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HomeMy WebLinkAbout24-7227 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-7227 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 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 N E IN CITY# ❑ cawsloN 07 - 11 - 2024 0557 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ MAPLE VALLEY HWY BLOCK NO. e✓ 2201 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 1 2 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2067476417 0 11 30 6� LAST NAME TRUE FIRSTNAME WILLIAM MIDDLE S 1 1 2 31 INITIAL STREET ❑, 2201 MAPLE VALLEYHVVYAPT66 CITy RENTON ST WA 2jp, 980573931 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ Pi aT�S� CED3951 sTArI WAvIN# 3GNDA13D66S641732 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# Rom ro TRLR. A'RLA2 1 3 33 12 4 0 VIN#' VIN#' >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 2 2006 CHEV HHR DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO WILLIAM TRUE 2201 MAPLE VALLEY HWY APT 66 RENTON WA 98057 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE z INSURANCE CO GEICO 6115809987 4 LI EFFECT I POLICY# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:3602374972 16 a LAST NAME JORDAN FIRST NAME JOSEPH MIDDLE W INITIAL 17❑ STREET ❑', 626 APPLE VALLEY RD SW CITY' OLYMPIA ST WA ZIP 985129449 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 DRIVER'S STATE WA SEX M D.O.B. 07 20 _ 1976 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE 1 C31040X TAre WA VIN1t 3(BNEC12T84G222272 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE pLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2004 MAKE CHEV MODEL AVALANC STYLE VEHICLE TOWED TO BLIN TOWED eY GOV HI 44 24 DAMAGE YES NO (',ENE MEYERS YES NO REGISTERED OWNER INFO TERESA JORDAN 185 KRUGER RD ONALASKA WA 98570 VEHICLE NO.2 SHADE IN DA GEbAREA z Cdd LIABILITY INSURANCE I PORGY#E CO PROGRESSIVE 9773544410IN 1 VEwGLE ❑ ,J� CITATION# CHARGE25 GQ LEGALLY YES N`L J s � e 7CA NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26LAN 12007 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE99212 COLLISION REPORT III III III III III 111 1591972 CASE# 24-7227 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MALMSTROM /SAAC S (LAST FIRST, ADDRESS&PHONE# D O.B. ' 15205 140TH WAY SE RENTON WA 98056 2065139555 SEX M MMDDYyry 09 - 03 - 1995 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 NJURY 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' On July 11, 2024, at 0557 hours dispatch requested that I respond to a collision that occurred at 2201 Maple Valley Hwy, in the city of Renton. Upon contact, I spoke with the driver of unit 2. The driver explained they were going eastbound on Maple Valley Hwy and approaching the Riviera Apartments when he was struck by unit 1. He explained that unit 1 exited the parking lot as he drove past the entrance. His vehicle sustained damage to his passenger side. Unit 2 was towed away by Gene Meyers towing. I then spoke with the driver of unit 1 and they explained they were also exiting the Rivera Apartments when the collision took place. They stated they failed to notice unit 2 driving eastbound in the number 1 lane on Maple Valley Hwy. the driver stated he merged into lane 1, striking unit 2. A witness also recounted the same story as the two drivers. They stated that the driver of unit 1 exited the parking lot as unit 2 was driving past the entrance. Based on the information, 1 believe the driver of unit 1 failed to merge properly when entering the roadway. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 07-19-24 12:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 7/25/2024 3:45:11 PM BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 5:57 AM TIME POLICE ARRIVED 6:05 AM PART I PAGE 2�OF❑ REPORT NO. EE99212 CASE# 24-7227 DATE AND TIME 07/11/24 05:57 OF COLLISION r , f l 5 S c,V�s G. t NM1 "Y. ��1, kgY4 1 i t 4 Z 4 qt, r$ �,Y',,,t. , �rR §,flrta'•;.va§ n�ic r w ,.. ". �, sMt i 4,. .,s�,m. 1 .h..+u.?axL'.�w i;a u,�`,ai` ,"„�ie .AYci'�1."�s,". ?r`'i,. �,'k`3Nn,$a� e', n.°R,1..t=S}4Ik.k.',°�;dd'^X�3M1ti3r..�'�3.�."a�S\ PAGE 3 OF 3