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Home My WebLink About23-11532 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-11532 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 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: 10 - 08 - 2023 1327 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 15600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:4255911277 0 81 30 6� LAST NAME LANDES FIRSTNAME ZACHARY MIDDLE A 1 2 31 INITIAL STREET ❑ 1515 207TH PL NE CITY SAMMAMISH ST WA ZIP 98074 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� D13740D sTAT� WAVIN# 1GCDT14W7YK114350 IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM ro TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TQ yv�D,g y GOVT.VEHICLE J 9 34 13 2 2000 CHEV S110 PK DAMAGE vEs 0NO ffXg(S vEs❑ No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO GEICO 4436422986 4 IN EFFECT &POLICY# TOPVEHCLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:4253503001 16 a LAST NAME SOBOWALE FIRST NAME ADEDOYIN MIDDLE JA INITIAL 17❑ STREET ❑', 7533 137TH AVE SE CITY NEWCASTLE ST WA ZIP 98059 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YEs❑NOR INTERLOCK vEs❑NOF YES ❑NOF 19 DRIVER'S STATE CA SEX M I D.C.B. 01 28 _ 1979 39 LICENSE# MMDDYY HELMET {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE 7AZN238 TATe CA vlN;t JTJBM7FX6D5061448 ❑ 41 PLATE# ❑ 42 22❑ TRAILER 3O57YW STATE WA TRAILER STATE PLATE# PLATE# 23❑ 43 TRLR RLR VIN#. IN#. TOWED By Gov HI 44 VEH YEAR 2013 MAKE LEX$ MODEL GX460 STYLE UT —FEHICLE TOWED✓ NOO BLIN BANKERS YES No�/ 24❑ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2 SHADE IN DA GEbAREA z Cdd LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 936023376IN I STOP 5 VE""LE CITATION# CHARGE G BOTTOM LEGALLY YES Nu 25❑ s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JOSEPH SINGER 12056 JWA 0171300 PART A PAGE 01 OF 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE07091 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11532 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' Vehicle 1, being driven by Zachary Landes, crashed into the boat and boat trailer, being hauled by vehicle 2. Vehicle 2 was legally stopped and waiting at a red light. Vehicle 1 advised he had been looking over the vehicle 2 and not noticed they stopped. Vehicle 1 received major damage to the front of the vehicle and was towed by Clarke's towing. Vehicle 2 received damage to the passenger-side. The boat and boat trailer received damage and was towed by Bankers. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JOSEPH SINGER 10-08-23 03:03 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT DESIRES SCOTT 10272 101812023 5:19:11 PM BADGE OR ID# 12056 OR]# WA0171300 TIME POLICE DISPATCHED, 1:28 PM TIME POLICE ARRIVED 1:46 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EE07091 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-11532 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 DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YEs� IN 1 4 29 LAST NAME : UNKNOWN FIRST NAME MIDDLE INITIAL STREET 30 NEW AnDR FS CITY NEWCASTLE ST ZIP 6 CDL IGNITION REQUIREb IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No IGNITION YES E]NaE YEs N DRIVER'S STATE I SEX U M��DVSYv' -� 2 LICENSE 7 ON DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES F� USE CLASS 8 ❑ 1 32 LICENSE WN6011NU TAr WA VIN# PNYUSYEAB606 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLI anvi vEH1C P FROM TO 2006 OTH STINGRA BT THE DAMAGE YES�NO YES NO REGISTERED OWNER INFOELLEN REH 510 MOUNT DEFIANCE CIR SW ISSAQUAHWA 98027 D:4257616524 m 33 12 � SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# t 9 1"01? VEHICLE 1 o BarroM 34 13 LFcnuv YES NO01 CITATION# CHARGE STANDING S} 8 7 14 ❑ UNIT Tr Vd 1QRE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36 STREET 16 NEW AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiREE7 IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑ 17 5 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 ❑ [441 TRLR TRLR 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 INEO_ SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l 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. JOSEPH SINGER 10-08-23 03:03 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 12056 O#I',WA0171300 SCOTT 10/8/2023 PAGE F OF 4 3000-345-013 fR 111181 REPORT NO. EE07091 CASE# ' 23-11532 DATE AND TIME 10/08/23 13:27 OF COLLISION IIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 156th ave se 3 oat and trailer Z z m c: Not to-SCALE PAGE 4 OF 4