HomeMy WebLinkAbout22-13147 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c
COLLISION REP FIT 1591971
CASE 22-13147 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 12 - 1-- 2022 1703 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 3200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 750 00 FEET MILES e S B W e NE 12TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:7143061961 0 7 30
5� LAST NAME FENTON FIRSTNAME SHAUN MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 3715 NE 14TH ST CITY RENTON ST WA ZIP 980563399 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CDV0903 sTArI WAVIN# WA 1 CNAFY6L2064144
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE g 9 34
13 2020 AUDI Q5 SV DAMAGE YES NO �LII� RS YES[:] No
REGISTERED OWNER INFO S..FENTON 3711 NE 14TH ST RENTON WA 98056 D:7143061961 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14LIABILI INSURANCE INSURANCE CO GEICO 6020867591 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY Yes❑NO❑ CITATION# W22067723 INATTENTION 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNPR ❑ YES 1/ No D:4
16 a 256334783
LAST NAME HOU FIRST NAME FAY MIDDLE X
INITIAL
17❑ NEW STREETR 12560 S
7 E 52ND ST CITY BELLEVUE ST WA ZIP 980062911 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK vEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ ILICENSE PLA E# BOB5823 TArE WA VIN# 1HGCV1F19JA231500 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED By Gov HI 44
VEH YEAR 2018 MAKE yOND MODEL ACCORD STYLE 4W —7EHICLE
TOWED✓ NOO BLIN BANKERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY BX11657700 1 9TOP
IN EFFECT
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ s
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED14495
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13147
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MATTHEW NUGENT 12-13-22 03:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.MORR/S 2613 1211412022 3:53:54 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 5:05 PM TIME POLICE ARRIVED',5:11 PM
PART I PAGE IT]OF 5�
REPORT NO. ED14495 CASE# 22-13147 OF COLLISION
12/12/22 17:03
OF CbLLI510N
NARRATIVE
22-13147
On 12/12/2022 at approximately 1705 hours, I was dispatched to an unknown-if-injury and blocking
vehicle collision in the 3200 block of NE Sunset Blvd, within the City Limits of Renton, County of King,
State of Washington.
Dispatch advised of a 3-vehicle collision and that the involved vehicles were blocking an unknown
direction of travel. Upon arrival and contacting the involved parties, I noticed airbag deployment on
one of the involved vehicles and heavy mechanism to two of the involved vehicles therefore I
requested the Renton Regional Fire Department respond for a precautionary evaluation. While on
scene, I collected each involved party's driving information and independent recollection of the events
leading up to the collision. Renton Fire later responded and treated all involved parties at the scene.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling westbound in
about the 3200 block of NE Sunset Blvd in lane 2 of 2. The driver of Unit#1 stated that an uninvolved
vehicle had triggered a collision warning sensor inside of Unit#1's vehicle. The driver of Unit#1
stated he was momentarily distracted by the warning alerts inside of the vehicle and upon looking
back up at the roadway, he noticed Unit#2 stopped in traffic directly in front of Unit#1. The driver of
Unit#1 stated that he tried swerving into the center-turn-lane to avoid the collision but ultimately was
unable to stop in time and collided with the rear of Unit#2 causing significant damage to the front of
Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and traveling westbound in about
the 3200 block of NE Sunset Blvd in lane 2 of 2. The driver of Unit#2 stated she was stopped for
queued traffic at the upcoming intersection. The driver of Unit#2 stated that while stopped, Unit#1
collided with the rear of Unit#2 causing significant damage. As a result of the initial impact between
Unit#1 and Unit#2, Unit#2 was then pushed into the rear of Unit#3 causing additional damage to
the front bumper of Unit#2.
The driver of Unit#3 said he was the sole occupant of his vehicle and was also traveling westbound
in about the 3200 block of NE Sunset Blvd in lane 2 of 2. The driver of Unit#3 stated he was stopped
for queued traffic at the upcoming intersection. The driver of Unit#3 stated that while stopped, Unit#2
collided with the rear of Unit#3 causing minor damage to the rear bumper of Unit#3.
Based on the above statements, I determined that the Driver of Unit#1 (Fenton) was the predominant
factor for the cause of collision due to Inattention causing a collision. The driver of Unit#1 should
have been paying more attention to traffic in front of him. Both Unit#1 and Unit#2 had to be
impounded due to extensive damage. Unit#3 was able to be driven away without further incident. An
exchange of information was provided to all involved parties.
I issued the driver of Unit#1 (Fenton) a Written Warning for Inattention.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 3:10 PM 12/13/2022 Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. ED14495
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 22-13147
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 t_"J CYCLE _) PEDESTRIAN � OWNER � YES NO
D:2064223262
0 7 29
LAST NAME : KHUU FIRST NAME TAN MIDDLE Q
INITIAL
STREET 30
NEW AnDRFSP'. 10211 6TH AVE SW CITY SEATTLE ST WA ZIP 981461521
6 ❑ 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO zERLOCK YES❑N0� YES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 10 TOE]- 1994
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BNE4321 TAr Wq VIN# 4T1BK36B27U178004
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2007 MAKE TOYT MODELA VALON STYLE 4D I VEHICLE TOME E T SABLIN TOWED BY anvi vFH1C P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO CUONG KHUU 10211 6TH AVE SW SEATTLE WA 98146 D:2064223262 SHADE IN DAMAGED AREA 9 9 33
12 z 3
FROM TO
LIABILITY INSURANCE INSURANCE CO COUNTRY FINANCIAL P46A5110828 GQO
IN EFFECT &POLICY# 1EHICLE 34
13LTAGFlGEGALLY YES NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
RTY YES[—]AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME N DL 36
❑
AL
STREET
16Fl NFWAET F-] CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YES NO ❑
17 4 37
LICENSE# STATE SEX MMMOOYBYY -� II
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE CLASS
19 ❑ LICENSE TAr VIN# 39
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ ❑ 41
TRLR TRLR
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED 3 4 4 AREA F 43
z 3
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
MATTHEW NUGENT 12-13-22 03:11 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 11498 O#I',WA0171300 APMORRIS 12114/202 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO.! ED14495 CASE# ' 22-13147 DATE AND TIME 12/12/22 17:03
OF COLLISION
U„ttl
[J�It 92.
'Pianram not kscalc
NE 12th:St
PAGE 5 OF 5