HomeMy WebLinkAbout25-149 STATE OF I !�� I III I III I IIII III II I . 0 27c REPORT NO EF54770
COLLISION REP FIT
1591971
❑ RESULTED ❑ CASE 25-149 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 01 STRUCK CONCRETE/JERSEYBARRIER
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 01 - 1-- 2025 1513 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO. e✓ 2500
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:3609302139 30
6F] LAST NAME LOPEZ FIRSTNAME ANTHONIE MIDDLE J 1 0 4 31
INITIAL
STREET ❑, 10438 NE STATE HIGHWAY 104 AP CITY KINGSTON ST WA 2jp, 983468443 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'M MID
-O B 10 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE T INJURIES 2❑
USE CLASS INJURY TD FACE,ARMS,AND HEAD
3
LICENSE 094RBU STATE WA VIN#' 1HGCM66553AO49766
10❑ PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12❑ VIN#j VIN#
2003 HOND ACD4D 4D I HI
FROM 34
13
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VECLE
2 DAMAGE YES NO �I YES[:] HI
REGISTERED OWNER INFO SCOTTSTRANOJORD STRANDJORDLINDA K BELLEVUE WA 98004 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE z INSURANCE CO SAFECO HIS13188 �3g 4
LI EFFECT &POLICY#VE—LE CHARGE 36
LEGALLv res❑NO❑ CITATION# 1
15❑ STA''ING 7 6
UNIT a2 VE ICCMOTOLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
17❑ NEW ADDRESS❑' CITY ST ZIP ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE VIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. '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
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF54770
COLLISION REPORT III III III III III 111
1591972 CASE# 25-149
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.
C.CATALAN 01-05-25 05:24 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 11812025 2:25:08 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 3:15 PM TIME POLICE ARRIVED',3:17 PM
PART I PAGE IT]OF 4�
REPORT NO. EF54770 CASE# 25-149 OF COLLISION
01/05/25 15:13
OF CbLLI510N
NARRATIVE
On January 5, 2025, at approximately 1513 hours, I was dispatched to a single injury vehicle collision
just east of Classics Sports Bar, 2431 Maple Valley Hwy, within the City Limits of Renton, County of
King, State of Washington.
Upon my arrival, I observed heavy mechanism to the involved vehicle with airbag deployment as well
as the involved driver complaining of pain. The Renton Regional Fire Authority (RRFA) responded to
the scene for evaluation. While on scene, I collected the involved party's driving information and their
independent recollection of the events leading up to the collision.
The driver of Unit 1 said he was the sole occupant of the vehicle and was traveling eastbound in
about the 2500 block of Maple Valley Hwy and approaching the intersection of SE 5th St in lane 1 of
2. The driver of Unit 1 stated he was going too fast for conditions. He mentioned he was going about
50 mph as he entered the S turns of Maple Valley Hwy.
*It important to note that a 35-mph precautionary sign sits just west of the S turn entrance.
The driver also stated that one of his tires was smooth and slick which contributed to the collision. As
he entered the S turns, his front right tire lost traction. He struck the jersey barrier twice which then
flung him across the westbound lanes, striking the hill head on. The hill is on the northside of Maple
Valley Hwy.
The vehicle sustained severe damage which caused his vehicle to go up in flames. Unit 1 required a
tow due to extensive damage.
The driver was cleared by Renton Fire and refused to be transported to the a hospital.
Based on the above statements, I determined that the Driver of Unit 1 is the proximate cause for the
cause of collision as the driver violated RCW 46.61.400 which states that a vehicle on the highway at
a speed greater than is reasonable and prudent under the conditions and having regard to the actual
and potential hazards then existing. In every event speed shall be so controlled as may be necessary
to avoid colliding with any person, vehicle, or other conveyance on or entering the highway in
compliance with legal requirements.
I provided the driver with my case number and contact information.
PAGE 3 OF 4
REPORT NO. EF54770 CASE# ' 25-149 DATE AND TIME 01/05/25 15:13
OF COLLISION
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