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HomeMy WebLinkAbout22-13480 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 22-13480 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 4 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# COLLISION'. 12 - 1-- 2022 1126 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ MAPLE VALLEY HWY BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e 154TH PL SE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4253065943 1 01 30 6� LAST NAME BECKHAM FIRSTNAME JIAYI MIDDLE J 1 2 31 INITIAL STREET ❑ 26318 203RD PL SE CITY COVINGTON ST WA ZIP, 980425062 z 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� 8M24918 sTArI CA urN# 1 GCCS33E188222091 TRAILER STATE TRAILER STATE 11 5 0 PLATE# PLATE# ROM ro TRLR. TRLR. 5 1 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 1 3 34 13 2 2008 CHEV IMPALA DAMAGE YES NO �MEYER YES : NO✓ REGISTERED OWNER INFO ENTERPRISELESING 11100 BEECHAVE FONTANA CA 90749 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ❑ INSURANCE CO 3 4 LIABILITY INSURANCE IN EFFECT &POLICV# 9TOP VE— CHARGE 10BOTTOM 5 36 LEGALLY YEs❑NO CITATION# 2A0276937,2A0276937 SPEED TOO FAST FOR CONDITIONS, 15❑ STANDING 7 6 UNIT 02 VEHICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERRTY ❑ DYES NO OLD MET PHONE 16 a LAST NAME HELLAND FIRST NAME JEFFREY MIDDLE A INITIAL 17❑ STREET ❑', 21110 SE 200TH ST CITY' RENTON ST WA ZIP 980580237 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 LDI IVER # STATE WA SEX M M .C... 11 � 1959 22 _ El 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I C51715Y TAre WA vIN# 4F4YR12D56PM03025 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2006 MAKE MAZp MODEL B2300 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO UNKNOWN YES NO REGISTERED OWNER INFO JEFFREY HELLAND 21110 SE 200TH ST RENTON WA 980580237 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU PORGY#E CO GEIC04114-80-28-14IN 9TOP 5 VE""LE ❑ N,J� CITATION# CHARGE LEG i o BOTTOM ALLY YES 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED19080 COLLISION REPORT III III III III III 111 1591972 CASE# 22-13480 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MILLER LOGAN (LAST FIRST, ADDRESS&PHONE# 2533896138 SEX i U MMDOYyry 05 - 26 - 1984 --------------------------- PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ POS. USE CLASS NAME '(LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 12-20-22 12:45 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 1212712022 12:58:52 PM BADGE OR ID# Y517 ORI# WA0171300 TIME POLICE DISPATCHED 49:27 AM TIME POLICE ARRIVED 11:36 AM PART I PAGE 2�OF❑ REPORT NO. ED19080 CASE# 22-13480 OF COLLISION 12/20/22 11:26 OF CbLLI510N NARRATIVE gray/unit 1 mvh slides thru red hit wht/unit 2 pu and then hits unit 3 slv suv while attempting left from 154th CC Within the city limits of Renton/King/WA I responded to a 3 car blocking crash at the intersection of Maple Valley Hwy at 154th PI SE. I contacted the driver of unit 3 who told me he was making a left turn from 154th to MVH when he saw unit 1 sliding through her red light and crash into the truck in front of him. After unit 1 hit unit 2 he said unit one then hit him. He did not complain of injury but damages required a tow truck. I contacted the driver of unit 2 who told me he was proceeding on his green light to turn left from 154th onto MVH when unit 1 going too fast for the snow/slush conditions slid through the her red light and crashed into the side of his truck. He did not complain of injury and damages required a tow truck. He refused a rtto tow and used his own. I contacted the driver of unit 1 ID'd by her picture WADL. She told me she was trying to stop but her tires just kept rollings. I asked if she meant skidding/sliding and she didnt answer. She said her light was red and she could not stop and did not provide additional information. She did not provide any form of insurance for her rental car. I cited unit 1 via complaint ref RCW 45.61.400 Speeds too fast for conditions and ref RCW 46.30.020 No Insurance. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 12/20/2022 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED19080 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 22-13480 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YEs� NO D:4253069065 0 29 LAST NAME : WONG FIRST NAME TI MIDDLE 1 INITIAL STREET 30 NEW AnDRFSP' 4916 SE 2ND PL CITY RENTON ST WA ZIP 98059 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No zERLOCK YES[:]NO[:] YEs N DRIVER'S LICENSE STATE I WA SEX U MMDDYYv 04 - 04 - 1960 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BVS1018 [TAT WA VIN# 2T3RWRFVXLW098273 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2020 MAKE TOYT I MODELRAV4 STYLE VEHICLE TOWE ET SABLI W,6'•ER GnVT VFI.1C F FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO.TI VUONG 4916 SE 2ND PL RENTON WA 98059 1 3 33 12 SHADE IN DAMAGED AREA 7 j FROM TO INSURANCE CO LIABILITY INSURANCE SAME. 1i"01 m 34 IN EFFECT &POLICY# 13 ❑ VEHICLE ❑ ❑ CITATION# CHARGE 0 BOTTOM VEHICLEGALLY YES NO STANDING S} 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE ❑ 36 ET 16 STRETRENEW "F ' CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR.I EJECT I HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr vIN# PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. X LEVERTON 12-20-22 12:45 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED 226 � BADGE O#I'WA0171300 N 12 PAGE OF 3000-345-013(R 11118) REPORT NO.! ED19080 CASE# ' 22-13480 DATE AND TIME 12/20/22 11:26 OF COLLISION lstevent nts 2nd event nts Poo k G PAGE 5 OF 5