HomeMy WebLinkAbout22-13842 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED19972 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 22-13842 z 0 3
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4100 3 6 4
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 2145 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 180TH ST BLOCK NO. e --- ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a NORTH 1-167
2 0 29
UNIT MOTOR
VEHICL PI PEDAL-
CYCLE ElDDAMYESA✓THRESHOLD PHONE 1 11
30
6 LAST NAME VAN ZANDT FIRST NAME ZACHARY MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 50O S 27TH P! TON WA
NEW ADDRESS ST zIP', 98055 2
CITY REN
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 6 RESTR 2 EJECT 1 HELMETU E 2 CLASS 7 [NATURE OF INJURIES
HEAD/BUSTED LIP z❑
3
10[1 P1 ATE 14 CWU1877 sTAr WAu N#' JTHBK262772031976
TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#.
ROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34
13 4 2007 LEXS IS-F SD DAMAGE YES NO �MEYERS YES❑ NO✓
REGISTERED OWNER INFO ZACHARY.1 ZANDT 500 S 27TH PL RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO <1 V34
IN EFFECTI SUR N#❑ LEGA LE CHARGE 36
15 2 VE- YEs No clTAnoN# 2A0677263 RECKLESS DRIVING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066615720
LAST NAME WEBSTER FIRST NAME COLLEEN MIDDLE K
INITIAL
17 STREET NEW ADOREs7 2091 GEMSTONE DR CITY RENTON ST WA ZIP 99392 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19[—] LICENSE# STATE WA SEX F M D.C.B. 12 _ 16 _ 1950 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY E NATURE OF INJURIES ❑ 40
LICENSE ❑21❑ PLA E# CBX6417 TArE WA VIN 41
SFNYF6H24N6028290 1
42
22❑ PLATILER E# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
TOWED BY Gov HI 44
VEH YEAR 2022 MAKE HOND MODEL PILOT EX STYLE $D DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO STATE FARM 1838888CO3-47WIN 1 9TOP
VLEGA— ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`[J
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MICAH BATTLE 12049 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED19972
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13842
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SMITH MARGARET
(LAST FIRST,
ADDRESS&PHONE#
523 S 31ST ST RENTON WA 98055 2063005050 SEXi F MMDOYyry 03 - 13 - 1955
PASSENGER WITNESS # SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
UNIT
❑ ❑ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) HOLMES XYLEN
ADDRESS&PHONE# DOB
526 1 ST AVE S RENTON WA 98059 4254955295 SEX: F MMooYYYv 10 - 16 - 1995
PASSENGER UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) BROTHERS KAITLYN
AooREss PHONE# 19244 136TH PL RENTON WA 98058 4252418090 SEX F D.O•B. 01 _ 12 _ 2005
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
MICAH BATTLE 12-29-22 03:52 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 12/29/2022 4:03:53 PM
BADGE OR ID# 12049 ORI# WA0171300 TIME POLICE DISPATCHED 9:49 PSI TIME POLICE ARRIVED',9:58 PM
PART I PAGE IT]OF❑
REPORT NO. ED19972 CASE# 22-13842 OF COLLISION
12/28/22 21:45
OF CbLLI510N
NARRATIVE
22-13842
On 12/28/22 at 2149 hours, I was dispatched to an injury accident at S 180th St and SR167 N, within
the City of Renton, County of King, Washington.
Dispatch advised several vehicle were involved and one vehicle was believed to be racing prior to the
accident.
Unit 1 was identified as Zachary D. Van-Zandt (3/15/92) who was driving WA-CWU1877.
Unit 2 was identified as Colleen K. Webster (12/16/50) who was driving WA-CBX8417.
Unit 3 was identified as Paul H. Brown (4/22/53) who was driving WA-CCX5071.
Also involved were witnesses, Margaret Smith (3/13/55), Xylen Holmes (10/16/95), and Kaitlyn
Brothers (1/12/05)
All witnesses stated in verbal and written statements that U1 was driving at least 100MPH and
swerving through traffic eastbound on S 180th ST.
Unit 1 stated he was stopped in traffic at the light S 180th ST and SR167 N when the light turned
green he started driving eastbound when suddenly U3 came to an abrupt stop causing him to be rear
ended by U 1.
Unit 2 stated she was at the intersection of S 180th ST and SR167 N when she was struck from the
rear by U2.
I observed extreme damage to the front end of U1 causing the engine compartment to be completely
caved in. U3 had extensive damage to its rear end and minor damage to the front end. U2 had minor
rear damage.
Unit 3 was heavily concussed and was transported to the hospital, he showed no other obvious
injuries. U3 signed a medical release form. Unit 1 was also heavily concussed and was also bleeding
from the lip, he was transported to Valley Medical Center.
U1 and U3 were towed.
I established probable cause to charge Zachary D. Van-Zandt (3/15/92) with reckless driving (RCW
46.61.500) by driving with willful or wanton disregard for the safety of others. (Cite# 2A0677263)
U1 has extensive recent priors for reckless driving, negligent driving, and excessive speeding. He
also has an active arrest warrant for reckless driving (XZC000424).
U1 was cited and released to the hospital.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically Signed, M. Battle 12049, 12/29/22, 0249
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED19972
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 22-13842
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YEs� NO
1 1 29
LAST NAME BROWN FIRST NAME PAUL MIDDLE'.. H
INITIAL
STREET 30
NFW AnDRFSP' 12625 SE 201ST PL CITY KENT ST WA ZIP 98031
6 ❑ 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO NTERLOCK YEs❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 04 - 22 - 1953
7
HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG'' 6 RESTR. 4 EJECT 1 USE 2 CLASS 7 HEAD INJURY
8 ❑ 1 32
LICENSE CCX5071 TAT WA VIN# WBAJA9C57JB250559
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2018 MAKE MERZ MODEL530E STYLE SO VEHICLE TOWS E T SABLI T�'W_-''ERS Gf1VT VFHIG P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFOPAUL BROWN 12625 SE 201ST PL KENT WA 98031 ] $ 33
12 � SHADE IN DAMAGED AREA
2 3 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 91C7I'
VEHICLE 7080TTfJM m 34
CITATION# CHARGE
13 LEG LEY YES NO
STANDING❑ dRO PROPERTY Y
❑ 35GNHROE
VEHICLE CYCLE OWNER O14 UNIT� D
j PHONE
15 LAST NAME FIRST NAME N!I IAL
MIDDLE ❑ 36
STREET"[—]
16 NFW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK 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 AREA 43
3 4 71
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.
MICAH BATTLE 12-29-22 03:52 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 12049 O#II,WA0171300 APTHIELMAN 12129/202 PAGE I OF F
3000-345-013(R 11118)
REPORT NO.! ED19972 CASE# 22-13842 DATE AND TIME 12/28/22 21:45
OF COLLISION
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U1
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U) vi-W
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PAGE 5 OF 5