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Home My WebLink About25-632 STATE OF I !�� I III I III I IIII III II I . 0 27c REPORT NO EF57614 COLLISION REP FIT 1591971 ❑ ❑ RESULTED ❑ CASE zs-s32 2 INTERSTATE CITY STREET FIRE 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cowsloN 01 - 19 - 2025 1929 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 2439 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4254269384 1 6 30 6❑ LAST NAME RAMIREZJUAREZ FIRSTNAME BRANDON MIDDLE 1 2 31 INITIAL STREET 01 24020 96TH AVE S CITY KENT ST WA Zjp, 98030 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MM D Y 11 1— 03 — 2004 2 32 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10 pl ATE 14 CMT9589 sTAr WA V N# 3N16C1CP1Al360576 TRAILER STATE TRAILER STATE 11 5 0 PLATE# PLATE# IR.. ro TRLR. TRLR 5 7 33 12 5 0 VIN#' VIN#i FROM TO VEH.YEAR 2010 MAKE NISS MODEL VERSA STYLE 4C VEHICLE TOWEDNOO pLSSBLIN TSIYY.Ep9vMEYERS VEHICLE 7 3 34 13❑ DAMAGE LJI (�ciV6 REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 912P VEHICLE CHARGE 5 36 LEGALLY Yes❑NO❑ CITATION# 10 BOTTOM 15❑ NDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4252089122 16 a LAST NAME ESQUIVEL SOTO FIRST NAME GAEL MIDDLE / INITIAL 17 NEW STREETR 7' 11902 SE 170TH PL CITY RENTON ST WA ZIP 98508 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YEs❑NOF,/ 19 DRIVERS STATEWSEXM _ _ 39 # MMo D.C.B. 20 ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 H EET 2 NJAU SY 6 COMPLAINT OF PAIN TO KNEE,LEG,AND SIDE ❑F—NATUREOF INJURIES 40 LICENSE I ❑21❑ PLA E# CAZ8761 TArE 41 WA vIN# JTHBD182810010381 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2001 MAKE LEXS MODEL VMO STYLE 46 I VEHICLE TOWED TO BLIN TOWEDII GOV HI 44 24 DAMAGE YES NO GENE MEYERS YES NO REGISTERED OWNER INFO GAEL ESQUIVEL SOTO 11902 SE 170THPL RENTONWA98508 D:4252089122 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5 Le L..LLY YES❑ N J CE] CITATION# CHARGE to BOTTOM LEGA 25 BADJ e OFFICER'S NAME(PRINT) OFFICER PHONE GE OR ID# AGENCY 26 JOSEPH MELLO 13020 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF57614 COLLISION REPORT III III III III III 111 1591972 CASE# 25-632 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) NAIK DRUTI P (LAST FIRST, ADDRESS&PHONE# D O.B. ' 16246 236TH AVE SE ISSAQUAH WA 98027 2064274111 SEXi F MMDDYyry 09 - 15 - 2000 SEAT ' HELMET I INJURY NATURE OF INJURIES PASSENGER WITNESS❑ UNIT# 3 pOS 3 AIRBAG 6 RESTR. 9 EJECT 1 USE CLASS 6 HADASMALL GMF AND TREATED NAME (LAST,FIRST,MIDDLE INITIAL) : DESAI NEENA ADDRESS&PHONE# 16246 236TH AVE SE ISSAQUAH WA 98027 SEX I F D'O.B. _ MMDDYYYY UT, - 25 1969 SEAT HELMET I INJURY NATURE OF INJURIES PASSENGER PIWITNESSO UNIT# 3 pCS 9 AIRBAG'6 RESTR. 9 EJECT 1 USE CLASS 5 COMPLAINT OF BACK PAIN NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. _ PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Unit 1 was at a stop sign in the parking lot of Classics Sports Bar signaling to turn westbound on Maple Valley Highway. Unit 1 saw Unit 2 driving at a high rate of speed eastbound on Maple Valley Highway. Unit 1 misjudged Unit 2's speed and turned west to enter traffic and collided at an angle with Unit 2. The collision caused Unit 2 to enter oncoming traffic going westbound and collided with Unit 3 head-on. The driver and a passenger from Unit 3 were transported to receive further medical treatment. The proximate cause for the collision was Unit 1's failure to yield for the right of way. An NCIC/WACIC check returned the three driver's status as licensed and their vehicle registrations current. None of the drivers were able to provide proof of insurance.The driver of Unit 1 was cited for Failure to Yield to the Right of Way, and for Failure to Provide Proof of Insurance. I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Electronically signed by J. Mello #13020 on 01/20/2025 @ 0145 hours in Renton WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JOSEPH MELLO 01-20-25 01:47AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 888 1 112012025 1:55:54 AM BADGE OR ID# ! 13020 OR]# WA0171300 TIME POLICE DISPATCHED} 7:29 Pry( TIME POLICE ARRIVED 7:34 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. EF57614 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-632 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70T !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GINAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YEs� NO D:4259618959 6 29 LAST NAME NAIK FIRST NAME KAREENA MIDDLE 1 INITIAL STREET 30 ❑ NEW AnoRFsP- 16246 236TH AVE SE CITY ISSAQUAH ST WA ZIP 98027 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31 INTERLOCK YEs NO NTERLOCK YES❑N0� vES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv', 10 - 17 - 2003 7 HELMET :INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG 6 RESTR. 9 EJECT 1 USE 2 CLASS 6 COMPLAINT OF PAIN TREATED BYFIRE 8 ❑ 1 32 LICENSE BNR4796 TAr Wq VIN# JHMFC1F30KX006334 PLATE# 9 3] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 5 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLI anvi vEH1G P FROM TO 2019 HOND CIVIC 4C T tALB�'ERS DAMAGE YES�NO YES NO 33 REGISTERED OWNER INFOKAREENA NAIK 16246 236TH AVE SE ISSAQUAH WA 98027 0:4259618959 3 ] 12 SHADE IN DAMAGED AREA 4� FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 91C7I' VEHICLE 70 Bt}TTOM 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE pp�� STANDING } MOTOR g 7 6 14 ❑ UNIT Tr Vd 1QRE O CYCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME N!I IAL MIDDLE ❑ 36 STREET 16 NEW Aa "F CITY ST ZIP CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED NTERLOCK 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 ICLASS 19 ❑ 39 LICENSE rnr VIN# 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 LEwcLE 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. JOSEPH MELLO 01-20-25 01:47 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 13020 O#I',WA0171300 SUMMERS 112012025 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EF57614 CASE# ' 25-632 DATE AND TIME 01/19/25 19:29 OF COLLISION r q $4 y ti t��aia 'rw s4 � t fY z Y 7 `4 4{} re v 4� �J F 5 si. i� 5 2 I. Y G� Z' t 4\ I 1 4 }4 }N ti 44r �ryy G r r� ti S' r PAGE 4 OF 4