HomeMy WebLinkAbout24-6004 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 3 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STIR FIRE CASE
EET ❑
24-sooa z
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT ❑2$
i TRIBAL 1 02 STRUCK FENCE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 06 - 1-- 2024 1808 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
140TH WAY SE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e MAPLE VALLEYHWY
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4259317796 30
6❑ LAST NAME MARSH FIRSTNAME MARGARET MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 14023 171 ST AVE SE CITY RENTON ST WA ZIP 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 02 - 12 - 1969 32
INJURY -, [NATURE OF INJURIES
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U SE CLASS 7 I STATED BACK HURT z❑
3
10❑ P1 ATNES# BHR2465 sTAr WAv N# 2C3CD26T9FH702971
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom TO
TRLR. YRLR. 5 1 33
12❑ vIN#' UIN#
IC FL—E
FROM
34
VEH.YEAR 2OIS MAKE DODG MODEL CHALLE STYLE 2D VEHICLE TOWEDNOO pLSSBLIN TSIYY.Ep9vMEYER vOS❑ENO✓
13❑ DAMAGE LJI (�ciV6
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILIT INSURANCE❑ INSURANCE CO
IN EFFECT & LI POCY# 9TOP
❑ VEI"LL CHARGE 10BOTTOM 36
15 1 LEGA1LNG res No CITATION# 4g0223036,4A0223036, OP MOT VEH W/OUT INSURANCE,FL
UNIT U2 VEHICCMOTOLE ❑ CYCLE ❑ PEDESTRIAN OWNER YES
✓� DYES✓ NO THROLD MET PHONE
16❑
LAST NAME MAPLEWODO GOLF COURSE FIRST NAME MIDDLE
INITIAL
17❑ STREET ❑', 4050 MAPLE VALLEY HWY CITY RENTON ST WA ZIP 98058 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 LLIRIVERISTICENS # STATE SEX U MMDDYY -❑_ 39
WELMET INJURY NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE VIN# 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 1 9TOP 5
NODALOVIC
❑ C[:] CITATION# CHARGE i o BOTTOM
YES N
25 s e
'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
11628 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE84559
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6004
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CONRAD DAVID
(IAST FIRST,
ADDRESS&PHONE# D O.B.
2532617711 SEX U MMDDYYYY -❑
PASSENGER❑ � SOS. USE ICLASS
J WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMETCLAINJURY RYSS NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL) I MOODY ANTHONY
ADDRESS&PHONE# D O B
3606085464 SEX U MMDDYYIV
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
N.ODALOV/C 06-07-24 04:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 6/7/2024 9:00:45 PM
BADGE OR ID# 11628 ORI# WA0171300 TIME POLICE DISPATCHED 8:08 PM TIME POLICE ARRIVED',6:08 PM
PART I PAGE IT]OF 4�
REPORT NO. EE84559 CASE# 24-6004 OF COLLISION
06/06/24 18:08
OF CbLLI510N
NARRATIVE
U1 was traveling northbound on 140th Way SE with the intent of turning west onto Maple Valley Hwy
utilizing a left turn lane. Instead, U1 proceeded north through the intersection, on top of a dirt mound,
and collided into a pole into Maplewood Golf Course's property. The driver of U1, Margaret, stated
she does not remember the collision and the last memory she had was driving northbound on 140th
Way SE "coming down the hill".
Witnesses on scene stated Margaret was traveling at a high rate of speed and was in a left turn lane,
but then proceeded straight and crashed. Margaret initially did not complain of any injury, but then
later stated her back was sore from the collision. Margaret was evaluated by the Renton Fire
Authority (RFA) on scene. Margaret was not transported to a hospital. Margaret had an existing
broken right arm which was in a sling. Margaret's vehicle was severely damaged from the pole and
airbags were deployed. Margaret stated she had not eaten in a day in a half. Margaret agreed to
complete a few field sobriety tests which did not show impairment. Margaret later thought that maybe
her sling caused her to steer the vehicle from the left turn lane.
I did not observe brake marks on the roadway prior to final rest stop of U1.
U1 was towed by Gene Meyer Towing. Maplewood Golf Course employees were on scene and were
provided a case number. Ofc Rivera took photos of the scene which were later uploaded to
evidence.com.
Prior to Margaret's departure from the scene, I asked if she had insurance. Margaret stated she did
have insurance but did not have proof of insurance in U1 or on her cellphone. I provided Margaret
with my business card which had my email on it. I asked Margaret to email me proof of her insurance.
At the time of writing this report, Margaret did not email me her insurance information.
I also reviewed city cameras at the intersection. The footage shows U1 in lane 1 which is the west left
turn lane. U1 then veers from the lane, through the next two lanes, onto the sidewalk/curb, and then
straight to where U1 came to a rest. The footage is quite glitchy and I am unable to determine if
Margaret was traveling any faster than the other vehicles traveling on the roadway. The camera
footage was uploaded to evidence.com.
Margaret was cited under citation number 4AO223036 for:
RCW 46.30.020 operating a vehicle with no insurance
RCW 46.16A.030.5.0 failure to renew vehicle registration grater than two months
RCW 46.6.055 failure to obey a traffic control legend
During this incident I was equipped with body-worn camera which records both audio and video.
Portions of the incident were recorded. This report is merely a summary of the incident and is not
intended to be an exact transcription of the entire investigation or what may have been captured with
the recording system.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Weather: SUNNY
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EE84559 CASE# ' 24-6004 DATE AND TIME 06/06/24 18:08
OF COLLISION
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PAGE 4 OF 4