HomeMy WebLinkAbout23-7253 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-7253 2 0 4
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ STOLE F ❑ LOCAL AOENC 3 6 5
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 01 STRUCK' TREE OR STUMP
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 06 - 26 - 2023 1758 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
JACKSON PL SW BLOCK NO. e✓ ---
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ e S ❑❑ FEET OF LONGACRES DR SW
2 3 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ✓NO D:2062476665 30
6❑ LAST NAME LYONS FIRSTNAME JOSIAH MIDDLE D 1 1 2 31
INITIAL
STREET ❑, 4041 S 150TH ST CITY TUKWILA ST WA ZIP', 98188 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 09 — 01 — 2003 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 5 NATURE OF INJURIES 2❑
USE CLASS PARTIALLY AMPUTATED RIGHT LOWER LEG
3
10❑ Pl ENSEATE 14 1FA6P8CF1N5145875 STATE WA VIN#' 1FA6P8CF1N5145875
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12❑ VIN# VIN#
FROM
34
13 2 VEH.YEAR 2O22 MAKE FORD MODEL MUSTAN STYLE CP EHICLIV AMAGE TO YES NOO pLSABLIN TSIYYEp9vMEYERS VEHICLE
�
❑ DAMAGE IILLJJII (SciV6
REGISTERED OWNER INFO JOSIAH LYONS 4041 S 150TH ST TUKWILA WA 98188 D:2062476665 VEHICLE❑ NO. 1 ❑SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO UNKNOWN 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# BOTTOM
15❑ STAIN,DIING 6
UNIT VEHICL PEDAL-E ❑ CYCLE ❑ PEDESTRIAN ❑ PROPERTY ❑ DYES H OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE IN# 41
V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. 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 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
E.EDMUNDS 12576 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED80067
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7253
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MCKINNEY ANDRE
(LAST FIRST,
ADDRESS&PHONE#
2063349689 SEX' M MMDDYYYY -❑
---------------------------
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) HOFFMAN JESSICA
ADDRESS&PHONE# D O B
SEX F MMDDYYYY 05 Tog
_ 1987
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) HERNANDEZ RAFAEL
AppRESS&PHONE#
SEXI M I D.O.B. 11 _ 04 _ 1990
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.
E.EDMUNDS 06-26-23 07:27 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 711612023 2:33:35 PM
BADGE OR ID# 12576 ORI#' WA0171300 TIME POLICE DISPATCHED; 5:59 PM TIME POLICE ARRIVED]6:01 PM
PART Ei PAGE IT]OF 4�
REPORT NO. ED80067 CASE# 23-7253 OF COLLISION
06/26/23 17:58
OF CbLLI510N
NARRATIVE
On 06/26/2023 1 was working a marked patrol unit in the City of Renton, County of King, State of
Washington. I was assigned to District 15. At approximately 1759 hours, I was dispatched to a single
vehicle collision near the intersection of Lonacres DR SW and Jackson PL SW (Renton WA, King
county).
Call notes stated:
"VEH INTO TREE -ADULT MALE - CONS - LEG AMPUTATED...PEN LINE, MALE SAYING
"PLEASE HELP ME", FEM SAYING THERES AN ACCIDENT, FEM SAYING "WE NEED AN
AMBULANCE", UNC 8, WPH2, AT&T., SMOKE FROM ENGINE COMPARTMENT - ***PT IS NOW
INS RP'S VEH / SIL DODG JOURNEY...NEW RP REPORTING SAME, GRN MUST GT..."
Actions:
I arrived on scene and located the driver/patient, Josiah David Lyons (09/01/2003) seated in the rear
of an uninvolved vehicle. Lyons right leg appeared to have an open fracture just below the knee. Per
my training, I applied a tourniquet to Lyons' leg near the groin. I advised Dispatch that it was safe for
fire and asked Lyons to remain calm.
Lyons was able to provide me his full name and date of birth for identification. I asked Lyons to
describe the collision to me. Lyons stated he had gotten new tires on the vehicle and drove out to
Longacres to test their performance. Lyons estimated he was traveling around 80 mph, approaching
the intersection with Jackson PL SW from west to east on Longacres DR SW, when he lost control of
the vehicle in the curve. The vehicle left the roadway and collided with a tree.
Lyons' vehicle, (WA license plate A6450114) had extensive front end damage. It was apparent the
damage exceeded $1000 dollars.
Medical personnel arrived on scene and began treating Lyons. I was unable to obtain Lyons
insurance information due to the significance of his injuries and the urgency of treatment. An
NCIC/WACIC check was conducted with Lyons' information. He returned clear.
Lyon's was transported to Valley Medical Center for further treatment. The vehicle was impounded by
Gene Meyers Towing.
This concluded my involvement with the case.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by E. Edmunds/12576 at 1907 hours on 06/26/2023, in the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. ED80067 CASE# ' 23-7253 DATE AND TIME 06/26/23 17:58
OF COLLISION
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PAGE 4 OF 4