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HomeMy WebLinkAbout25-80197 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG61539OLCERA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-80197 2 RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 04 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 1534 17 =.[� S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ JERICHO AVE NE BLOCK ST e 473 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 F--1 MILES 1.1 FEET B S B W e 0 1 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2067300204 1 4 30 6 LAST NAME DOYEA FIRST NAME DERRICK MIDDLE L 1 1 2 31 INITIAL STREET ❑ 14203 142ND AVE SE CITY; RENTON ST I WA ZIP; 980595449 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs No INTERLOCKVEs No YES NOF 8 DRIVER # STATE WA SEXI M MMDDYY' 12 - 11 - 1956 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 NATURE of INJURIES 2 10 LI ENSE' AVN5854 STATE WA VIN# 2G1WC581369302188 3 11[-j- TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# ROM To TRLR TRLR 5 1 33 12 0 0 VIN#' VIN# FROM TO 13 2 VEH.YEAR2006 MAKE CHEV MODEL IMPALA STYLE VEHICLE TOYED NO�iS46LIN T� {J RSTOWING GCS❑VT EHICLE NO m34 DAMAGE IIII._IIII REGISTERED OWNER INFO DERRICK DO.14203142ND AVE SE RENTON WA 98059 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE / INSURANCE CO ALL STATE 817913 693 <�3VIN EFFECT &POLICY#V""' CHARGE 36 LEGALLY YES❑NO❑ CITATION#15 STM ING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4253067738 16❑ LAST NAME TRAN FIRST NAME LE MIDDLE N INITIAL STREET ❑ 37 17� NEW ADDRE SS❑' 461 JERiCHO AVE NE CITY' RENTON ST, WA ZIP 980598550 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38 INTERLOCKYEs No INTERLOCK YES NO YEs NO 19[ DRIVER'S STATE WA SEX I M I D.O.B. 03 17 1958 39 LICENSE# MMDDYY — HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 9 USE 9 CLASS 0 ❑ 21 LICEN E LATEIBJB6325 rare WA vIN# JTMBFREV1JJ202518 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 201$ MAKE TQyT MODEL RAV4 STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24� DAMAGE YES NO� VES NO REGISTERED OWNER INFO ANH-VUINGUYEN461 JERICHO A VE NE RENTON WA 98059 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 984462479 IN EFFECT &POLICY# t STOP VEHICLE ❑ ,.I—I CITATION# CHARGE to BOTTOM LE—Y YES N 25 s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.CATALAN 12007 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG61539 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80197 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 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 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.CATALAN 12-02-25 04:50 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 1212212025 10:21:56 AM BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:34 PM TIME POLICE ARRIVED i 3:38 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG61539 CASE# 25-80197 O OF COLLI 510N TIME 11/26/25 15:34 COLLISION NARRATIVE On 12/02/2025 at approximately 1534 hours, I was dispatched to a single vehicle collision at 473 Jericho Ave NE, within the City Limits of Renton, County of King, State of Washington. A nearby resident stated that a 60-year-old male possibly had a diabetic episode and had struck a parked vehicle. Upon arrival, I contacted the involved driver and confirmed no injuries had occurred. However, due to a possible diabetic episode, medical assistance was requested. RRFA responded and evaluated the involved driver and was treated at the scene. The driver was released later by RRFA. There, I collected the involved drivers driving documents and their independent recollection of events leading up to the collision. The driver of Unit#1, identified as Derrick L. Doyea, explained he was stopped at the intersection of Jericho Ave NE and NE 4th St. Derrick said he intended to make a left turn to travel westbound on NE 4th St following the turn. As he waited, Derrick felt faint, so he decided to drive through the intersection instead of making a left turn. When the light turned green, he proceeded forward, but then everything went "dark." Derrick went unconscious. When he awoke, he had crashed into the front yard belonging to 473 Jericho Ave NE. While speaking with Derrick, I never detected odor of alcohol emitting from his breath. He appeared normal and no signs of being intoxicated were noticed. Derrick said he was prescribed diabetic medications but was not currently using them. However, he stated he was tired after cleaning his house all day. After speaking with Derrick, it appeared that his vehicle proceeded through the intersection, but veered left and struck Unit#2 which was parked on the west side of Jericho Ave NE. After the vehicle collision occurred, Unit#1 drove onto the front lawn of 461 and 473 Jericho Ave NE. Unit#1 came to a stop after striking shrubbery. Based on the above statements, I determined that the Driver of Unit#1 (Derrick) is the proximate cause for the collision due to an unknown medical condition causing a collision. Unit#1 was towed away by Bankers Towing. I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by C. Catalan 12/2/2025 Renton, King County, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG61 539POLICE TRAFFIC 1 27 ... ^'� COLLISION REPORT CASE# 25-80197 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWUR : NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 PEDESTRIAN �' vest No D:2063546713 5 VEHICLE CYCLE OWNER MIDDLE 29 LAST NAME NGUYEN FIRST NAME , LONG INITIAL H STREET 30 NEW anrlRFs:❑. 467 JERICHO AVE NE CITY RENTON ST WA Z'P 980598550 6 PRESENT MEDICALTANSPORTED' 1 31 CDL IGNITION REbUIRED 1{iNi7ION :: .. INTERLOCK YES NO ':INTERLOCK YES 0 Nd YES N 2 DRIVER'S STATE SEX'M MM DWY 12 31 - 1967 ❑ LICENSE 7 ONDUTY : STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruREofINJURIEs USE CLASS 8 ❑ 1 32 LICENSE rAT UIN. PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 TRLR TRLR VIN.#. VIN#. 11 VEIL YEAR MAKE MODEL STYLE VEHICLE To E T ABLIN TOWED BY GovT.vEHICI E FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 � SHADE IN DAMAGED AREA LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO 7t)P IN EFFECT &POLICY# 34 13 YES NO CITATION# CHARGE 1080TTOM ecauv srnNoiNc 4 MOTOR ❑ PEDAL- ❑ PF20PERTY .. L DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO F I D:4252698812 36 15 ❑ LAST NAME THAT FIRST NAME FRIEF MIDDLE (tq INITIAL 16 ❑ STREET ❑' 473 JERICHO AVE NE CITY; RENTON ST WA ZIP 980598550 NEW A Df1h'83a CDL IGNITION RE}UIRED 1GNITION PRESENT MEDICALTANSPORTED 17 INTERLOCK YES N INTERLOCK YEs Nt7 :YES NP. DRIVER'S STATE SEX M D.O.B 37 18 LICENSE# MMDD 10 - 01 - 1970 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#:: 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 DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT ❑ &POLICY# ).c;Q E. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..EG_ 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. C.CATALAN 12-02-25 04:50 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE 1 OR ID# 12007 O#RI WA0171300 APJACOBS 12122/202 PAGE OF � 3000-345-013(R 11/18) REPORT NO. EG61539 CASE# 25-80197 DATE AND TIME 11/26/2515:34 OF COLLISION 4 ti s \ l st Y a } l 9 8y,, Y� 1 l t y��gSk 1 4 PAGE 5 OF 5