HomeMy WebLinkAbout23-3567 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . $ 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-3567 2 6 0
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 03 - 1-- 2023 1235 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N SOUTHPORT DR BLOCK NO. e✓ 1300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e I-405
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2083055044 0 4 30
6� LAST NAME HYDE FIRSTNAME BRETT MIDDLE R 1 F 2 31
INITIAL
STREET ❑ 1303 S MICA PARK DR CITY SPOKANE VALLEY ST WA Zjp, 992063130 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ I INTERLOCK YES NO�/ YES R NO
8� LRIIVERS STATE WA SEX'M MM ovY' 12 1- 20 - 1986 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 1❑ PI ATE 14 CCE2428 STATE WA u N#' 1 C4PJMDS3EW266129
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IRM ro
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 3 $ 34
13 2 2014 JEEP CHERO UT DAMAGE vEs 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO ALL STATE S17077318 4
IN EFFECT &POLICY# TOPVEHCLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# 3A0318963 FAIL TO OBEY TRAFFIC CONTROL <1�3
orrow
15❑ STANDING 7 6
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2534269793
16 a
LAST NAME CORKUM FIRST NAME JAYCOB MIDDLE I T
INITIAL
17 STREET❑ NEW ADOREss❑' 13751 MEMORY LN SW CITY PORT ORCHARD ST WA ZIP 983679494 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE 2 INJURY 7 NATURE of INJURIES 40
USE CLASS PAIN
LICENSE I ❑21❑ PLA E# C92512F TATE 41
WA VIN 1 3N63MOYN6FK727031 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE CHEV MODEL CITY STYLE VN VEHICLE TOWED TO BLIN TOWED ev GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO SANDS PETROLEUM 3521172ND STNE ARLINGTON WA 98223 D:8777451563 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POLICY#E CO UNKIN 9TOP 5
L..Le ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N J
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
S.WOODWARD 11528 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED49499
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3567
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ISAACSON ALAN R
(I.P.ST FIRST,
ADDRESS&PHONE#
3316E 15TH AVE SPOKANE VALLEY WA 99223 2086273114 SEX M MMDDYyry 08 - 13 - 1972
PASSENGER I�I WITNESS R UNIT# l 1 POS. 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE of INJURIES
L�!1 USE 1 2 CLASS !1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# SEX DOB
MM-D YY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 03-29-23, at approx. 1241 hrs I was dispatched to a blocking collision at N. Southport Dr/SB 405
involving two vehicles.
The vehicles were identified as a white 2015 Chevrolet Express van, WALP C92512F and a black
2014 Jeep Cherokee, WALP CCE2428. Both vehicles were clear and valid.
On arrival at approx. 1244 hrs, I found both vehicles and their drivers on scene. The collision was
found to be on N. Southport Dr, right beside the entrance ramp onto southbound 1-405. 1 spoke to
both drivers and obtained the following statements:
Driv 1, photo identified through his WADL as Brett R. Hyde (12-20-86), was coming up the hill,
eastbound on N. Southport Dr. He was in the left through lane (#2 lane) of eastbound traffic. He was
confused by the lanes for getting onto 1-405 and continuing east and didn't see the light had turned
red for him. He went through the red light, failing to stop for it and hitting a vehicle that was turning left
in front of him.
Driv 2, photo identified through his WADL as Jaycob T. Corkum (02-15-93), was coming down the hill,
westbound and in the turn lane to enter onto southbound 1-405. He had a solid green arrow for the
turn. He made the left turn and struck the vehicle that went through the light coming up the hill.
The front end of Veh 1 struck the front passenger side of Veh 2, causing moderate damage to both
vehicles. Both vehicles came to rest on the southeast corner of the intersection. Fire department was
called to check on Driv 2 with him eventually being cleared and released on scene.
For failing to come to a stop for the red-light signal and yield to oncoming traffic, I determined Driv 1
was the proximate cause of the collision. I completed a Sector citation for the violation and sent it to
the court to be mailed to him.
Nothing further.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
S.WOODWARD 04-08-23 08:41 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 4/8/2023 8:59:56 AM
BADGE OR ID# 11528 OR]# WA0171300 TIME POLICE DISPATCHED 12:41 PM TIME POLICE ARRIVED 12:44 PM
PART I PAGE IT]OF
REPORT NO. ED49499 CASE# ' 23-3567 DATE AND TIME 03/29/23 12:35
OF COLLISION
1-405 off ramp
N
N. Southport
1-405 on ramp
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