HomeMy WebLinkAbout25-4240 ("7—
STATECETRAFF'c" REPORT N0. EF96596 3 127
COLLISION REP F 1591971
CASE# 25-4240 z
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4100 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL UNITS#OF 01 S JECT 1 RUCK CONCRETEMERSEY BARRIER 28
RESERVATION 1 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 05 - 14 - 1 0104 17 �. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAPLE VALLEY HWY BLOCK NO. 8 131000 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.= FEET e Se W8 131STAVESE
0 1 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES ,/No D:9197936223 30
g� LAST NAME : GOW/N FIRST NAME RAJENDRA MIDDLE' N 1 2 31
INITIAL
STREET E:1' 15283 OAK OR CITY RENTON WA
NEW ADDRESS S7 ZIP 98058 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT NEDICALTRANSPOftTED 3
INTERLOCK YES NO,/ INTERLOCKYES NoW
8❑ LICENSE# STATE WA SEX'M MMDDW 10 - 02 - 1962 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET
L E7 2 1 INJURYCLASS 6 HEAD TRAUMANATURE OF IES 2
10❑ LICn NSte BRH5163 sr WA WIN# WAUKJAFM5CA012162 3
RA TRAILER
11 5 0 PLATE# STATE PLATE# STATE FROM -
TRLR TRLR. 7 3 33
12 VIN# VIN#
: FROM TO
13 4 VEH.YEAR2012 MAKE AUDI MODEL A3 STYLE SD VEHICLE TOWED 2NO ll—IN Tv4&LBYMEYERS Govv ENOL� m 34
❑ DAMAGE II1I._IIII -IIJJ
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
❑ SHADE 1N DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE NSURANCE CO UNKNOWN
IN EFFECT &POLICY# ®TOP
VEHICLE ❑ 36
EGALI v YES[:]NO❑ CITATION# CHARGE BOTTOM
15❑ STANDwG
UNIT ' MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
❑
VEHICLE CYCLE OWNER YES NO
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
17
STREET
CITY' ST' ZIP 37
❑ {I��I
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YES No INTERLOCK YES NO YES No
19❑ LICENSE# S1A7E SEX MMDDYY - _ 3❑ 39
20❑ ON DUTY STATUS AIRBAG RESTR EJECT HELMET I INJURY NnruREOFINJURIES ❑ 40
USE CLASS
21 LICENSE❑ PLATE# TATE' VIN# 41
❑ 42
22 TRAILER TRAILER
PLATE# STATE PLATE S7A7E
23 43
TRLR RLR
VIN# IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GO HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO E 3 4
IN EFFECT &POLICY# t GQ
VEHICLE ❑ .1-1 CITATION# CHARGE
25
LEGALLY YES NC[:]
s e
71FFIIER�S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7AGENCY
26
N TURNER 12650 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF96596
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4240
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
POS. ' USE GLASS 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 0,SS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJU S' NATURE OF INJURIES
❑ ❑ POS. I USE GLASS
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.
JASON TURNER 05-28-25 12:52 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 5/31/2025 8:05:30 PM
BADGE OR ID# 12650 ORI# WA0171300 TIME POLICE DISPATCHED 1 1:04 AM TIME POLICE ARRIVED i 1:08 AM
PART B 3000-345.160(Brute) PAGE 0 OF 47
REPORT NO. EF96596 CASE# 25-4240 OF COLLI ION 05/14/25 01:04
OF COLLISION
NARRATIVE
On 05/14/2025 at approximately 0104 hours, I was working as a Police Officer for the City of Renton.
While working i was dispatched to a single vehicle accident at the intersection of Maple Valley HWY
and 131 st Ave SE, located in the city of Renton, King County, Washington.
The notes of the call stated that a vehicle had struck a cement wall and the occupant has not gotten
out.
I arrived on scene and observed the vehicle, a 2012 Audi A3 (WA LIC: BRH5163) in the bushes next
to the right eastbound lane. The vehicle had appeared to have veered off the roadway and struck a
concrete barrier head on. Officer Nguyen contacted the driver/registered owner of the vehicle,
identified as Rajendra Gowin. Officer Nguyen advised that Rajendra appeared to be actively seizing.
I was able to speak with Rajendra about the collision and he reported that he had been traveling
eastbound on Maple Valley Hwy approaching 131 st Ave SE when he began to pass out. He began to
veer off the roadway eventually striking the concrete barrier.
Renton Fire arrived on scene an evaluation. Rajendra reported that he was a diabetic and it was
found that his blood sugar was extremely low. Due to the collision and Rajendra's sugar levels they
recommended Rajendra be transported to the hospital. Rajendra was transported to Valley Medical
Center.
Rajendra's vehicle was towed by Gene Meyers Towing. Rajendra's vehicle had extreme damage all
over the vehicle with multiple airbags deployed.
I find that the proximate cause of the collision is the medical issue Rajendra suffered while driving.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by J. Turner 12650 on 05/28/2025 at 0045 hours.
PAGE 3 OF 4
REPORT NO. EF96596 CASE# 25-4240 DATE AND TIME 05/14/2501:04
OF COLLISION
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PAGE 4 OF 4