HomeMy WebLinkAbout25-8195 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG31033OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-8195 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL STRUCK#OF OBJECT 1 28
TRIBAL UNITS U9 GUARDRAIL
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 09 - 21 - 2025 0343 17 =.[� S 8 W e OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO.
❑
MILE POST e
4a
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 10001.1 FEET e✓ S 8 W e✓ SE STH ST
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2538677314 30
LAST NAME CORLETTO-FARKAS FIRST NAME SOPHIA MIDDLE M
6 INITIAL 1 2 31
STREET ❑ 19522 SE 261ST ST
NEW ADDRESS CITY I COVINGTON S7' WA ZIP; 98042 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No�/ INTERLOCKYEs NO�/ YEs NO r✓
8 DRIVER' # STATE WA SEXI F MMDDYY' 07 — 07 — 2002 32
9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT ', ) HELMET 2 INJURY 6 NATURE OF INJURIES 2
USE CLASS NECK PAIN,WRIST PAIN,SEATBELT BURN
10 LI ENSE' ALC3634 STATE WA VIN# 1HGFA16216LO60397 3
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM To
TRLR zRLR 3 3 33
12� UIN#' VIN#
FROM TO
GO
HICLE
13 4 VER YEAR 2006 MAKE HOND MODEL CIVIC STYLE SD DAMAGE TOWED NO�iS46LIN T(QigWgYMEYERS YES❑E NO m 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE NSURANCE CO PROGRESS UNKNOWN 3
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 36
Lemur yes❑NO❑ CITATION# t a 80TTOM
15❑ sTANowc 7
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
UNIT�' PEDESTRIAN
VEHICLE CYCLE' OWNER YES NO
16❑
LAST NAME FIRST NAME MIDDLE'
INITIAL
17❑ STREET ❑ CITY ST ZIP 4❑ 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED: 38
INTERLOCKYEs No INTERLOCK YES No vEs NQ
19 DRIVERS
# STATE SEX MMDDYY —= 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASSLICENSE
❑
21 PLATE# 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# 9TOP
YemcLe YES N❑ C[ CITATION# CHARGE to BOTTOM
EEGAEEY
25 s s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JASON TURNER 12650 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG31033
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8195
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 NJURY 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
POS. I USE CLASS
NARRATIVE
Unit 1 was driving eastbound in the 2500 block of Maple Valley Hwy, Unit 1 stated they were going
the posted speed limit of 45mph in the right most lane. It had just begun raining and the roads had
become slick. Unit 1 had begun traveling into a curved portion of the roadway when she began to
hydroplane and spin out. Unit 1 lost control of the vehicle and began to spin to the right, striking the
concrete guardrail on the right side of the lane. Unit 1 struck the guard rail with the front bumper of the
vehicle, the impact of the crash spun the vehicle completely around with the vehicle resting north
blocking both of the eastbound lanes.
Unit 1 had minor injuries, reporting that her chest and wrist both hurt. The driver had an observable
burn from the seatbelt and was evaluated by fire at the scene.
The vehicle was no longer operable and towed by Gene Meyers.
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 09/21/2025 at 0441 hours.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 09-21-25 04:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 i 912312025 8:12:15 PM
BADGE OR ID# 12650 ORI# WA0171300 TIME POLICE DISPATCHED 3:43 AM TIME POLICE ARRIVED i 3:43 AM
D'ART B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. EG31033 CASE# 25-8195 DATE AND TIME 09/21/25 03:43
OF COLLISION
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