8

THIS REPORT IS FOR THE USE OF THE DIVISION OF MOTOR VEHICLES. THE DATA IS COLLECTED FOR
6
DMV-349 (Rev. 1/2009) STATISTICAL ANALYSIS AND SUBSEQUENT HIGHWAY SAFETY PROGRAMMING. DETERMINATIONS OF Do not write in these spaces
"FAULT" ARE THE RESPONSIBILITY OF INSURERS OR OF THE STATE'S COURTS.
2 9

1 No. of Units Involved Form 1 of 4 Supplemental Report Non-Reportable 2018003710 Date Received by DMV
Crash Date County Time Local Use/Patrol Area
3
02/03/2018 NEW HANOVER 22:04 DISTRICT 5
mm/dd/ccyy (24 Hour Clock)
10
2 Crash X In outside municipality
L Roadway Surface 5 occurred Near WILMINGTON 14
33 Relation to
3 O Municipality
or Miles N S E W
X X
C on PVA 250 RACINE DR Miles 88 ft. N S E W
(R.R. Crossing # ) (0 ft.-Intersection)
A Highway Number, or Highway, Street. (If ramp or service road, indicate on line)
Ramp or
3 T Service Road (If available)
11
1 O at or from LCL RACINE DR
I
X X toward LCL GOVERNMENT CENTER
Latitude

N
Use Highway Number, Street Name or Adjacent County or State Line N S E W Use Highway Number, Street Name or Adjacent County or State Line Longitude
14
Altitude

UNIT # 1 VEHICLE X PEDESTRIAN HIT & RUN COMMERCIAL UNIT # 2 X VEHICLE PEDESTRIAN HIT & RUN OTHER
20 VEHICLE

4 Driver VINCENT CHASE IVENTOSCH Driver STUART WILLIAM BROOKS

First Middle Last Suffix First Middle Last Suffix
1
Address 7625 MALLOW RD Address 128 CAPTAINS CT
5

City WILMINGTON State NC Zip 28411 City WRIGHTSVILLE BEACH State NC Zip 28480 12

Driver's H ( 910 ) 538-0259 Driver's H ( 910 ) 674-2396 0

Same Address on Driver's Same Address on Driver's
Phone Phone 13
License? Yes X No Numbers W ( ) License? Yes X No Numbers W ( )

6 D.L. D.L.
D.L. # Class C State NC D.L. # Class C State NC
2 CDL License CDL License
34Vision 35 Physical 36D.L. 34Vision 35 Physical 36D.L. 14
DOB
08/12/1991 Obstruction 0 Condition 5 Restrictions
DOB
06/10/1988 Obstruction 0 Condition 5 Restrictions 0
mm/dd/ccyy mm/dd/ccyy
30
37 Alcohol/ 38 Alcohol/ 39 Results 40 Vehicle 37 Alcohol/ 38 Alcohol/ 39 Results 40 Vehicle
7 Drugs Suspected 1 Drugs Test 0 (if known) 0 Seizure (DWI) Drugs Suspected 1 Drugs Test 0 (if known) 0 Seizure (DWI)
15

4 32
Owner Owner KRYSTAL ADAMS WHITE 16
Same as Driver? Same as Driver?

Address Address 7274 SANCTUARY DR

Same Address as Driver? Same Address as Driver?

City State Zip City WILMINGTON State NC Zip 28411 17

Plate Plate FCR2303 Plate NC Plate 2018 30

Plate # Plate #
State Year State Year 18
5TFAW5F15FX446774
VIN VIN 38
X
24 TOYT 2015 2
Yes Yes 19
Vehicle Vehicle 41 Vehicle 42 Vehicle Vehicle Vehicle 41 Vehicle 42 Vehicle
Make Year Style (Type) Drivable No Make Year Style (Type) Drivable No

43 TAD
44 Estimated $0.00 43 TAD LD 0|UND0| 44 Estimated $0.00
Damage Damage
Insurance Insurance GEICO
Company Company

Policy # Policy # 4125718240

20 COMMERCIAL VEHICLE: Cargo, Carrier Name, Address, Source Carrier Identification Numbers, GVWR, Axles
Source:
Unit 45 Cargo Body Type Same Address as Owner?
Truck US DOT# ICC# Axles on Vehicle
Including Trailers

Shipping State State# IFTA#

papers

Driver Gross Vehicle

FEI# Fleet# Weight Rating

21 22 23 24 25 26 27 28 29 30 31 32 Names and Addresses for All Persons (Unit 1/Unit 2 Drv, Ped, etc. - See Above); Use check blocks if address same as Driver

1
Unit1-Drv1, Ped1, etc. see
A 1 3 see above O M 0 0 2 1 2 above Veh#___ Towed To/By:

2
Unit2-Drv2, Ped2, etc. see
B 2 1 1 see above W M 10 1 4 2 1 5 above LEFT THE SCENE
Veh#___ Towed To/By: LEFT THE SCENE
C
KEVIN WILLIAM OHARA
2 2 6 11/06/1984 W M 2 0 0 2 1 5 2 MEIER AVE WRIGHTSVILLE BEACH NC 28480
D
STEPHEN ANTHONY WHITE
2 2 3 01/26/1984 W M 2 1 4 2 1 5 7247 SANCTUARY DR WILMINGTON NC 28411
E

46 Name of EMS A NEW HANOVER 46 Name of EMS

47 Injured Taken A NEW HANOVER REGIONAL MED 47 Injured Taken
by EMS to (Treatment Facility and City or Town) by EMS to (Treatment Facility and City or Town)
 Form 2 of 4 Accident #: 2018003710
48 POINTS OF INITIAL
Unit# 1 VEHICLE INFO. Veh # 1 Veh # 2 ROADWAY INFO. WORK ZONE RELATED
CONTACT
(Write in Codes)
Unit# 2 6 7 60 Authorized Speed Limit
15 69 Road Feature
0 78 Workzone Area 5
1 2
79 Work Activity
CRASH SEQUENCE (Unit Level) Unit# Unit# 61 Estimate of Original Traveling Speed
10 70 Road Character
1
80 Work Area Marked
49 Vehicle Maneuver/Action
14 62 Estimate of Speed at Impact
10 71 Road Classification
6
81 Crash Location
50 Non-Motorist Action
8 63 Tire Impressions Before Impact (ft.) 72 Road Surface Type
3
TRAILER INFO. 1 2
13 MOVE 2
51 Non-Motorist Location Prior to Impact 64 Distance Traveled After Impact (ft.) 73 Road Configuration Unit# Unit#

52 Crash Sequence - First Event for This Unit

14 14 65 Emergency Vehicle Use 74 Access Control
1 82 Trailer Type
00 00
53 Crash Sequence - Second Event " 66 Post Crash Fire (if "Yes" check block) 75 Number of Lanes
0 1st Trailer No. Axles

" Width (inches)

54 Crash Sequence - Third Event " 67 School Bus - Contact Vehicle 76 Traffic Control Type
0
Length (feet)
55 Crash Sequence - Fourth Event " 68 School Bus - Noncontact Vehicle " 77 Traffic Control Oper
2nd Trailer No. Axles
56 Most Harmful Event for This Unit
14 14 COMMERCIAL VEHICLE: Hazardous Materials Involvement Width (inches)

0 1
57 Distance/Direction to Object Struck Haz Mat Placard Yes No From Placard indicate: Length (feet)

Hazardous Cargo 4-digit placard number or 1-digit number from 83 Unit# Overwidth Permit #
Yes No
58 Vehicle Underride/Override
1 2 Released (does not include fuel from fuel tank)
name from diamond or box bottom of diamond
Overwidth Trailer
and Overwidth
59 Vehicle Defects
0 Carrying Haz Mat Yes No Mobile Home

84 DIAGRAM

Indicate
North

Traveling
X X Traveling
X X
Unit# 1 was: Parked Facing N S E W on 250 RACINE DR Unit# 2 was: Parked Facing N S E W on 250 RACINE DR
(Include pertinent and unusual aspects,
85 NARRATIVE which are not listed elsewhere on the form)
At 2204, 2/3/2018, I was dispatched to a traffic collision. Prior to my arrival driver-2
had fled the crash scene and pedestrian-1 had been transported to the hospital. I spoke
with witness-1 who told me he had witnessed the entire event. Witness-1 said that
pedestrian-1 had been standing in front of vehicle-2 when vehicle-2 started forward and
drove over pedestrian-1 and then fled the scene without stopping to provide information or
aid. Witness-2 told me he was present but deferred to witness-1. Witness-2 told me that
witness-1 had "seen more of the event." At the hospital I attempted to speak briefly with
pedestrian-1 who no longer wanted to answer my questions and asked me to leave. CSI
documented the injuries incurred by pedestrian-1 and the crash scene. At 1011, 2/4/2018, I
was dispatched to the crash scene to meet with driver-2 and both passengers who occupied
vehicle-2 at the time of the collision. Driver-2 and both passengers followed me to the
State
ADDITIONAL PROPERTY DAMAGE Property?
86 Type/ Owner Address Estimated $
Owner Phone Damage

WITNESSES
Name DYLAN MATTHEW REED Address 9662 HOLLY HILLS DR NE, LELAND, NC 28451 Phone No. ( (910) )622-7077
Name STETSON LEE STRICKLAND Address 117 OLDE WELL LOOP RD, WILMINGTON, NC 28411 Phone No. ( (910) )795-7658
TRAFFIC VIOLATION(S)
Name Charge(s)
(Citation # optional)
Name Charge(s)
Officer Name Officer Number Department Date of Report
PO ANDERSON, M. G. PA4060 0650200 02/03/2018
 3 4
Form ______ of ______ Accident #: 2018003710

ACCIDENT DESCRIPTION (continued)

police department where CSI photographed vehicle-2 and the passengers and driver-2 provided
written and video statements concerning the incident. Driver-2 said that as he and his
passengers were in the vehicle they were being confronted by pedestrian-1, witness-1 and
witness-2. Driver-2 said that witness-1 was "hitting the passenger side windows with his
hands and pedestrian-1 was on the driver side. During this witness-2 arrived in his
vehicle. Driver-2 said he fled the area but was unaware that he had struck pedestrian-1
until seeing a local news report. Both passengers gave essentially the same account of the
event. On 2/5/2018, I spoke with pedestrian-1 at the hospital. He told me that he
approached vehicle-2 and its occupants in the pva because he believed that vehicle-2 was
actually the vehicle owned by witness-1 and then asked for "a ride home." When driver-2 and
the vehicle occupants refused to provide a ride, there was a small verbal exchange as
pedestrian-1 walked away. Pedestrian-1 said the he and witness-1 had not confronted the
occupants of vehicle-2 but did attempt to retrieve property that pedestrian-1 believed he
had left in vehicle-2. Witness-1 and witness-2 later gave later gave written and video
statements concerning the incident. Witness-2 said that he thought vehicle-2 had driven
over the curb island as it left the scene. My investigation revealed that driver-2 failed
to see before starting forward that the movement could be made safely. Pedestrian-1 failed
to step away from the vehicle to safety and was standing in a location so close to the
vehicle as to be unreasonable as the vehicle attempted to leave the pva. Driver-2 said he
believed that he and the vehicle occupants were being confronted by a number of people and
chose to leave rather than be involved in a physical confrontation. All occupants of
vehicle-2 denied knowledge of striking pedestrian-1 as they left the pva. All person(s)
involved in this event had been consuming alcoholic beverages prior to the event. No tests
for alcohol or drugs were given or made available to Law Enforcement at the time of this
report.
Form 4 of 4 Accident #: 2018003710

DIAGRAM