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HomeMy WebLinkAbout25-5452 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG06252OLCERA COLLISION REPORT 1591971 ASE# 25-5452 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4200 3 COUNTY RD NVOLVED CODING PRIVATE WAY 2❑ TRIBAL TOTAL 1 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 GOLL.ISION'. 06 - 23 - 2025 0856 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a S 3RD ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 . FEET e S 8 W e SHATTUCKAVES OF 4 29 MOTtlR PEDAL- DAMAG THRESHOLD MET PHON UNIT 01 E VEHICLE ❑ CYCLE ❑ YES No �/ D:2067023335 0 1 30 6 LAST NAME WESTON FIRST NAME DAVID MIDDLE S 1 1 2 31 INITIAL STREET ❑ 24032 231ST AVE SE CITY MAPLE VALLEY ST WA ZIP 980385254 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs NO I INTERLOCKYE! No YES F NO 8 LICIENSE# STATE WA SEX M MMOCSYY' 08 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY CLASS 1 NAruRE of INJURIES 2 10 as ENSrtEI RP22493 STATE WA VN# 1XPBDP9XXRD680807 3 TRAILER 39373AK STATE WA TRAILER ..STATE 11 2 5 PLATE# PLATE# ROM TO TRLR TAR 7 1 33 12 2 5 VIN# VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT VEHICLE 13 1 2024 PTRB TRUCK DAMAGE vesNo ✓ ves❑ No 7 3 34 REGISTERED OWNER INFO PLYMOUTH POULTRY COMPANY 2230TH STNE SUITE 102 AUBURN WA 98002 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14� UABILITYINSURANCE� INSURANCE CoALASKANAT..INSURANCECO24HAU12644 2 3 4 IN EFFECT &POLICY# 4TOP _ Yes srgNOLNG ❑NO❑ CITATION# 5A0512690 CHARGE PROWIMPROPER TURN s o ooTrofi 36 15 III MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT O2 VEHICLE CYCLE nWNFR YES)/ NO D:4252249725 16� LAST NAME SMITH FIRST NAME EPHRAIM MIDDLE R INITIAL 17 F1 STREET ❑'❑ 813 LAFAYETTE ST S CITY TACOMA ST, WA ZIP 37 984444921 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSP©RTED' ❑ 38 INTERLOCKYEs No INTERLOCKYEs NOR yEs No 19 DRIVER'S STATE WA SEX M I D.O.B. 08 14 1978 ❑ 39 LICENSE# MMDDYY' — HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSE I PATE# CRB2306 TATE WA VIN# 4T1BF28B52U237762 41 22❑ PLATE# STATE PAAILER TE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. TOWED BY GOV HI 44 VEH.YEAR 2002 MAKE TOYT MODEL AVALON STYLE DAMIAGE TOWED�/ No BLIN PRIVATE TOW YES No V/ 24 REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT 8.POLICY# 9TOP 1-1— ❑ ,.I—I CITATION# CHARGE t080TTOM LE—Y YES NCO J 25 s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG06252 COLLISION REPORT III III III III III 111 1591972 CASE# 25-5452 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. C.ARNOLD 06-23-25 11:05 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE 7/3/2025 8:54:26 AM C.JACOBS 1953 BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:58 AM TIME POLICE ARRIVED 10:15 AM PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 57 REPORT No.` EG06252 CASE# 25-5452 O COLLI COLLISION TIME OF 06/23/25 09:56 COLLI NARRATIVE CC 25-5452 On 6/23/2025 at 0958 hours I was dispatched to a motor vehicle collision at intersection of S 3rd St and Shattuck Ave S in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that he was traveling East on S 3rd St approaching Shattuck Ave S in the #2 lane. Driver 1 stated that he was traveling East on S 3rd St approaching Shattuck Ave S in the #1 lane preparing to perform a lefthand turn to proceed North on Shattuck Ave S. Collision Driver 2 stated that as he entered the intersection of S 3rd St and Shattuck Ave S, Unit 1 began a lefthand turn in the intersection from the #1 lane. Driver 2 stated that he was unable to avoid a collision. Driver 2 stated that the rear drivers side trailer of Unit 1 collided with the front passenger side A-Pillar of the windshield. Driver 2 also stated that the rear drivers side wheel of Unit 1 collided with the passenger side doors of Unit 2. Unit 2 was then forced into the curb striking the front drivers side tire. Driver 1 stated that he did not see Unit 2 and that as he began his lefthand turn, Unit 2 collided with the drivers side middle trailer and rear drivers side wheels of Unit 1. Driver 1 provided me video of the incident that shows the collision and both Drivers stories matched. A witness was on scene but left before providing comment. His information was partially gathered by Driver 2 and a video statement that was taken by Driver 2 of the Witness was uploaded to evidence.com. Injuries No injuries reported. Vehicle Disposition Unit 1 was operational and Unit 2 was rendered inoperable. Driver 2 called for a private tow. Proximate Cause I determined that Driver 1 is the proximate cause of this collision because the driver of a vehicle intending to turn left shall approach the turn in the extreme left-hand lane lawfully available to traffic moving in the direction of travel of the vehicle. Whenever practicable the left turn shall be made to the left of the center of the intersection and so as to leave the intersection or other location in the extreme left-hand lane lawfully available to traffic moving in the same direction as the vehicle on the roadway being entered. Driver 1 was cited per RCW 46.61.290. 1 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 C. Arnold #12509 at 10:48 on 6/23/2025 in the City of Renton, King County, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG06252POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 25-5452 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ UNIT# 1 USDOT ICC# VEHICLE TYPE s 1 CARGO BODY 2 TYPE 2 ❑ 1 28 CARRIER NAME. PLYMOUTH POULTRY COMPANY 3 ❑ CARRIER 22 30TH ST NE SUITE 102 L ADDRESS CITY AUBURN ST WA I ZIP 98002 4 NAME I I # PLACARD. -� NAME IF NO NUMBER SOURCE' 3 AXLES 03 GwvR 36000 + 4a ❑ ADDITIONAL UNITS 5 U UNIT N�T.µ MOTOR PEDAL- PROPERTY DAMAGE HONE THRESHOLD MET P '# VEHICLE ❑ : CYCLE ❑ PEDESTRIAN OWNER ❑ YES NO MIDDLE; 29 LAST NAME FIRST NAME fNITCAL STREET 30 NFW ADDRFs CITY ST ZIP 6 1 CDL GMTIt7N REQUIRED PRESENT MEDICAL TANSPORTED 1 31 I ONO[:] '.iGNi71GN INTERLOCK YES :INTERLOCK YES NO[] YES N G LICENSE STATE I SEX MMODvvv -�- 7 ON DUTY STATUS: AIRBAG RESTR. EJECT HELMET INJURY NATUREOFINJURIES USE GLASS 8 ❑ LICENSE VIN 1 32 PLATE# TAT 9 TRAILER TRAILER 2 PLATE# 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 m 33 REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO IN EFFECT &POLICY# �GQl 34 13 YES NO CITATION# CHARGE vewc�e ecauv DAMAGE THRESHOLD MET PHONE 35 sTnNoiNc MOTOR PEDAL- ' PROPERTY 1:1 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 15 LAST NAME FIRST NAME ❑INITMIDDL ALE 36 16 ❑ STREET CITY ST ZIP NFW ADDRESS" GDL IGNITION REOUIRED IGNITION PRESENT ME INTERLOCK YES ]NO INTERLOCK YE5 NO .YES NO 17 37 LLIICENSE RIVERS STATE SEX JD- MDfl - C===� 18 ❑ HELMET INJURY NATURE OF INJURIES 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 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 I INSURANCE CO IN EFFECT &POLICY# tK-99 5 44 vewc�e ❑ ❑ CITATION# CHARGE 24 ITGA VES NOSTWN3 3 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.ARNOLD 06-23-25 11:05 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 12509 O#RI WA0171300 APJACOBS 713312025 PAGE OF 3000-345-013(R 11l18) REPORT NO. EG06252 CASE# 25-5452 DATE AND TIME i 06/23/25 09:56 OF COLLISION J?a` Ylpy ulk HATT i 3 S sa3 �{ k a� U k, I E �i PAGE 5 OF 5