HomeMy WebLinkAbout24-2290 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
SASE 24-2290 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OS STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 03 - 01 - 2024 1816 17 �.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 3900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
6❑ 150 00 FEET e S ❑ W e 131STAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2539851939 0 7 30
6 LAST NAME LEMUS MARTINEZ FIRST NAME JESUS MIDDLE 1 1 2 31
INITIAL
STREET El 609 117TH ST S CITY TACOMA ST I WA Zlp, 98444 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs Z/NO YES R NoF,/
LRIIVER # STATE WA SEXI M I EL MI MIT Y
8❑ ' 05 — 12 — 1992 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATFBit C12962R sTArr WA urN#' 1FTFW1ET16F648885
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 4 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 4 2011 FORD F150 PK DAMAGE YES No YES[:] No
No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO <53 4IN EFFECT &POLICY# rOPVEHICLE CHARGE 36
LEGALLY YES NO CITATION# 4AO047927 OP MOT VEH W/OUT INSURANCEorrom
15❑ STANDING 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4252433318
16 a
LAST NAME YEUNG FIRST NAME SABRINA MIDDLE K
INITIAL
17 NEW STREETR 7' 15212 SE 179TH ST CITY RENTON ST WA ZIP 98058 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 LDIIVEW # STATE WA ]SEX IF M .C... 11 21 1959 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLATE# AOR5895 TArE WA VIN1i JTMZK33V675015125 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2007 MAKE 7'Oy7' MODEL RA V4 STYLE P4 DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEbAREA
3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO ALLSTATE 976053117IN STOP
VE""LE CITATION# CHARGE
25 to BOTTOM
LEGALLY YES Nu
❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE56992
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2290
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
PM 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'
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 03-01-24 08:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 31712024 2:19:20 PM
BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED 6:17 PM TIME POLICE ARRIVED',6:25 PM
PART I PAGE IT]OF 5�
TIME
REPORT NO. EE56992 CASE# 24-2290 OF COLLISIONO3/01/24 18:16
NARRATIVE
24-2290 COLL
On 3/1/2024 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 three-vehicle collision in the 3900 block of Maple
Valley Highway Renton/King/WA. I arrived on scene and located all three involved vehicles, a white
2011 Ford F150 WA/C12962R was the last vehicle. I spoke with the driver who identified himself via
his WADL as Jesus Lemus Martinez DOB: 5/12/1992.
Jesus told me that he was driving east on Maple Valley Highway when he noticed the vehicle in front
of him had stopped. He said that he locked the brakes up and attempted to stop but was not able too
and collided with the vehicle in front of him. There was damage to the front the F150 and the rear of
the Rav4. Jesus was not injured and was able to driver away from the scene.
I then spoke with the driver of the Toyota Rav4 WA/AQR5895 who identified herself as Sabrina K
Yeung DOB: 11/21/1959 by her WADL. She advised that she was stopped for traffic when she was
struck from behind by the Ford F150 which caused her to collide with the vehicle in front of her. There
was damage to the front and rear of Sabrina's Rav4. She advised she was not injured and was able
to drive away from the scene.
I then spoke with the driver of the Buick Envision WA/BZZ2371, who was identified by his WADL as
Jason E Jazbinschenk DOB: 10/1/1983. Jason also advised that he was stopped for traffic when he
was struck from behind by the Rav4. There was damage to the rear bumper of the Buick. Jason said
that he possibly had whiplash from the collision but declined to be seen by RRFA. Jason was able to
drive away from the scene.
Based on accounts from the involved drivers and damage to the involved vehicles it appeared that
the Rav 4 and Buick were stopped for traffic and the F150 failed to stop and collided with the Rav 4.
When I asked Jesus for his insurance, he admitted he did not have any insurance on the vehicle at
all. When I ran Jesus through WADOL it showed that Jesus did not have a valid operator's license, it
showed him as Not Licensed -Eligible.
I completed a Sector citation for Operating a Motor Vehicle Without Valid Insurance RCW 46.30.020
and No Valid Operator's License with ID RCW 46.20.015 for Jesus and advised him that it would be
mailed to his address.
Jesus confirmed his address to me as 609 117th St S Tacoma WA 98444.
This citation should be mailed to Jesus.
Nothing further.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE556992
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-2290
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:4077385295
0 7 29
LAST NAME JAZBINSCHECK FIRST NAME JASON MIDDLE E
INITIAL
STREET 30
NEW AnnRFrtP 17526 149TH AVE SE UNIT J2 CITY RENTON ST WA ZIP 98058
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO zERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 10 TO]
- 1983
7
HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 COMPLAINT OF WHIPLASH
8 ❑ 1 32
LICENSE BZZ2371 [TAT WA VIN# LRBFZPR41MD125990
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 4 0 VEH.YEAR2021 MAKE BUIC MODELENVIS/ON STYLE P4 VEHICLE TOWE E T SABLIN TOWED BY f;nVT vFHIG F FROM TO
DAMAGE YES NO YES NO
OWNED BY DRIVER J 9 33
REGISTERED OWNER INFO
12 � SHADE IN DAMAGED AREA
7 j FROM TO
LIABILITY INSURANCE INSURANCE CO GEICO 4604-53.08.34 R"i"Olx
IN EFFECT &POLICY# 1
VEHICLE 34
13 4 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTOM
STANDING } 7
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME N DL
ME
AL
❑ 36
STREET
16Fl NEWAET [-% CITY ST ZIP
CDL IGNITION REdUiR rD IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY -� II
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE CLASS
19 ❑ LICENSE TAr 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 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 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LECALLv
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 03-01-24 08:18 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 12421 O#I',WA0171300 APPROVED
3n/2024 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EE56992 CASE# ' 24-2290 DATE AND TIME 03/01/24 18:16
OF COLLISION
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PAGE 5 OF 5