HomeMy WebLinkAbout23-1473 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-1473 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 1 5 6 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 02 - 1-- 2023 1053 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 14000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 ❑ FEET e S ❑ W e 140THWAYSE
❑
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:5039986096 0 9 30
6� LAST NAME DAVIS FIRSTNAME GABRIEL MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 24411 222ND AVE SE CITY MAPLE VALLEY ST WA 2jp, 98038 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
LICENSE CFG3566 sTAr WAvN# 19UUA66217A008768
10 1❑ PI ATF�
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2007 ACUR TL 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 4110-09.22.46 4
INEFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO ,/ D:2066796179
16 a
LAST NAME WITCHER FIRST NAME MYLES MIDDLE
INITIAL
17 STREET NEW ADDREsS❑' 28127 224TH AVE SE CITY MAPLE VALLEY ST WA ZIP 98038 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
❑ 41
CL
21❑ ILICENSE PLA E# BXR1119 TArE WA VIN# JM3KFBDMOJ0367098 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE MAZp MODEL CX-5 STYLE SP VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DIONNE WITCHER 28127224TH AVE SE MAPLE VALLEY WA 98038 D:2066796179 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 470-1756-E27-47IN 1GVEHICLE
TOP
CITATION# CHARGE OTTOM
LEGALLY YES[Z NE
25❑ s a
71L
CER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
LIAM RIDGEWAY 12500 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED37020
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1473
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'
23-1473
At about 1058 hours on 02/04/2023, 1 was dispatched to an unknown injury accident that occurred on
Maple Valley Highway and 140th Way SE in the City of Renton, King County, Washington. Upon
arrival, I confirmed no injuries. Unit 1 was a gray 2007 Acura TL (CFG3566/WA), driven by the
registered owner: Gabriel D. Davis (DOB:08/08/1984 -verified by WADL photo). Unit 2 was a gray
2018 Mazda CX-5 (BXR1 1 19/WA), driven by Myles Witcher (DOB:03/18/2005-verified by WADL
photo). The Mazda is owned by Myles's mother: Dionne Witcher. Both parties were told they were
being recorded. Both parties said they were traveling eastbound on Maple Valley Highway,
approaching a green light at 140th Way SE, when a police car driving westbound with lights and
sirens, caused Unit 2 to slow to a stop. Unit 1 was unable stop in time and rear-ended Unit 2. Photos
of the damage were taken and uploaded onto Axon Evidence.com. Unit 1 suffered minor rear end
damage. Unit 2 suffered moderate front end damage. Both parties were provided with an exchange of
information form and business/case number.
This concludes my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by W. Ridgeway#12500 on 02/04/2023 at 1211 hours in Renton, Washington.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
WILLIAM RIDGEWAY 02-04-23 12:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 2/24/2023 6:00:19 PM
BADGE OR ID# 12500 ORI# WA0171300 TIME POLICE DISPATCHED 10:58 AM TIME POLICE ARRIVED 11:02 AM
PART I PAGE IT]OF
REPORT NO. EU37020 CASE# 23-1473 DATE AND TIME 02/04/2310:53
OF COLLISION
POLICE CAR RUNNING CODE
MAPLE VALLEY HIGHWAY
UNIT
UNIT 2
Lu
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