Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-10002 )STATE
TFcN 6 Q 27i t
Oc� RA EF23547
COLLISION REPRT 1591971
CASE# 24-10002 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL ACENC'Y 4200 3
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 03 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
COLLISION'. 09 - 24 - 2024 0801 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
MAPLE VALLEY HWY
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET H S 8 W e 152ND AVE SE
0 1 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:2063831522 0 1 30
5 LAST NAME GRAVELLE FIRST NAME ILONA MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 23811 132ND AVE SE APT P1 CITY KENT ST; WA ZIP 980423261 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES ND INTERLOCKYEs N YES R NOF
8 DRIVERCENS STATE WA SEX F MMOCSYY 05 - 12 - 1997 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASS 1 NAruRE of INJURIES 2
LICENSE, CGS1925 STATE WA VIN# 4S4BSALC2F3214022 3
10 PI ATF#
TRAILER STATE TRAILER ,STATE
11 5 0 PLATE# PLATE# FROM TO
TRLR TRLR 7 3 33
12 2 5 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT VEHICLE
13 2 2015 SUBA OVTBA DAMAGE YES ✓ YES❑ NO 1 5 34
REGISTERED OWNER INFO NATHANIEL GRAVELLE6801 S 133RDSTAPT1281 SEATTLEWA98178 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 4
14 GEICO 4556819938
IN EFFECT &POLICY# 4TOP
vEnic�E CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 7 0 80TTOM
15❑ STANDING 7 e
MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs,/ No D:4255985462
16�
LAST NAME PERDIDO FIRST NAME ERICO MIDDLEI L
INITIAL
37
❑
17 STREET'❑ 1818 ELMA AVE NE CITY RENTON ST, WA ZIP 980594173
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED. 38
INTERLOCKYEs No INTERLOCK YES NO Yes NO
19 DRIVER'S STATE WA SEXIM D•CLB. 11 16 1971 39
LICENSE# MMDDYY' -
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSLATE E BKF2025 TATE WA VIN# 2HKRW2H86JH641086 41
22❑ PLTL ATE# STATE TILER PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q1$ MAKE HOND MODEL CR—V STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO THAPANEE PANVISAVAS 1818 ELMA AVE NE RENTON WA 98059 VEHICLE NO.2
SHADE DAGAREA
LIABILITY INSURANCE INSURANCECO AMERICAN FAMILY BX09174884
IN EFFECT &POLICY# I 9TOP
HICL
LEIAIL YES❑ N CL J CITATION# CHARGE t080TTOM
VEE
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.CATALAN 12007 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF23547
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10002
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME GRAVELLE ODIN
(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D(?B
SEX M MMooYYYv 08 - 24 - 2016
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
E 1 SOS. 9 2 4 1 USE 2 CLASS 1 �_ ---�
'NAME
LAsr F RST,MIDDLE INITIAL) GRAVELLE LYLA
ADDRESS&PHONE#
SEX F D.O.B. 12 15_ _ 2017
MMDDYVYY
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER z WITNESSEl UNIT# 1 POS. 7 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----�
NAME MIDDLE INITIAL) PANVISAVAS THAPANEE N
',(LAST,FIRST,
AOQREss a PHONE# 1818 ELMA AVE NE RENTON WA 980594173 SEX; F D.O.B. 09 _ 04 _ 1978
MMDDYVYY
PASSENGER Z WITNESS UNIT# 2 SEAT 3 AIRBAG 6 RESTR. 4 EJECT 1 HELMET 2 NJURY 1 NATURE OF INJURIES
Q 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.
C.CATALAN 09-26-24 11:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 10/7/2024 12:41:51 PM
BADGE OR ID# 12007 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:02 AM TIME POLICE ARRIVED 8:07 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 7�
POLIICFETRAFFICN CORRECTION REPORT NO. EF23547
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10002
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME PERDZDO ERICA
(LAST,FIRST,MIDDLE INITIAL}
ADDRESS&PHONE# DOB
RENTONWA SEX' F MMDDYYYY 09 — 10 — 2011
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
z Ej 2 POS. 7 6 4 1 USE 2 OLASS ;1 --�
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
S ' D.O
EX .B.MMDD -F L----------�
YYYY
EAT HELMETNJURY URE OF
PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M —T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q' POS. USE CLASS r— ----j
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.
C.CATALAN 09-26-24 11:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 10/7/2024 12:41:51 PM
BADGE OR ID# 12007 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 6:02 AM TIME POLICE ARRIVED 6:07 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 37 OF 7�
EAN
REPORT No.` EF23547 CASE# 24-10002 OF COLLI COLLISION TIME 09/24/24 08:01
COLLI
NARRATIVE
On September 24, 2024, at approximately 0801 hours, I was dispatched to an injury and blocking
vehicle collision at the intersection of Maple Valley Hwy and 152nd Ave SE, within the City Limits of
Renton, County of King, State of Washington.
Upon my arrival Renton Regional Fire Authority (RRFA) had already respond as a precaution due to
airbag deployment.
While on scene, I was able to collect each involved party's information and independent summary of
the events leading up to the collision.
The driver of Unit 1 said he was traveling eastbound on Maple Valley Hwy and was approaching the
signal-controlled intersecting roadway of 152nd Ave SE. The driver of Unit 1 stated that she was
intending to continue straight at the intersection. The driver of Unit 1 stated that that the light was in a
standstill yellow, so she tried to "beat" the light. The driver of Unit 1 proceeded through the
intersection when Unit 2 suddenly appeared in front of her. The driver of unit 1 stated she was unable
to bring her vehicle to a complete stop. Both Unit 1 and Unit 2 collided in the roadway causing minor
damage to the front bumper of Unit 1.
The driver of Unit 2 was accompanied by his wife in the front passenger seat, and his daughter rear
right seat. The driver stated he was stopped in the southbound lane at the intersection of 152nd Ave
SE and Maple Valley Hwy. The driver of Unit 2 stated he intended to go through the controlled
intersection, but all four signals at the intersection were flashing red. Once it was his turn to proceed
forward, he drove through the intersection. The driver of Unit 2 stated that upon reaching the
intersecting driveway, Unit 1 failed to yield to his vehicle at the intersection. The driver of Unit 1 was
unable to avoid the collision and subsequently collided into Unit 1 causing significant damage to the
right side of Unit 2.
The driver of unit 3 was also stopped at the intersection of Maple Valley Hwy and 152nd Ave SE. The
driver of unit 3 provided a similar story as unit 2. The driver of unit 3 was stopped facing northbound
and stated that the signals at the intersection were flashing red. As unit 2 drove southbound through
the intersection, they was subsequently hit by unit 1. After the two vehicles collided, unit 2 rolled back
into unit 3 causing minor damage to the front bumper of unit 3.
Later, I was told by a supervisor that the traffic cameras were pointed towards a signal crew working
on a box instead of the intersection.
The driver of unit 2 does have a dash camera, but I was unable to review the video because he could
not upload at that time.
Based on the above statements, 1 determined that the Driver of Unit 1 is the proximate cause for the
cause of collision as the driver did not grant the right of way to traffic already in the roadway and
underway. The driver violated RCW 46.61.190(2) as every driver of a vehicle approaching an
intersecting roadway shall stop where the driver has a view of approaching traffic on the intersecting
roadway before entering the roadway, and after having stopped shall yield the right-of-way to any
vehicle in the intersection or approaching on another roadway so closely as to constitute an
immediate hazard during the time when such driver is moving across or within the intersection or
junction of roadways.
Unit 2 had to be privately towed due to extensive damage. An exchange of information was provided
to all involved parties.
PAGE 4 OF 7
EAN
REPORT NO.` EF23547 CASE# 24-10002 O OF COLLI COLLISION TIME 09/24/24 08:01
COLLI
NARRATIVE
PAGE 5 OF 7
SUPPLEMENTAL REPORT No. EF23547
POLICE TRAFFIC
1 1 8 27
µ ^'� COLLISION REPORT CASE#+ 24-10002
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS
CITY ST ZIP
4 ❑ NAME # PLACARD
GWVR NO NUMBER
SOURCE AXLES1:1 + NAME IF
4a ❑ ADDITIONAL UNITS
,µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 � UNIT# 3 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑'. YES NO
D:4257584159
0 8 29
LAST NAME JEFFERS FIRST NAME MYRANDA MIDDLE L
INITIAL
STREET 30
NEW ArnDRF 3124 SE 6TH ST CITY RENTON ST WA ZIP 980582816
6 ❑ CDL GNITION REQUIRED PRESENT MEC7ICALTANSPORTED: 1 1 2 31
I :{GNi71ON
INTERLOCK YES NO INTERLOCK YES NO
DRIVER'S STATE SEX F D.O.B 01 - 26 - 1994 2
LICENSE' MMDD;
7
ON DUTY STATUS: AIRBAG 2 RESTR. ¢ EJEG7 1 H USEE7 2 1 INJURY
CLASS 1 NATURE OF INJURIES
LICENSE CKCO214 TAT WA VIN# 1YVHZ8BH8A5M14345
PLATE#
9 TRAILER TRAILER 2
PLATE#i STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.# VIN.#.
11 2 5 VEH.YEAR2010 MAKE MAZD MODEL6 I STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO
DAMAGE YES NO ✓ YES NO
SCOTT JEFFERS 2721191STAVE E GRAHAM WA 98338 9 9 33
REGISTERED OWNER INFO SHADE IN DAMAGED AREA
12
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
O
IN EFFECT &POLICY# T ;5 m 34
YES❑ NO
13 2 vEnICEE CITATION# CHARGE tE28OT"!OM
ALLY ❑
sTANoINc
MOTOR PEDAL- ' PROPERTY DAMAGE THRESHOLD MET 35
PHONE ❑
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YESF-1 NO
❑
36
15 LAST NAME FIRST NAME : INITIAL
16 ❑ STREET F' CITY ST! ZIP
NEW ADDRESS"
GDL IGNITION RE(]UIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES NO INTERLOCK YES NO 'YES NOD 1 17 37
DRIVERS
# STATE SEX M�DDWY -
18 ❑ ❑
HELMET INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ LICENSE TAT viN ❑ 39
PLATE# #
20 ❑ TRAILER' TRAILER ❑ 40
PLATE#. STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN#; VIN#+.
42
22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE[—] INSURANCE CO
IN EFFECT &POLICY# t.K-99
5 44
vFHICEE ❑ ❑ CITATION# CHARGE 24 IEGALLY VES NO3 3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 09-26-24 11:01 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE
A D# 12007 O#RI WA0171300 APJOHNSON 10n/2024
PAGE OF 7�
3000-345-013(R 11l18)
REPORT NO. EF23547 CASE# 24-10002 DATE AND TIME i 09/24/24 08:01
OF COLLISION
t ��t
SS \
c �y
�I
s t
ik
Y 3s
3
s
yy z
! t4`
PAGE 7 OF 7