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HomeMy WebLinkAbout23-1349 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-1349 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT 8 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# ❑ cawsloN 02 - 01 - 2023 0826 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 140TH WAY SE BLOCK NO. e✓ 15300 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 150 00 FMILES N EET e S B E e SE 154TH PL 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2069159948 0 7 30 6� LAST NAME VOZNYUK FIRSTNAME PETER MIDDLE A 1 1 2 31 INITIAL STREET ❑, 12678 SE 307TH ST CITY AUBURN ST WA 2jp, 980923198 z 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 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑ 3 10 9❑ pICENSE1l ATE 14 SH18810 STATE WA u N# WD3PE8CC7C5666942 TRAILER STATE TRAILED STATE 11 4 0 PLATE# PLATE# FROM ro TRLR. TRLR. 5 1 33 12 4 0 VIN#' VIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34 13 4 2012 MERZ SPRINT VN DAMAGE YES YES[:] No REGISTERED OWNER INFO PETER VOZNYUK 12678 SE 307TH ST AUBURN WA 98092 D:2069159948 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 4 INSURANCE CO 3 4 14 IN EF IT INSURANCE SAFECO H2366215 IN EFFECT &POLICY# 9TOP EGA LE CHARGE 36 L EH'C YES❑NO❑ CITATION# 10 BOTTOM 15❑ 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062281828 16 a LAST NAME MA FIRST NAME TEA MIDDLE K INITIAL 17❑ NEW STREETR 15447 S 7 E 21 ST PL CITY' BELLEVUE ST WA ZIP 980076301 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX M D.C... 08 _ 10 _ 1957 39 LICENSE# MMDCDY 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ILICENSE 21❑ PLA E# AYM1240 TATE WA VIN# 41 STDZA23C86S456811 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2006 MAKE TOYT MODEL SIENNA STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO TEA MA 15447 SE 21STPL BELLEVUE WA 98007 D:2062281828 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU8 PORGY#E CO PROGRESSIVE 962296060IN 1 GD VE""LE CITATION# CHARGELEGAL25 LY YES N� ❑ s e =UGENT (PRINT) OFFICER PHONE BADGE OR ID# 77P�1300 26 11498 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED30440 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1349 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST 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. MATTHEW NUGENT 02-01-23 10:59 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 2/1/2023 4:58:10 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED: 8:38 AM TIME POLICE ARRIVED',8:48 AM PART I PAGE IT]OF TIME REPORT NO. ED30440 CASE# 23-1349 OF COLLISIONO2/01/23 08:26 NARRATIVE 23-1349 On 02/01/2023 at approximately 0838 hours, I was dispatched to a non-injury and blocking vehicle collision in the 15300 block of 140th Way SE, within the City Limits of Renton, County of King, State of Washington. Upon arrival, I confirmed there were no complaints of injury requiring immediate medical response. The driver of Unit#3 did complaint of minor chest pain from her seatbelt but stated she would follow- up with her doctor at a later date. While on scene, I collected the each of the involved driver's information and their independent recollection of the events leading up to the collision. The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling northbound in the 15300 block of 140th Way SE in lane 1 of 2 JNO the intersection of SE 154th Pl. The driver of Unit#1 stated he was traveling directly behind Unit#2 when he noticed Unit#2 immediate come to a stop due to queued traffic ahead. Unit#1 stated that he subsequently collided with the rear of Unit#2 causing minor damage to the front of Unit#1. The driver of Unit#2 said he was the sole occupant of his vehicle and was traveling northbound in the 15300 block of 140th Way SE in lane 1 of 2 JNO the intersection of SE 154th PI. The driver of Unit#2 stated he had come to a stop for traffic that had queued in front of him. While Unit#2 was stopped, Unit#1 collided with the rear of Unit#2 causing minor damage to the rear bumper of Unit#2. The driver of Unit#3 said she was the sole occupant of her vehicle and was also traveling northbound in the 15300 block of 140th Way SE in lane 1 of 2 JNO the intersection of SE 154th PI. The driver of Unit#3 stated she was traveling directly behind Unit#1 when she noticed Unit#1 immediate come to an abrupt stop. The driver of Unit#3 stated she was unable to avoid the collision and subsequently collided with the rear of Unit#1 causing significant damage to the front of Unit#3 and additional damage caused to the rear of Unit#2. Based on the above statements, I determined that the Driver of Unit#1 (Voznyuk) was the predominant factor for the cause of collision due to not paying attention to traffic stopped in front of him causing a collision. All of the involved vehicles were able to be driven away 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 10:59 AM 2/1/2023 Renton, King County, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED30440 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-1349 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70T !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:2532178303 0 1 29 LAST NAME TOLONEN FIRST NAME KELLY MIDDLE' E INITIAL STREET 30 NEW AnnRFSP 11400 SE 223RD ST CITY KENT ST WA ZIP 980312635 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO zERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 08 - 28 - 1992 7 HELMET :INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 6 C/O CHEST PAIN FROM SEA TBELT 8 ❑ 1 32 LICENSE BGG3209 TAr Wq VIN# 5J6RE4H51AL030618 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN It VIN.#. 11 4 O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' P FROM TO 2010 HOND CR-V SV DAMAGE YES NO YES NO 33 REGISTERED OWNER INFOKELLY TOLONEN 17512149TH AVE SE UNIT FI2 RENTON WA 98058 D:2532178303 $ 1 12 SHADE IN DAMAGED AREA 7 j 4 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 937574972 q"i"Olx IN EFFECT &POLICY# VEHICLE 34 13 ❑ Lecnuv YES[:] NO❑ CITATION CHARGE 10 BOTTUM STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME INITIAL MIDDLE ❑ 36 STREET 16 NEW AnnRFs� CITY ST ZIP CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv 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 02-01-23 10:59 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26F7 OI BADGE 11498 O#I WA0171300 JOHNSON 2/1/2023 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. ED30440 CASE# 23-1349 DATE AND TIME 02/01/23 08:26 OF COLLISION Uniitt#2 *Diagram not to scale0 Unit#1 Unit#3 =Direction of Travel,prior to impact PAGE 5 OF 5