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Home My WebLink About24-4228 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 SASE 24-4228 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OZ STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ COLLISION'. 04 - 18 - 2024 1055 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ MAPLE VALLEY HWY BLOCK NO. e✓ 3000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 6❑ 50 00 FEET e MILES S B W e SE 5TH ST 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2063511370 0 7 30 6� LAST NAME COMBS FIRSTNAME ROBERT MIDDLE P 1 1 2 31 INITIAL STREET ❑ 11904 226TH AVE CT E CITy BONNEY LAKE ST WA ZIP' 983910000 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z YEs No�/ 8❑ LRIIVER # � ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE C11591K sTArI WAvIN# 1M2AX07COHM037033 10 F91 PI ATE# TRAILER 68758AA STATE WA TRAILER STATE 11 4 0 PLATE# PLATE# FROM ro TRLR TRLR 4 8 33 12 4 0 vIN#'4S9P2D357HS331171 VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 4 9 34 13 2 ZO17 MACK 700 DAMAGE YES YES : NO✓ REGISTERED OWNER INFO SILVER STREAK/NC 23700 SE 264TH ST MAPLE VALLEYWA 98038 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO ALASKA NAT INS CO 23G AT 12977 3 4 IN EFFECT &POLICY# 9TOP 15❑ vewCLE 5 36 LECALLv res❑NO❑ CITATION# CHARGE 10 BOTTOM STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2063107695 16 a LAST NAME BOND FIRST NAME RUTH MIDDLE I B INITIAL 17 STREET ❑', 22622 SE 237TH ST CITY' MAPLE VALLEY ST WA ZIP 980385082 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALt—T�RANSPORTED 38 INTERLOCK ES❑No� INTERLOCK YEs I I NoF YEs t l Noz 19[ DRIVER'S STATE WA SEX F D.C.B. 1 03 _ 06 _ 1950 39 LICENSE# MMDDYY El WELMET {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE BYS3724 TAre WA vIN1i 1FMCU9H97MUA20717 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2021 MAKE FORD MODEL ESCAPE STYLE 4H VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO RUTH BOND 22622 SE 237TH ST MAPLE VALLEY WA 98038 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE &POINSURGY#E CO FARMERS INS 187662425IN 1 9TOP VEHICLE CITATION# CHARGE i o BOTTOM LEGALLY YES NC[:] 25❑ s 7.FF1CJEO-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 HNSON 0505 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE69655 COLLISION REPORT III III III III III 111 1591972 CASE# 24-4228 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. CO.JOHNSON 04-18-24 02:39 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 4/19/2024 6:20:38 PM BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED; 11:03 AM TIME POLICE ARRIVED',11:14 AM PART I PAGE IT]OF REPORT NO. EE69655 CASE# 24-4228 OF COLLISION 04/18/24 10:55 OF CbLLI510N NARRATIVE U2 NB MVH lane #1 stopped for traffic; front of U1 into U2 On 04-19-2024 at about 1117 hours, I self dispatched to a Collision in the vicinity of the 3100 block of Maple Valley Highway in the City of Renton, County of King, Washington State. Patrol officers responded to a cellphone 911 hangup in the area and determined it was actually a collision. The vehicles moved off the roadway onto SE 5th St. I arrived in the area at about 1119 hours. When slowing to make a left onto SE 5th St, 1 observed an unknown maintenance vehicle with flashing amber lights blocking the #1 northbound lane of Maple Valley Highway. The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. The driver said she was wearing a seatbelt and not injured as a result of the collision. The driver said she was northbound on Maple Valley Highway in lane #1. Traffic ahead was stopped in lane #1 so she slowed her vehicle and came to a stop. She looked in her rear view mirror and saw Unit 01 closing distance behind her. She said Unit 01 hit her vehicle from behind. The driver of Unit 01 was identified by WA CDL and admitted to driving the listed vehicle. The driver said he was wearing a seatbelt and not injured as a result of the collision. The driver said he was northbound on Maple Valley Highway in lane #1 and behind Unit 02. Traffic ahead came to a stop. The driver of Unit 01 looked down, saw Unit 02 stopping and attempted to stop. Unit 01 impacted the rear of Unit 02. Unit 01 is a full sized dump truck pulling a dump trailer with a combined GVWR of 105,500 pounds. Unit 01 was empty at the time of the collision. There was minimal to no observable damage to the front bumper of Unit 01. There was significant damage to the rear hatch of Unit 02. The damage to the vehicles corresponded to the information provided by both drivers. The proximate cause of the collision was Unit 01 failing to come to a complete stop for other vehicles stopped on the roadway. Were it not for the actions of the driver of Unit 01, the collision would not have occurred. No citations or infractions issued. Report for information and insurance. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EE69655 r` COLLISIONOITRAFFPEA 1 27 T CASE# 24-4228 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT# 1 USDOT 1783532 ICC# VEHICLE TYPE 4 CARGO BODY 5 TYPE 2 ❑ 1 28 CARRIER NAME SILVER STREAK INC ....... 3 CARRIER ADDRESS 23700 SE 264TH ST CITY MAPLE VALLEY ST WA ZIP 98038 4 ❑ NAME # PLACARD: :❑ NAME IF NO NUMBER SOURCE 3 AXLES 05 GwvR 105500 + 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 AnnRFSP 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 vEHIC 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 EHILLE 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 ZIP CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs N. El 17 37 LICENSE# STATE SEX MMDDDYSYY 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. CO,JOHNSON 04-18-24 02:39 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED, PLACE SIGNED APPROVED BY DATE 26 OR ID# 0505 O#IL WA0171300 JOHNSON 411912024 PAGE F OF 3000-345-013(R 11118) REPORT NO. EE69655 CASE# ' 24-4228 DATE AND TIME 04/18/24 10:55 OF COLLISION 1 t PAGE 5 OF 5