HomeMy WebLinkAbout23-213 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ 23-213 z
FIRE ❑ CASE#
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER VFHIC;I F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 28
5
RESERVATION 1
TRIBAL UNITS 02 STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 01 - 05 - 2023 1552 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S GRADY WAY BLOCK NO. e✓ 1055
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 8 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:4254307500 0 11
30
6� LAST NAME WOODWARD FIRSTNAME SCOTT MIDDLE D 1 1 2 31
INITIAL
STREET ❑✓ 1055 S GRADY WAY CITY RENTON ST WA ZIP 98056 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R No�/
8❑ LRIIVERS STATE WA SEXI M MM DAY' 09 1— 22 — 1975 2 32
CENSE 9 ON DUTY✓❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10� P1 aT�S� 67618D sTATr WAurN# 1GNLCDEC6KR355209
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. RLR 1 7 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE ] $ 34
13 2019 CHEV TAHOE DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO CITY OF RENTON 1055 S GRADY WAY RENTON WA 98056 D:4254307500 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14� UABILI INSURANCE INSURANCECO CITY OF RENTON SELF INSURED 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2063879492
16 a
LAST NAME GREWAL FIRST NAME HAKAM MIDDLE I S
INITIAL
17❑ STREET ❑', 15811 SE 256TH ST CITY COVINGTON ST WA ZIP 980424118 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES
t l NOF,/
19[ D IVERI #
{NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS ❑
21❑ LICENSE BWP7236 TATe I WA VIN1t JTDKBRFU4H3030033
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2017 MAKE TOYT MODEL PRIUS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO HAKAM GREWAL 15811 SE 256TH ST COVINGTON W COVINGTON WA 98042 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO COMMERCE WESTACPA-002539696IN 1UR
VEHICLe ❑ ,.I—I CITATION# CHARGELEGALLY YES N25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
K.LANE 10008 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED23874
COLLISION REPORT III III III III III 111
1591972 CASE# 23-213
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
POS. 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'
Unit 1, a fully marked Renton Police patrol vehicle with emergency lights not activated, was traveling
southbound on Benson RD S intending to turn right, westbound down a driveway, and into the
parking lot of Renton City Hall 1055 S Grady Way. Unit 2 was traveling eastbound through the
parking lot of Renton City Hall towards the driveway out onto Benson RD S. This driveway has a
downgrade from the high point on Benson RD S down into the low point inside of the parking lot.
Video is available of the collision, as Unit 2 begins uphill onto the driveway, it is positioned to the
center/south third of the driveway as it proceeds eastbound towards Benson RD S. At the same
moment, Unit 1 began the right turn, swinging wide towards the center/north third of the driveway.
Driver 1 states he could not see Unit 2 due to the small vehicle size, downward grade of the driveway,
and large hood area of the patrol vehicle. Both vehicle movements (Unit 1 right turn/Unit 2 eastbound
on the driveway) brought them together and the front push bars of Unit 1 struck the front driver's side
corner of Unit 2. Unit 1 sustained minor damage to the push bars; Unit 2 sustained moderate
damage to the front driver's side headlight area. This report is to document the collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
K.LANE 01-06-23 08:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
S.MORRIS 2613 111112023 8:26:24 AM
BADGE OR ID# 10008 ORI# WA0171300 TIME POLICE DISPATCHED', 3:52 PM TIME POLICE ARRIVED 3:52 PM
PART I PAGE IT]OF 3�
REPORT NO. ED23874 CASE# ' 23-213 DATE AND TIME 01/055/23 15:52
OF COLLISION
NEEMENEENEENEEMMMMMMMmmmmmmmmmommm
BENSON RD
***NOT TO SCALE-
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