEHICLE I DENTIFICATION NUMBER:
L J REFER TO NARRATIVE
(707)321 -2785 NONE
□ INSURANCE CARRIER POLICY NUMBER
VEHICLE TYPE DESCRIBE VEHICLE DAMAGE
OuNK □ NONE □ MINOR
SHADE !N DAMAGED AREA
111'111.11
AAA
E SR-12
CAAS100317201
DIR OF TRAVEl O N STREET OR HIGHWAY
I
ISPEED LIMIT
50
I
07
CA
CAL•T
I [i] MOO
TCP/PSC
DOT
□ MAJOR□ ROLL-OVER
MC/MX
D
PARTY
2
DRIVER'S LICENSE NUMBER
C3485498 ID
I
STAT E
CA
Icts AIR BAG
M
SAFE~EQUIP.
VEH. YEAR
18
MAKE/ MODEL I COLOR
FORD FUSION BLK
LICENSE NUMBER
8DHC922
STATE
CA
DRIVERNAME(FIRST, MIDDLE, LAST)
Iii ANGELA FAYE MCGANT\' OWNER'S NAME lxJSAME AS DRIVER
?EDES-STREET ADDRESS
TR~
[i] SAME AS DRIVER
□
199 BURGUNDY WAY OWNER'S ADDRESS
PARKECCITY I STATE/ ZIP
\/Err FAIRFIELD CA 94533 □
DISPOSITION_OF VEHICLE ON ORDERS OF: (i] DRIVER
OFFICER □ OTHER
BICY•
CLIST
SEX
IHAIR !EYES
HEIGHT WEIGKT
MO
BIRTHOATE
DAY YEARIw
RACE DRIVEN AWAY
□ M BLN BLU 5-05 135 10/26/1965
BUSINESS PHONE
PRIOR MECHANICAL DEFECTS IYl NONE APP.
VEHICLE IOENTJACATION NUMBER:
r 7REFER TO NARRATIVE
OTHER HOME PHONE
(707)384-9078
□
NONE VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHAOE IN DAMAGED AREA
INSURANCE CARRIER POLICY NUMBER OuNK □ NONE □ MINOR 11Pillll
n
PARTY
ESURANCE
DIR OF TRAVE1 ON STREET OR HIGHWAY
W SR-12 .
DRIVER'S U CENSE NUMBER I I
STATE •
PACA-008722994
CLASS I
' SPEED LIMIT
AIR BAGI
50
SAFETY EQUIP.
01
CA
CAL·T
I
VEH. YEAR
[i] MOO
TCPJPSC
DOT
□MAJOR
MAKE I MODEL I COLOR
MCIMX
ROLL-OVER
D
LICENSE NUMBER STATE
3
DRIVERNAMEIFIRST, MIDDLE, LAST)
□
PEDES-STREET ADDRESS
OWNER'S NAME □ SAME AS DRIVER
TRIAN
□
PARKED CITY I STATE I ZJP
OWNER'S ADDRESS □ SAME AS DRIVER
!VEHICLE
LJ OFFICERLJ DRIVER LJ OTHER
□
DISPOSITION OF VEHICLE ON ORDERS OF:
BICY-
CLIST
SEX
IHAIR 'EYES
HEIGHT WEIGHT
MO
BI RTHOATE
DAY YEARI
RACE
□
OTHER HOME PHONE BUSINESS PHONE
PRIOR MECHANCJAL DEFECTS I I NONEAPP.
VEHICLE lOENTIFICATION NUMBER:
I I REFER TO NARRATIVE
□ INSURANCE CARRIER POLICY NUMBER
VEHICLE TYPE DESCRIBE VEHICLE DAMAGE
O uNK □ N~NE □ MINOR
SHADE IN DAMAGED AREA
I □ MOD □ MAJOR □ ROLL-OVER
DIR OF TRAVE1 ON STREET OR HIGHWAY ISPEED LIMIT CA DOT
CAL•T TCP/PSC MCIMX
PREPARER'S NAME DISPATCH NOTIFIED REVIEWER'S NAME DATE REVIEWED
BRIAN COMPTON 014948 Ii] NIA JOSE MENDOZA 019086 12/21/2020
DYES □ NO
AN INTERNATIONALLY ACCREDITED AGENCY
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC COLLISION CODING
I
PAGE 2 OF 7
CHP 555 CARS PAGE2 (REV. 04-11) OPI 060
DATE OF COLLISION (MO. DAY
YEAR)
·I
TIME(2•00) INCIC# IO FFICER 1.0. NUMBER .
12/16/2020 0810 9365 014948 9365-2020-01888
OWNER"S NAME IOWNER ADDRESS I NOTIFIED
PROPERTY 0 YES "0NO
DAMAGE DESCRIPTION OF DAMAGE
SEATING POSITION SAFETY EQUIPMENT AIR BAG INATTENTION CODES
OCCUPANTS CHCLD RESTRAINT
B-UNKNOWN
A · CELL PHONE HANOHELO
I\ A· NONE IN VEHICLE Q - IN VEHICLE USED L • AIR BAG DEPLOYED
B • CELL PHONE HANOSFREE
B-UNKNOWN R - IN VEHICLE NOT USED M • AIR BAG NOT DEPLOYED
~ C • LAP BELT USED S - IN VEHICLE USE UNKNOWN
N -OTHER
C • ELECTRONIC EQUIPMENT
0-RAOIO/CO
0 • LAP BELT NOT USED T - IN VEHICLE IMPROPER USE
P • NOT REQUIRED
1-DRIVER E - SMOKING
1 2 3 2 TO 6 • PASSENGERS
E • SHOULDER HARNESS USED U • NONE IN VEHICLE
F-EATING
F • SHOULDER HARNESS NOT USED EJECTED FROM VEHICLE
4 5 6 7 • STATION WAGON REAR
G - LAP/SHOULDER HARNESS USED M / C BICYCLE HELMET
G-CHILOREN
ace
8 • REAR. TRK. OR VAN
H - LAP/SHOULDER HARNESS NOT USED
O • NOT EJECTED H - ANIMALS
9 - POSITION UNKNOWN DRIVER PASSENGER 1 • FULLY EJECTED I• PERSONAL HYGIENE
J • PASSIVE RESTRAINT USED
7 0-0THER
K - PASSIVE RESTRAINT NOT USED
V-NO X- NO 2 . PARTIALLY EJECTED J • READING
W - YES Y-YES K-OTHER
P - NOT REQUIRED 3-UNKNOWN
ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(") SHOULD BE EXPLAl~ED IN THE NARRATIVE.
PRIMARY COLLISION FACTOR MOVEMENT PRECEDING
LIST NUMBER(#) OF PARTY AT FAULT
TRAFFIC CONTROL DEVICES 1 2 3 SPECIAL INFORMATION 1 2 3 COLLISION
VC SECTION VIOLATED:
CH EO LJ YE.S
y A CONTROLS FUNCTIONING A HAZARDOUS MATERIAL A STOPPED
1 A 22350 lx] NO B CONTROLS NOT FUNCTIONING' B CELL PHONE HANDHELD IN USE IY B PROCEEDING STRAIGHT
B OTHER IMPRO PER'DRIVING" ·cCONTROLS OBSCURED C CELL PHONE HANDSFREE IN USE C RAN OFF ROAD
D NO CONTROLS PRESENT I FACTOR' y y D CELL PHONE NOT IN USE D MAKING RIGHT TURN
C OTHER THAN DRIVER" TYPE OF COLLISION E SCHOOL BUS RELATED E MAKING LEFT TURN
D UNKNOWN• A HEAD-ON F 75 FT MOTORTRUCK COMBO F MAKING U TURN
B SIDESWIPE G 32 FT TRAILER COMBO G BACKING
IY C REAR ENO H y H SLOWING/ STOPPING
WEATHER (MARK 1 TO 2 ITEMS) D BROADSIDE . I I PASSING OTHER VEHICLE
X A CLEAR E HIT OBJECT J J CHANGING LANES
B CLOUOY F OVERTURNED K K PARKING MANEUVER
C RAINING G VEHICLE I PEDESTRIAN L L ENTERING TRAFFIC
D SNOWING H OTHER": M M OTHER UNSAFE TURNING
E FOG I VISIBILITY FT. N N XING INTO OPPOSING LANE
F OTHER:' MOTOR VEHICLE INVOLVED WITH 0 0 PARKED
G WINO A NON • COLLISION P MERGING
LIGHTING B PEDESTRIAN Q TRAVELING WRONG WAY
X A DAYLIGHT y C OTHER MOTOR VEHICLE OTHER ASSOCIATED FACTORS R OTHER":
B DUSK -OAWN 1
. D MOTOR VEHICLE ON OTHER ROADWAY 2 3 (MARK 1 TO 2 ITEMS}
C DARK· STREET LIGHTS E PARKED MOTOR VEHICLE c1rE0: 0
VC SECTION VIOLATEO: n:s
~ A
D DARK • NO STREET LIGHTS F TRAIN lf4,'-J;i 0•0
•
G BICYCLE ~-.~ BVC SECTI0.'4 VIOlATED:
CJTEO:LJ YES
E DARK· STREET LIGl:fTS NOT
FUNCTIONING" H ANIMAL: ~ 0 •0 SOBRIETY · DRUG
ROADWAY SURFACE YC SECTIO:i VIOLATED:
CfTEO: o
YES PHYSICAL
C 1. 2 3
y A ORY I FIXED OBJECT: NO (MARK 1 TO 2 ITEMS)
B WET D ~11&· XY A HAD NOT BEEN DRINKING
C SNOWY- ICY J OTHER OBJECT: E VISION OBSCUREMENT: B HBD • UNDER INFLUENCE
D SLIPPERY (MUDDY, OILY, ETC.} X F INATTENTION": K-OTHER C HBO · NOT UNDER INFLUENCE'
ROA!)WAY CONDITION(S} G STOP & GO TRAFFIC D HBO - IMPAIRMENT UNKNOWN"
(MARK 1 TO 2 ITEMS} PEDESTRIAN'S ACTIONS H ENTERING/ LEAVING RAMP E UNDER DRUG INFLUENCE'
A HOLES, DEEP RUT" X A NO PEDESTRIANS INVOLVED I PREVIOUS COLLISION F IMPAIRMENT · PHYSICAL'
B LOOSE MATERIAL ON ROADWAY' B CROSSING IN CROSSWALK - J UNFAMILIAR WITH ROAD G IMPAIRMENT NOT KNOWN
C OBSTRUCTION ON ROADWAY' AT INTERSECTION K DEFECTIVE VEH. EQUIP.:
CITED H NOT APPLICABLE
D CONSTRUCTION· REPAIR ZONE C CROSSING IN CROSSWALK - NOT □ "' I SLEEPY/ FATIGUED'
E REDUCED ROADWAY W IDTH AT INTERSECTION □ NO
F FLOODED' D CROSSING • NOT IN CROSSWALK L UNINVOLVED VEHICLE
G OTHER": E IN ROAD - INCLUDES SHOULDER M OTHER' :
X H NO UNUSUAL CONDITIONS F NOT IN ROAD y N NONE APPARENT
G APPROACHING/ LEAVING SCHOOL BUS 0 RUNAWAY VEHICLE
MISCELLANEOUS
SKETCH DIAGRAM, SEE PAGE 4
0
SKETCH •- ·FOR
INOICATE NORTH
AN INTERNATION ALLY ACCREDITED AGENCY
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED/ WITNESSES/ PASSENGERS** PAGE 3 OF7
CHP 555 CARS PAGE 3 (REV 11-16) OPI 060
····· ·
TIME(2400)
DATE OF COLLISION (MO. DAY YEAR) I NCIC # OFFICER 1.0. NUMBER
12/ 16/2020 0810 9365 014948 9365-2020-01888
WITNESS PASSENGER AGE sex EXTENT OF lNJURY('X' ONE) INJURED WAS ('X' ONE) PARTY SEAT AJ R SAFETY EJECTED
ONLY ONLY NUMBER POS. BAG EQUIP.
FATAL SUSPECTED SERIOUS