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Home My WebLink About23-4008 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-4008 z INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED 1 STOLEN STATE ROUTE OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4'/00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ COLLISION.. 04 - 09 - 2023 1407 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✓ 1600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 500 00 FEET e MILES S ❑ W e I405 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:4257616078 0 7 30 6 LAST NAME DOYLE FIRSTNAME JADEN MIDDLE D 1 1 2 31 INITIAL STREET ❑ 24605 SE 380TH ST CITY ENUMCLAW ST WA 21p 980226807 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ Pi aT�S� AYL1398 sTAr1 WAvIN# 1J4GZ78Y9VC638786 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 4 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 3 9 TOWED BY GOVT.VEHICLE 34 13 1997 JEEP GRAND DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO JADEN DOYLE 24605 SE 380TH ST ENUMCLAW WA 98022 D:4257616078 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 UABILI INSURANCE INSURANCE CO STATE FARM 5141131-EOI.47A 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 3AO030375 INATTENTIVE DRIVING 1 o eorrom 15❑ STANDING 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/ NO D:2063218458 16 a LAST NAME PABALATE FIRST NAME PETER MIDDLE A INITIAL 17 STREET NEW ADDRESS❑' 11025 SE 241ST PL APT K103 CITY KENT ST WA ZIP 980305282 37 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDI IVERI # STATE WA SEX M M D.O.B. 03 _ 23 _ 1976 39 20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET INJURY 6 NATURE OF INJURIES 40 USE CLASS NECK PAIN LICENSE ❑21❑ PLA E# CDL8825 TArE 41 WA VIN# JN16Y1AR16M371395 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2011 MAKE INFI MODEL M37 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO PETER PABALATE 26285238TH LN SE APT M202 MAPLE VALLEY WA 98038 D:2063218458 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU&PORGY#E CO FIRST NATIONAL INS H2532793IN STOP VEHICLE CITATION# CHARGE i o BOTTOM 25❑ 7PLANTAGNE LLY LEGA YES[Z NC[:] J s a S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 12575 WA0171300 PART A PAGE 01 OF 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED52133 COLLISION REPORT III III III III III 111 1591972 CASE# 23-4008 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) BARRIE AARON D (LAST FIRST, ADDRESS&PHONE# 23807 SE 284TH ST MAPLE VALLEY WA 98038 4257612744 SEX M MMDOYyry 02 - OS - 2004 PASSENGER Z WITNESS❑ UNIT# 1 SEAPOS 3 AIRBAG 2 RESTR. q EJECT ? 1 HEL EET INJASS 1 NATURE OF INJURIES NAME (LAST,FIRST,MIDDLE INITIAL) FOX KENNETH E ADDRESS&PHONE# D O B 26538 221ST PL SE MAPLE VALLEY WA 980387435 2068493618 SEX M MMDDY!Y Y 11 _ 07 _ 1972 SEAT HELMET I INJURY NATURE of INJURIES PASSENGER Z WITNESS UNIT# 3 pOS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.Q.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. P.LANTAGNE 04-09-23 07:13 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIREE SCOTT 10272 1 411712023 5:44:08 PM BADGE OR ID# 12575 ORI#' WA0171300 TIME POLICE DISPATCHED! Y:08 PM TIME POLICE ARRIVED',2:11 PM PART Ei PAGE IT]OF REPORT NO. ED52133 CASE# 23-4008 OF COLLISION 04/09/23 14:07 OF CbLLI510N NARRATIVE 23-4008 On 04/09/2023 at approximately 1407 hours, I, Officer Lantagne, responded to a blocking, minor injury collision in approximately the 1600 block of Maple Valley HWY, which is located in the City of Renton, County of King, and the State of Washington. I responded in my fully marked police vehicle, wearing my patrol uniform. I arrived on scene and observed Unit#1, a 1997 Jeep Grand Cherokee with license plates AYL1398 issued out of Washington State, Unit#2, a 2011 Infiniti M37 with license plates CDL8825 issued out of Washington State, and Unit#3, a 2010 Ford Ranger with license plates C95473L issued out of Washington State, blocking the curb lane of westbound Maple Valley HWY just west of the private roadway to the Henry Moses Aquatic Center. I was advised the driver of Unit#2 had neck pain. I contacted the driver of Unit#1, Jayden D. Doyle (DOB 08/19/2004), who told me the following: Doyle was driving westbound on Maple Valley HWY in the far-left lane and did not see that traffic had stopped in front of him. Doyle swerved his vehicle to the right but could not stop in time and the front left of his vehicle struck Unit#2 which forced Unit#2 into Unit#3. 1 contacted the driver of Unit#2, Peter A. Pabalate (DOB 03/23/1976), who told me the following: Pabalate was stopped for traffic in the far-left lane of westbound Maple Valley HWY. While Pabalate was waiting for the traffic to move, the rear of his vehicle was struck by Unit#1 which forced his vehicle into Unit#3. 1 contacted the driver of Unit#3, Brian A. Fox (DOB 12/24/2002), who told me the following: Fox was stopped for traffic in the far-left lane of westbound Maple Valley HWY. While Fox was waiting for the traffic to move, the rear of his vehicle was struck by Unit#2. Fox only felt one collision. I observed the damage to the vehicles and other physical evidence was consistent with the statements made by all drivers. Unit#1 had significant damage to the front end of the vehicle which was crumpled in on the left side with a front left flat tire. Unit#2 had significant damage including a crumpled trunk on the right side The right rear tire of Unit#2 was broken off at the hub. Unit#3 had minor damage to the rear bumper consisting of dents and scrapes. The box of the truck was bent slightly downwards at the rear. The collision diagram is an accurate illustration of the events leading up to the collision. I provided an exchange of information to all parties. I later issued Doyle a citation for inattentive driving to be mailed through the court. I, Officer P. Lantagne #12575, certify (or declare) under penalty of perjury, under the laws of the State of Washington, the foregoing is true and correct. Electronically signed by Officer P. Lantagne #12575 at 1911 hours on 04/09/2023 at Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. ED52133 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-4008 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:2068493618 OF 7 29 LAST NAME FOX FIRST NAME BRIAN MIDDLE A INr:j ITIAL STREET 30 NEW AnDRFrtP 26538 221ST PL SE CITY MAPLE VALLEY ST WA ZIP 980387435 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 12 - 24 - 2002 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE C95473L TAr Wq VIN# 1FTKR1AD7APA56662 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 4 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' E FROM TO 2010 FORD RANGER DAMAGE vES NO �/ YES NO REGISTERED OWNER INFOKENNETH FOX 26538221ST PL SE MAPLE VALLEY WA 98038 D:2068493618 $ 9 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO SAFECO INS H1614650 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YEs NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. P,LANTAGNE 04-09-23 07:13 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 12575 O#I WA0171300 SCOTT 4117/2023 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. ED52133 CASE# ' 23-4008 DATE AND TIME 04/09/23 14:07 OF COLLISION MAPLE VALLEY HWY f SR169 IJnit#3 Unit#2 Unit#1 ...Case#23-4008 Not to Scale P. Lantagne#12575 Private Road to Henry Moses Aquatic Center- 1719 MAPLE VALLEY HWY PAGE 5 OF 5