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HomeMy WebLinkAbout24-7885 IT �iNII I IIII �� I I III I I IIII IIIII I 27c REPORT NO. POLICE COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE ❑ CASE# 24-7885 2 RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE LOL`CO A`GENC'Y 4200 COUNTY RD NVOLVED CODING 2 PRIVATE WAY ❑ TRIBAL UNITS#OFTOTAL TRUCK 28 03 GUARDRAIL RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsfoN' 07 - 27 - 2024 0517 17 =.�� S W e IN OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION EASTVALLEYRD MILE POST e 1600 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 100 MILES FEET � S 8✓ W e SW 16TH ST 0 1 29 MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE' YES ✓NO D:3609987173 30 6 LAST NAME BURTON FIRST NAME KEISHA MIDDLE M 1 2 31 INITIAL STREET 1:1 2368 YAKIMA AVE UNIT 514 CITY TACOMA ST WA ZIP 984053916 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3 INTERLOCKYEs Z/ INTERLOCKYES NO✓NO YES F NO,/ 8 DRIVE # MMDC STATE WA SEX F SYY' 01 — O6 — 1997 32 9 ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 HELM USEET CLASS 1 NAruRE of N3uRIEs 2 LICENSE, CGV2247 II STATE WA vNiL JM3KFBAM3P0196814 3 10 PI ATF# TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# FROM TO TRLR TRLR 5 1 33 12 VIN# VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN GOS VEHICLE m 34 13 2 2023 MAZD CX-5 UT DAMAGE YES ✓ No7 {ZRS TOWING YES NO✓ REGISTERED OWNER INFO NONE PAL AMERICAN SECURITY 900 SW 16TH ST STE 315 RENTON WA 98057 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE INSURANCE CO 3Q14 4 GREAT AMER/CAN ASSURANCE COMPANY CAPFt30979-00 IN EFFECT &POLICY# 4 CHARGE 36 YES❑NO❑ CITATION# 7 o B 15❑ STM ING e MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT 02 PEDESTRIAN1:1 ✓ D:2067685700 VEHICLE CYCLE' nWNFR YES�/ NO 16❑ LAST NAME WA STATE DOT FIRST NAME NONE MIDDLE' INITIAL STREET ❑ 17 6431 CORSON AVE S CITY SEATTLE ST, WA ZIP 98108 g 37 NEW ADORESS 1$� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCKYEs No INTERLOCKYEs NO yEs No 19 LICEENSE# STATE SEX U I DOB MMDDYY' -� E 39 HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASSLICENSE ❑ 21 PLATE# TATE 'l # 41 22❑ [TILER TRAILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR RLR 43 UIN#. 'IN#. VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP vemae ❑ ,.I—I CITATION# CHARGE to BOTTOM nLLv YES N`LJ 25 s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JESSE VANDERHOEK 11631 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. COLLISION REPORT III III III III III 111 1591972 CASE# 24-7885 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 N NATURE OF INJURIES Ej POS. USE CLASS LASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. — L----------� MMDDYYYY PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j NARRATIVE RTF Vehicle #1 was traveling northbound in the 1600 block of East Valley Rd, approaching the curve to turn west onto SW 16th St. The driver of vehicle #1 advised me that as she approached this curve, she fell asleep, causing her to not negotiate the curve and instead continue straight. This caused her vehicle to veer off the right side of the roadway, crash through a chain link fence, and then crash into a freeway on-ramp guardrail. This was the guardrail for the ramp that merges onto SR-167 southbound from 1-405 north. I took photos of the scene. I have since notified the City of Renton streets department regarding the damaged chain link fence and WA state DOT regarding the damaged guardrail. Based on the totality of the circumstnaces, it appears the actions of the driver of vehicle #1 were the proximate cause of this collision. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JESSE VANDERHOEK 07-27-24 06:42 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 8/25/2024 4:36:11 PM BADGE OR ID# 11631 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:23 AM TIME POLICE ARRIVED 5:29 AM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 47 SUPPLEMENTAL REPORT NO.POLICE TRAFFIC 1 27 ... ;'� COLLISION REPORT CASE# 24-7885 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. NAME IF GWVR NO NUMBER SOURCE' AXLES ' 1:1 + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE }j� PEDESTRIAN �/ D:4254306400 5 UNIT vT 3 VEHICLE CI CYCLE '. C) C� OWNER '.� YES NO 29 FIRST NAME MIDDLE'. LAST NAME CITY OF RENTON NONE INITIAL STREET 30 NEW ADDRF. 1055 S GRADY WAY CITY RENTON ST WA ZJP 98057 6 ❑ PRESENT MEDICALTANSPORTED 1 31 CDL IGNITION REQUIRED IGNITION INTERLOCK YES NO INTERLOCK YES NO YES N 2 DRIVER'S STATE SEX U MMDD YYv -C.� LICENSE 7 ON DUTY STATUS: AIRBAG RESTR. EJECT HELMET INJURY NAruREofINJURIEs USE CLASS 8 ❑ #LICENSE VIN 1 32 PLATE# TAT 9 TRAILER TRAILER 2 PLATE#i STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.# VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO DAMAGE YES NO YES NO D OWNER INFO. m 33 REGISTERE SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO TO IN EFFECT &POLICY# 34 13 YES NO[jj CITATION# CHARGE 10 8C)1`l OM ecauv sTnNoiNc MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 15 LAST NAME FIRST NAME ❑INITMIDDL ALE 36 16 ❑ STREET CITY ST! ZIP NEW ADDRESS" GDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES ] . INTERLOCK YES NO YES NO: 17 37 L ICENSE# STATE SEX MD,O _= 18 ❑ HELMET INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE GLASS 19 ❑ ❑ 39 LICENSE viN PLATE# TAT # 20 ❑ TRAILER TRAILER ❑ 40 PLATE#. STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN#! VIN#: 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TO BY GOVT.VEHICLE DAMAGE YES NO YESR NO LI 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE[—] INSURANCE CO IN EFFECT &POLICY# t.. 1�.TOF___ 5 44 vFHic�F ❑ ❑ CITATION# CHARGE 70 BOTLOM 24 I..EG_ VES NO El STIWDING 3 3 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JESSE VANDERHOEK 07-27-24 06:42 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE OR ID# ! 11631 O#RI WA0171300 APTIBEAU 8122512024 PAGE OF 3000-345-013(R 11l18) REPORT NO. CASE# 24-7885 DATE AND TIME 07/27/24 05:17 OF COLLISION Not to scab ' b i S�lY1 4� y t PAGE 4 OF 4