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HomeMy WebLinkAbout23-2501 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-2501 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 02 STRUCK OVER EMBANKMENT RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 03 - 01 - 2023 0604 17 ❑. S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 2003 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e 0 1 29 UNIT MOTOR E Z CYDALVEHICCLE ElDDAMYESA✓NOESHOLDMET PHONE Q 11 30 6� LAST NAME GROSSMAN FIRSTNAME SHERYL MIDDLE L 1 1 2 31 INITIAL STREET ❑, 15012 133RD AVE SE CITY RENTON ST WA 2jp, 98058 z NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/iNTERLOCKYEs NO INTERLOCKYEs Z/NO YES 1/ NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES z❑ USE CLASS RIGHT ARM/SHOULDERIUNKNOWN 3 10 Pl ATNFS# 016YZ0 STATE WA VIN#' JTEES41A482032315 ----� TRAILER STATE TRAILER STATE11 0 0 PLATE# I PLATE# I I FROM To TRLR. TRLR 1 5 33 vIN# 12 0 0 ' VIN# FROM TO VEH.YEAR 2008 TOYT HIGHLA UT MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34 13 4 DAMAGE YES No �LII� RS YES[:] No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO GEICO 0510913205 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064077218 16 a LAST NAME BERMANI FIRST NAME ALI MIDDLE H INITIAL 17 STREET NEW ADOREss❑' 25708 160TH PL SE CITY COVINGTON ST WA ZIP 98042 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES ❑NO/ 19 LCENSE DIIVERI # STATE WA SEX M MMDDYY 11 7 30 _ 1982 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ 41 21❑ ILICENSE PLATE# 61799D TATE WA vIN1 1FMCU9GD2HU668205 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2017 MAKE FORD MODEL ESCAPE STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO CITY OF SEATTLE 7005TH AVE STE 5200 SEATTLE WA 98104 D:2066848213 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE &POLICY#E CO CITYOFSEATTLEIN 1 9TOP VEHICLE YES[:] ,.I—I CITATION# CHARGE i o BOTTOM LEGALLY N 25 $ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 ROSEANNE HYNES 12612 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED38550 COLLISION REPORT III III III III III 111 1591972 CASE# 23-2501 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' 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. ROSEANNE HYNES 03-01-23 08:56 AM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 31112023 11:39:09 AM BADGE OR ID# 12612 ORI# WA0171300 TIME POLICE DISPATCHED 6:08 AM TIME POLICE ARRIVED 6:14 AM PART Ei PAGE IT]OF 4� TIME REPORT NO. ED38550 CASE# 23-2501 OF COLLISIONO3/01/23 06:04 NARRATIVE On 03/01/2023 at 0608 hours, I was in full patrol uniform and driving a marked Renton Police patrol vehicle when I responded to 1915 Maple Valley Highway in the city of Renton, County of King, State of Washington regarding a traffic collision. The comments in the call said in summary: Two vehicle accident, unknown injuries...locking unknown direction of travel...nknown description of vehicle RP says too dark. Upon arrival, I saw a vehicle in the embankment on the east side of Maple Valley Highway. It was in front of 2003 Maple Valley Highway. The vehicle (V1) was a silver Toyota Highlander (WA LIC# 016YZO). V1 was facing a southeast direction. There was major front end damage. The rear tires were in the water & mud of the embankment. Shortly after exiting my patrol vehicle, an unknown male approached me and pointed to a woman in the embankment. The unknown male appeared to be a good Samaritan that was not involved in the accident. As I attended to the female in the ditch, the unknown male subject left the location. I saw a female subject in the ditch. She was next to V1 and was stuck in the mud and water. The female was later identified as Sheryl L. Grossman. Officer T. Nelson and 1 assisted in pulling Grossman out of the water and mud until Renton Fire arrived. Renton Fire removed Grossman from the embankment and placed her into an ambulance. During my contact with Grossman, she appeared confused. 1 asked Grossman if she was driving the vehicle and what happened and she repeatedly said, "no". I asked her what her name was and she said, "no". Grossman was unable to provide basic information to me or medical personal on scene. V1 was unoccupied. It is unknown if Grossman sustained injury as she was not able to verbally communicate with me. I observed that her right shoulder may have been injured because of it's limited movement. Her injury is unknown. I spoke with Reporting Person/Driver 2 (D2) Ali H. Bermani and he told me in summary: He was driving his work vehicle (WA LIC# 61799D). He was driving north of Maple Valley Highway. He pointed to where the accident happened on the roadway and it appeared to be in the 2000 block of Maple Valley Highway. As he drove north in the left lane, V1 was driving south on Maple Valley Highway. As V1 drove in the opposite direction of him, V1 swerved into the back of his vehicle and veered off the roadway. D2-Bermani said his vehicle and called 911. He walked to where V1 was and saw a male subject (good samaritan) attempting to pull the female out of the embankment. D2 said he was not injured and declined medical assistance. I did not observe visible injury upon him. I asked D2 if he saw who was driving V1 and he did not know. He also did not see Grossman exit the driver seat. When he walked to V1, Grossman was already stuck in the water/mud. I ran V1 and found that the vehicle was registered to Grossman. Grossman was positively identified through her matching Department of Licensing photograph. Although Grossman is the registered owner of V1, I was unable to determine if Grossman was driving the vehicle. No witnesses saw her driving and nobody saw her exit the vehicle. In the event that Grossman was driving, it should be noted that I did not observe anything that would lead me to believe she was under the influence of a substance. I am not a medical professional, but it Grossman may have had an unknown medical emergency, was injured and confused from the accident or both. V1 was not drivable and was towed from the scene. A written impound form was completed. One copy was left with V1 and the rest were given to Renton records. I took photographs of the scene and of V1 and V2. There were no witnesses at the scene and I did not see video cameras in the area. I have nothing further at this time. This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: R. Hynes #12612 Date & Place: 03/01/2023 @ 0820 hrs Renton, WA PAGE 3 OF 4 REPORT NO. ED38550 CASE# 23-2501 DATE AND TIME 03/01/23 06:04 OF COLLISION LIU `Not Drawn to Scale m �a �e C Vi 4 Point of Impact i PAGE 4 OF 4