HomeMy WebLinkAbout23-497 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z3-497 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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#
cawsloN 01 - 1-- 2023 0516 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ p ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 3RD ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:4256812897 0 11
30
6� LAST NAME HAMMERLEE FIRSTNAME AUDRA MIDDLE R 1 1 2 31
INITIAL
STREET ❑, 350 3RD PL NW CITY ISSAQUAH ST WA 2jp, 98027 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'F MM DAY' 03 1- 15 - 1996 2 32
CENSE 9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELMETU E 2 CLASS 7 [NATURE OF INJURIES
COMPLAINT OF CHEST PAW 2❑
3
10[1P1 ATNES# 947YDY sTAT WAv N# JHLRD18631 C044667
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# Rom ro
TRLR. TRLR 1 1 3 33
2 3 5 vIN#' VIN#
FROM TO
❑ VEH.YEAR 2001 HOND CRV MAKE MODEL STYLE VEHICLE TOWED TO BLIN Tg YMEYER GOVT.VEHICLE 5 1 34
13 4 DAMAGE YES No YES[:] No
REGISTERED OWNER INFO AUDRA HAMMERLEE 35031D PL NW ISSAQUAH WA 98027 D:4256812897 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 IN EFFECT INSURANCE STATE FARM 4748799.614.47
IN EFFECT &POLICY# 9TOP
vE—LE CHAR to BOTTOM 5 36
-ALLY YES❑NO CITATION# 3A0139731 GE FAIL TO OBEY TRAFFIC CONTROL 5
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM1/ THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO D:2536865659
16 a
LAST NAME BONERTZ FIRST NAME PAIGE MIDDLE A
INITIAL
17❑ NEW STREETR 416 120
7 TH ST S CITY TACOMA ST WA ZIP 98444 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS I
AIRBAG,2 RESTR 4 EJECT 1 H EET 2 NJAU SY 7 COMPLAINT OF HEAD PAIN ❑ 40
❑21❑ 41
ILICENSE PLA E# BIL3599 TATE WA vIN# JTDKN3DU8F1983215 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2015 MAKE TOYT MODEL PRIUS STYLE SD VEHICLETOWED TO BLIN TOWEDII GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO PAIGE BONERTZ 416120TH ST S TACOMA WA 98444 D:2536865659 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO STATE FARM 4680613-D20-47AIN STOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N 6
25 7NE
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
ON 12327 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED24765
COLLISION REPORT III III III III III 111
1591972 CASE# 23-497
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FAULKS CURTIS
(LAST FIRST,
ADDRESS&PHONE#
2069300866 SEX i U MMDDYYYY 12 - 11 - 1973
---------------------------
PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓S UNIT# POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) i SWANSON ANDREA
ADDRESS&PHONE# O B
2069308395 SEX: U 4:o- 13 _ 1976
PASSENGER []WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
T.NELSON 01-13-23 06:41 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 111412023 4:21:41 AM
BADGE OR ID# 12327 ORI# WA0171300 TIME POLICE DISPATCHED; 5:22 AM TIME POLICE ARRIVED 5:24 AM
PART I PAGE IT]OF 4]
REPORT NO. ED24765 CASE# 23-497 OF COLLISION
01/13/23 05:16
OF CbLLI510N
NARRATIVE
23-497
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 01-13-2023 at approximately 0522 hours I was dispatched to an injury collision at Sunset Blvd N
and NE 3rd St.
I arrived and located the involved vehicles. Unit 1 had significant front-end damage and unit 2 had
significant front driver side damage. The driver of unit 1, Hammerlee, complained of chest pain from
the airbag deployment. The driver of unit 2, Bonertz, complained of head pain. Both drivers were
evaluated and medically cleared by the Fire Department.
Hammerlee was shaken up and unable to advise exactly what happened.
Bonertz advised that she was travelling north on Sunset Blvd N in lane 3. Bonertz had a green light
and was continuing straight through the intersection when she was struck by unit 2 who was travelling
south on Sunset Blvd N and making a left turn to travel east on NE 3rd St.
Two witnesses, Faulks and Swanson, both advised that they observed unit 1 make a left turn from
lane 4 of southbound Sunset Blvd N, which is not a turn lane, through a red light and strike unit 2.
The damage to both vehicles was consistent with the information relayed and the damage to the
vehicles.
Both vehicles were inoperable and were towed by Gene Meyer Towing.
Based on what Bonertz and the witnesses advised, I was led to believe that unit 1 ran the red light
and was therefore the proximate cause of the collision.
Hammerlee was cited for violating RCW 46.61.050.
1 declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by T. Nelson 12327 on 01-13-2023 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. ED24765 CASE# ' 23-497 DATE AND TIME 01/13/23 05:16
OF COLLISION
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