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Home My WebLink About23-5102 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-5102 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 28 TRIBAL UNITS 03 STRUCK' FENCE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ CowsloN 05 - 1-- 2023 2342 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE PETROVITSKY RD BLOCK NO. e✓ 12500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2063766219 N:2533767254 30 6� INITIAL LAST NAME MOSES FIRSTNAME KENDAL MIDDLE S 1 1 2 31 STREET El 23106 107TH PL SE CITY KENT ST I WA 2jp, 98031 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YEs No�/ $F-I LICENS DRIVER # STATE WA SEX'M MID LOB 05 - 18 - 2000 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 2 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� BOV2792 sTArI WAvrN# 1GNEK13Z84J264770 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FR.. To TRLR. TRLR. 7 3 2❑ 33 1 vIN#' VIN# Rom 34 13 VEH.YEAR2004 MAKE CHEV MODEL TAHOE STYLE VEHICLE TOWED0NOOffBLIN WAWkkRS yOES❑ENO DAMAGE IILLJJII tSA1Vi�6 REGISTERED OWNER INFO DWAYNE MOSES 1.01 SE 239THPL APT2L205 KENTWA 98031 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICV# �1'OP VEI" CHARGE BOTTOM ❑ 36 EGALLv YES No CITATION# 3A0357731,3A0357731, SPEED TOO FAST FOR CONDITIONS, 15❑ NDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:8882255773 16❑ LAST NAME SOUND ENERGY FIRST NAME PUGET MIDDLE INITIAL 17❑ STREET ❑' 10885 NE 4TH ST CITY' BELLEVUE ST' WA ZIP 98006 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l No❑ 19 LLIICENS RIVERIS# STATE SEX U MMDDYY 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ TArE LICENSE vIN# 41 PLATE# 42 22❑ PR TRAILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN It 'IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO I VEHICLELLY ❑ ,.I—I CITATION# CHARGE 25 GQ LEGA YES N`LJ s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 K.LANE 10008 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED61377 COLLISION REPORT III III III III III 111 1591972 CASE# 23-5102 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) DAMMANN MATAEYA L (I.P.ST FIRST, ADDRESS&PHONE# D O.B. ' 14623 182ND AVE SE RENTON WA 98059 4252219793 SEXi F MMDOYyry 05 - 30 - 2000 PASSENGER WITNESS UNIT# 1 POS 2 CLASS 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET NATURE of INJURIES USE ' i 1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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. K.LANE 05-08-23 10:24 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 511812023 1:51:34 PM BADGE OR ID# 10008 OR]# WA0171300 TIME POLICE DISPATCHED 11:42 PM TIME POLICE ARRIVED]11:42 PM PART I PAGE IT]OF REPORT NO. ED61377 CASE# 23-5102 OF COLLISION 05/05/23 23:42 OF CbLLI510N NARRATIVE Unit 1 was traveling eastbound approaching the 12500 blk of SE Petrovitsky RD. There was a Fire/AID car and two police cars all with their emergency lights activated handling an unrelated subject on the far south side of the roadway occupying only the right (south) most lane. This portion of SE Petrovitsky RD eastbound has a sweeping left hand turn and the emergency vehicles were positioned at the end of this curve and the roadway conditions were wet. As Unit 1 approached these emergency vehicles in the 12500 blk, it was traveling at too high a speed. As Unit 1 attempted to brake to avoid the emergency vehicles, the vehicle's speed caused it to slide out of control rotating counterclockwise until it was sliding perpendicular to the direction of travel. The vehicle continued to rotate counterclockwise eventually to the point the vehicle was facing nearly backwards and the tires gained rotational traction. This caused the vehicle to divert course as the momentum applied to the now rotating tires sent Unit 1 "backwards" suddenly to the south and towards the sidewalk. Unit 1 went up onto the sidewalk and impacted a large wooden power pole (Unit 2) causing heavy damage to Unit 1 and completely destroying Unit 2 - knocking out power. The force of this collision rotated Unit 1 clockwise and on to its passenger side as it destroyed the fence (Unit 3) of the property line. Both occupants reported no injuries. All three Units appeared completely destroyed. The owner of Unit 3 could not be located or contacted as of this report. Unit 1 towed by Bankers tow. Driver 1, ID via WA ST ID card, DOL return indicated he was without a license and was ID only. Driver 1 advised the vehicle was not insured. Driver 1 was cited for speed to fast for conditions by traveling at such a speed, at night, and on wet roadways, that he could not safely navigate an easily manageable obstacle resulting in the vehicle losing control and crashing. Driver 1 was also cited for operating a motor vehicle without a valid operator's license (NVOL 2nd) and operating a motor vehicle without insurance. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED61 377 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-5102 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L 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 I_J CYCLE u PEDESTRIAN � OWNER � YEs� IN MIDDLE' 29 LAST NAME UNKNOWN FIRST NAME , INITIAL STREET 30 NEW AnnRFrtP 12509 SE PETROVITSKY RD CITY RENTON ST WA ZIP 98058 6 CDL GNITIttN REQUIRE GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES NO 3NTERLOCK YEs�NO� YES[:]N DRIVER'S STATE I SEX U M��DYSYv' —� 2 LICENSE 7 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET I INJURY NATURE OF INJURIES USE GLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9F-I TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG E FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NEn+AnnREs.�' CITY'. ST ZIP CDL IGNITION REdUiREE7 IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES NO INTERLOCK YEs NO YEs Nb E17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv 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. K.LANE 05-08-23 10:24 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 10008 O#IL WA0171300 JOHNSON 511812023 PAGE F OF 3000-345-013(R 11118) REPORT NO. ED61377 CASE# 23-5102 DATE AND TIME 05/05/23 23:42 OF COLLISION r 70 SCALE.., d� CJ� s a 2� '� ... 12609SEPETRO t. 4.a PAGE 5 OF 5