HomeMy WebLinkAbout23-14878 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-14878 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE OTHER ❑ HIT F ❑ LOCAL AOENC 4'100 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.. 12 - 1-- 2023 1953 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
140TH WAY SE BLOCK NO. e✓ 15200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e MAPLE VALLEYHIGHWAY
0 8 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YEs �/No D:2069564542 0 4 30
6� LAST NAME SAMADI FIRSTNAME ELYAR MIDDLE 1 2 31
INITIAL
STREET ❑, 16553 162ND PL SE CITY RENTON ST WA ZIP 98058 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]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❑ PI ATE BWX2620 sTATr WAurN# 5YJSA1E27GF143352
11[-� TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# ROM ro
TRLR. TRLR 7 5 33
12 4 0 VIN#' VIN#'
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 $ 34
13 3 2016 TESL MODEL P4 DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 987-916.056 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 3AO856868 FAIL TO REDUCE SPEED FOR <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ Y
CYCLE ❑ ❑ OWNER ❑ ES 1/ No D:2065512474
16 a
LAST NAME JANSKOVITCH FIRST NAME TRACY MIDDLE IL
INITIAL
17 STREET NEW ADOREs�' 2305 1ST AVE,APT B5 CITY SEATTLE ST WA ZIP 98121 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER'S STATE WA SEX F D.O.B. 09 _ 29 _ 1960 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS KNEE PAIN
❑21❑ PLATE# CBE1593 TATE WA VIN# 41
W04GRSECX61088194 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2011 MAKE BUIC MODEL REGAL STYLE P4 DAMAGE TOWED✓ NOO BLIN BANKERS TOWING YES No
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DA GEbAREA
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
Le
L..LLY YES❑ NC[:]J� CITATION# CHARGE to BOTTOM
LEGA6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE38048
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14878
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WEATHERLY LILLIAN F
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
14603 SE 198TH ST RENTON WA 98058 2064064759 SEXi F MMDOYyvv 12 - 08 - 2006
PASSENGER WITNESS❑'UNIT# 3 SEA 'I 3 AIRBAG 2 RESTR. q EJECT ? HELMET INJURY NATURE OF INJURIES
USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) GREEN MICHAEL
ADDRESS&PHONE# DOB -
1055 S GRADY WAY RENTON WA 98057 2062761505 SEX: M MMDDvvvv
PASSENGER ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS R 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.
D.NELSON 12-27-23 10:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 11712024 4:35:16 PM
BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED 7:56 PM TIME POLICE ARRIVED',8:05 PM
PART I PAGE IT]OF 5�
REPORT NO. EE38048 CASE# 23-14878 OF COLLISION
12/27/23 19:53
OF CbLLI510N
NARRATIVE
On 12/27/2023 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a multiple vehicle collision in the intersection of Maple
Valley Highway and 140th Way SE Renton/King/WA. Numerous callers were reporting a 3-4 vehicle
collision with unknown injury.
I arrived on scene and located all involved parties. I spoke with Elyar Samadi (DOB: 3/21/1983) who
was the driver of a white 2016 Tesla Model S (WA/BWX2620). Elyar said that he was turning south
on 140th Way SE from eastbound Maple Valley Highway when a driver turning south from westbound
Maple Valley Highway struck him causing the collision.
Elyar has a curb that separates his designated turn lane onto 140th Way SE from Maple Valley
Highway.
I then spoke with the driver of a tan 2011 Buick Regal (WA/CBE1593), driven by Tracey L
Janskovitch (DOB: 9/29/1960). Tracey said that she was turning south onto 140th Way SE from
Maple Valley Highway when she was struck by another vehicle. Tracey was not sure what happened.
The airbags had gone off in Tracey's vehicle and she had a complaint of knee pain. She was
evaluated by RRFA personnel and cleared at the scene. The Buick was towed by Bankers Towing.
I then spoke with the driver of the green 1996 Toyota Corolla (WA/CER2104), driven by Ryan M
Lloyd (DOB: 11/7/2006). Ryan said that he was stopped at the light preparing to turn west on Maple
Valley Highway from 140th Way SE when he was struck by the Buick after it had been struck by the
Tesla. Ryan had complaint of head pain and was evaluated by RRFA and cleared at the scene. The
Toyota had damage down the entire driver side. The Toyota was removed from the scene by Bankers
Towing.
I spoke with uninvolved witness Michael Green who advised he was driving in front of Elyar on Maple
Valley Highway and saw Elyar approaching the intersection at a high rate of speed. He said that he
watched as Elyar drove his Tesla into the turn, lost control and went over the curb, striking the Buick
who was in her proper lane making a left-hand turn.
I also spoke with involved party, Ryan M Llyod, who said that he believed Elyar was driving at a
speed too fast to make to turn which caused the collision.
There was damage to the front bumper and left front quarter panel of the Tesla.
Based on the damage to the Tesla and witness accounts I believe Elyar was operating his vehicle too
fast for the conditions of the road which resulted in a multiple vehicle collision.
I completed Sector citation 3AO856868 for RCW 46.61.400.3 Failure to Reduce Speeds for
Conditions. This citation should be mailed to Elyar.
Nothing further.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE38048
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-14878
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 DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YEs NO
D:2067476323
rFO 8 29
LAST NAME LLOYD FIRST NAME RYAN MIDDLE
INITIAL
STREET 30
NFW AnDRFSP' 16235 SE 175TH PL CITY RENTON ST WA ZIP 98058
6 [2 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO NTERLOCK YEs❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 11 TOE]- 2006
7
HELMET INJURY NATURE INJURIES
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 COMPLAINT
NT OF HEAD PAIN
8 ❑ 1 32
LICENSE CER2104 TAT WA VIN 1NXBB02E2TZ442394
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 4 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLI anvi vEH1I'P FROM TO
1996 TOYT COROLL P4 T�NETOWINC�
DAMAGE YES�NO YES NO
REGISTERED OWNER INFOKATHERINE LLOYD 16235 SE 175TH PL RENTONWA 98058 D:2067476323 SHADE IN DAMAGED AREA 9 9 33
12 z 3 4
FROM TO
LIABILITY INSURANCE INSURANCE CO GARRISON PROPERTYAND INSURANCE 01604.32.56R71013 gl"OI'
IN EFFECT &POLICY# )
VEHICLE m 34
13 LEG LEY YES NO 01 CITATION# CHARGE _7 TT�}-_
STANDING
❑ VdIROE PROPERTY NHREOLD METPHONE
35
14 U A PDESTRIAN � W YESGO
r E
15 LAST NAME FIRST NAME INITIAL
MIDDLE ❑ 36
STRE
16 ET NFW ETnnR".9 CITY ST ZIP
CDL IGNITION REdUiREO IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES NO NTERLOCK YES NO YES NO ❑
17 4 37
LICENSE# STATE SEX MMDDD_Y -� II
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE CLASS
19 ❑ LICENSE TAT VIN# 39
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ ❑ 41
TRLR TRLR
ViN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED 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.
D.NELSON 12-27-23 10:19 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
BADGE O#I' AP 126 ORID# 12421 WA0171300 SUMMERS n/2 PAGE F41 OF F
3000-345-013 fR 11118)
REPORT NO. EE38048 CASE# ' 23-14878 DATE AND TIME 12/27/23 19:53
OF COLLISION
MAPLE VALLEY HIGHWAY
�. Vehicle 2(Burk)
Vehicle 1(Testa) Final Slapping Point
Vehicle 3(Toyota).
14011-1 WAY SL'=..
PAGE 5 OF 5