HomeMy WebLinkAbout23-148 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z3-1a8 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 01 - 1-- 2023 0833 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE CARR RD BLOCK NO. e✓ 10600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 106TH PL SE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063278915 0 81
30
6� LAST NAME TRUONG FIRSTNAME KIM MIDDLE H 1 1 2 31
INITIAL
STREET ❑ 3000 SE ROYAL HILLS DR APT 12 CITy RENTON ST WA ZIP' 980583858 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 2❑
USE CLASS FACIAL/NJURY FROM AIRBAG
3
10[1 PI ENSE CBW6901 STATE WA VIN If 7FARWIH89HE030203
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 9 9 34
13 2 2017 HOND CR-V SV DAMAGE YES NOBS YES : No✓
REGISTERED OWNER INFO .TRUONG 3000 SE ROYAL HILLS DR APT 12 RENTONWA 98058 D:2063278915 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO AMERICAN FAMILY 41075-00951.68 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 3AO055408 INATTENTIVE DRIVING )o eorrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No DD 2
16 a 533809933
LAST NAME JORGENSEN FIRST NAME LARRY MIDDLE I C
INITIAL
17❑ STREET NEW ADOREss❑' 162 SHELTON RD CITY RANDLE ST WA ZIP 983779614 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs❑NOF YES
❑NOF,/
19 D IVEW #
❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE 2 INJURY 6 NATURE of INJURIES ❑ 40
USE CLASS C/O BACK SORENESS
❑21❑ PLATE# C45570L TATE 41
WA vIN# 1GCSHAF43D1133711 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2013 MAKE CHEV MODEL EXPRESS STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ADVANCED IMAGES INC 162 SHELTON RD RANDLEWA98377 D:2533809933 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#ECO STATE FARM 4900219-D10-47AIN 1 9TOP
'E""LE CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES Nu
❑ s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED23873
COLLISION REPORT III III III III III 111
1591972 CASE# 23-148
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 01-04-23 02:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.MORR/S 2613 111112023 8:26:33 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED' 8:35 AM TIME POLICE ARRIVED 8:42 AM
PART I PAGE IT]OF 4�
REPORT NO. ED23873 CASE# 23-148 OF COLLISION
01/04/23 08:33
OF CbLLI510N
NARRATIVE
23-148
On 01/04/2023 at approximately 0835 hours, I was dispatched to a vehicle collision with reports of
injury at the intersection of 106th PI SE and SE Carr Road, within the City Limits of Renton, County of
King, State of Washington.
While en route, Dispatch advised that there were two vehicles involved and that one of the involved
parties was complaining of an unknown injury and that Renton Regional Fire would be simultaneously
dispatched as a result.
Upon arrival, Renton Regional Fire was already on scene evaluating the involved parties. I confirmed
that the driver of Unit#1 had facial bruising from airbag deployment. The driver of Unit#2 had
complained of back pain/soreness. Both involved parties were treated at the scene and released by
Renton Regional Fire. While on scene, I collected each involved party's information and summary of
their involvement leading up to the collision.
The driver of Unit#1 said she was the sole occupant of her vehicle and was traveling eastbound in
about the 10500 block of SE Carr Rd approaching the intersection of 106th PL SE in what was
believed to be lane 2 of 3. The driver of Unit#1 stated she had felt fatigued and did not remember
what happened in the moments just prior to impact. The driver of Unit#1 stated she remembered
turning up her music because she felt tired but did not remember what happened after that. The
driver of Unit#1 stated that her next memory was her being involved in the collision with Unit#2. As a
result, Unit#1 collided with the rear of Unit#2 causing significant damage to the front of Unit#1.
The driver of Unit#2 said he was the sole occupant of his company vehicle and was also traveling
eastbound in about the 10500 block of SE Carr Rd in lane 3 of 3 (left-turn lane). The driver of Unit#2
stated he was stopped for a stale red traffic light at the intersection of 106th PI SE. The driver of Unit
#2 stated that while stopped, Unit#1 collided with the rear of Unit#2 causing significant damage to
the rear passenger side of Unit#2.
Based on the above statements, I determined that the Driver of Unit#1 (Truong) was the predominant
factor for the cause of collision due to Inattention causing a collision. Truong violated Renton
Municipal Code 10-12-25 (INATTENTIVE DRIVING). Per 10-12-25, "Inattentive manner" in this
section means a lack of: 1) attentiveness required to safely operate the vehicle under the prevailing
conditions, including, but not limited to, the nature and condition of the roadway, the weather
conditions, the presence of pedestrians, the presence of other traffic, or by the driver focusing or
directing the driver's attention to something other than driving the motor vehicle; or 2) attentiveness
that would permit the driver of a motor vehicle to observe anything resting on, or traveling on, or
entering the roadway in time to take appropriate action as circumstances require.
Truong was not paying attention to the road she was traveling on at the time of collision. I cited
Truong via mail for Inattention causing a collision.
Unit#1 had to be impounded due to extensive damage. Unit#2 was able to be driven away from the
scene without further incident. An exchange of information was provided to all involved parties.
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 2:24 PM 1/4/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED23873 CASE# ' 23-148 DATE AND TIME 01/04/23 08:33
OF COLLISION
w
U `diagram not to scale
CD
T
tJnit2
Unit 9!t
SE Carr Road
PAGE 4 OF 4