HomeMy WebLinkAbout25-3438 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF84800oc� RA
COLLISION REPORT 1591971
CASE# 25-3438 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 28
TRIBAL i UNITS U9 STRUCK TREE OR STUMP
RESERVATION I 1 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDL�ISION' 04 - 16 - 2025 1712 17 =.�� S W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
DUVALL AVE NE BLOCK NO. e 400 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e NE 4TH ST
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:9702915635 30
6 LAST NAME TAYLOR FIRST NAME STEPHEN MIDDLE IS 0 1 31
INITIAL
STREET ] 1912 HEARTLAND DR CITY; LYNDEN ST WA ZIP; 982649367 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3
INTERLOCKYEs ND INTERLOCKYEs NO YES NO
8❑ DCIENSE# STATE WA SE XI Ni MMDDYY' O6 — 03 — 1999 32
9� ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET CLASSY 1 NATURE of INJURIES 2=
10 LICENSE ARX8132 STATE WA yIN 2MEFM74WXWX606307 3
TRAILER STATE TRAILER STATE
11 3 5 ,LATE# PLATE# FROM To
TRLR rRLR 7 1 33
12 VIN#' VIN#
FROM TO
VEH.YEAR 1998 MAKE MERC MODEL GRAND STYLE VEHICLE TOWED[n TO ZBLIN TOWED BY GOVT VEHICLE m 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO DANIEL LA BLANC 131134171ST AVE SE RENTON WA 98059 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO PROGRESSIVE 970f04750 3 4
IN EFFECT &POLICY# 4TOP
vEnicLE CHARGE 5 36
Lemur yes❑NO❑ CITATION# 7 0 80TTOM
15❑ STM ING s 7 e
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
UNIT 0' PEDESTRIAN
VEHICLE CYCLE' OWNER YES NO
16❑
LAST NAME FIRST NAME MIDDLE'
INITIAL
17❑ STREET ❑ CITY ST ZIP ❑ 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED 38
INTERLOCKYEs ND INTERLOCK YES R No vEs NQ
19 LICENS# STATE SEX MMDDYY —= 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASS ❑
21 1
LICENSE I,LATE# TATE VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# GQ
vewae ❑ .I—I CITATION# CHARGE
EEGnEEY YES N`L]
25 a ' s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ROGER RANAN 13156 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF84800
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3438
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) JENKINS ASHLYNNA
ADDRESS&PHONE#
1704 15TH AVE MILTON WA 983549105 SEXi F MMDDD B. 08 — 24 — 2004
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
Q 1 POS. 3 2 4 1 USE CLASS 11 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
:.(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I USE CLASS
NARRATIVE
CC 25-3438
On 4/16/2025 at 1714 hours I was dispatched to a single motor vehicle collision at 400 block of Duvall
Ave NE in the City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that he was performing a lefthand turn from NE 4th St in the left turn lane facing East
on NE 4th St at Duvall Ave NE.
Collision
Driver 1 stated that his brakes locked up and he was unable to slow down during his turn to proceed
North on Duvall Ave NE. Driver 1 stated that Unit 1 exited the roadway on the East side of Duvall Ave
NE and struck a tree, then coming to a rest.
Injuries
No injuries reported.
Vehicle Disposition
Unit 1 was towed from the scene.
Proximate Cause
This appears to be a mechanical failure of the brakes from Unit 1.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer R. Ranan #13156 at 17:38 on 4/16/2025 in the City of Renton, King
County, Washington.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
ROGER RANAN 04-16-25 05:44 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY E
DAT
P.KORDEL 9676 412212025 6:01:54 PM
BADGE OR ID# j 13156 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:14 PM TIME POLICE ARRIVED i 5:24 PM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3
REPORT NO. EF84800 CASE# 25-3438 DATE AND TIME 04/16/2517:12
OF COLLISION
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