HomeMy WebLinkAbout23-8894 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-8894 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 1 ❑28
TRIBAL UNITS 02 STRUCK' TRAFFIC SIGNAL POLE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 08 - 1-- 2023 1118 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e LIND AVE SW
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:6787932473 30
6� LAST NAME ARYKU FIRSTNAME ALEKSANDR MIDDLE P 1 1 2 31
INITIAL
STREET ❑ 2057 RIDGE RD CITY DALLAS
NEW ADDRESS ST GA 2jp, 301576787 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM
USEET I IINLJA
URY 1 [!!RE OF INJURIES 2❑
3
10❑ P1 ATE 14 P 1164857 STATE I! VIN# 4V4X99KLOHN969302
TRAILER 794231ST STATE IL TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
12❑ rRLR. TRLR. 3 7 33
vIN#' 13NE53301C3554781 VIN#
2017 VOLV SEMI nIG FROM 34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO❑BLIN TOWED BY GOVT.VEHICLE
13 DAMAGE YES NO 1I YES[:] NO
REGISTERED OWNER INFO GCT 1111011 IR.G PARK RD STE 207 ROSELLE OD 1L 60172 D:7737069002 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCE CO ACORD SAME 3 4
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 5 36
LEGALLY res❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4254307400
16❑
LAST NAME RENTON FIRST NAME CITY OF MIDDLE
INITIAL
17❑ STREET ❑', 3555 NE 2ND ST CITY' RENTON ST WA ZIP 98056 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 LLIICENS # STATE SEX U MMDDYY —❑_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE LICENSE vIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES Nu
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
M.LEVERTON 2517 [V7�ENCY
A0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED86328
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8894
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HEWITT GRANT W
(/AST FIRST,
ADDRESS&PHONE# D O.B. '
3605928655 SEX M MMDDYYYY O6 - 09 - 1970
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ �', POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O 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.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.
M.LEVERTON 08-04-23 01:40 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 8/4/2023 5:50:04 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 11:19 AM TIME POLICE ARRIVED',11:28 AM
PART I PAGE 2�OF❑
REPORT NO. ED86328 CASE# 23-8894 OF COLLISION
08/04/23 11:18
OF CbLLI510N
NARRATIVE
hewitt, grant w 6-9-70 360-592-8655
lane 2 wb 16-11 pole 17.4ft
RTF
Information/Insurance only
Within the city limits of Renton/King/WA I responded to the intersection of SW Grady Way at Lind Ave
S for a semi truck vs light pole. When I arrived the electric traffic control device over lane 2
westbound was hanging by only wires. I had a police vehicle block this lane while waiting for Signals
to arrive.
I contacted the driver of the semi-truck trailer. He was hauling a large spool of rolled pipe. The spool
was standing on end and measured 16'11" at its highest point. This was the outer edges of the spool.
The inner portion of the spool was about 6 inches lower. Unit 1 driver told me he was communicating
by radio to he spotter/surveyor truck in front of him that gave him direction and the go ahead to pass
under this light fixture. After hitting the light he stopped a short distance later and waited for police.
I contacted Wit/hewitt, the driver of the spotter vehicle. He has a measuring post mounted on the
front of his vehicle. He stated the measuring post is set of 174". He measured the lane 2 signal and
directed the driver of unit 1 to proceed with the outer portions of the spool on either side of the light
fixture. Although Hewitt believed this would be sufficient clearance the light still touched, bending the
fixture and breaking off the mounting bracket. It also tore the insulation around the rolled piping.
There was no other damage to any other vehicle or injury to any person(s). Unit 1 and Hewitt
remained on scene to provide the required information ref the contact and damage. They also
provided me with 6-7 page oversize permit. A picture is attached with the permit number on the front
page and following each additional page.
The Signal shops arrived and took over traffic control so they could repair the damaged parts.
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 8/4/2023
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED86328
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-8894
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 1 USDOT 2292399 ICC# VEHICLE TYPE 4 CARGO BODY 1 4
TYPE
2 ❑ 1 28
CARRIER NAME CT EXPRESS
....... G
3 CARRIER
ADDRESS 701 E IRWING PARK RD STE 207
CITY ROSELLE OD ST IL ZIP 60172
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 2 AXLES 08 GI 80001 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36
STREET
16 NFln+AnntxFs.� CITY'. ST 21P
CDL IGNITION REDUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK 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 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
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 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
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.
X LEVERTON 08-04-23 01:40 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 2517 O#IL WA0171300 JOHNSON 8/4/2023 PAGE F41 OFF
3000-345-013(R 11118)
REPORT NO. ED86328 CASE# ' 23-8894 DATE AND TIME 08/04/23 11:18
OF COLLISION
Y
r
PAGE 5 OF 5