HomeMy WebLinkAbout25-3079 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF80148oc� RA
COLLISION REPORT 1591971
FIRE CASE# 25-3079 2
INTERSTATE � CITY STREET ❑RESULTED
1 1 STATE ROUTE OTHER STOLEN
❑ � VEHICLE ❑ LOCAL AGENCY 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED TOTAL 1
2❑ TRIBAL UNITS#OF 03 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
cbLLISION' 04 - 06 - 2025 0707 17 =.= S 8 W e IN OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
MAPLE VALLEY HWY MILE POST
e 2500 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S 8 W
2 3 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:5104181944 0 1 30
6❑ LAST NAME AVELLANEDA-CARMONA FIRST NAME IRWING MIDDLE p
INITIAL 1 2 31
STREET ❑ 16700 31 ST AVE S APT150 CITY SEATAC ST; WA ZIP 98188 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO�/ INTERLOCKYEs N �/ YES�/ NO
8� LICIENS# STATE WA SEX M MMor YY' 04 - 16 - 1992 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT, 1 HELMET 2 INJURY 6 NATURE of N SE&S 2
USE CLASS BLOODY NOE&SODYPAIN
10 9 LI ENSE', A8125566 sTArE WA vrN# 5YJ3E1EBOKF437600 3
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# RON To
rRLR TRLR 3 7 33
1 0
'.....: FROM TO
2 Q VIN# VIN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT VEHICLE 7 3 34
13 2 2019 TESL MODEL SD DAMAGE YESONo �MEYERS Yes No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ ANCE CO
14 �/ DA/RYLAND AUTO 11410023136
IN EFFECT &INSURPOLICY# 9TOP
vEnicLE CHARGE S 36
Lemur YES[:]NO[:] CITATION# 7 o BOTTOM
15❑ STMDwc 7 e
III MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES,/ NO D:5202802771
16�
LAST NAME LINCOLN FIRST NAME DEVIN MIDDLE I M
17 F1 INITIAL I
STREET ❑
'NEW ADDRESS❑ 2607 NE 4TH ST APT 228 CITY I RENTON ST, WA ZIP 98056 4 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIOAL TRANSPORTEDI 38
INTERLOCKYEs No INTERLOCK YES NO YEs No
19 DRIVER'S STATE WA SEX NI D.O.e. 03 13 2004 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY' 6 NATURE OF INJURIES 40
USE CLASS BLOODY NOSE&LEG PAIN
21 LICENSLATE E CFH8191 TATE WA VIN# 1HGCR6F74FA010545 � 41
42
22❑ PLATE# STATE PATE# STATE
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2015 MAKE HOND MODEL ACCORD STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE vEs�/ No GENE MEYER
REGISTERED OWNER INFO DEVIN LINCOLN 2607 NE 4TH ST APT 228 RENTON WA 98056 D5202802771 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO UNKNOWN UNKNOWN
IN EFFECT &POLICY# 9TOP
vemae ❑ CITATION11 CHARGE to BOTTOM
LEGnllr YES N 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
BLAKE BOWIE 12105 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF80148
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3079
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'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
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.
BLAKE BOWIE 04-06-25 11:21 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 4/6/2025 3:33:39 PM
BADGE OR ID# 12105 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:09 AM TIME POLICE ARRIVED 7:14 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 57
REPORT No.` EF80148 CASE# 25-3079 COLLI SICiN TIME OF 04/06/25 07:07
COLLI
NARRATIVE
On 04-06-2025 at 0709 hours I was dispatched to Maple Valley Hwy/ SE 5th St, in the City of
Renton, County of King, State of Washington, for a reported three vehicle collision with injuries.
While enroute, dispatch advised that three vehicles were in a collision and they were blocking all
lanes of Maple Valley Hwy. The three vehicles included a Tesla, Tahoe, and sedan. The reporting
party stated the Tesla involved in the collision was going 80-90 MPH. The next update was that a
subject was trapped in a white sedan.
Upon Arrival, the Renton Fire Department was already on scene evaluating the three drivers. All
three vehicles has significant damage and blocked all lanes of traffic.
I contacted Dale R. Thurman (DOB: 11-21-1962) which was the driver of the white 2021 Chevy
Tahoe (WA LIC: CPY0957). He stated he was in the left lane going eastbound on Maple Valley Hwy
through the "S" curves when the Tesla going westbound drifted into the eastbound lanes at a high
rate of speed. The Tesla hit the front side of the white sedan, spun and hit the front of his Tahoe. Dale
tried to turn out of the way but it was to late. Dale had minor injuries to hit finger but his back/neck
was hurting so he was transported to Valley Medical Center for further evaluation. 1 provided Dale
with my business card which contained the case number for his records.
Next, I contacted Devin M. Lincoln (DOB: 03-13-2004) which was the driver of the white 2015 Honda
Accord (WA LIC: CFH8191). He was shaken up and not feeling very well so he did not remember
much of what happened. He remembered driving eastbound on Maple Valley Hwy when a Tesla
came into his lane and hit him. His airbags went off and eventually some people were pulling him out
of his vehicle. Devin was bleeding from his nose and his leg hurt so he was transported to Valley
Medical Center. I provided his family with my business card which contained the case number for his
records.
Officer Fajarillo spoke with Irwing D. Avellaneda-Carmona (DOB: 04-16-1992) which was the driver of
the gray 2019 Tesla Model 3 (WA LIC: A8125566). Irwing stated he was driving eastbound on Maple
Valley Hwy (which seems to be incorrect) after his shift at Amazon. While driving 35 mph, his Tesla
drifted into the other lane and he tried to correct it but got in a collision with the other vehicles. He
does not know how he got into a collision and did not know where the other vehicles were. See
Officer Fajarillo's report for further information. Irwing had minor injuries and was transported to
Valley Medical Center for further evaluation.
All three vehicles had significant damage so they were all towed.
Based on the information gathered from the drivers, looking at the damaged vehicles, and where they
ended up, 1 believe the following happened. The Honda and Tahoe were driving eastbound on Maple
Valley Hwy when the speeding Tesla was unable to maintain its lane around the curve of the road
and came into oncoming traffic. The Honda was hit on the front drivers side corner/door which pinned
the driver inside and pushed the Honda to the far south cement barrier. Once the Tesla hit the Honda,
the Tahoe was trying to turn out of the way but the Tesla spun and hit its back passenger side straight
into the front of the Tahoe. The Tahoe was pushed into oncoming traffic and the Tesla stopped
sideways in the middle of the four lanes facing north.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electrically signed by Officer B. Bowie / 12105 on 04-06-2025 at 1050 hours in the City of Renton.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EF80148
POLICE TRAFFIC
1 1 8 27
COLLISION REPORT CASE#+ 25-3079
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
GWVR NO NUMBER
SOURCE AXLES1:1 + NAME IF
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT : 3 �✓ PEDESTRIAN vps No D:2069311029
5 VEHICLE CYCLE OWNER
0 1 29
I NITIAL E
LAST NAME THURMAN FIRST NAME DALE I ; R
ITCA
STREET 30
NEW nDDR s 24211 231 ST AVE SE CITY MAPLE VALLEY ST WA ZIP98038
6 IGNITION REQUIRED iIGNITION PRESENT MEDICALTANSPORTED: 1 1 2 31
CDL
INTERLOCK YES; NO�/ INTERLOCK YES NOS/ YES / N
G
DRIVERS STATE WA SEXM D.O.B 11
LICENSE; MMDD w - 21 - 1962
ATURE 7
HELMET INJURY NIGEIOFINJURIEs
ON DUTY STATUS: AIRBAG 6 RESTR. 4 EJECT 1 USE 2 CLASS 6 FINGER AND BACK/NECK PAIN
LICENSE CPY0957 rar WA VIN# 1GNSKNKD5MR123270
PLATE#
9 9 TRAILER TRAILER 2
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2021 MAKE CHEV MODEL TAHOE I STYLE VEHICLE TOWE�/ E T ABLI �9�Y'ER GO VT
AMAGE YES NO S VFHINOCI E PROM TO
D YE
REGISTERED OWNER INFOOWNED BYDRIVER 7 3 33
SHADE IN DAMAGED AREA
12 3 4
LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2027362522 ROM TO
❑ IN EFFECT &POLICY# 34
13 2 vEnic�E YES NO[jj CITATION# CHARGE 1C}80T TC)M
ecauv
s-rnNoiNc A 6
MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME NIIT ALE
MIDDL
❑
16 ❑ STREET CITY ST! ZIP
NEW ADDRESS"
GNITION REQUIRED GNITION PRESENT MEDICAL TANS.
PORTED
NTERLOC O
17 INTERLOCK Y=ESNO YES NO
4 37
LLIICENSE RIVERS STATE SEX MMDD _�
18 ❑
HELMET INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ LICENSE TAT VIN# 39
PLATE#
20 ❑ TRAILER TRAILER ❑ 40
PLATE#. STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
VIN#�. VIN#+.
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE[—] INSURANCE CO
IN EFFECT &POLICY# t.K-99
5 44
vFHic�F ❑ ❑ CITATION# CHARGE 24 IEG_ VES NOSTIWDING3 3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
BLAKE BOWIE 04-06-25 11:21 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OR ID# ! 12105 O#RI WA0171300 APPROVED BY
41612025
PAGE[4 OF
3000-345-013(R 11l18)
REPORT NO. EF80148 CASE# 25-3079 DATE AND TIME i 04/06/25 07:07
OF COLLISION
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PAGE 5 OF 5