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HomeMy WebLinkAbout25-80157 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG55509oc� RA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-80157 2 RESULTED STOLENSTATE ROUTE OTHER VEHICLE LdCCODIOENC'Y 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 7 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 11 - 26 - 2025 0624 17 =.[� S 8 W e IN OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ OAKESDALE AVE SW BLOCK MILE POST ST e 4a 3300 .� ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 2501.1 00 FEET e✓ S 8 W e SW 34TH ST 0 3 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2068075308 2 0 30 6 LAST NAME SINGH FIRST NAME GURNAM MIDDLE N 1 1 2 31 INITIAL STREET ❑ 2307 S 252ND PL CITY; DES MOINES ST I WA ZIP; 981989095 2 NEW ADDRESS 7 +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKvEs NO INTERLOCKYEs N© ves ND 8 DCIENSE# STATE WA SEXI M MMDDYY' 07 — 01 — 1960 1 2 32 9 ON DUTY STATUS' AIRBAG 1 RESTR 4 EJECT 1 N USEET INJUR CLASSY 14 NATURE of INJURIES 2 LICENSE, C47879J STATE WA VIN# 4V4NC9EH8EN149061 3 10 Fq I PI ATP tI TRAILER T574011 STATE TN TRAILER STATE 11 3 5 PLATE# PLATE# ROM To 12 3 5 UIN# 3M2CG40293S100947 vlRivL 5 3 33 FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GI VEHICLE 13 2 2014 VOLV VN DAMAGE YES NO ✓ Yes❑ No 5 1 34 REGISTERED OWNER INFO GURNAM SINGH 2307 S 252ND PL DES MOINES WA 981989095 D:2068075308 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 LIABILITY INSURANCE INSURANCE CO 2 3 4 14 GREAT WEST 1CP01 189E IN EFFECT &POLICY# 4TOP CHARGE t S ❑ 36 ecnvewcLeur yes[:]NO[:] CITATION# 7 0 80TTOM 15❑ STM ING s 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ THR NO D:4252822453 16� LAST NAME HICKS FIRST NAME SIR-RONALD MIDDLE R INITIAL STREET ❑ 37 17 ❑ 23327 84TH PL S APT A204 CITY KENT ST, WA ZIP 980312916 NEW ADDRESS 18❑ CDL IGNITION RE4UlRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYEs No INTERLOCK YES o res NO 19 DRIVER'S ' STATE WA SEX M D.O.B. 07 09 1982 � 39 LICENSE# MMDDYY - HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSLATE E BZR6314 rare WA vIN# JT8BD69S740197063 41 22❑ STATE PLAAILER TE# STATE 42 PLATE# 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2QQ4 MAKE LEXS MODEL (�`S STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES �/ No GENE MEYER vEs No�/ REGISTERED OWNER INFO SIR-RONALD HICKS 2332784TH PL S APT A204 KENTWA980312916 Dr4252822453 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO GEICO 6155678144 IN EFFECT &POLICY# 9TOP vewcLE ❑ NIL] CITATION11 CHARGE to BOTTOM EEGnEEy YES __J 25 7'OFFLOFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 EVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG55509 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80157 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 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 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 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. M.LEVERTON 12-02-25 06:34 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 12/5/2025 11:23:12 AM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 6:25 AM TIME POLICE ARRIVED i 6:32 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 57 REPORT NO. EG55509 CASE# 25-80157 O OF COLLI 510N TIME 11/26/25 06:24 COLLISION NARRATIVE unitl In 1 into In 2 for boeing rt unit 2 In 2 into In 1 to go around nope RTF Within the city limits of Renton/King/Wa I responded to a crash alert collision somewhere near SW 34th St at Oakesdale Ave SW. No other information was available initially. While enroute to check the area Dispatch advised this was a semi-truck trailer vs car. I located the semi pulled into a Boeing business driveway but could not see the other vehicle. The other vehicle was located in the V created from the truck trailer. I contacted the driver of unit 1/semi who told me he was in lane 1 northbound Oakesdale and wanted to turn into the driveway he was stopped in. He told me he moved his semi over into lane 2 to make his right turn and did not see unit 2. He did not complain injury and damages were unremarkable. I contacted the driver of unit 2 who told me he was in lane 2 northbound Oakesdale when he saw the semi get over into lane 2, so he moved his vehicle into lane 1. This lane change took place at about the same time unit 1 was making his lane change and they contacted just about the driveway location where unit 1 was making his right turn from lane 2. Unit 2 did not complain of injury and damages required a tow truck. Unit 2 vehicle looked like a total loss from damages. Information/insurance only I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 11/26/2025 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG55509POLICE TRAFFIC 1 27 ... ^'� COLLISION REPORT CASE# 25-80157 013197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ UNIT# 1 USDOT 63005 ICC# VEHICLE TYPE 1 4 1 CAR7GO BODY 2 2 ❑ 1 28 CARRIER NAME. ELLIOT BAY SERVICE TRANSF ..: 3 CARRIER L ADDRESS 349 UPLAND DR CITY TUKW►LA I ST' WA 7IP', 98188 4 ❑ NAME # PLACARD NAME IF NO NUMBER SOURCE 3 AXLES 05 GWVR 80000 + 4a ❑ ADDITIONAL UNITS UNIT# MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ VEHICLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER '❑ YES NO MIDDLE 29 LAST NAME FIRST NAME INITIAL STREET 30 NFW ADDRFSJ—jl CITY ST ZIP 6 PRESENT MEDICAL TANSPORTED 1 31 CDL IGNITION REQUIRED 1{iNiTION INTERLOCK YES: NO INTERLOCK YES NO YES[:]N LICENSE STATE SEX MMDDYBYY -C-1 7 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruRE OF INJURIES 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 Y(-E V VFHICI F FROM TO DAMAGE YES NO YES NO m 33 REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO TP 4 FROM TO IN EFFECT &POLICY# I """" S m 34 13 YES NO[jj CITATION# CHARGE 1080TTOM ecauv sTnNoiNc MOTOR PEDAL_ ' 1:1PROPERTYDAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME IN L 16 ❑ STREET CITY ST ZIP NEW ADDRESS" CDL IGNITION REZu;y IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES ]NO INTERLOCK YEs NO .YES No 17 37 SE M©L STATE DrrICENSE# 18 ❑ HELMET '.INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT AN# PLATE# 20 TRAILER TRAILER 40 PLATE# STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# 7c;Q S. 44 vece ❑ ❑ 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. M.LEVERTON 12-02-25 06:34 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE GRID# 2517 O#RI WA0171300 APJACOBS 121512025 PAGE F OFF 3000-345-013(R 11/18) REPORT NO. EG55509 CASE# 25-80157 DATE AND TIME 11/26/2506:24 OF COLLISION wa���,„ '�x',�, c�.;��.sawu�amc���;s„�3���`�,�,��s`a,raMSi>>y�s,.• �;.,. � <Y:.';, �r'a„��'�,`"�'�'�...`.,'„ �. ., ,hL w`�ti,..�� i 71 t °1�,.`�` �� ..�„ k � �' ��fit r' �yl`Gf �� a �"ihi�t ;�1+2•.k°'? R c t � t t { e, q Y P: PAGE 5 OF 5