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Home My WebLink About25-907 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF67174OLCERA COLLISION REPORT 1591971 ❑ 0 RESULTED I $ 25-907 2 INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 7 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E eDLLIs[oN' 01 - 28 - 2025 0851 17 =.= S 8 W E INOF 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOEASTVALLEYHWY MILE POST e 3400 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 2251.1 00-] MILES N FEET e✓ S 8✓ E e SW 34TH ST 0 3 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4046646539 0 1 30 5 LAST NAME WHITE FIRST NAME WILLIE MIDDLE N 1 1 2 31 INITIAL STREET ❑ 1630 228TH ST SE APT A201 CITY; BOTHELL I ST WA ZIP; 980217432 2 NEW ADDRESS 7 CDL IGNITION REQUIRED I ESGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs NO INTERLOCKY NC YES NO 8❑ DCIENSE# STATE WA SEXI M MMDDYY' 02 — 18 — 1982 1 2 32 9 ON DUTY❑ STATUS' AIRBAG 1 RESTR 4 EJECT 1 N USEET CLASSY 7 LATU EG RE OF INJURIES 2 10 LI ENSE' D00946C STATE WA y!N# 3HAEVTAR3PL745940 3 TRAILER STATE TRAILER STATE 11 3 5 ,LATE# PLATE# FROM To TRLR zRLR 5 3 33 12 3 5 VIN# vIN# FROM TO 13 2 VEH.YEAR2023 MAKE INTL MODEL MV607 STYLE VEHILETOYED NOpLS�46LIN T�VyED.6LRS GESI�`TEND 5 1 34 DAMAGE IIII._IIII HHttVVii((tt u REGISTERED OWNER INFO HORIZON DISTRIBUTORS INC 955 LIND AVE SW RENTON WA 98057 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 LIABILITY INSURANCE INSURANCE CO 3 4 14 LIBERTY MUTUAL AS2651294626034 IN EFFECT &POLICY# 9TOP v` CHARGE t S 36 LEGALLY yES❑NO❑ CITATION# HARE i a BOTTOM 15❑ STM ING B 7 e MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:3605102416 16� LAST NAME WENTZ FIRST NAME ROSEMARIE MIDDLE C INITIAL ❑ 17 STREET ❑ 25724 PACIFIC ST CITY' BLACK DIAMOND ST, yyq ZIP 37 980109743 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38 INTERLOCK YEs ND INTERLOCK YES NO YEs NO 19 DRIVER'S STATE WA SEX F D.O.B. 12 11 1982 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 7 HELMET INJURY NATURE OF INJURIES ❑ 40 USE CLASS NECK 21 LICEN� ATT2837 rare WA vIN# KL7CJRSB4FBO71404 41 PLATE 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# TOWED BY GOV HI 44 VEH.YEAR 2015 MAKE CHEV MODEL TRAX STYLE VEHICLE TOWED✓ No BLIN BANKERS 24 REGISTERED OWNER INFO ROSEMARIE WENTZ 25724 PACIFIC ST BLACK DIAMOND WA 980109743 D:3605102416 VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO GEICO 6191234605 IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,J—I CITATION11 CHARGE tO BOTTOM LEGALLY YES N J 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF67174 COLLISION REPORT III III III III III 111 1591972 CASE# 25-907 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) LUNA GEORGEL ADDRESS&PHONE 2532971287 SEXi M MpDDYBVYY —� C--------� PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES 1:10 POS. USE CLASS ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYYYY D.D.B. — PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.D.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I 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 01-28-25 11:01 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 211912025 1:54:37 PM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:54 AM TIME POLICE ARRIVED i 9:01 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 57 REPORT NO. EF67174 CASE# 25-907 O OF COLLI 510N TIME 01/28/25 08:51 COLLISION NARRATIVE orange/2 nb flatbed rt RTF Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at about the 3400 block of East Valley Rd. While enroute I was advised this was a non injury and blocking with an orange vehicle and a white flat bed truck that had pulled into a storage facility. When I arrived from the north I could only see a while flatbed north of the storage facility that was blocking both the northbound lane and 2WCLTL of East Valley Rd. I continued towards the storage facility and noticed an orange car stuck to the side of the flatbed at the entrance to Brightview. I contacted the driver of unit 2 who told me she was north on East Valley Rd. She said she saw unit 1 in the 2WCLTL but did not see a turn signal. She described that while she was northbound the flatbed made a right turn from the 2WCLTL across her lane hitting her car. She was basically stuck to unit 1 and could only exit her vehicle from the passenger side. She complained of injury and was checked by Renton Fire on scene. She declined transport and would seek additional medical treatment on her own. Unit 2 did provide a dash camera that did not reveal any pre collision video, only post collision. I contacted the driver of unit 1 who told me he was making a right turn from his lane from lane 1. He told me he had to swing out a little bit to make the turn and somehow unit 2 drove under his vehicle (into the side). His vehicle was 30 foot flatbed commercial truck with multiple pallets on board and a 3 wheel forklift attached to the back. He did complain of leg pain on the right side but was ambulatory. He was checked and released on scene by Renton Fire. His vehicle required a class C tow truck for damages. I did see his turn signal was blinking but I had to squat way down to see it. The turn signal was blocked by the 3 wheel forklift and very difficult to see while standing behind the truck even at a distance. Unit 1 had 2 witnesses come out from the yard he was delivering to and the listed Wit said that unit 1 was swinging out to make his right turn and unit 2 was impatient and attempted to pass. He told me he was behind unit 2 and watched the crash. The other witness said exactly the same thing but was translated in Spanish, I did not gather his name. The dash cam from unit 2 or another independent withness that was not affiliated with unit 1 would have helped determine lane position etc. Unit 1 was going to walk to the hospital for additional treatment. I offered to drive him, he climbed into what appeared to be another company truck similar to his and left the area. Information/Insurance only. 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 1/28/2025 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EF671 74 I�� NRCOI COLLISION TRAFFIC 'ASE# 25-907 1 27 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ U N IT# 1 USDOT 0664786 ICC# VEHICLE TYPE 1 3 1 CARTGO BODY 4 2 ❑ 1 28 CARRIER NAME. HORIZON DISTRIBUTORS .....: 3 CARRIER L ADDRESS 955 LIND AVE SW CITY RENTON ST WA ZIP 1 98057 4 ❑ NAME I I # PLACARD NAME IF NO NUMBER SOURCE 3 AXLES 'p4 GWVR 54000 + 4a ❑ ADDITIONAL UNITS 5 ❑ UNIT r' MOTORVEHICL CI CYDLE C) PEDESTRIAN OWNER ❑ YE -DAM1 THRESHOLD MET PHONE MIDDLE; 29 LAST NAME FIRST NAME INITIAL STREET 30 NEW AnnRFSJ—jl CITY ST ZiP 6 1 PRESENT MEDICALTANSPORTED'. 1 31 CDL I GNITION REQUIRED 1{iNi7iON :: INTERLOCK YES NO :NTERLOCK vEsD-El vEs N LICENSE STATE SEX MMDD$ 'C� 7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruRE of INJURIES USE CLASS 8 ❑ 1 32 LICENSE TAT VIN. PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY Y(-E V vFHICI E FROM TO DAMAGE YES NO YES NO m 33 REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO IN EFFECT &POLICY# �GQl 34 13 vewcEe YES NO[jj CITATION# CHARGE ecauv sTANoINc MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET CITY ST ZIP NFW ADDRESS" CDL IGNITION REZu;y IGNITION : PRESENT MEDICALTANSPORTED INTERLOCK VEs NO INTERLOCK YE NO :YES NO ❑ 17 37 LICENSE#RIVERS — STATE SEX MD.00.B i 18 ❑ ❑ HELMET NJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS 19 ❑ ❑ 39 LICENSE TAT vIN# PLATE# 20 TRAILER TRAILER 40 PLATE#. STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# .. ) E 44 24 YES❑ NO CITATION# CHARGE OM STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 01-28-25 11:01 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE OR ID# 2517 O#RI WA0171300 APJACOBS 2/119/2025 PAGE�OF 3000-345-013(R 11/18) REPORT NO. E F67174 CASE# 25-907 DATE AND TIME 01/28/25 08:51 OF COLLISION c s t � ti i S� r, :}: rid�};a t e�,` tiY i i,'•iy�'a3 y u t" t ,a � S t 4Y t y � •, �� Y � " R r PAGE 5 OF 5