HomeMy WebLinkAbout25-80522 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-80522 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 01 STRUCK' GUARDRAIL
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
COLLISION.. 12 - 09 - 2025 0139 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO. e✓ 3000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2532940110 30
6� INITIAL
LAST NAME GROHALL FIRSTNAME CHRISTOPHER MIDDLE M 1 1 2 31
STREET ❑, 21226 SE 268TH PL CITY MAPLE VALLEY ST I WA 2jp, 98038 z
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
❑
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z/ _YES R No�/
8❑ LDRIVER # STATE WA SEX'M MMDDYY 02 — O6 — 2007 1 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM
USEET 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 ATNES# D48471 F sTAr WAv N# 1 FTRW08L41 KD93799
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12❑ VIN#j VIN#
FROM
34
13� VEH.YEAR2001 MAKE FORD MODEL F150 STYLE PK VEHICLE TOWEDNOOpLSABLIN TSIYYEp9vMEYERS vOs❑ENo /
DAMAGE IILLJJII (��IV6
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILITY INSURANCE INSURANCE CO AMERICAN FAMILY 411082321032 3
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 36
LEGALLY, YES❑NO❑ CITATION# 10 BOTTOM
15❑ STAIN.D" 8
UNIT a2 VE ICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER RTY ❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME INMIDDLEITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE IN# 41
V 1
PLATE#
42
22❑ PIR I I TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. 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
#E CO
IN EFFECT &PO I VEwcLE ❑ ,J� CITATION# CHARGE25 GQ
LEGALLY YES N`L J
s � e
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EG57451
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80522
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 1 reported that he was driving east bound in the 3000 block of Maple Valley Hwy in the #2 lane.
Unit 1 stated that he was negotiating the curve but the roadway was wet and it was actively raining.
At the end of the curve Unit 1 lost traction and began to hydroplane, Unit 1 attempted to regain
control but spun out causing his vehicle to spin towards the southern side of the intersection. The
vehicle's rear struck the guardrail laying it rest on the sidewalk facing northbound.
Unit 1 reported no injuries. Unit 1's vehicle was disabled as the driver's side rear axle fell off the
vehicle. The vehicle was towed by Gene Meyers.
I find that the proximate cause of the collision is Unit 1 likely driving too fast for conditions due to the
wet roadway and active rain.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 12-09-25 02:37 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 1211112025 2:29:27 AM
BADGE OR ID# 12650 ORI# WA0171300 TIME POLICE DISPATCHED' 4:39 AM TIME POLICE ARRIVED 1:46 AM
PART I PAGE IT]OF
REPORT NO. EG57451 CASE# 25-80522 DATE AND TIME 12/09/25 01:39
OF COLLISION
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