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Agency Case Number Agency NCIC No. GEORGIA County Date Rec. by DOT
21-140330 1210000 MOTOR VEHICLE CRASH REPORT RICHMOND 5/19/2021
Estimated Crash Dispatch Arrival Total Number of Inside City Of
Date Time Date Time Date Time Vehicles Injuries Fatalities Augusta-Richmond County
5/19/2021 16:01 5/19/2021 16:03 5/19/2021 16:09 2 3 0

Road of At Its Intersection JACKSON RD

WRIGHTSBORO RD Suppl. To Original?
Occurence With
Miles North East
Not At Its
Feet South West Of Private Property?
Intersection But

Latitude (Y) 33.469392 Longitude (X) -82.066785 Hit And Run?

(Format) 00.00000 (Format) -00.00000

Unit # Driver LAST NAME FIRST MIDDLE Unit # Driver LAST NAME FIRST MIDDLE
Ped RATLIFF SHERICE C Ped KERNODLE JUNIE F
1 Bike
Address
2 Bike
Address
Susp At Fault Susp At Fault

City State Zip DOB City State Zip DOB

GROVETOWN (COLUMBIA) GA 30813 /1983 AUGUSTA (RICHMOND) GA 30906 /1952
Driver's License No Class State Country Driver's License No Class State Country
049702733 CLASS C GA USA 055111563 CLASS C GA USA
Insurance Co. Policy No. Telephone No. Insurance Co. Policy No. Telephone No.
GARRISON PROPERTY + CASUALTY 042324388 R 07101 MID CENTURY INS CO 195625453
Year Make Model Year Make Model
2016 DODGE CHARGER 2013 CHRYSLER TOWN & COUNTRY
VIN Vehicle Color VIN Vehicle Color
2C3CDXGJ9GH355848 Black 2C4RC1CG1DR734901 Blue-Light
Tag # State County Year Tag # State County Year
CNK7602 GA COLUMBIA 2021 TKZ890 GA RICHMOND 2021
Trailer Tag # State County Year Trailer Tag # State County Year

Same as Driver Owner's Last Name First Middle Same as Driver Owner's Last Name First Middle
RATLIFF SHERICE C KERNODLE JUNIE F
Address Address

City State Zip City State Zip

GROVETOWN (COLUMBIA) GA 30813 AUGUSTA (RICHMOND) GA 30906
Removed By: C AND A TOWING Request List Removed By: RICK'S PAINT AND BODY Request List
Alcohol Test: Type: Results: Drug Test: Type: Results: Alcohol Test: Type: Results: Drug Test: Type: Results:
No No No No

First Harmful Event: Most Harmful Event: Operator/Ped Cond: First Harmful Event: Most Harmful Event: Operator/Ped Cond:
Motor Vehicle In Motion Motor Vehicle In Motion Not Drinking Motor Vehicle In Motion Motor Vehicle In Motion Not Drinking

Operator Factors: Failed to Yield Operator Factors: No Contributing Factors

Vehicle Factors: No Contributing Factors Roadway Factors: No Contributing Factors Vehicle Factors: No Contributing Factors Roadway Factors: No Contributing Factors

Direction of Travel: Vehicle Maneuver: Non-Motor Maneuver: Direction of Travel: Vehicle Maneuver: Non-Motor Maneuver:
North Turning Left West Straight

Vehicle Class: Vehicle Type: Vision Obscured: Vehicle Class: Vehicle Type: Vision Obscured:
Privately Owned Passenger Car Not Obscured Privately Owned Van Not Obscured

Number of Occupants: Area of Initial Contact: Damage to Vehicle: Number of Occupants: Area of Initial Contact: Damage to Vehicle:
1 Right Side-Center Disabling Damage 2 Front End Disabling Damage

Traffic Way Flow: Road Composition: Road Character: Traffic Way Flow: Road Composition: Road Character:
Two-Way Trafficway with no physical Black Top Straight and Level Two-Way Trafficway with no physical Black Top Straight and Level
separation separation
Number of Lanes: 6 Posted Speed: 45 Work Zone: None Number of Lanes: 6 Posted Speed: 45 Work Zone: None

Traffic Control: Traffic Signal Device Inoperative: Yes No Traffic Control: Traffic Signal Device Inoperative: Yes No
Citation Information: Citation Information:
Citation # 289389 O.C.G.A. § 40-6-71 Citation # O.C.G.A. §
Citation # O.C.G.A. § Citation # O.C.G.A. §
Citation # O.C.G.A. § Citation # O.C.G.A. §
COMMERCIAL MOTOR VEHICLES ONLY COMMERCIAL MOTOR VEHICLES ONLY
Carrier Name Carrier Name
Address City State Zip Address City State Zip

U.S. D.O.T. # No. of Axles G.V.W.R U.S. D.O.T. # No. of Axles G.V.W.R

Cargo Body Type Vehicle Config. Interstate Fed. Reportable Cargo Body Type Vehicle Config. Interstate Fed. Reportable
Intrastate Yes No Intrastate Yes No

C.D.L. ? Yes No C.D.L. Suspended? Yes No C.D.L. ? Yes No C.D.L. Suspended? Yes No
Vehicle Placarded? Yes No Hazardous Materials? Yes No Vehicle Placarded? Yes No Hazardous Materials? Yes No
Hazmat Released? Yes No Hazmat Released? Yes No
If YES: Name or 4 Digit Number from Diamond or Box: If YES: Name or 4 Digit Number from Diamond or Box:
One Digit Number from Bottom of Diamond: One Digit Number from Bottom of Diamond:
Ran Off Road Down Hill Runaway Cargo Loss or Shift Separation of Units Ran Off Road Down Hill Runaway Cargo Loss or Shift Separation of Units

GDOT-523 (07/17)
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COLLISION FIELDS

On Roadway - Roadway
Manner of Collision: Angle Location at Area of Impact: Intersection
Weather: Cloudy Surface Condition: Dry Light Condition: Daylight

NARRATIVE

V1 was traveling east on Wrightsboro Rd in the left turn lane at its intersection with Jackson Rd. V2 was traveling west on Wrightsboro Rd in the right through lane at its intersection with Jackson Rd.
The driver of V1 stated she attempted to turn left onto Jackson Rd through a yellow flashing left turn arrow. The driver of V2 stated he was traveling through the intersection on a green light. The
front of V2 struck the right side of V1. Deputy's investigation revealed the driver of V1 is at fault for Failure to Yield While Turning Left. BWC was utilized.

DIAGRAM

PROPERTY DAMAGE INFORMATION

Damage Other Than Vehicle: Owner:

WITNESS INFORMATION

Name (Last, First) Address City State Zip Code Telephone Number

GDOT-523 (07/17)
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OCCUPANT INFORMATION

Name (Last, First): RATLIFF, SHERICE Address: GROVETOWN (COLUMBIA), GA 30813

Age: Sex: Unit # Position: Safety Eq: Ejected: Extricated: Air Bag: Injury: Taken for Treatment:
1 38 Female 1 Front Seat-Left Side Lap and Shoulder Belt Used Not Ejected No Deployed Multiple Possible Injury or Yes
Complaint (C)
Injured Taken To: By: EMS Notified Time: EMS Arrival Time: Hospital Arrival Time:

Name (Last, First): KERNODLE, JUNIE Address: AUGUSTA (RICHMOND), GA 30906

Age: Sex: Unit # Position: Safety Eq: Ejected: Extricated: Air Bag: Injury: Taken for Treatment:
2 69 Male 2 Front Seat-Left Side Lap and Shoulder Belt Used Not Ejected No Non-Deployed Air Possible Injury or No
Complaint (C)
Injured Taken To: By: EMS Notified Time: EMS Arrival Time: Hospital Arrival Time:

Name (Last, First): KERNODLE, SUN Address: AUGUSTA (RICHMOND), GA 30906

Age: Sex: Unit # Position: Safety Eq: Ejected: Extricated: Air Bag: Injury: Taken for Treatment:
3 71 Female 2 Front Seat-Right Side Lap and Shoulder Belt Used Not Ejected No Non-Deployed Air Possible Injury or Yes
Complaint (C)
Injured Taken To: By: EMS Notified Time: EMS Arrival Time: Hospital Arrival Time:

Name (Last, First): Address:

Age: Sex: Unit # Position: Safety Eq: Ejected: Extricated: Air Bag: Injury: Taken for Treatment:
4
Injured Taken To: By: EMS Notified Time: EMS Arrival Time: Hospital Arrival Time:

ADMINISTRATIVE

Photos Taken: Yes No By: Officer Note: If collision resulted in a fatality, please send prompt notification to the
GDOT Crash Reporting Unit via either email at GeorgiaFARS@dot.ga.gov or Fax at
(404) 635-2963.
Report By: Agency: Report Date: Checked By: Date Checked:
DARLING, HOY (B706) Richmond Co Sheriff's Office 05/19/2021 18:17 Edenfield, George 5/19/2021

GDOT-523 (07/17) [Printed: 5/19/2021 | 8067741] MAIL TO: Georgia Department of Transportation, CRASH REPORTING UNIT, 935 East Confederate Ave., Atlanta, GA 30316-2590