HomeMy WebLinkAbout25-3263 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF82292oc� RA
COLLISION REPORT 1591971
CASE# 25-3263 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOt`CO AGENCY 4100 3
COUNTY RD NVOLVED CODING
2❑ TOTAL 1
PRIVATE WAY
TRIBAL UNITS#OF 02 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
coLLISION' 04 - 11 - 2025 0513 17 =.= S 8 W E OF IN M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
LAKE WASHINGTON BLVD BLOCK NO. e 1300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S 8 w
0 1 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO O 1 30
6 LAST NAME MOE FIRST NAME ZACHARY MIDDLE A 1 1 2 31
INITIAL
STREET 1:1 11529 87TH AVE S
NEW CITY, SEATTLE ST WA ZIP 98178 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No✓ INTERLOCKYEs NO✓ YES✓ NO.
8❑ DCIENSE# STATE WA SEX M MMOCSYY' 05 1 2 32
9 ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 IN
5 —NATURE of INJURIES
2
USE CLASS UNKNOWN
10 9 al ENSrtEI D19284E STATE WA VIN# 1FTFW1EVOAFB82588 3
11[-j- TRAILER STATE TRAILER ,STATE
11 2 5 PLATE# PLATE# FROM To
TRLR rRLR 1 5 33
12 2 5 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 v GOVT VEHICLE g 1 34
13 2 2010 FORD F150 PK DAMAGE YES ✓ No d gWg MEYERS YE s� No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ NSURANCE CO UNKNOWN 3 4
IN EFFECT &POLICY# 4TOP
v `LE CHARGE 5 36
Lec Ly YES❑NO❑ CITATION# 76 BOTTOM
MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE' ❑ ❑ nWNFR fl YE:
No �/ D:2064786443
16�
LAST NAME SWANSON FIRST NAME ARMOND MIDDLE G
INITIAL
17 F1 STREET ❑
317 S 202ND ST CITY DES MO/NES ST, WA ZIP 98198 4 37
NEW AbbRESS
18� CDL ...; IGNITION REQUIRED IGNITION PRESENT MEDIGALTRAN$PORTED' 38
INTERLOCKYEs No✓ jNTERLOCKYEs No✓ vEs No,✓
19 DRIVER'S STATE WA SEXI M I DO.B• I 10 12 1967 39
LICENSE# MMDDYY -
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H UET 2 SE CLAY 1 NATURE OF INJURIES 40
SS
21 LICENSE I PATE# C97495H TATE I WA VIN# 3BPZX2OX9HF173914 41
22❑ PLTL ATE# STATE TILER PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2017 MAKE pTRg MODEL CONVEN STYLE GG VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24= DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO RABANCO LTD 220f076TH AVE S KENT WA 98032 D:2064786443 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO AMERICAN INSURANCE ISA H10740083
IN EFFECT &POLICY# t❑ ,. CITATION# CHARGE YES N 25 q�Q
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RAYMOND WATSON 13127 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF82292
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3263
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.
RAYMOND WATSON 04-12-25 05:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 411412025 8:39:27 AM
BADGE OR ID# 13127 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:13 AM TIME POLICE ARRIVED 5:18 AM
PART B 3 Do-345-,ao(Rtrras) PAGE 27 OF 57
EAN
REPORT No.` EF82292 CASE# 25-3263 O OF COLLI COLLISION TIME 04/11/25 05:13
COLLI
NARRATIVE
25-3263
This report is a summary of events that occurred and is not an exact sequencing of events.
Statements have been paraphrased and summarized.
On 04/11/2025 at approximately 0515 hours, I was dispatched to a blocking two-vehicle collision with
injuries in the 1300 block Lake Washington BLVD N, within the City Limits of Renton, County of King,
State of Washington.
Upon arrival, I saw a black pickup facing southbound and a garbage truck facing northbound had
collided. I contacted the driver of the garbage truck, who was standing at the doorway of the black
pickup. He informed me that the driver of the pickup was not responsive but breathing.
The driver of Unit#1(WA Plate# D19284E, Zachary A. Moe DOB 05/01/1975, verified by WADOL
photo) was unresponsive but breathing upon my arrival. After noticing that Moe was having difficulty
breathing, I went into the rear seat of his vehicle to stop his head from leaning forward and
obstructing his airway. After Renton Fire Department (RFD) personnel arrived on scene, I conducted
a visual check of the area. Unit#1 appeared to be traveling southbound on Lake Washington BLVD N
when he struck Unit#2 in front of the 1300 block of Lake Washington BLVD N. The driver of Unit#1
was unable to give his account of the events leading up to the collision while at the incident. There
was extensive front-end damage to Unit#1.
The operator of Unit#2 (WA Plate# C97495H, Armond G. Swanson DOB 10/12/1967, verified by
WADOL photo), who was driving a Republic Garbage truck, stated that he was picking up a refuse
container at 1300 Lake Washington BLVD N when he noticed out of the corner of his view a truck
moving at a high rate of speed southbound on Lake Washington BLVD N when he was struck by Unit
#1. Swanson also stated that he did not believe Unit#1 had his lights on when he was coming down
the road. Swanson later provided other officers on scene with his documentation. Unit#1 made
impact with the rear left tires and no noticeable areas were damaged on U nit#2.
Other officers on scene attempted to contact the Hampton Inn and Residence Inn to see if their video
security footage captured the collision, but none was obtained at this time. A business card was left
with both hotels in case they are able to obtain footage. The driver of Unit#1 was transported to
Harborview Medical Center for treatment.
Unit#1 was towed by Gene Meyers due to the extensive damage, the vehicle blocking the roadway
and the operator being transported to the hospital. Unit#2 was able to be driven from the scene. I
uploaded photos taken of the collision scene to evidence.com.
I contacted a family friend of Moe's, who was with his mother, and informed them of where his vehicle
was towed to and the hospital he was transported to.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by R. Watson #13127 on 04/11/2025 at 0957 hours in Renton, Washington.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EF82292POLICE TRAFFIC
1 27
COLLISION REPORT CASE# 25-3263
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓
UNIT# 2 USDOT ICC# VEHICLE TYPE 2 1 CARGO BODY 8
TYPE
2 ❑ 1 28
CARRIER NAME RABANCO LTD
3 CARRIER L
ADDRESS 22010 76TH AVE S
CITY KENT ST WA ZIP 98032
4 NAME # PLACARD. -�
NAME IF NO NUMBER
SOURCE 13 1 AXLES ,03 GWVR 1000 +
4a ❑ ADDITIONAL UNITS
1�N IT.µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5
lJ '# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
CI '. C) �
MIDDLE; 29
LAST NAME FIRST NAME INITCAL
STREET 30
NFW ADDRFG� CITY ST ZIP
6 2 PRESENT MEDICAL TANSPORTED
1 31
GDL IGNITION REfJUIRED IGNi710N
INTERLOCK YES NO (INTERLOCK YES[]NO[] YES NOD
IDRIVER'S
LIC NSE STATE SEX M�oDvw -
7
ON DUTY STATUS: AIRBAG RESTR. EJEG7 HELMET INJURY NAruREofINJURIEs
USE CLASS
8 ❑ #LICNSE VIN 1 32
PLATE# rAT
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 GOVr.VFHICI F FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 1GQI
m 34
13 vewc�e YES NO CITATION# CHARGE
sT7 t
MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET PHONE 1:1
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 REOUIRED IGNITION PRESENT MEDiCAiTANSPORTED
INTERLOCK YES NO INTERLOCK VES NO YE NO
17 37
LDRIVERS IGENS # STATE SEX M�oflYBYY'
18 ❑ NATURE OF INJURIES ❑
HELMET INJURY 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ ❑ 39
LICENSE viN
PLATE# TAT #
20 ❑ TRAILER' TRAILER ❑ 40
PLATE#. STATE PLATE# STATE
21 ❑ TRLR TRLR 41
UIN# 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 I &POLICY# tK-99
5 44
vewc�e ❑ ❑ 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.
RAYMOND WATSON 04-12-25 05:09 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE 1 OR ID# 13127 O#RI WA0171300 APPROVED By 4114/2025
PAGE OF
3000-345-013(R 11/18)
REPORT NO. EF82292 CASE# 25-3263 DATE AND TIME i 04/11/25 05:13
OF COLLISION
i
tr+'
1
�4
4
wi
i{
k
F
I
aiyC
t
PAGE 5 OF 5