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HomeMy WebLinkAbout24-10917 ouCE OF ASHINGcN I� I �I) , II� I I I (III I�I I) SUPPLEMENTALREPORT NO. EF26451 5 1 27
COLLISION REPOFIT 1591971
SASE# 24-10917 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ STOLE F ❑ LOCAL AGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 28
s TRIBAL UNITS 02 STRUCK FENCE
RESERVATION
z
3 DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E CITY# ❑
CowsloN 10 - 20 - 2024 0558 17 ❑.❑ S IN 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE PETROVITSKY RD BLOCK NO. e✓ 11700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:3602806895 N:3602808525 30
6� LAST NAME JAPHET FIRSTNAME MARK MIDDLE E 1 1 2 31
INITIAL
STREET ❑ 2206 59TH AVE NW CITY OLYMPIA ST WA ZIP 98502 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs No�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 6 RESTR 9 EJECT 1 H U SE CLASS 7 SORE CHEST INJURIES z❑
3
10[ P1 ATF 14 D611938 JBTATIJ WAv N#' 1 FTWW3BR4AEA56193
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR 7 3 33
12❑ VIN#j VIN#
RomM TO
34
13 VEH.YEAR2010 MAKE FORD MODEL F350 STYLE PK VEHICLE TOWED0NOOffBLIN WAWkkRSTOWING vOs❑ENo /
DAMAGE IILLJJII
REGISTERED OWNER INFO MARKJAPHET220651THAVENW OLYMPIA WA 98502 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCE CO COUNTRY PREFERRED INSURANCE P46A4123141
IN EFFECT &POLICY#VEHICLE CHARGE 36
LECALLv YES❑NO❑ CITATION# C?>
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ No D:4252917988 N:2064378931
16❑
LAST NAME THOMAS FIRST NAME SAUNDRA MIDDLE M
INITIAL
17 STREET❑ NEW ADOREss❑' 17466 117TH AVE SE CITY RENTON ST WA ZIP 98058 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE vIN1 41
5
PLATE#
42
22❑ PIR TRAILER LATE# STATE PLATE# STATE
23❑ 000 43
TRLR RLR
UIN It 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JESSE VANDERHOEK 11631 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF26451
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10917
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
POS. 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'
Vehicle #1 was traveling eastbound in the 11700 block of SE Petrovitsky Rd. Vehicle #1 veered to
the left off the roadway, causing the vehicle to collide through a wooden fence and into the back yard
of the residence located at 17466 117th Ave SE, Renton, WA. As the vehicle continued through this
back yard, it also collided with two trees and the back porch attached to the house before it came to a
stop. No one at the residence was injured. The fence, the porch, the yard, and the trees were all
damaged. MARK, who was the driver of vehicle #1 advised me he did not fall asleep, he was not
distracted, and did not believe he had a medical issue. He stated he was unsure why his vehicle left
the roadway. A voluntary preliminary breath test concluded MARK was not under the influence of
alcohol. It should be noted that MARK had several thousand dollars of cash on his person for some
contractors he was enroute to meet, however he wanted to give all of this cash to police and the tow
truck drivers as a gratuity. I advised MARK I would not take the money due to Renton PD policy for
gratuities. The tow truck drivers were allowed to take gratuities so MARK voluntarily gave the two tow
truck drivers $1,000 each. MARK asked that I place the rest of the money in the center console of his
pickup truck, which I did. The pickup truck was towed to Bankers Towing. I later spoke on the phone
to MARK's wife, JULIE, and she advised me that MARK was likely experiencing a mental health
episode, as all of his behavior surrounding this collision were not normal for him and were consistent
with his mental health episodes in the past.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JESSE VANDERHOEK 02-21-25 10:11 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
JESSE VANDERHOEK 11631 1 2/21/2025 10:12:48 AM
BADGE OR ID# 11631 OR]# WA0171300 TIME POLICE DISPATCHED 6:01 AM TIME POLICE ARRIVED',6:06 AM
PART I PAGE IT]OF 3�
REPORT NO. EF26451 CASE# 24-10917 DATE AND TIME 10/20/24 05:58
OF COLLISION
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