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19001666WASHINGTON STATE PATROL case # 19"001666

REPORT OF INVESTIGATION cooper: M. Canham #437Fatality Collision Case Summary

SYNOPSIS

On 01/18/2019 at approximately. 1010 hours, WSP communications advised of a one car, onesemi collision that occurred on SR 101 at MP 62. Approximately 25 mins later, WSP troopersarrived on scene to investigate the collision. At this time, aid was already on scene, andadvised WSP troopers that the driver of the passenger car, Johnson, Vicky L (07/11/1954) wasdeceased.

DETAILS

On 01/18/2019 at approximately 1010 hours, WSP communications advised of a one car, onesemi blocking collision on SR 101 at MP 62. Trooper M. Canham #437 arrived at the scene atapproximately 1036 hours. Trooper Canham observed a small black SUV blocking thesouthbound side of SR 101 and a blue semi-tractor parked just behind the black SUV on thesouthbound side shoulder. Fire and aid were already on scene and were performing CPR onthe driver of the black SUV. Within a couple minutes of Trooper Canham arriving on scene, aiddetermined the driver of the SUV was deceased. Trooper Canham advised WSPcommunications that the driver of the SUV was deceased, and that the road would be closed forinvestigation.

State Route 101 in the area of the collision is a two lane roadway paved with asphalt with onenorthbound lane and one southbound lane. The lanes are separated by a yellow doublecenterline and the roadway is grooved at the centerline. The centerline also has orangereflectors inset at intervals. Both shoulders are paved and are wide enough to park a patrol carclear of the lane travel. The shoulders are separated from their respective lanes by a white roadedge line (fogline).

Johnson was driving her vehicle southbound on SR 101. Leitz, Keith (02/22/1956) wasidentified as the driver of the semi-truck by his Oregon Commercial driver's license. Leitz wasdriving his semi-truck, pulling two septate empty flatbed trailers, northbound on SR 101 whenthe second empty trailer crossed over the center yellow line and struck the drivers front/side ofJohnson's SUV.

Parsons, Timothy J (04/30/1959) was traveling behind Johnson and witnessed the collision.Parsons stated that he saw the second trailer coming into the southbound lane by approx. 3-5ftand hit Johnson's car. Parsons is a coworker to Johnson and both were on their way to work inRaymond. When Trooper Canham contacted Parsons, he was on the phone with Johnson'shusband, and informed him of the collision.

Trooper J. Mullins #1094 arrived on scene at approximately 1048 hours and assumed the role ofCertified Technical Specialist and began his investigation. Trooper B. Passolt#1143 arrived onscene at approximately 1057 hours and began assisting in the investigation. Sgt B. Moon #271arrived on scene at approximately 1134 hours and assumed the role of scene supervisor.

At approximately 1147 hours, Trooper Canham escorted Leitz to Williapa hospital for a voluntaryblood draw. Trooper J. Schaffer#646, a Drug Recognition Expert, was also dispatched to

19001666 Case #17-019662

Williapa hospital to perform DRE evaluation. At approximately 1304 hours, Trooper Canhamcleared Williapa hospital and took Leitz back to the scene. Trooper Schaffer cleared as well,finding no signs of impairment.

Commercial vehicle officer A. Stevens, X935, arrived on scene at approximately 1058hours andbegan his investigation of the commercial truck. Commercial vehicle officer I. Ruby, X819arrived on scene at approximately 1108 hours and assisted in the inspection of the commercialtruck.

At approximately 1448 hours, SR 101 was reopened to traffic.

CONCLUSION

On 01/18/2019 at approximately 1010 hours, Johnson, Vickywas traveling southbound on SR101 at MP 62 when she struck the second flatbed trailer of a semi-truck driven by Leitz, Keith. Itappeared that Leitz had drifted onto the northbound shoulder and corrected this by turningtoward the left/center line, which caused his second trailer to "whip" into oncoming traffic. Cityof Raymond Fire and Aid arrived and began resuscitation on Johnson, but declared herdeceased. WSP troopers arrived on scene and conducted their investigation. Johnson's bodywas taken to Stollers mortuary in Raymond, and then it was moved to Coleman mortuary inHoquiam.

certify (or declare) under penalty of perjury under the laws of the State of Washingtonthat this report is true and correct (RCW 9A.72.085):

Officer's Signat Badge#:437

Date:05/30/2019

Location:Naselle, WA

3000-110-008 (R 4/05)

9001656 REPORT OF INVESTIGATIONPrimary Officer's Narrative

19-001666Citation #

Officer's Name: Michael Canham Badge No.: 437

On 01/18/2019 at approximately 1010hrs dispatch put out a one car, one semi-truck collision N101 MP 62. Iwas patrolling SR 101 at MP 35, and started heading toward the collision. After reading the notes in the log, Icalled Trooper Passolt (1143) and advised him that I would need his assistance.

I arrived on scene and observed a small black SUV, with substantial driver's side damage blocking thesouthbound lane. I also observed a green semi-truck, the tractor trailer only, also sitting on the southbound sideof SR 101. I observed a debris field from the center line to the southbound lane. I also observed heavy furrowson the northbound shoulder, indicating a vehicle had went off the road. The black SUVwas identified with aWashington registration of BNK7890, a 2015 Nissan Rogue. The green semi was identified by Washingtonregistration of C42842G, a 2000 Peterbuilt model 379.

Aid was already on scene, and had the driver of the black SUV on the ground. Aid was performing CPR on thedriver. Aid informed me they had extracted the driver from the SUV, and that she did not have a pulse nor wasshe breathing. Within a few minutes of me being on scene, Aid advised me that they were going to pronounce

her dead at approximately 1037hrs.

At this time, I closed both lanes on SR 101 and had WSDOT reroute traffic from smith creek to butte creek road.Collison Tech, Trooper Mullins (1094) got on scene and began his investigation. I went to talk to the diver ofthe semi-truck, identified as Leitz Keith A (DOB 02/22/1956) by his Oregon State commercial driver's license. Iobserved that Leitz's Semi-truck appeared to be undamaged. When I asked Leitz about it, he stated thelollision occurred with his second, unloaded flatbed trailer. I observed that there was not any flatbed trailers on

scene, and Leitz stated after the collision he continued northbound on SR101 until he found a wide pull outwhere he could safely stop. Leitz then dropped his two flatbed trailers, and came back to the scene.

I asked Leitz what had happened and he stated that he had heard a loud crash, then saw his second trailerdrifting off onto the right side of the road. Leitz described it as "being thrown off the road." Leitz stated he wasnot aware if his trailers were over the center line, stating he did not feel or hear the "rumble" strips in the centerof the road. Leitz stated he was trying to stay as close to the right solid white fog line as possible, also stating"to his knowledge, his trailers did not cross the center line." At this time, I asked Leitz if he had any alcohol todrink, which he stated "No, I didn't drink" I then asked if he had taken any illegal drugs, to which he also stated"no." I asked Leitz if he was taking any prescribed medications, Leitz stated he was taking medications forDiabetes and Cellulitis. I asked Leitz if he would be willing to perform some voluntary field sobriety tests, andLeitz stated yes. I observed no clues on HGN, 2 out of 8 clues on the walk and turn. Leitz did not perform theone leg stand, as he stated he doesn't have much felling in his feet due to the Diabetes. At this time I did notfeel as if Leitz was impaired.

At this time, I went over to the witness, identified as Parsons, Timothy J (DOB 04/30/1959) by his WashingtonState driver's license. Parsons stated he was following the black SUV, and knew the driver. Parsons statedthey were co-workers, and were on their way to work. Parsons identified the driver of the SUV as Johnson,Vicky L. Parsons stated he witnessed the last trailer of the semi-truck cross the center yellow line, by "at least2-3 feet" and strike Johnson's car. Parsons stated that if Johnson hadn't hit the trailer, he would have. I hadParson's fill out a witness statement, and as I was explaining it, Parson received a phone call from Johnson'shusband.

'.then went back to the black SUV, and began looking for registration and insurance information. I located aarge pink purse, and wallet. Inside the wallet was Johnsons Washington State Driver's license. Due to thecollison, I was not able to get inside the glove box and located the vehicle registration and insurance. I heldonto Johnson's purse and wallet for safekeeping until I could return it to her family.

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REPORT OF INVESTIGATION656 Primary Officer's Narrative

Case #

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At this time, Sgt Moon, Brad (271) arrived on scene and took over supervision. Sgt Moon instructed me to seeif Leitz would do a voluntary blood draw, and stated we need to have a Drug Recognition Expert perform anevaluation on Leitz. I then walked back over to Leitz, who was still standing behind his semi, I asked him if hewould be willing to do a voluntary blood draw. Leitz stated he would do it.

I then transported Leitz to the Willipa Harbor Hospital for the voluntary blood draw. I contacted communicationsand requested a DRE to meet me at the Hospital. Trooper Schaffer (646) signed up and came from LewisCounty.

Lab assistant McAuley, Cassandra preformed the blood draw, extracting the blood into two Washington StatePatrol approved vials. As McAuleyjust finished up the blood draw, Trooper Schaffer arrived at the hospital.Trooper Schaffer preformed his evaluation, and informed me that he saw no signs of impairment.

I then transported Leitz back to the scene. Trooper Mullins, Trooper Passolt, and Sgt Moon were mapping thescene. Johnson's body had been removed and taken to Stoller Mortuary. Commercial Officer Stevens, Andrew(X935) was on scene and informed me that he needed Leitz to move his truck back to the trailers, so that hecould finish his inspection.

After Trooper Mullins was done mapping the scene, I let Leitz move the semi-truck back to where the trailer waslocated.

Full Throttle Towing arrived on scene and removed the black SUV. Once all the debris was removed from theroad, I re-opened SR 101, and cleared the scene. I then drove the approx. one mile north, to the location of thetwo flatbed trailers. I observed the rear axle on the second trailer to be nearly broken off. The rear tires wereacing the rear of the trailer. I observed CVEO Steven's talking with Leitz.

At this time, I gave Leitz back his driver's license and semi-truck information and stated he was free to leave. Ithen cleared and headed back to the office to process the blood as evidence. The blood was submitted into theWashington State Patrol evidence system.

I am referring charges of negligent driving 2nd degree to the prosecution office at this time.

/ certify (or declare) under penalty of perjury under the laws of the State of Washingtonthat this report is true and correct (RCW 9A.72.085):

Officer's Signature

fPlace Signed

Naselle, WA

Officer's Printed Name

Michael Canham

Reviewed by (Signatuw)^, Reviewed by (Printed Name)*

'û^xvfio A,Awl

Badge #

437Badge #

2-[{

Date Signed

02/02/2019Date Signed

-7-27r2ai*Report is valid without reyle^.

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19001666REPORT OF INVESTIGATION

Certified Technical Specialist's Narrative

Case #

19-001666Citation #

Officer's Name: J. Mulljns _ Badge No.: 1094Video file name (if applicable): Coban

Video viewed by officer for this report: YES |X| NO

SUMMARY

On January 18, 2019 at approximately 1010 hours, a commercial vehicle and passenger vehiclesingle fatality collision occurred on State Route (SR) 101 just north ofmilepost 62. A semi-truckpulling double flatbed trailers was northbound and a black Nissan Rouge was travelingsouthbound. The semi-truckwas in a left to right curve, the rear trailer came across the centerline,and it struck the Nissan at the front driver's wheel. The female driver of the Nissan sustained fatalinjuries.

INVESTIGATIVE PROCESS

On January 18, 2019, at approximately 10:10 hours, I heard Washington State Patrol (WSP)Communications advise the Naselle Detachment troopers of a semi versus passenger vehiclecollision on SR 101 milepost at 62. At approximately 1030 hours, I was requested to respond asa Certified Technical Specialist (CTS). While en route, Communications advised of a confirmedfatality.

I arrived on scene at approximately 1048 hours. The Washington Department of Transportation(DOT) had a detour at Smith Creek Road for southbound traffic, and one at Butte Creek Road fornorthbound traffic.

I observed a turquoise blue semi- truck parked on the southbound shoulder behind a blackNissan Rogue. The Nissan was at rest, on its wheels, facing east, on the southbound shoulder,and with the rear wheels in the ditch. The Nissan sustained significant damage to the frontdriver's side area.

Trooper M. Canham, # 437, was on scene. I asked him where the deceased was and he showedme where fire personnel had removed the driver's and left passenger door for the extricationprocess. The deceased driver was lying on a yellow backboard covered by a white sheet on thesouthbound shoulder near the left passenger area of the Nissan.

I asked Canham where the truck was and he stated the turquoise semi-truck was the vehicleinvolved. Canham advised the truck was traveling northbound pulling an empty flatbed and theNissan struck the flatbed trailer. The driver dropped the flatbed off, because of the damage to it,and drove back. The truck driver was standing near us and I asked him where the flatbed wasdropped. The driver advised me the trailer was dropped approximately a half mile north of thescene.

The driver of the semi-truckwas identified as: Keith A. Leitz DOB: 2/22/1956. I briefly spoke withLeitz regarding the collision and asked him what happened. Leitz stated he was drivingnorthbound close to the fogline. He said he felt something and the trailer swung into thenorthbound ditch. Leitz said he thought he struck the guardrail and continued north becausethere was no place to stop. He pulled over approximately a half mile north of the collision,examined the trailer, and observed the left side of the rear axle on the second trailer wasdamaged. Leitz dropped the trailers off, drove back, and saw a vehicle was involved.

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^ U U I 0 u uCase #

19-001666REPORT OF INVESTIGATIONCertified Technical Specialist's Narrative Citation #

Officer's Name: J.Myllins _ Badge No.: _1 OQ4_

Canham advised the deceased's co-worker was following her and observed the collision. The co-

worker was identified as: Timothy J. Parsons DOB: 4/30/1959. Parsons advised Canham hecalled the deceased's husband and advised him of the collision. Pacific County Sheriffs Deputy,J. Eastham, # 1P14, was on scene and removed the driver's purse from the front passengerarea. He located a valid WA driver's license identifying the deceased as: Vicky L. Johnson DOB:7/11/1954.

I conducted a walk-through of the scene and walked back to my patrol car to get my camera. Iobserved a pick-up truck stopped on the shoulder a few vehicles back behind my patrol car. Twomen approached me and one asked where his wife was because he was told she was involvedin a crash. I confirmed he was only told there was a collision. The husband was identified as:John H. Johnson.I then conducted the next of kin advisementwith Mr. Johnson.

I conducted a visual field exam and took photographs ofJohnson. Aid personnel had cut herclothes away during life saving efforts. Johnson was wearing a red shirt, black pants, black dresssocks, black dress shoes, and a black jacket. Her shirt and bra were cut away and her pantswere cut to the ankles. Johnson appeared to be a healthy female in her late fifties to early sixties.I observed there was a laceration in her hairline just above the center of the forehead. There wasa major laceration on the left side of the left calf area which ran with the grain of the muscle.There was a major laceration to the outside of the left forearm just below the elbow. There wasanother major laceration to the outside of the left arm in between the elbow and the shoulder.The lacerations to her leg and arm did not have major hemorrhaging indicating they were not lifethreatening. I observed a very prominent dark contusion left of center on her left breast justunder the left nipple. I noted a contusion to the lower right area of the right breast. There wereabrasions which ran diagonally from the left side of the chest to the right hip area. I also noted alateral bruise on the lower portion of the abdomen. There was blood coming out of both nasalpassages, but the left ear canal was clear of blood. I did not examine the right ear canal. Bothlegs had multiple contusions consistent with fractures. The left leg sustained greater visible injurythan the right. There was a large confusion to the left rib cage area and there was an abrasion atthe left hip.

I photographed the scene, marked evidence with orange surveyor's paint, and photographed thescene again. Sergeant B. Moon, # 271, and Trooper B. Passolt, # 1143, assisted with measuringthe scene using the baseline coordinate method. Passolt and Canham conducted the vehiclemeasurements on the Nissan. Passolt and Canham assisted with measuring the grade andsuper elevation. WSP Commercial Vehicle Enforcement Officers, A. Stevens # X935 and R.ignacio # X819, conducted a Level 1 inspection on the tractor and trailers.

The trailers were located at a wide gravel area just north of Smith Creek Road approximately 1.3miles north of the scene (*according to Google Maps). I photographed the trailers and Stevensand Ignacio arrived to inspect them. Leitz also arrived and I spoke with him in further detail. Icleared the scene 1448 hours.

January 19,2019

On the field examination, I observed the diagonal abrasions on the chest were lined up as ifJohnson had been wearing the shoulder strap under her left arm. I followed up at ColemanMortuary in Hoquiam where Johnson's body was taken. Johnson's body had already beencleaned and embalmed. I met with Clarence Pittackwho had prepared Johnson's body. Headvised an autopsy was not conducted. I asked him questions regarding injuries he observed.

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9001666Case #REPORT OF INVESTIGATION

Certified Technical Specialist's Narrative19-001666Citation #

Officer's Name: J. Mullins _ ___ Badge No.:_1094

He noted the lacerations to the left arm and leg did not cut any arteries because the embalmingfluid did not leak there. He advised there was a small amount of blood that came out of the rightear canal during embalming. I asked him about possible neck fractures and he said he did notnotice any abnormal movement, but he could not be certain.

I re-examined Johnson's body and Pittack pointed out a prominent contusion on the left eyewhich I did not observe on the field examination. It appeared Johnson was improperly wearingher shoulder strap under her left arm when the collision occurred. I re-examined the diagonalabrasions and noted two separate ones. The first lined up with the dark contusion on the leftbreast just below and left of the nipple. The lower abrasion was approximately 4 inches belowthe contusion on the left breast. Both abrasions ran diagonally to just above the right hip. Therewas a dark contusion just above the right hip but below the lateral confusion on the lower portionof the abdomen. I determined the dark contusion just above the right hip was caused from theseatbelt buckle receiver. I photographed and noted the injuries.

I met with Mr. Johnson that afternoon to deliver personal property to him. I asked him if his wifewas in the habit of wearing the shoulder strap under her arm and he advised that is how shenormally wore it. How Johnson received her injuries will be covered in the occupant kinematics.

On February 25, 2019, at approximately 1700 hours, I returned to the scene because theroadway was mostly dry. I re-examined the area of impact and the centerline was still damp. I didnot locate any additional roadway evidence that was not documented at the time of the initialinvestigation.

AMBIENCE

I arrived on scene and noted the roadway was wet and the sky was overcast. The temperaturewas approximately 43 degrees Fahrenheit which was measured with my patrol car thermometer.It began to rain lightly approximately 30 minutes after I arrived.

ROADWAY DESCRIPTION

State Route 101 in the area of the collision is a two lane roadway paved with asphalt with onenorthbound lane and one southbound lane. The lanes are separated by a yellow doublecenterline and the roadway is grooved at the centerline. The centerline also has orangereflectors inset at intervals. Both shoulders are paved and are wide enough to park a patrol carclear of the lane of travel. The shoulders are separated from their respective lanes by a whiteroad edge line (fogline).

There is a left to right curve with a downhill grade for northbound traffic. The road has a superelevation which runs downhill eastward from the southbound lane to the northbound lane.Traveling northbound, the collision occurred approximately 124 feet after the curve began^Measurement was obtained using Google Maps).

The grade was measured at the centerline at the area of impact using a 4 foot level.2 5/8"

= 0.054 or 5.4% grade.48"

The super elevation was measured at the centerline at the area of impact using a 4 foot level.4.S"

= 0.093 or 9.3% super elevation.48"

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Case #

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Officer's Name: J. Mullins Badge No.: 1094

*Google Maps

WITNESS STATEMENTS

Timothy Parsons(Paraphrased excerpts from his voice recorded statement)

Parson met Johnson at her office in Aberdeen at approximately 0900 hours. He said thatJohnson was her normal happy self that morning. She had been ill a couple weeks prior to thatand only had a small cough now. He didn't think she was manifesting any symptoms thatmorning.

They were supposed to be in Raymond around 1000 hours to deliver meals. They were runningabout 10-15 minutes behind schedule due to a work vehicle issue. Parsons added it did notcause any urgency because they were not supposed deliver any meals until after 1000 hours.Johnson drove her personal vehicle while Parsons drove a work vehicle.

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9001666REPORT OF INVESTIGATION I ?asen#


Officer's Name: J. Mullins Badge No.: _1094

They stopped at a coffee drive-thru in Cosmopolis where Johnson paid for coffee for the both ofthem. Parsons advised the roadway was wet but didn't think it was raining because he didn'tremember having to use the wipers. He also stated it wasn't foggy and their speeds ranged from35 - 60 MPH depending on the corners. He did not have any concerns for her driving thatmorning. He also stated he has ridden with Johnson several times and has had no concerns.

Parsons advised he was driving behind Johnson between 4-5 car lengths and estimated a carlength as 10-12 feet. They were in a left hand curve and he saw a truck coming around thecorner.

"Vicky was ahead of me as I came up further around the truck, I noticed the tail end of the truckwas coming over into or already into Vicky's lane and I thought to myself that it was moving overinto um, and then I saw it hit the side of her car."

Parsons described the truck as pulling two empty flatbed trailers. He estimated the rear of thesecond trailer crossed into the southbound lane by 2-3 feet by how far the trailer was over thecenterline. Parsons stated he did not see any reaction by Johnson and believed it was less thana second from when the trailer crossed the centerline to the collision.

Parsons went to Johnson's vehicle and called 911. Parsons felt for a pulse and observed at least2 breaths and 2 moans. He did not see any further life signs and estimated three minutes hadpassed from when he called 911 to when he did not see any further signs of life.

Parsons shared his phone history information and showed me he made the 911 call at 1009hours and the phone call lasted 8 minutes and 1 1 seconds.

INVOLVED PARTY

Driver

Keith A. Leitz, a 62 year old male, was driving a turquoise blue 2000 Peterbilt semi-truck pullingtwo empty flatbed trailers. Leitz did not sustain any injury during the collision.

Shortly after I arrived on scene, I spoke with Leitz and asked him a few questions regarding thecollision. The questions and quotes were recorded on my patrol car dash camera.

Trooper Mullins: 'What do you remember about it?"

Leitz: "What I remember about it is, I was driving around the corner here and I didn't hear therumble strips or anything. I, you know, they make a lot of noise and hear those right away. Andall of a sudden my rear trailer went off into the ditch, and originally I thought well maybe I hit theguardrail because you know I do, we do, run close to the white line. But when I dropped thetrailer the damage was on the other side. So I knew there was" -

Trooper Mullins: "Did you know you hit a car?"Leitz: "I did not know I hit a car or the car hit me until I actually came to a stop and looked at theback pair and realized the, the left hand side had the damage not the right hand side. Originally, Ithought maybe I clipped the end of the guardrail and tore out that side."

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^JIQJA6?6RiT OF INVESTIGATION-°_ Q. :).^T OF INVESTIGATIONCertified Technical Specialist's Narrative

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19-001666Citation #

Officer's Name: J^^^ Badge No.:_•\094_

Trooper Mullins: "Do you have a dash cam?"Leitz: "I do not have a dash cam."

I spoke with Leitz again where he dropped off the trailers and further questioned him. My patrolcar camera was not activated at this time.

Leitz advised he was hauling boulders from the Beaver Lake Quarry in Mount Vernon, WA to thenorth jetty in llwaco, WA. He started his trip at 0100 hours and dropped the load in llwaco atapproximately 0800 hours. He stopped at the 76 gas station in South Bend where he purchasedcoffee and fried chicken. He advised he got about six hours of sleep that night.

Leitz advised his normal day consists of delivering the boulders to lllwaco and he returns to thequarry where the trailers are loaded for the next day's trip. He then sleeps in the sleeper cab ofthe truck. Leitz advised he takes two different medications for diabetes. 500 mg twice a day andanother prescription but he couldn't remember the name because he just started taking it. Healso said he has sleep apnea and uses a CPAP machine.

Leitz advised he has been driving truck for about 10 years, and two years with the currentcompany. He also stated he normally drives a 48 foot trailer and recently just started driving thedouble trailers for hauling boulders.

OCCUPANT KINEMATICS

Leitz, advised he did not feel the collision, - he was just driving and stated, "All of a sudden myrear trailer went off into the ditch." Occupant kinematics do not apply in this situation.

INVOLVED PARTY

Driver

Vicky L. Johnson, a 64 year old female, was driving a black 2015 Nissan Rogue. Johnson waswearing her 3 point seatbelt improperly. She had the shoulder strap under her left arm. Johnsonsustained blunt force trauma to her head which caused her death. She also sustained multiplefractures in both legs, a major laceration to her left leg, a major laceration to her left arm,abrasions and contusions.

OCCUPANT KINEMATICS

The left rear trailer wheels struck the Nissan at an 11:30 to 5:30 principal direction of force usinga clock face as a reference. Johnson was wearing her seatbelt shoulder strap under her left arm.Examination of her injuries, indicate the seatbelt was not tight and had slack before the collision.The shoulder strap was resting partially on the left side of her left breast. The lap belt was notproperly across her hips, which contributed to her kinematics. Instead, it was across the lowerportion of the abdomen. Johnson's Department of Licensing information listed her height andweight as: 5'4" 210 Ibs. At impact, the Nissan began to decelerate and all of the airbagsdeployed. This included the steering wheel, driver's seat, and the driver's curtain airbags. At thesame time the airbags deployed, the driver's seatbelt pre-tensioner fired pulling the slack out ofthe seatbelt. The shoulder strap resting on the left side ofJohnson's left breast caused thecontusion to the left breast from the pre-tensioner firing.

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I J.I..I LI. „.____-.'WASHWGTON STATE PATROL



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It also caused a diagonai abrasion across her chest and abdomen to her left hip area. Johnson'sbody was moving towards the driver's "A" pillar as the airbags deployed and the seatbelt pre-tensioner fired. At that approximate time, minor intrusion began into the driver's footcompartment.

The front left wheel began to be ripped off and induced damage began in the deformation of theroof line, driver's "A" pillar, the driver's "B" pillar, and door skin. Because the shoulder strap was

under her left arm, her upper torso was not secured against her seatback. Her upper torso

continued forward towards the driver's "A" pillar. The lap belt was across the lower portion of theabdomen, Johnson's abdomen compressed against the lap belt allowing her upper torso to pullher lower torso upward in a rolling motion around the lap belt. This allowed further forwardmovement of the upper torso. Johnson's left rib cage and chest compressed against the seatbeltcausing her head to continue forward in a whipping action. This placed her head down andforward and her forehead struck or was struck by an unidentified vehicle part, which caused theblunt force trauma to the brain as indicated by the head laceration and the blood in the right earcanal.

Johnson's right breast was struck by the steering wheel airbag, which caused a contusion to theunderside of the breast. The intrusion into the driver's foot compartment caused fractures to bothlegs. The driver's door armrest impacted her left side as the trailer wheel swiped the door. Herleft leg and left arm also sustained lacerations.

The Nissan rotated counter clockwise across the southbound lane and came to rest on thesouthbound shoulder. Johnson's body continued towards the passenger side as the Nissancame to rest. Her body then slumped to her right side.

Lap belt acrosslower abdomeninstead of the hips

Lap belt compressing into theabdomen allowing it to be thepivot point. This in turn allowedadditional upward and forwardmovement of the upper torso.

Shoulder strap

Upper torso moving forwardand pivoting

Moving upward

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Thrust Vector Additional upper torso movementallowed by the shoulder strapunder the left arm,

^Representation Only

SCENE ANALYSIS

I observed a turquoise blue semi-truck parked on the southbound shoulder behind a blackNissan Rogue. The Nissan was at rest, on its wheels, facing east, on the southbound shoulder,and with the rear wheels in the ditch. The Nissan sustained traumatic damage to the frontdriver's side area. There were vehicle parts and pieces coned out from near the centerline. Ilocated some scrapes, which began near the centerline and ended near the Nissan. TheNissan's left front wheel was lying on the southbound shoulder a few feet north of the Nissan.The deceased driver was covered by a white sheet and lying on the southbound shoulder nearthe left rear side of the Nissan. There was dirt strewn about the northbound lanes into part: of thesouthbound lane north of the Nissan at rest. Furrows in the northbound ditch led to rolling tireimprint onto the northbound shoulder, and then dirt strewn in the roadway. There was littleroadway evidence to indicate where the area of impact was due to the wet roadway conditions.The flatbed trailers the semi-truck was pulling were located on a wide gravel shoulder.

VEHICLE ANALYSIS

Second Trailer WA registration: 8214VK

The trailer is a stand-alone trailer with two axles: one at the front and one at the very rear. Eachaxle has dual wheels on each side. The left side of the rear axle was broken off its brackets andpushed backwards to approximately a 45 degree angle.

The strap ratchet located on the side of the trailer above the left axle sustained contact damageand it was bent sideways towards the rear of the trailer. Both dual left tires sustained contactdamage and became de-beaded from their respective wheels. There was a piece of the rimmissing near the lug hole on the outside wheel. An area on the lip of the outside wheel sustainedcontact damage and was bent. I was not certain this occurred as a result of the collision. The leftwheel hub had sustained minor contact damage. The damage may have been pre-existing. Thelower edge of the left are of the rear bumper was bent upward from the left dual wheels beingpushed back through it.

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Case #

19-001666Citation #

Officer's Name: J. Mullins __ __ Badge No.: 1094

The rear trailer was being used to haul extremely large boulders. Some of the observed contactdamage could have been a result of incident(s) in the loading or unloading of the trailer. TheLevel 1 Commercial Vehicle inspection of the tractor and both trailers are attached.

Black 2015 Nissan Rogue

Contact damage began at the front left wheel area just behind the left side of the front bumper.The contact damage continued to the driver's "A" pillar. The left front wheel had been ripped off.There was induced damage to the entire hood, front, and the left side of the roof line. The frontbumper cover was hanging by the right corner. The driver's door, the left passenger door, andthe driver's "A" and "B" pillars were removed by fire personnel for extrication. I spoke with fire

fighter, Cameron Cogdill, who advised there was some intrusion to the driver's door from contactdamage. There was intrusion into the driver's compartment on the left side of the dash area. Iestimated 8-10 inches from the left side of the driver's knee bolter area to the front left side of thedriver's seat. The driver's seatbelt buckle was still in the receiver and the belt was cut by firepersonnel. Ail airbags in the Nissan were deployed. The front windshield was shattered and lyingon the hood. All of the windows on the left side were shattered.

EVIDENCE

Leitz provided a voluntary blood sample which was submitted to theWSP Toxicology Laboratory.See Trooper Canham's report for the blood test results.

The Pacific County Coroner's Office conducted the standard death investigation blood draw onJohnson. The blood was submitted to theWSP Toxicotogy Laboratory. See Trooper Canham'sreport.

SPEED CALCULATIONS

Time Distance AnalysisSemi; 40 mph or 58.64 fpsNissan; 50 mph or 73,3 fps

i?seandsfl16.6' ' ^^1.5 seconds —il Second

1109.95' i 73.3'

The red line indicates the area of impact,The semi's distance is based on the second trailer's last axle due it being the part that struck the Nissan,

I conducted a time distance analysis to gain a better understanding of perception and reactiontime. I attempted to conduct this analysis with realistic average speeds that I have observed inpassenger and commercial in this particular section of roadway over that past 20 years. I used40 mph for the semi-truck and 50 mph for the Nissan.

3000-110-033 (R 8/17) PaQC 9 Of 18

Q n n " ?<, />. Û • U 0 0

REPORT OF INVESTIGATIONCertified Technical Specialist's Narrative

19-001666Citation #


The recognized average reaction time after a threat is perceived is1.5 seconds.The model demonstrates that even at 1.5 seconds (*187.91') away, the threat had notmanifested in the average reaction time. *187.91' = Semi: 87.96' + Nissan: 109.95'

Semi-Truck: 40 MPH x 1 .466 = 58.64 Feet Per Second (FPS)d = rear trailer's rear left dual wheel distance from area of impact.

.5 Seconds: d = 58.64 fps x .5 seconds = 29.32'1 Second: d = 58.64 fps x 1 second = 58.64'

1.5 Seconds: d = 58.64 fps x 1.5 seconds = 87.96'2 Seconds: d = 58.64 fps x 2 seconds = 117.28'

Nissan Rogue: 50 MPH x 1.466 = 73.3 FPS d = front of Nissan from impact.

.5 Seconds: d = 73.3 fps x .5 seconds = 36.65'1 Second: d = 73.3 fps x 1 second = 73.3'

1.5 Seconds: d = 73.3fps x 1.5 seconds = 109.95'2 Seconds: d = 73.3 fpsx2 seconds= 146.6'

COLLISION

Leitz was driving a semi-truck pulling two flatbed trailers northbound SR101.Johnson wasdriving a black Nissan Rogue traveling southbound. The semi-truck entered a left to right curvewith a downhill grade and a super elevation which runs downward from the southbound lane tothe northbound lane. Leitz induced a whip in the trailers from a sharp steering correction. Therear of the second trailer crossed over into the southbound lane and struck the Nissan in the leftfront wheel area. The Nissan rotated counter-clockwise across the southbound lane and came torest on the southbound shoulder. The rear wheels were partially in the ditch and the Nissan wasfacing in an easterly direction. Leitz continued north until he found a suitable location to pull over.He examined the damage and observed he must have struck a vehicle. He then dropped thetrailers off and returned to the scene,

Rearward Amplification (Trailer Whip):

Trailer whip is a common issue regarding commercial vehicles pulling a combination of units.There is training and emphasis regarding the problem and how to combat it. RearwardAmplification as defined by the University of Michigan Transportation Research Institute; "Thetendency of each trailer to exaggerate the lateral movements of the preceding unit."

I have inserted an excerpt from the Washington Department of Licensing Commercial DriverGuide. This is from Section 6-1 for combination of units. It speaks of the "dangerous crack thewhip effect" (rearward amplification).

It shows an illustration comparing a tractor pulling a 45 foot trailer (5 axles including the tractor)and compares other combinations on how many times more likely they are to roll as compared toit. The second to the last combination is the closest in comparison to the combinations involvedin this collision. The chart shows it is two times more likely to have rearward amplification thanthe 5 axle.

3000-110-033 (R 8/17) Page 1 0 Of 1 8



Case #

19-001666Citation #


Trucks with trailers have a dangerous "crack-the-whip" effect. When

you make a quick lane change, the crack-the-whip effect can turnthe trailer over. There are many accidents where only the trailer hasoverturned.

"Rearward amplification" causes the crack-the-whip effect Figure6.1 shows eight types of combination vehicles and the rearwardamplification each has in a quick lane change. Rigs with the leastcrack-the-whip effect are shown at the top and those with the most,at the bottom. Rearward amplitication of 2.0 in the chart means thatthe rear trailer is twice as likely to turn over as the tractor. You cansee that triples have a rearward amplification of 3.5. This means youcan roll the last trailer of triples 3.5 times as easily as a tive-axletractor.

Steer gently and smoothly when you are pulling trailers. If you makea sudden movement with your steering wheel, your trailer could tipover. Follow far enough behind other vehicles (at least 1 second foreach 10 feet of your vehicle length, plus another second if going over40 mph). Look far enough down the road to avoid being surprisedand having to make a sudden lane change. At night, drive slowlyenough to see obstacles with your heacHights before it is too late tochange lanes or stop gently. Slow down to a safe speed before goinginto a turn.

Brake Early

Control your speed whether fully loaded or empty. Large combinationvehicles take longer to stop when they are empty than when they arefully loaded. When lightly loaded, the very stiff suspension springsand strong brakes give poor traction and make It very easy to lock upthe wheels. Your trailer can swing out and strike other vehicles. Yourtractor can jackknife very quickly. You also must be very careful aboutdriving "bobtail" tractors (tractors without semitrailers). Tests haveshown that bobtails can be very hard to stop smoothly. It takes themlonger to stop than a tractor-semitrailer loaded to maximum grossweight.

6-2

•lf~i flftl ^, / /I ^ U U i. 0 b.b


Case #

19-001666Citation #


Influence of combination type on rearward amplification

5 asda tractor

semltrallerwith 45 ft.

3 axle tractorsemltraller

with 27 ft.

turnpike double45 ft. trailers

B-lrqin double27 ft. trailers

Rocky mountaindouble - 45 ft.

California truckfull trailer

65ft.conventionaldouble - 27 ft,

Triple27 ft. trailers

1.0 1.5 2.0 2.5 3.0 3.5 4.0

II?S\ i

u

•ww

s j:"ytT^Vf

il

1\l\

"M"-t:

^Rearward amplification (trailer whip) can be understood better by picturing someone cracking awhip. The handle of the whip is a cantilever which is the actuator for the whip. The handle isbrought up into the loaded position and then unloaded in a quick downward movement. The firstlateral movement of the semi-truck would be considered the pre-load movement. The semi-truckreaching its final point in the lateral movement would be the loaded position. The semi-truckmoving back to the other direction would be the unloading movement.

There are 4 points of lateral movement in this example.

*Representation Only ^ _^-^—

-^r^~I

Sharp Steering Inputproducing trailer whip

3000-110-033 (R 8/17) Page 12 of 18

"I 9 0 U 1 6 66iHINCTON STATE PATROt. REPORT OF INVESTIGATION


Case #

19-001666Citation #


* Representation Only.

Pre-load Movement


Loading the Whip

* Representation Only

Unloading the Whip

3000-110-033 (R 8/17) Page 13 of 18

I 9 0(n 6 66REPORT OF INVESTIGATION


Officer's Name: J. Mullins

Case #

19-001666Citation #

Badge No.: 1094

* Representation Only

First Trailer Progression


Final Progression

PRE-COLLISION

Leitz dropped off a load of boulders at the north jetty in llwaco, WA at approximately 0800 hours.He stopped at the 76 gas station in South Bend where he purchased coffee and fried chicken.He then began driving north towards Mount Vernon, WA. Leitz entered the area of the collisionand conducted a sharp correction to the left then back to the right after driving onto the shoulder.The sharp correction introduced trailer whip causing the end of the rear trailer to cross over thecenterline.

Johnson began her day in her office in Aberdeen, WA. She met up with her co-worker, TimothyParsons. They had to drive to Raymond, WA and drove in separate vehicles with Johnsondriving her personal vehicle. Johnson and Parsons stopped in Cosmopolis, WA. where Johnsonpurchased coffee for Parsons and herself before continuing on to Raymond.

3000-110-033 (R 8/17) PQQQ 14 Of 1 i

19001666REPORT OF INVESTIGATION I ?Qsen#



COLLISION DYNAMICS

The left rear trailer wheels struck the Nissan at an 11:30 to 5:30 principal direction of force usinga clock face as a reference. The thrust was very dynamic and came in at a sweeping, slappingmotion. The left front wheel was ripped off and the driver's door skin was mostly ripped off. TheNissan rotated in a counter-clockwise motion across the southbound lane and came to rest onthe southbound shoulder facing in an easterly direction.

POST-COLLISION

Leitz continued northbound and stopped just north of Smith Creek Road where he disconnectedboth trailers and returned to the scene.

The driver's door and the left passenger door were removed by fire personnel in order toextricate Johnson and she was pronounced deceased on scene.

CONCLUSION

The rear of the second trailer crossing the centerline was the cause of the collision. The semi-truck entered a left to right curve which means the trailers will track to the inside of the curve.There was no evidence to suggest Leitz drove across the centerline. CVEO A. Stevens advisedhe did not observe anything in his inspection of the semi-truck and trailers that would havecaused the collision.

My conclusion examines the Human, Vehicle, and Environmental (HVE) factors involved in thiscollision and how they, if any, contributed to the collision.

Unit 1

Human Factor:

Leitz's day started in Mt. Vernon, WA at approximately 0100 hours. I was advised by CVEO A.Stevens that Leitz would not have been able to make it back to Mt. Vernon before he ran out ofhours. He stopped in South Bend and purchased fried chicken and coffee. Leitz advised he wasdriving close to the fogline and thought he hit the guardrail. There are rumble strips on thecenterline and on both shoulders in the area of the collision. Although Leitz advised he didn'tremember hearing running over the shoulder rumble strip, he thought he struck the guardrailbecause he was crowding the fogline. My question regarding that is: How did he think he hit theguardrail if he didn't think he drove over the rumble strip? This would lead me to believe he diddrive on or over the rumble strip on the northbound shoulder and corrected too sharply for thecurve he was in. Leitz advised he just recently started pulling double trailers opposed to a 45 foottrailer that he normally pulls. Leitz has an Oregon Commercial driver's license with double andtriple trailers endorsement. This means he has knowledge of the cause of trailer whip. I did notnote any evidence to indicate Leitz was exceeding a reasonably safe speed. I know from myexperience over the years with that particular curve, it's typically driven by passenger vehicles atapproximately 50 MPH or less. I typically have observed commercial vehicles at the cautionaryspeed of 40 MPH or less.

3000-110-033 (R 8/17) PQQQ 15 Of 1 8

'."; (.\ f\»-.' S I

? -^ f /" {''I y [I U 1 b 6 6•IfnlNtii?' Kfcl-'UKI Uh INVfcSTIOATION | 19-Q01666

Certified Technical Specialist's NarrativeREPORT OF INVESTIGATION I ?os_en#n

Citation #

Officer's Name: J. Mullins __ Badge No.: 1094

Vehicle:CVEO A. Stevens advised there were several pre-existing conditions, which placed the semi-truck and the first trailer out of service. The second trailer would have been if it hadn't beendamaged in the collision. However, he advised those issues did not contribute to the collision.

Environment:It was a damp overcast day with good visibility and no sun glare. The roadway in the area of thecollision was in good repair and the roadway warning signs were properly posted. I did not noteany foreign substances on the roadway other than vehicle parts from the collision. The wetroadway might have contributed a minor amount. The wet conditions might have lowered theroadway coefficient of friction (COF) enough to allow the lateral movement of the rear trailerfurther than it would have in dry conditions.

Unit 2

Human factor:Johnson was in good spirits that morning as described by Parsons. There was a work vehicleissue which led to Johnson and Parsons getting behind schedule by 10 - 15 minutes. However,Parsons advised it wasn't a problem because they weren't supposed to start delivering mealsbefore 1000 hours. To demonstrate the work vehicle issue did not create an urgent condition;Johnson stopped at a coffee stand in Cosmopolis and purchased coffee for Parsons and herself.There are two coffee stands in Raymond they could have went to if they didn't have time to getcoffee in the Aberdeen area. Parsons was following Johnson to Raymond. Parsons advised hehas ridden with Johnson several times in the past. Her previous driving and her driving thatmorning did not alarm him. He advised she was driving anywhere from 35 - 60 MPH. The postedspeed limit south ofCosmopolis Hill (SR 101 MP 77) to entering the Raymond city limits (SR 101MP 60) is 55 MPH.

The roadway evidence began next to the centerline in the southbound lane. Neither Leitz norParsons made any statements suggesting Johnson drove over the centerline. Being acommissioned trooper during the past 10 years has benefited me in observing driving behaviorsand habits from a law enforcement perspective. I have commonly observed the poor driving habitof cutting into a curve (plowing). It is not a traffic violation, but a prudent driver with good drivinghabits would be wise to avoid plowing a curve. The area where the roadway evidence, such asscrapes and scars, first appeared lead me to believe Johnson most likely was plowing the curve.Although this driving behavior is not a traffic violation, it did limit perception and reaction timemaking it a minor contributing factor.

In Johnson's occupant kinematics, I explained how Johnson was wearing her shoulder strapunder her left arm, which was confirmed as her habit by her husband. An autopsy was notperformed. However, based on my observations, it appeared the collision was more likely thannot, survivable had Johnson been properly wearing her seatbelt.

Vehicle:I did not note any defects, which might have contributed to the collision.

Environment:See environment in HVE Unit 1.

3000-110-033 (R 8/17) PaQG 16 Of 1 8

900165 oREPORT OF INVESTIGATION


Case #

19-001666Citation #


Based on Leitz statements, vehicle evidence, and roadway evidence, it appears Leitz conducteda sharp correction in a left to right curve, which caused rearward amplification (trailer whip). Thisultimately caused the rear of the second trailer to cross into the southbound lane and strikeJohnson's vehicle.

For the purposes of collision investigation, strategy is defined as "Actions or precautionsconcerning driving that are prescribed partly by law or suggested by road markings andinfluenced by the driving environment."

Leitz was driving at or near the cautionary speed of 40 MPH (See Unit 1 HVE Human Factor)and he advised he was wearing his seatbelt. He was driving a semi-truck pulling double flatbedtrailers near or over the northbound fogline. The semi-truck and both trailers had mechanicalissues that would have placed them out of service.

Johnson was driving at or under the speed limit and she was improperly wearing her seatbelt

For the purposes of collision investigation, tactics are defined as "Actions or reactions concerningdriving that are not prescribed by law which are a response to a hazard, real or perceived."

I did not locate any evidence to suggest Leitz attempted to avoid the collision. The time distanceanalysis showed Johnson would not have had time to react.

*The signed copy of the signature page has been inserted into the next page to preserve theintegrity of this electronic report.

/ certify (or declare) under penalty of perjury under the laws of the Statethat this report is true and correct (RCW9A.72.085):

Officer's Signature Officer's Printed Name

J. MullinsLocation Signed

Hoquiam

3f Washington

Badge#

WADate Signed

3/6/2019

CID Review

Case Type:D FATAL D PATROL CAR COLLISION

D FELONY COLLISION

D OTHER

Detective Signature Badge # Date Signed

FOB Review

Place Signed

»00-110-033(R8/17)

Approved by (Signature) Approved by (Printed Name) Badge # Date Signed

Page M of 18

? 9 0016 66REPORT OF INVESTIGATION


Officer's Name: J. Mullins

Case #

19-001666Citation #

Badge No.: 1094


Case »19-001666Cita&m it

Officer's Nama: J. Muflins Badge No.: 1094

Based on Leltz ststements, vehicle evidence, and roadway Qvidancs, it appsars Leitz conducteda sharp correction In 9 left to right curve which caused reaward amplification (trailer whip). Thisultimately caused the rear of the sscond trailer to cross into the souihbound lane and strikeJohnson's vehicle,For the purposes of collision investigation, strategy is ctefined as "Actions of precaufionsconcerning driving that are prescribed partly by Saw or suggested by road markings and/nffuenoed by the driving environtnent."

Leitz was driving at or near the csautionary speed of 40 MPH (See Unit 1 HVE Human Factor)and he advised he was wearing his seatbelt. He was driving a semi-truck pulling double flattedtrailers near or over the northbound fogline. The semi-truck and both trailers had mechanicalissues that would have placed them out of service.

Johnson was driving at or under the speed limit arc) she was improperly wearing her seatbelt

Fortha purposes o-f collision investigation, tactics are defined as 'Actions orrQactions coiicerningdriving that are not prescribed bylaw which are a response to a hazard, real or perceived."

I did not locate any evidence to suggest Leltz attempted to gvoid the collision. The time distanceanalysis showed Johnson would not have had time to react.

/ certify (or dociare) under penalty Qf perjury under the laws of the State of Washingtonthat this report Is tnia and correct (ROW 9A.72.085):

OKcer's Pi'nlcd Nair.a

J. MullinsiDQtiiicn Signed

HoquiamBadge* ( Dale Spied

WA | 3/6/2019

C/D Review

caê Tyaecffl-FATAl, Q PATROl CAC< COIXIStW)

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3000-110-033 (R 8/17)

Page M of 17

Page 18 of 18

1 90016 6^!(}'REPORT OF INVESTIGATIONAssisting Officer's Narrative

Case #

19-001666Citation #

Officer's Name: Trooper J. Schaffer Badge No.: 646

Video file name (if applicable):

Video viewed by officer for this report: I—I YES 12SJ NO

1, Trooper Justin R. Schaffer, depose and say that I am an appointed, qualified, and acting lawenforcement officer for the Washington State Patrol. I am charged with the responsibility for theinvestigation of criminal activity occurring within the State of Washington. I was on duty in LewisCounty, WA, in full uniform and in my state issued patrol vehicle.

On January 18th, 2019 I was requested to respond to Willipa Harbor Hospital in South Bend inthe capacity of a Drug Recognition Expert. I was advised that Trooper Canham was investigatinga car v. semi fatality collision that occurred on SR101 near milepost 62. Trooper Canham hadtransported the driver of the semi to the hospital for a voluntary blood draw.

I arrived at Willipa Harbor Hospital at 12:42 hours and contacted Trooper Canham. TrooperCanham provided me with the driver's ID that identified him as Leitz, Keith A. 2-22-56. I wasadvised of the details of the collision and that Mr. Leitz already submitted to SFST's. TrooperCanham stated he had no concerns about possible impairment and that Mr. Leitz alreadysubmitted to a voluntary blood draw.

I informed Mr. Leitz the reason I was there and he consented to performing more voluntary tests.Mr. Leitz stated he is currently suffering from Diabetes and Cellulitis. I was also informed that Mr.Leitz has Neuropathy in both feet due to the diabetes. Mr. Leitz was currently only takingmedication for his diabetes, does not consume marijuana or any illicit drug. Mr. Leitz stated hedoes not wear corrective lenses or have issues with his eyes.

• HGN:0 Clues• Lack of Convergence: Present• Walk and Turn: 3 Clues. Off balance during instruction phase. Stepped off line on steps 2

and 17. Arms raised on steps 2 and 8.• One Leg Stand: Not performed due to loss of feeling in feet.• Modified Romberg: Estimated the passing of 30 seconds in a timed 26 seconds.

• Pulse: 90 b.p.m.

Additionally I observed Mr. Leitz to have appropriate pupil size for the current lighting conditions.Mr. Leitz's speech was normal and his reactions/movements appeared to be normal. I had noconcerns that Mr. Leitz was under the influence and I deemed a full evaluation would beunnecessary.

I relayed my observations to Trooper Canham and cleared the hospital. This ended myinvolvement in the matter.

/ certify (or declare) under penalty of perjury under the laws of the State of Washingtonthat this report is true and correct (RCW 9A.72.085):

Officer's Signature

/s/ J. Schaffer

Place Signed

Lewis County


J. Schaffer

Reviewed by (Signature^.

^Reviewed by (Printed Name)*

.rR,P^Â (^ /4^lJ

Badge #

646Badge #

^

Date Signed

1-19-19

Date Signed

J'2-7-2^1*Report is valid withouf r^vie\

3000-110-011 (R 2/15) Page 1 of 1

9 001 6 66REPORT OF INVESTIGATION | %.ecfoi666Assisting Officer's Narrative Citation #

Officer's Name: CVE02 Andrew Stevens Badge No.: X935

Video file name (if applicable):

Video viewed by officer for this report: I—I YES 12SJ NO

On 01/18/19, at approx. 1020hrs, I was dispatched to a 1 semi vs passenger vehicle injurycollision on SR 101 at MP 62. While enroute communications updated me, informing this wasnow a fatality collision.

I arrived on scene and observed a bobtailed semi-truck and a black passenger vehicle both inthe SB lane. The passenger vehicle had extensive driver side damage to it.

I contacted Trooper Mike Canham, 437, to determine what occurred. Trooper Canham statedthe semi-truck, with trailers was traveling NB on SR 101, with the passenger vehicle travelingSB. One of the vehicles crossed the center line, causing the trailers rear axle to run over thedriver's side of the passenger vehicle. After the collision, the CMV driver continued north, pullingover about 1/<i> mile away and dropped both trailers. After disconnecting from the trailers, theCMV driver returned to the collision scene.

At the time of this report, the causing driver as not been determined.

While the CMV driver was being interviewed, I met CVE01 Ignacio Rub! (X819) at the trailerslocation where we conducted the inspection on the two trailers.

We began a Level 1 Commercial Vehicle Safety Alliance inspection (WAW806011125) on thesetwo units. Due to the truck not being on site, we used my portable air compressor to check thebrake measurements.

I began by attempting to hook up my glad hand to the trailers air system. Due to air leaking fromthe second trailers glad hand connection, and being unable to get seal with my glad hands, I wasunable to build enough air into the trailers system to release and check the brakes. Because ofthese air leaks, I had to attach my air hoses directly to each of the trailers brake chambers. Afterobtaining the brakes measurements, we proceeded to inspect the trailers and obtainmeasurements. Once completing this, the both of us returned to the collision site.

I contacted Trooper J. Mullins (1094), who was the collision tech for the scene, and advised himof our progress and explained that I would need the CMV driver to reconnect the truck to thetrailers in order to complete my inspection. Once the driver was released from the scene, Iescorted him back to his trailers, had him reconnect to them and completed my inspection andmeasurements of the combination.

The following are the pre and post collision Code of Federal Regulation (CFR) violations foundon the combination:

1. CFR 393.75(a)(3)-Tire-flat-Axle 7 left side inner and outer tire, collision caused, unit 32. CFR 396.5B-KHLOW-Hubs-outer wheel hub broken, axle 7 left, collision caused, unit 33. CFR 393.201D-Frame Accessories-broken rear impact guard, left side-collision caused, unit

34. CFR 393.45DLUVOBrake connections-air lines to brake chambers, axle 7, separated from

brakes-collision caused, unit 35. CFR 393.48A-lnoperative brakes, axle 7 left/right-collision caused, unit 3

3000-110-on (R 2/15) Page 1. of 2

'1 500? 6 66REPORT OF INVESTIGATIONAssisting Officer's Narrative

Case #19-001666Citation #

Officer's Name: CVE02 Andrew Stevens Badge No.: X935

6. CFR 393.2070-Leaf spring assembly defective, broken/separated from frame-collisioncaused

393.9TS-lnoperative turn signal-right rear, unit 3, pre collision393.75A3-Tire-flat, axle 2 left air pressure measured at 20psi, 110 max, unit 1 pre collision393.47E-Brakes out of adjustment on all three units, 5 of 14 brakes-pre collision

10. 393.53B-Auto airbrake adjustment system fails to compensate for wear, unit 1-pre collision11. 396.3A1BOS-Brakes out ofService-more than 20 percent out of adjustment-pre collision

7.

8.

9.

The carrier of the CMV was Central Freight INC, USDOT number 2839415. The driver wasidentified by his Oregon driver's license as Keith A Leitz, DOB 02/22/1956, license number1888293. Leitz was operating a 2000 Peterbuilt semi-truck, WA license C42843G, a 1988 semi-trailer, WA license 53082AA, and a1970 full trailer, WA license 8214VK. The truck wasregistered to Central Freight, with trailers being leased by them.

Leitz stated he was returning from llwaco to Mount Vernon after delivering boulders for hisemployer.

Photos were taken at the scene.

The commercial motor vehicle was placed out of service as required by the 2018 CommercialVehicle Safety Alliance out of Service Criteria for the defective brakes and collision damage.

On 01/22/19 I mailed the completed CVSA inspection to the carrier. I also issued infractionnumber 9Z0004028 to Central Freight for defective brakes, having the courts mail it to them.

/ certify (or declare) under penalty of perjury under the laws of the State of Washingtonthat this report is true and correct (RCW9A.72.085):

Officer's Signature

/S/ Andrew Stevens

Place Signed

Shelton


Andrew Stevens

Reviewed by (Signature)*

/S/ Peter SponburghReviewed by (Printed Name)*

Peter Sponburgh

Badgeff

X935Badge #

X706

Date Signed

01/22/19Date Signed

1/22/19

*Report is valid without review.

3000-110-033 (R 2/15) Page 2 of 2

Commercial Motor Vehicle Collision Da_9 0 0 'I

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uorCASE # |L(-~<30|^<o PAGE OF

Grave! D Dirt D Grass OtherSurface: ^j Paved

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Special InstructionsPhotographs should be taken of the exterior of the commercial motor vehicle load and any contributing factors of the collisionincluding, but not limited to, equipment failures, improper securement, load shift, etc.

If driver fatigue is a contributing factor, carefully photograph/scan the log book and all supporting documents. Deliver all supportingdocuments to the primary investigator.

If at all possible, request a collision technical specialist take the photographs. If you do not have photographic equipment capable ofcapturing the evidence, note it in your report of investigation and/or document with a Collision Investigation (Field Diagram) Form ft3000-110-143.

Photographs taken(see above) by

Report(s) of Investigation Complete and submitted into CITE.AêUÂj

Supporting documentsdelivered to

Date l))S\\C{ . Time,/^_(L__dA.M.InspectingCVEO/CVD Trooper /r\. ^tPU-YVS,Assisting CVEO/CVD Trooper J^ (So-^lAssisting CVEO/CVD Trooper

'P.M. UDVIR LjALj5PfcC>t' fo> rBadge # K^ ^Badge #

Badge #JCtl^

3000-150 03S(H6>18

Commercial Motor Vehicle Collision Data 1 9 00 U 6 X V. ».<

uarCASE # / ct -GOI^fct' PAGE "^T OF XL

Trailer License # T^&SÂ State (ÂVIN _LT"T ^^r^rtCô^y&aTVehicle Year/<?S-S- Make fc^T^ T f^J^cTModel -—-

Empty WeightStyle ^T

AirTank(s)

êa

GVWR

J_Suspension Type(s)

Spring Lash (trailer)

Owner _ ^ (J ^Tr,^g_ \ n.^^^.nt±

TRAILER DIMENSIONS

w^trailer width)

a-'ip"

Second Trailer License # ^

VIN ©{<'- 3n003>Llc?Vehicle Year /c\") ° Make

Model L-^\^. Style

Empty Weight ^î^Spring Lash (trailer) i^r<\-~

x(track width)ST'^°

¥^)^V

1^!pr

AirTank(s)

Owner ^c^^p ^ ^_3 -S\c>y-\^

K

I

Y(deck height)

^^"

GVWR

Suspension Type(s)

Equipment #

z(trailer height)-yr

State LJ A-

(Ây^T^r

0 PQ S T

DISTANCE FROM FRONT OF TRACTORN

(eye of pintle hitch)

0

0(front of trailer)

s(rear axle reartacu

p(dolly/front axle)

(rear of trailer)

Q(king pin/articulation)

D(pintle eye hgtj^

R(front axle rear tandem)

v(trailer deck hgt.)

TRAILER DIMENSIONS

w(trailer width)^ > ^ t<

x(track width)

y t/''

Yj;deckj'}ejaht}

Lr^11

2(trailer height)t, t^"

3000.150-036 (K 6118)

Commercial Motor Vehicle Collision Brake/Tire Datai 9 0 0 •; 6 .;

J J

UBTCASE # _ /C1 - 0®i(5(^ PAGE _^3___ OF ___y_

Vehicle License #(s) _G_ So)-^ ^ Date and Time of Inspection / I I }~ i I C

S-Caml3- Disc D

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

-£-z:^-9e

N/A

1^N/A

Slack Adjuster Length

if unknov

^psi

psi

,32

,32

Slack Adjuster Type: D M or QW,

Brake Lining: Top ^ Bottom")^

Tire Rolling Radius

Applied Air a'€>

Axle I ABS (on-dash)

ABS Sensory Left [Slight T^None

Chamber Type

^0Chamber

Type/Size

^0ChamberType/Size

Pushrod Travel

Weight

^^XY ^ d ^ <Tire Size ^T -»<;£. A^.-C

|Stack Adjuster Length ""

Slack Adjuster Type: i^M or ^S^fi,

Brake Lining: Top _?^_ Bottom "7°

Tire Rolling Radius __<5^ j

Applied Air 1 0

Disc D

-s-

S-Cam ^

Disc Brand

Lining Code ^ ("F" if unknown)

0/S Tire Pressure (ô< psi

1/S Tire Pressure N/A psi

0/S Tread Depth ,._|_^_/32

1/S Tread Depth N/A ,32

Drum Diameter

S-Cam B) Disc D

Disc Brand

Lining Code r f'F" if unknown)

0/S Tire Pressure

Axle Aq o

ABS Sensor CyLeft (0 Right Qîone

Spring Brake ®Yes D No

psi

1/S Tire Pressure CTL<"L psi

,32

13, ,32

0/S Tread Depth

1/S Tread Depth

Drum Diameter

Slack Adjuster Length _"~^

Slack Adjuster Type: D M or 13'A

Brake Lining: Top >y Bottom _^p

Tire Rolling Radius

Applied Air

^ ^Chamber

AA ^L^<

Type/Size

Pushrod Travel

Weight

Tire Size

ChamberType/Slze

S-Cam

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

Disc a

_£_t?-

("F" if unknown)

9o

_Qob8^^


Slack Adjuster Type:

Brake Lining: Top

Tire Rolling Radius

: D M or [^

Bottom

_^L

psi

psi

,32

,32

?A

-A^- Applied Air

S-Cam Cy

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

c\0

Disc 0

_£_("F~ if unknown)

c?0 psi

Cf t) psi

S ,32

I A ,32•"•^

*"hs,


Slack Adjuster Type: D M or t3 f\

Brake Lining: Top >tf_ Bottom _*^>

Tire Rolling Radius

Applied Air ^°-

S-CamQP Disc D

Disc Brand f^~

^Lining Code

Axle ^

J^0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

("F" if unknown)

Qo psi

S^psi,32

,32

ABS Sensor [y-eft 1^'Right ^None

Spring Brake QBYes D No

A.


Slack Adjuster Type: D M or ^f\

Brake Lining: Top V3 Bottom )^

Tire Rolling Radius

iApplied Air _("\ ^

^° ^ChamberType/Size

Chamber IType/Size L

Pushrod Travel

Weight

Tire Size

3000-150 046 (6/18)

Commercial Motor Vehicle Collision Brake/Tire Data! 9f .- / / ..'

'j 'J 'J J uar/^ ^ Oe>/(^fc 6CASE # PAGE ^T OF

y//^1^Vehicle License #(s) CL<-0-^<-< !\€s> Date and Time of Inspection

S-Cam (p Disc D

Disc Brand

Lining Code

(^F"

("F" if unknown)

0/S Tire Pressure Q '> psi

1/S Tire Pressure '-' ^ psi

0/S Tread Depth y ,32

t/S Tread Depth I ^ ,32

Drum Diameter


Slack Adjuster Type: QPvl or D A

Brake Lining: Top Y7 Bottom

Ire Rolling Radius ^J- (

Applied Air c? 6>

Axle h- ABS (on-dash)

ABS Sensor D Left D Right ^'None

Chamber Type

•3o ^>o

3-Cam 1^0

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Deplh

1/S Tread Depth

Drum Diameter

ChamberType/Size

Chamber iType/Size '—

PIH

A>s^

Pushrod Travel

Weight

Tire Size

P/M

^-^


Slack Adjuster Type: C^M or D A

Brake Lining: Top T~' Bottom

Tire Rolling Radius

Applied Air

Disc D

FF ('P if unknown)

"7o psi

-7 I

_LL

^psi

,32

,32

q^T

i-Cam'EjP Disc D

Disc Brand

Lining Code _I' (-F" if unknov/n)

0/S Tire Pressure / 00 psi

1/S Tire Pressure *7 U psi

0/S Tread Depth U ,32

1/S Tread Depth _Ls?L_/32

Drum Diameter

-SlAxle

ABS Sensor D Left D Right D None

Spring Brake D Yes D No

Disc a

^


Slack Adjuster Type: 0'M or D A

Brake Lining: Top yBptlom

Tire Rolling Radius

lAppliedAir Q^

S-Cam

Disc Brand

Lining Code r _("F" if unknown)

0/S Tire Pressure / 0 <S> psi

1/S Tire Pressure Ly 0_ psi

0/S Tread Depth /»L. ,32

1/S Tread Depth f ot. ,32

Drum Diameter

,C^T'<C_ Tire Size _..C^-^TIS^


Slack Adjuster Type: [S-M or D A

Brake Lining; Top *T~ Boltom /^~

Tire Rolling Radius

Applied Air CZ c) ._

S-Camtp Disc D

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

FAxle 1Q_

Disc D

("F" if unknown)

$TO

ABS Sensor D Left D Righl D None


F

Slack Adjuster Length —

Slack Adjuster Type: C^M or D A

Brake Lining: Top ^~f Bottom

ITire Rolling Radius

lApplied Air

1^±

ChamberType/Size

^6ChamberType/Size

S-Cam{y

Disc Brand

Lining Code r _("F" if unknown)

0/S Tire Pressure 0" psi

1/S Tire Pressure '~t u _psi

0/S Tread Depth ' '^_ _ ,32

1/S Tread Depth ,32

^ -5l§-

Pushrod Travel

Weight

Tire Size-a^r

Drum Diameter

Slack Adjuster Length _''~~___.

Slack Adjuster Type: fiflvt or D A

Brake Lining: Top ^° Bottor

ITire Rolling Radius

I Applied Air _^ 0

3000-150 016 (6H 8)

Commercial Motor Vehicle Collision Brake/Tire Data•I 9 0016 66 axii.N

myCASE # /S -00/fcG?77 PAGE S OF

Vehicle License #(s) __C/ (^<^-^l4 ^ Cs> Date and Time of Inspection ___/_/J_^lj^_

Is-Cam ^3 Disc D

Disc Brand

Lining Code

(-

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter


Slack Adjuster Type: QS^\ or D A

Brake Lining: Top _<'^*Bottom _^

Tire Rolling Radius

Applied Air

Axle rz- ABS (on-dash)

ABS Sensor D Left D Right (g? None

Chamber Type

Chamber Chamber'/Size Type/Size L

Weight

^l^< Tire Size A^T

Disc D

(^S-Cam

Disc Brand

Lining Code V^~ ("F' if unknown)

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

1^6

~E

jK

psi

^psi

,32

,32


Slack Adjuster Type: ^PM or D A

Brake Lining: Top ~2° Bottom

Tire Rolling Radius Cs^-°

Applied Air ^S-Cam D Disc D

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter


Slack Adjuster Type: D

Brake Lining: Top

Tire Rolling Radius

Applied Air

fP if unKnov-

,psi

ps\

,32

,32

M or D A

Bottom

Axle



ChamberType/Size

ChamberType/Size

S-Cam D

Disc Brand

Lining Code

0/S Tire Pressure

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter

Disc D

CF" if unknown)

.psi

ps\

,32

,32

Pushrod Travel

Weigh!

Tire Size


Slack Adjuster Type: D M or D A

Brake Lining: Top _ Bottom

Tire Rolling Radius

Applied Air

IS-Cam Q Disc D

iDisc Brand

.ining Code

3/S Tire Pressure

/S Tire Pressure

3/S Tread Depth

1/S Tread Depth

Drum Diameter


Stack Adjuster Type: D

Brake Lining: Top

Tire Rolling Radius

Applied Air

("F" if unknown]

psi

^psi

,32

,32

M or D A

Bottom

Axle



S-Cam D

Disc Brand

Lining Code

ChamberType/Size

ChamberType/Size

Pushrod Travel

Weight

Tire Size

Disc D

("F* if unknown)

0/S Tire Pressure __ psi

_psi

,32

,32

1/S Tire Pressure

0/S Tread Depth

1/S Tread Depth

Drum Diameter


Slack Adjuster Type: D M or D A

Brake Lining: Top _ Bottom

Tire Rolling Radius

.Applied Air

3000 150 0-16 (8(18)

901 ) n

DRIVERAÊHICLE EXAMINATION REPORT Aspen 3.0.0.17

Washington State PatrolCommercial Vehicle DivisionP.O. Box 4261401ympia,WA 98504-2614Phone: (360)596-3815 Fax:

Report Number: WAW806011125Inspection Date: 01/18/2019Start: 10:51 AM PT End: 4:41:28 PM PTInspection Level: I - Full

HM Inspection Type: None

CENTRAL FREIGHT INC3361 KITTITAS HWYELLENBURG.WA 98926USDOT#: 02839415MC/MX#: 954604State#:

Location: -

Highway: 101County: PACIFIC, WA

Phone#: (509)859-3040Fax#:

MilePost: 62

Driver: LEITZ, KEITH ALicense#:1888293Date of Birth: 02/22/1956CoDriver:License#:Date of Birth:

Shipper:

State: OR

State:

Origin: ILWACO, WA Bill of Lading:Destination:MOUNT VERNON, WA Cargo: EMPTY

VEHICLE

Unit Type

1 TT2 ST3 FT

IDENTIFICATION

Make

PTRBUNK

B ROY

Year

20001988

1970

State

WAWAWA

Plate #

C42843G53082AA8214VK

Equipment ID VIN

1XP5DB9X1YD5107991TTF40205J1030588

ORS700349

GVWR105,500

CVSA # CVSA Issued # OOS Sticker

14512

14513

BRAKE ADJUSTMENTSAxle # 1RightLeftChamber C-20

211-30

311

C-30

4N/MN/MC-30

5

1 1/2C-30

61 1/4

C-30

71 1/2

C-30

VIOLATIONS

Via Code393.75A3

396.5B-HLOW

393.201 D

393.45DLUV

393.48A

393.207C

393.9TS393.75A3393.47E

393.53B

393.47E

393.47E

396.3A1BOS

Section

393.75(a)(3)

396.5(b)

393.201 (d)

393.45(d)

393.48(a)393.207(c)

393.9(a)393.75(a)(3)393.47(e)393.53(b)

393.47(e)393.47(e)396.3(a)(1)

Unit OOS Citation # Verify Crash Violations Discoveredu

NY

YYNN

NNY 9z000

Nu

uuNN

NNu

YY

NNNN

NNN

Tire-flat and/or audible air leak: axle 8, left side-inner andouter

Hubs - oil and/or Grease Leaking from hub - outer wheel:BROKEN HUBFrame accessories improperly attached: BROKEN REARIMPACT GUARD, LEFT SIDEBrake Connections with Leaks Under Vehicle: AIR LINE TOBRAKE CHAMBERS, AXLE 8 BOTH SIDES,SEPERATEDFROM CANSInoperative/defective brakes: AXLE 8 L/RLeaf spring assembly defective/missing:BROLEN/SEPERATED FROM FRAMEInoperative turn signal: right rear

Tire-flat and/or audible air leak: axle 2 left, inside-20psi

Clamp or Roto type brake out-of-adjustmentCMV manufactured after 10/19/94 has an automatic airbrakeadjustment system that fails to compensate for wear

Clamp or Roto type brake out-of-adjustment

Clamp or Roto type brake out-of-adjustment

BRAKES OUT OF SERVICE: The number of defective brakesis equal to or greater than 20 percent of the service brakeson the vehicle or combination

! Report Prepared By:STEVENS,A.

x_

Badge #:WA0935

Copy Received By:KEITH LEITZ

x

Page 1 of 2

02839415 WA WAW806011125

190016 6 •>DRIVER/VEHICLE EXAMINATION REPORT Aspen 3.0.0.17

Washington State PatrolCommercial Vehicle Division

P.O. Box 4261401ympia,WA 98504-2614Phone: (360)596-3815 Fax:

Report Number: WAW8060111 25Inspection Date: 01/18/2019

Start: 10:51 AM PT End: 4:41:28 PM PTInspection Level: | - Full

HM Inspection Type: None

CENTRAL FREIGHT ING3361 KITTITAS HWYELLENBURG, WA 98926USDOT#: 02839415IVIC/MX#: 954604State#:

Location: -

Highway: 101County: PACIFIC, WA

HazMat: No HM Transported.

Phone#: (509)859-3040Fax#:

Driver: LEITZ, KEITH ALicenses:1888293Date of Birth: 02/22/1956CoDriver:License#:Date of Birth:

IVlilePost: 62 Shipper:Origin: I LWACO, WA Bill of Lading:DestinatiomMOUNTVERNON, WA Cargo: EMPTY

Placard: No

State: OR

State:

Cargo Tank:

Special Checks: Size & Weight; Post Crash

State Information:DISTRICT (WSP ONLY): 08; DETACHMENT (WSP ONLY): 10;VIOLATIONS MARKED AS OUT OF SERVICE (OOS) MUST BE REPAIRED BEFORE VEHICLE/S CAN BE OPERATED. IF OOS FOR BRAKES ADJUSTMENT, ALL BRAKES MUSTBE WITHIN PROPER ADJUSTMENT LIMITS BEFORE VEHICLE/S CAN BE OPERATED.

I CERTIFY THAT ALL MECHANICAL VIOLATIONS WERE REPAIRED

Signature Of Repairer X:_ Facility:_ Date:.Advisory: This vehicle has been identified as having brake adjustment violations. 49CFR Section 393.53 requires that a self-adjusting brake system be equipped onthis vehicle. A qualified service technician needs to determine why the defective brake has excessive stroke and make the appropriate repairs. Simply re-adjusting aself-adjusting brake adjustor, or replacing it, does not guarantee that the problem is corrected. The problem may exist in the foundation brake system. By certifyingthis inspection report you have indicated that this vehicle now has a properly functioning self-adjusting brake adjustment system.

THE UNDERSIGNED CERTIFIES THAT ALL VIOLATIONS NOTED ON THIS REPORT HAVE BEEN CORRECTED AND ACTION HAS BEEN TAKEN TO ASSURE COMPLIANCEWITH ALL APPLICABLE FEDERAL AND STATE REGULATIONS. WITHINFIFTEEN (15) DAYS FOLLOWING THE DATE OF INSPECTION, THE MOTOR CARRIER OR INTERMODAL EQUIPMENT PROVIDER SHALL: (1)CERTIFY THAT ALL VIOLATIONS NOTED HAVE BEEN CORRECTED BY COMPLETING THE "SIGNATURE OF CARRIER/INTERMODAL EQUIPMENT PROVIDER OFFICIAL,TITLE, AND DATE SIGNED" PORTION OF THE FORM; AND (2)RETAIN A COPY AT THE MOTOR CARRIER'S PRINCIPAL PLACE OF BUSINESS, OR WHERE THE VEHICLE IS HOUSED FOR 12 MONTHS FROM THE DATE OF THEINSPECTION. FORQUESTIONS OR TO DISPUTE INFORMATION REGARDING THIS INSPECTION PLEASE USE THE FOLLOWING WEBSITE: HTTPS://DATAQS.FMCSA.DOT.GOV

Signature Of Motor Carrier X:. Title:_ Date:

Report Prepared^ By:STEVENS,A.

Badge #:WA0935

Copy Received By:KEITH LEITZ

x _

Page 2 of 2

02839415 WA WAW806011125

9 00TOXICOLOGY LABORATORY

WASHINGTON STATE PATROL2203 Airport Way South Suite 360 Seattle, WA 98134

(206) 262-6100 FAX No. (206) 262-6145

TOXICOLOGY TEST REPORT

Attention;

Agency:

Address:

Trooper Michael S. Canham

Naselle WSP

DRE Evaluator: Schaffer J 646

797 SR 4Naselle.WA 98638

ToxCase#: ST-19-01441 Case Type: DRE Report Date: 5/28/2019

Agency Case #: 19-001 666 Subject Name: Keith A. Leitz

Observation: No DRE face shest

Evidence; The following evidence was submitted to the Laboratory by Karen Burress of the Naselle WSP on

1/31/2019 via Campus Mail:(1) ST-19-01441-A: VGray, Lot# 734724, Blood . Peripheral

(2) ST-19-01441-B:VGray, Lot #734724, Blood - Peripheral

Volatile Analysis Results:

ST.1&-01441-A: Blood • Peripheral

ST-19-01441-A was tested by Headspace -Gas Chromatography for the presence of acetone, ethanol,

isopropanol, and methanol on 05/16/2019. The following result was obtained:

None Detected

Drug Anaj^sls_ Results:

ST.19-01441-A; Blood • Peripheral

ST-19-01441-Awas tested by Enzyme Multiplied Immunoassay Technique (EMIT) for the presence ofamphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine mBtabolite, and opiates on

05/09/2019. The following result(s) was obtained:

None Detected

(test conducted by Alexis Tillmon, Forensic Scientist 1)

COMMENTS

Stacey Doughw certfflss under penalty of perjury under Ihs laws of the State of Washington that the foregoing Isirue and corraot: Unlgss indicated otherwise, I performed alt testing reported above, for the submitted evidence.The document on which this csrfification appears is a true and complete copy of my official report and I havetechnically reviewed all relevant pages of testing documenlallon in the case record. The tests ware administeredaccording to testing methods approved by the state foxicologist pursuant to WA C 448-14-010, -020, -030 and/orRCW 46.61.506(3) by an analyst possessing a valid permit issued by the state toxlcologlst.

[R1.0-20190402] Page 1 of 2

Request ID: Sr-19-01441-0001

orExamined by:

) ;)Request ID: ST-19-01441-0001

Reviewed by:

Stao6y0ougher

Forensic Scientist 1

Executed this 2.'6'^flav offDn^ 2019at Seattle, Washington

flyv\r^~ p^Y\cr<-

Reviewer

Date: b / -3- /

[R1.0-20190402] Page 2 of 2

Reauast ID: ST-16-0144W01

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