HomeMy WebLinkAbout23-215 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE# 23-215 z
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 1653 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ 1200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a OAKESDALE AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2064460155 0 11
30
6❑ LAST NAME ALLEE FIRSTNAME RACHEL MIDDLE N 1 2 31
INITIAL
STREET ❑ 412 E NOVAK LN APT F101 CITY KENT ST WA 7jp, 980322020 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES 1/ NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 07 1— 22 — 1984 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 2❑
USE CLASS COMPLAINT OF PAIN UPPER BODY
3
10❑ Pl ATE 14 BBP9791 STATE WA VIN#' 183HB28AX9D173179
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM TO
TRLR. TRLR. 3 5 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 7 $ 34
13 A 2009 DODG CALIBE DAMAGE vE6 0NO f �LAWkkRS vEs❑ No
REGISTEREDOWNER WFO RACHEL ALLEE 412 E NOVAK LN APT F101 KENTWA98032 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14[Al
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 932675759 4
LI EFFECT &POLICY#VEHICLE CHARGE 36
LEGALLvYes❑NO CITATION# <,IQ
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064763790
LAST NAME PIGAREVA FIRST NAME ANASTASIA MIDDLE
INITIAL
17❑ STREET ❑', 516 SHATTUCK AVE S APT 102 CITY' RENTON ST WA ZIP 980572430 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER #
INJURY 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS BROKEN COLLARBONE
21❑ LICENSE I CCW0011 TATe I WA VIN# 2HGFG126X9H529706
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2009 MAKE HOND MODEL CIVIC STYLE I VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO ANASTASIA PIGAREVA 516 SHATTUCK AVE S APT 102 RENTON WA 98057 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE INSU PORGY#E CO TRAVELERS 605607421 203 1IN 9TOP 5
VE""LE ❑ N,J� CITATION# CHARGE
LEG to BOTTOM
ALLY YES 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
S.MORR/S 2613 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED26464
COLLISION REPORT III III III III III 111
1591972 CASE# 23-215
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'
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.
S.MORRIS 01-09-23 10:04 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 111912023 12:41:25 PM
BADGE OR ID# 2613 OR]# WA0171300 TIME POLICE DISPATCHED 4:55 PM TIME POLICE ARRIVED',5:06 PM
PART I PAGE IT]OF 4�
REPORT NO. ED26464 CASE# 23-215 OF COLLISION
01/05/23 16:53
OF CbLLI510N
NARRATIVE
On 01/05/23 at 1655 1 was dispatched to a two vehicle injury collision which occurred in the
intersection of SW Grady Way and Oakesdale Ave SW in Renton Washington King County.
Upon arrival both vehicles were disabled and had to be towed away from the scene. Bankers Towing
eventually responded and towed both vehicles.
Both drivers were identified by Washington State drivers licenses. U1 was being extracted by RFA.
U2 was sitting on the curb with her dog. The dog was also eventually taken to the vet to assess any
injuries. U2 complained of shoulder pain. U2 was driven to Valley Medical Center by her husband
who had responded to the scene after the collision.
In speaking with both parties the cause of the accident was U1 was making a left turn to go South on
Oakesdale Ave SW from SW Grady Way. U1 confirmed she had a yellow arrow to make the turn. U1
turned left but did not see U2 and stated U2 must have been speeding. U1 was not able to get
through the intersection before U2 hit her which U2 was going straight through the intersection on a
green light.
I was able to clear the scene after the vehicles were towed and meet both parties at Valley Medical
Center where I was able to return their paperwork.
Both parties were not exactly sure which lane U2 was in during the collision. Due to U1 turning left on
a yellow though it does not change the cause of the collision. U1 is the proximate cause of the
collision for not being able to complete the turn through the intersection before being hit.
Both drivers went to the hospital for evaluation. U2's dog also went to the VET to be evaluated. No
citations were issued in this collision.
PAGE 3 OF 4
REPORT NO. ED26464 CASE# 23-215 DATE AND TIME 01/05/23 16:53
OF COLLISION
0
0
77
fD
m
cn
SW Grady Way
mm ul
U2
PAGE 4 OF 4