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HomeMy WebLinkAbout23-1509 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. ED34214 170 27 COLLISION REP FIT 1591971 CASE 23-1509 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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# COLLISION.. 02 - 1-- 2023 0750 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ FACTORYPL N BLOCK NO. e✓ 400 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e N MAR/ON ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4257532372 0 11 30 6� LAST NAME RODRIGUEZ FIRSTNAME ROSA MIDDLE 1 2 31 INITIAL STREET ❑ 2603 NE 4TH ST 634 CITY RENTON ST WA ZIP' 98056 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVERS STATE WA SEX'F MM DAY' 09 1- 05 - 1967 2 32 CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 9❑ Pi aT�S� BGZ4880 sTArI WAurN# 4T18E32K73U194447 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR. TRLR 4 7 33 12 3 5 VIN#' VIN# >;. FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 4 $ 34 13 1 2003 TOYT CAMRY SD DAMAGE YES NO ves❑ No REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO STATE FARM 4114457C1447A 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES No CITATION 3A0189533 PROWIMPROPER TURN IoBorrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4259193991 16 a LAST NAME ROBINS FIRST NAME BRIAN MIDDLE IG INITIAL 17❑ NEW STREETREs7 16028 SE 148TH ST CITY RENTON ST WA ZIP 98059 37 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK vEs I I NOF YEs t l NOF,/ 19 LICENSE# STATE WA SEX M M D.O.B. 05 _ 09 _ 1961 39 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# ASR8226 TArE 41 WA VIN# 19XF62E56EE018229 1 42 22❑ PLATE# STATE PLATE ILER# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' Gov HI VEH YEAR 2014 MAKE HOND MODEL CIVIC STYLE $D —FEHICLE TOWED NO O✓ YES NO 1/AMA E BLIN TOWED By 44 24❑ fj REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DA GEbAREA LIABILITY INSURANCE &POLICY#E CO USAA 002753290CIN I STOP 5 VEHICLE ❑ C[:] CITATION# CHARGE to BOTTOM LEGALLY YES N 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 MATTHEW TRAINO 12811 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED34214 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1509 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 TRAINO 02-06-23 06:53 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT S.WOODWARD 11528 2/15/2023 11:38:48 AM BADGE OR ID# 12811 ORI# WA0171300 TIME POLICE DISPATCHED', 7:51 AM TIME POLICE ARRIVED',7:55 AM PART I PAGE IT]OF REPORT NO. ED34214 CASE# 23-1509 OF COLLISION 02/06/23 07:50 OF CbLLI510N NARRATIVE Unit# 1 was travelling northwest on Factory PI N. In this location there are 4 lanes of northward travel, #1 on the west side, through #4 on the east side of the road. U-1 was in the #2 lane. Unit# 2 was travelling northwest in the #1 lane. Unit# 3 was travelling northwest in the #4 lane. U-1 attempted to turn left to head westbound on N. Marion St. from the #2 lane, striking U-2 and causing that vehicle to lose control. U-2 struck U-3, which was in the #4 lane. Driver# 1 stated that she was travelling northwest on Factory PI N. D-1 said that she was in the #2 lane, and that she intended to turn left to head westbound on N. Marion St. D-1 said that she checked her mirror and did not see any vehicles in the #1 lane before initiating her turn, at which time she collided with U-2. D-1 reported no injuries. Driver#2 stated that he was travelling northwest on Factory PL N. D-2 stated that he was going straight in the #1 lane, when his vehicle was struck by U-2, causing him to momentarily lose control. D-2 stated that his vehicle spun 360 degrees before striking U-3. D-2 reported no injuries. Driver#3 stated that she was travelling northwest on Factory PL N. D-3 stated that she was going straight in the #4 lane, when her vehicle was struck by U-2 on the drivers side. D-3 reported no injuries. U-1 sustained moderate damage to the front left bumper. U-2 sustained moderate damage to the right side of the vehicle. U-3 sustained moderate damaged to the left side of the vehicle. U-3 was towed from the scene at the owners request. D-1 was cited for making an improper lane change under RCW 46.61.290. The infraction was explained to D-1, who stated that she understood. D-1 was identified by her WADOL. N/F. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. ED34214 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-1509 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GINAME 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:8037182673 0 1 29 LAST NAME WILLINGHAM FIRST NAME SHARONDA MIDDLE R INITIAL STREET 30 NEW AnDRFSP 2601 NE 4TH ST 631 CITY RENTON ST WA ZIP 98056 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv', 07 TO] - 1986 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CEZ6956 TAr Wq VIN# WAUP2AF26KN054025 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2019 MAKE AUDI I MODELA7 STYLE SD VEHICLE TOWS E T SABLI Wf_-R anvi vEHICi P FROM TO DAMAGE YES NO YES NO 33 REGISTERED OWNER INFOOWNED SYDRIVER Q $ SHADE IN DAMAGED AREA 12 2 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM 4799525E23478XP52329 gl"OI' IN EFFECT &POLICY# 1 VEHICLE 7080TTfJM m 34 CITATION# CHARGE 13 LEG LEY YES NO ❑ STANDING dRD PROPERTY Y ❑ 35GNHROE VEHICLE CYCLE OWNER O14 UNITr j PHONE 15 LAST NAME FIRST NAME INITIAL MIDDLE ❑ 36 STREET"[—] 16 NEW nnR CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK 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 LE C E STANDING 8 7 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MATTHEW TRAINO 02-06-23 06:53 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 12811 O#I',WA0171300 APWOODWARD 21115/2023 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. ED34214 CASE# 23-1509 DATE AND TIME 02/06/23 07:50 OF COLLISION Nir't.F'q:5esle p; Scene Not 6bsawed.. S�;a©ndery fmpenab. U,tN2 Seaondity HnRast N t#7 In tal4mpect NNIARIONSTi 'IJnitk'i::; Fomary Pa ntrrffnrpsa. PAGE 5 OF 5