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HomeMy WebLinkAbout24-7438 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-7438 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 04 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 07 - 1-- 2024 1239 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO. e✓ 1800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 375 00 FMILES NEET ❑ S ❑ E e SUNSET BLV N
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063219592 0 81
30
6� LAST NAME CORWIN FIRSTNAME DANICA MIDDLE C 1 1 2 31
INITIAL
STREET ❑ 14259 142ND AVE SE CITY RENTON ST WA ZIP 980595449 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED YES No 3
iNTERLOCKYEs NO INTERLOCK YES NO
8❑ LICIENSE# STATE Wq SEXI F M1-O B 10 — 23 — 1981 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3❑
10 1❑ pl ATE 14 832929E STATE WA u N# 1 GCHK63609F100867
11[-� TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# IR.. ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2009 CHEV SILVER DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO DANICA CORWIN 14259142ND AVE SE RENTON WA 980595449 D:2063219592 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO STATE FARM 082345A18.47E 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 4A0361540 INATTENTIVE DRIVING <1�3
orrom
15❑ NDING 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ :H D:4254667645
16 a
LAST NAME MITCHELL FIRST NAME CHRISTINA MIDDLE L
INITIAL
17❑ STREET ❑', 14235 142ND AVE SE CITY RENTON ST WA ZIP 980595449 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YES❑NO❑
19 DRIVER'S STATE WA ]SEX IF D.C.B. 07 16 _ 1981 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE A WK3097 TATE WA VIN# JTJHY7AXOA4049402
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE LEXS MODEL LX STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CHRISTINA MITCHELL 14235142ND AVE SE RENTON WA 980595449 D:4254667645 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO ST FARM 1634391-F14-47CIN STOP
VE""LE CITATION# CHARGE
LEGAL
25 i o BOTTOM
LY YES Nu
❑ s
OFFICER'S NAME 0(
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.EEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE97375
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7438
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.
M.LEVERTON 07-16-24 02:35 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1
711912024 2:53:08 PM
BADGE OR ID# Y517 ORI# WA0171300 TIME POLICE DISPATCHED 4:00 Pry TIME POLICE ARRIVED 1 1:00 PM
PART I PAGE IT]OF
REPORT NO. EE97375 CASE# 24-7438 OF COLLISION
07/16/24 12:39
OF CbLLI510N
NARRATIVE
wht truck/1 went on green wht suv/2 stopped wht sedan/3 stop red trk/4 just starting lane 3
CC
Within the city limits of Renton/King/WA I responded to a 4 car crash that occurred at the 1800 block
of Maple Valley Hwy. I contacted all 4 drivers at 1402 Bronson Way N
I contacted the driver of unit 4 who told me there was one car in front of her westbound lane 3 of
Maple Valley Hwy. When the traffic light turned green she just starting to move when she was hit
from behind by unit 3. She did not complain of injury and damages was merely paint transfer on her
tow hitch.
I contacted the driver of unit 3 who told me she was stopped behind unit 4 when she was hit from
behind by unit 2 pushing her into unit 4. She did not complain of injury and damages did not require a
tow truck.
I contacted the driver of unit 2 who was stopped behind unit 3 when she was hit from behind by unit 1,
which pushed her into unit 3, pushing 3 into unit 4. She did not complain of injury and although there
was heavy damage on the back of unit 2 she chose to not have it towed.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me she noticed the light change
from green to red and instinctively proceeded forward, however, other traffic in front of her was still
stopped or just moving. She made contact with unit 2 causing the chain reaction 4 car event. An
passenger/not identified in unit 1 was checked-treated and released on scene by Renton Fire. Unit 1
did not complain of injury and damages did not require a tow truck.
I cited unit 1 ref RMC 10-12-25 Driver Inattention 4 car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 7/16/2024
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE973755
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-7438
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 28
CARRIER
NAME
3 CARRIER
ADDRESS `❑
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 3 �✓ � PEDESTRIAN YES NO
5 VEHICLE CYCLE OWNER ✓ D:4255699801
OF 8 29
LAST NAME GILLESPIE FIRST NAME KAYLEE MIDDLE' M
INITIAL
1 0 30
STREET
NFW AnnRIFSP. 27807 256TH CT SE CITY MAPLE VALLEY ST WA ZIP 980382032
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YEs[:]NO[:]
YEs N
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv 07 - 05 - 2008
7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 1 2 32
LICENSE CHT5944 TAr Wq VIN# 4T1BE32K94U322799
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2004 MAKE TOYT MODEL CAMRY STYLE VEHICLE TOWE E T SABLIN TOWED BY anvi vEH1O P FROM TO
DAMAGE YES NO ✓ YES NO ✓
33
REGISTERED OWNER INFONATHANIEL GILLESPIE 26807316TH AVE SE RAVENSDALE WA 98051 J 9
12 4 O SHADE IN DAMAGED AREA
3 4 FROM TO
LIABILITY INSURANCE INSURANCE CO AM FAM 41006.8773068 q"i"Olx
IN EFFECT a Poucv# 3 7
VEHICLE 34
13 2 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTOM
STANDING 1 7
DAMAGE THRESHOLD MET PHONE ❑ 35
14 UNIT# 4 MOTOR ❑✓ PEDAL- 11 PEDESTRIAN ❑ PROPERTY ❑ YES NO
VEHICLE CYCLE OWNER ✓ D:2532507439
15 � ANGELES NOELANI MIDDLE': T
❑ 36
LAST NAME FIRST NAME INITIAL
2 STREET
16 ❑ ❑; 119 J ST NE CITY AUBURN ST WA ZIP 980025048
NFn+AnntxFss
CDL IGNITION REtIUiREE7 IGNITtGN PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YE.
NO INTERLOCK YEs NO rEs NO ❑
DRIVER'S STATE WA SEX F D.O.B
18 37
MMDDYYY` 11 - 19 - 1976
❑ ❑ON DUTY� STATUS' AIRBAG 2 RESTR, Q EJECT 1 HELMET INJURY'1 NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑
PLATE#
D67981D TAr WA v!N# 3TMCZ5ANOKM243611 39
20 ❑ TRAILER' STATE TRAILER ST ❑ 40
PLATE#< PLATE# ATE
21 ❑ TRLR TRLR 41❑
ViN# YIN#i
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE
2019 TOYT TACOM DAMAGE YES NO ✓ YES NO ✓
23 ❑ REGISTERED OWNER INFO ENRIQUEZ CRUZ 15040156TH PL SE RENTONWA 98058 SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 981729058 9'1'OP
❑ VEHICLE
EFFECT &POLICY# i _'.''_ 44
24 LEMLLE YES[:] NO❑ CITATION# CHARGE iq 60TiOM
LEGALLY
E:l
STANDING & 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
X LEVERTON 07-16-24 02:35 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
BADGE,.. O#I' APPROVED /1
ORID# 2517 WA0171300 SON FOF26 1 ❑
3000-345-013(R 11118)
REPORT NO. EE97375 CASE# ' 24-7438 DATE AND TIME 07/16/24 12:39
OF COLLISION
m �;t
6
o
4 ti
�M
Y
PAGE 5 OF 5