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Home My WebLink About23-1153 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED30171 170 27 COLLISION REP FIT 1591971 CASE 23-1153 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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.. 01 - 1-- 2023 0810 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 ❑ W e CEDAR RIVER PARK DR 2 0 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4253512717 0 7 30 6� LAST NAME HUGHES FIRSTNAME THOMAS MIDDLE R 1 2 31 INITIAL STREET ❑ 4718 S 315TH PL CITY AUBURN ST WA ZIP 980013725 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� B97753C sTArI WAVIN# 1D7HW48N15S164058 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FROM ro 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 J 9 34 13 2 ZOOS DODG DAKOTA DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO THOMAS HUGHES 4118 S 315TH PL AUBURN WA 980013725 D:4253512717 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO FARMERS 188119126 3 4 IN EFFECT &POLICY# 9TOP VEHICLe 15❑ EC 5 36 LALLv YES❑NO❑ CITATION# CHARGE 1 o BOTTOM STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ 16 a OWNER ❑ YES 1/ NO D:2068928768 LAST NAME SCHEIE FIRST NAME ERIC MIDDLE A INITIAL 17❑ STREET ❑', 11015 SE 294TH ST CITY'AUBURN ST WA ZIP 980921904 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑ 19[—] DRIVER'S STATE WA SEX M D.C.B. 10 _ 03 _ 1976 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE AXL7454 TAre I WA VIN# JMIGJ1V64F1175191 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2015 MAKE MAZp MODEL 6 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO ERIC SCHEIE 11015 SE 294TH ST AUBURN WA 980921904 D:2068928768 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE &POINSURGY#E CO STFARM 1908212 E2047AIN STOP 5 VE""LE CITATION# CHARGE 25 to BOTTOM LEGALLY YES Nu ❑ 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. ED30171 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1153 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 POS. 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. M.LEVERTON 01-27-23 09:25 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 113112023 5:11:56 PM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED! 8:11 AM TIME POLICE ARRIVED',8:15 AM PART I PAGE IT]OF REPORT NO. ED30171 CASE# 23-1153 OF COLLISION 01/27/23 08:10 OF CbLLI510N NARRATIVE gry truck 1 blk sedan 2 wht sedn 3 unit 1 lane change 2/3 stopped RTF Within the city limits of Renton/King/Wa I responded to a 3 car blocking crash near the intersection of Maple valley Hwy at Cedar River park Dr. All the vehicles were able to move off the roadway into the old Sharai's parking lot. I contacted the driver of unit 3 who told me she was stopped in traffic when she was hit from behind by unit 2 who was hit by unit 1. She did complain of a sore neck but did not want Renton Fire to check her. Damages did not require a tow truck. I contacted the driver of unit 2 who told me he was stopped in traffic when unit 1 hit him from behind and pushed him into unit 3. He did not complain of injury and damages did require a tow truck. I contacted the driver of unit 1 who told me he was changing lanes and was watching in his mirror traffic on his side, but didnt notice traffic in front of him was stopped. He contacted unit 2 pushing him into unit 3. He did not complain of injury and damages did not require a tow truck. Information/insurance only. 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 1/27/2023 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED301 71 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-1153 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 t_"J CYCLE _) PEDESTRIAN � OWNER � YES� NO D:4146592748 OF 7 29 LAST NAME SMITH FIRST NAME BRITTANY MIDDLE'.. A INr:j ITIAL STREET 30 NEW AnDRFSP' 11624 SE 238TH ST UNIT 9 CITY KENT ST I WA Z1P 980313776 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES�NO� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 01 - 18 - 1991 7 HELMET I INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG( 2 RESTR. 4 EJECT '1 USE CLASS 7 NECK REFUSED ONSCENE TREATMENT 8 ❑ 1 32 LICENSE BYR1009 TAr Wq VIN# WAUJ8GFF2H1023851 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2017 MAKE AUDI I MODELA3 STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOBRITTANY SMITH 11624 SE 238TH ST UNIT 9 KENT WA 980313776 D:4146592748 J 9 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO ALLSTATE 807471606 gTOp IN EFFECT &POLICY# 1 VEHICLE 34 13 2 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTUM STANDING } 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 36 15 LAST NAME FIRST NAME INITIALAL MDDLE ❑ STR 16 STREETEETAnnR"[-] CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YES NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT 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 3 a 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv 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. M.LEVERTON 01-27-23 09:25 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 2517 O#ILWA0171300 JOHNSON 1131/2023 PAGE 4 OFF 3000-345-013 IR 11t18) REPORT NO. ED30171 CASE# ' 23-1153 DATE AND TIME 01/27/23 08:10 OF COLLISION Cedar River Park Dr nts ON PAGE 5 OF 5