HomeMy WebLinkAbout25-4409 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF95171oc� RA
COLLISION REPORT 1591971
CASE# 25-4409 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eOCL s o v' 05 - 19 - 2025 1609 17 =.[� S 8 W e OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
EAST VALLEY RD
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e SW 41ST ST
0 4 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE
❑ CYCLE ❑ YES No �/ D:3038547801 N:5093633700 0 4 30
5 LAST NAME CARDINAL FIRST NAME CRANDALL MIDDLE K 1 1 2 31
INITIAL
STREET ] 5706 56TH AVE SE CITY; LACEY ST WA ZIP 985035995 2
NEW ADDRESS
7� +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYES D NOD I INTERLOCKVEs NO D YES NOD
8 DCIENSE# STATE WA SEXI M MMDDYY' 11 - 08 - 1986 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RE
STR 4 EJECT 1 N USE 2 CLASSY ? [NATURE of INJURIES 2
10 1� aiCENSE' RP11403 STATE WA VIN# 1XKYP40XORJ329800 3�
TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE#
TRLR zRLR 3 5 33
12 3 5 VIN# VIN#
FROM TO
VEH.YEAR 2024 MAKE KEN MODEL SEMI STYLE TR VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE 3 $ 34
13 DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO SYSTEM INC S 1405 HA YFORD RD CHENEY WA 99004 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 3 4
2 LIABILITY INSURANCE INSURANCE CO
14 Z ATTICRRG ATTSTJ125
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE t 5 36
Lemur yes[:]NO[:] CITATION# 7 0 80TTOM
15❑ sTnNowc s 7
1 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE PROPSnWNr YES�/ NO D:2069482251
16�
LAST NAME FOLLMER FIRST NAME MARK MIDDLE' A
INITIAL
17 F1 STREET ❑❑ 19629 104TH AVE SE CITY' RENTON ST, yyq ZIP 980557370 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTEI>'. 38
INTERLOCKYES NO INTERLOCK YES xz YES NO
19 DRIVER'S STATE WA SEXIM I DXIB 02 22 ?952 39
LICENSE# MMDDYY
11
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT ? USE 2 CLASS ? ❑
21 LICENSE BDL6071 TATE WA VIN# 5FNRL5H6XGB160046 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2016 MAKE HOND MODEL ODYSSEY STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO SUSAN FOLLMER 19629104TH AVE SE RENTON WA 98055 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO PEMCO INSURANCE CA 0319552
IN EFFECT &POLICY# t STOP
V EIL ,J—I CITATION# CHARGE to BOTTOM
LEn��Y YES❑ N`[
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.CATALAN 12007 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF95171
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4409
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&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
PC& I 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 05-20-25 02:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 512712025 9:57:26 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 1 4:11 Pry] TIME POLICE ARRIVED i 4:17 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 57
REPORT NO. EF95171 CASE# 25-4409 OF DATE AND r�N + 05/19/25 16:09
O�COLLISION
NARRATIVE
On May 19, 2025, at 1609 hours dispatch requested that I respond to a collision at the intersection of
East Valley Rd and SW 41 st St, in the city of Renton, county of King, and State of Washington.
Upon my arrival, I confirmed that no medical assistance was needed. While on scene, I was able to
collect each involved party's information and independent summary of the events leading up to the
collision.
The driver of Unit 1, identified as Crandall Cardinal, said he was making a left turn from SR 167 to go
southbound on East Valley Rd. While making his left turn, he was positioned in lane 4 of 4 (the
second left turn lane). Unit 2 was in the lane 3 of 4.
When the traffic signal turned green, both vehicles proceeded to make a left turn on East Valley Rd.
While turning, he failed to clear the space between his trailer and Unit 2. Both vehicles collided in the
intersection and Unit 1's trailer struck Unit 2's rear quarter panel causing moderate damage to Unit 2,
but minor damage to Unit 1.
The driver of unit 2, identified as Mark Follmer, recalled a similar story as Crandall. He stated that
Unit 1's trailer struck his vehicle while making a left turn. The damage was moderate and over $1000.
Based on the above statements, I determined that the Driver of Unit 1 (Crandall) is the proximate
cause for the cause of collision as he violated RCW 46.61.140(1) which states that a vehicle shall be
driven as nearly as practicable entirely within a single lane and shall not be moved from such lane
until the driver has first ascertained that such movement can be made with safety. Crandall made a
lane change into Unit 2's lane of travel which had the right of way and was underway.
Both Unit 1 and Unit 2 were driven away without further incident. An exchange of information was
provided to all involved parties.
No citations were given. Informational report only.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 05/20/2025 Renton
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EF951 71POLICE TRAFFIC
1 27
... ^'� COLLISION REPORT CASE#1 25-4409
t113197
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# 1 USDOT 0027935 ICC# 329800 VEHICLE TYPE 1 4 1 CARTGO BODY 4
YPE
CARRIER
2 ❑ 1 28
NAME. SYSTEM TRANSPORT INC.
...
3 CARRIER L
ADDRESS S 7405 HAYFORD RD
CITY CHENEY I ST WA ZIP 99004
4 ❑ NAME # PLACARD.
NAME IF NO NUMBER
SOURCE 3 AXLES 05 GWVR 105500 +
4a ❑ ADDITIONAL UNITS
UNIT# MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ VEHICLE ❑ ( CYCLE CI PEDESTRIAN C OWNER ❑'. YES NO
MIDDLE; 29
LAST NAME FIRST NAME INITIAL
STREET 30
CITY ST ZIP
NEW ARI3RFfi .
6 ❑ CDL GNITION REQUIRED PRESENT MEDICALTANSPORTED' 1 31
I RE' 1GNiTION ::
INTERLOCK YES NO :INTERLOCK YES NO YEs N
LICENSE STATE SEX MD.00.B _F�
7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruREofINJURIEs
USE CLASS
8 ❑ 1 32
LICENSE TAT VIN
PLATE#
9 TRAILER TRAILER L
PLATE# STATE PLATE# STATE
0
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
m 33
REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA
12
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
IN EFFECT &POLICY# �GQl
34
13 vewc�e YES NO[jj CITATION# CHARGE
ecauv
sTnNoiNc
MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME NIT AL
16 ❑ STREET �' CITY ST' ZIP
NFW AODRFss
CDL IGNITION RE6UIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES NO INTERLOCK YEs NO .YES NO
17 37
LLIRIVERS ICENSE# STATE SEX MD.r3O.B
18 ❑ ❑
HELMET 'INJURY NATURE OF INJURIES 38
ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS.
19 ❑ ❑ 39
LICENSE TAT viN#
PLATE#
20 TRAILER' TRAILER 40
PLATE#, STATE STATE PLATE# - ❑
21 ❑ TRLR TRLR 41
VIN# VIN#Y
42
22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY# 7c;Q
S. 44
vewc�e ❑ ❑ CITATION# CHARGE
24 I..TF_ YES NO
STIWDING 8 3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 05-20-25 02:34 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE OR ID# 12007 O#RI WA0171300 APJACOBS 5122712025
PAGE�OF
3000-345-013(R 11/18)
REPORT NO. EF95171 CASE# 25-4409 DATE AND TIME 05/19/2516:09
OF COLLISION> '
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PAGE 5 OF 5