HomeMy WebLinkAbout22-13284 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 22-13284 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING'
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 12 - 1-- 2022 1927 17 ❑.❑ S 8 W IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 1700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
6❑ 200 00 FEET e S ❑ W e I405 1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2064659622 0 11
30
6� LAST NAME LLOYD FIRSTNAME RYAN MIDDLE M 1 2 31
INITIAL
STREET ❑ 16235 SE 175TH PL CITY RENTON ST WA 21p 980589101 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATFBit BKF0276 sTArI WA urN#' 1HGCR2F8XFA011927
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 3 2015 HOND ACCOR DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO KATHERINE LLOYD 16235 SE 175TH PL RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE Z INSURANCE E CO WASHINGTON INSURANCE 0160432581271013 4
LI EFFECTISUR N# TOPVEHICLE CHARGE 36
LECALLv YES❑NO CITATION# 2A0720242 INATTENTION <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- :.PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069486476
16 a
LAST NAME SMITH FIRST NAME ELIJAH MIDDLE I E
INITIAL
17 NEW STREETRE55❑' 15822 SE FAIRWOOD BLVD CITY RENTON ST WA ZIP 980588632 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19[—] DRIVER'S STATE I WA SEX M D.C.B. 10 _ 01 1997 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BJL7822 TArE WA VIN# 41
2HGF62F77FH530900 1
42
22❑ PLATE# STATE PLATE ILER# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ELIJAH SMITH 15822 SE FAIRWOOD BLVD RENTON WA 98058 D:2069486476 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU8 PORGY#E CO LIBERTY MUTUAL AOS-268-512094-4090 IGQ
5
IN EFFECT
VE—LE ❑ ,J� CITATION# CHARGE
25
LEGALLY YES N`L J
s � a
7S/;S
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12225 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED19643
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13284
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
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.
E.SIMS 12-15-22 08:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 12/28/2022 6:56:00 PM
BADGE OR ID# ( 12225 ORI#' WA0171300 TIME POLICE DISPATCHED' 7:27 PM TIME POLICE ARRIVED',7:Y7 pryI
PART I PAGE IT]OF 4�
REPORT NO. ED19643 CASE# 22-13284 OF COLLISION
12/15/22 19:27
OF CbLLI510N
NARRATIVE
RPD CASE#: 22-13284
On 12/15/2022 at approximately 1927 hours, I was stopped in the westbound number 3 lane of traffic
in my marked patrol car, in the 1700 block of Maple Valley Highway, in the City of Renton, King
County, Washington. I had my rear emergency lights activated and was blocking traffic for a blocking
disabled vehicle that was stopped in the number 3 lane and in the process of being towed (RPD
incident#RP220069108).
I was sitting in my vehicle watching westbound traffic in my driver side mirror to ensure no vehicles hit
the driver of the tow truck as he was towing the vehicle. 1 observed unit 1 driving westbound in the
number 3 lane at a high rate of speed approaching my patrol car. I observed unit 2 traveling
westbound in the number two lane approaching my location.
As unit 1 approached the rear of my patrol car he slowed down and swerved into the number 2 lane
hitting unit 2. Both vehicles pulled over in front of the tow truck and I contacted both drivers who
stated they were not injured.
I identified unit 1 as a Black 2015 Honda Accord, bearing WA license #BKF0276. Unit 1 sustained
heavy damage to the front of the vehicle. I identified the driver of unit 1 via his WADL as Ryan
Matthew Lloyd (DOB 11/07/2006).
1 identified unit 2 as a Black 2015 Honda Civic, bearing WA license plate #BJL7822. Unit 2 sustained
minor damage to the rear passenger side of the vehicle. I identified the driver of unit 2 via his WADL
as Elijah Edward Smith (DOB 10/01/1997).
Lloyd is the at fault driver and he was advised he would receive a citation in the mail for Inattention.
Both drivers were given my business card with the case number on it. Unit 2 left the area and due to
the damage to unit 1 it was towed from the location.
Once the vehicle was towed from the location, 1 cleared the scene.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by E. Sims on 12/15/2022 at 2038 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO.! ED19643 CASE# ' 22-13284 DATE AND TIME 12/15/22 19:27
OF COLLISION
Patrai oar watt emergsuoy Igats acirvaled:
fJE9alate[t vetircke..
Tow truck;
Usti&t
Not to scale — _®
1700 block Maple Valley Highway
PAGE 4 OF 4