HomeMy WebLinkAbout23-1811 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
CASE#r` 23-1811 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER � VFHICI F ❑ LOCAL AGENCI 4/00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK RETAINING WALL
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 02 - 1-- 2023 1640 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SENECA AVE NW BLOCK NO. e✓ 510
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2069541801 30
6❑ LAST NAME DESTA FIRSTNAME DANIEL MIDDLE I W 1 1 2 31
INITIAL
STREET 01 507 SENECA AVE NIN CITY RENTON ST WA ZIP' 98057 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYES NO 1/ INTERLOCKYEs NO�/ YES No�/
8❑ LICENS DRIVER # STATE WA SEX'M MMDDYY 05 - 13 - 1964 32
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 2❑
USE CLASS DAZED POSSIBLE HEAD INJ
3
10� Pl ATE 14 NONE STATE WA ,I,#' 5YJ3E1EA9KF476483
TRAILER STATE PLAILE STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR. 7 3 33
12❑ VIN#' VIN#'
Rom 34
13� VEH.YEAR 2019 MAKE TESL MODEL MODEL STYLE IV
AMAGE TOWED NOO pLSABLIN TO yED.BLRS YES[:]DAMAGE IILLJJII ttSSAA1IVV/i��66
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ UABILI INSURANCE U INSURANCE CO ALLSTATE 917 308 684
IN EFFECT &POLICY# <10
VEHICLE CHARGE 36
LEGALLvYFS❑NO CITATION#
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067724010
16❑
LAST NAME MIDDLEBROOKE FIRST NAME LINDA MIDDLE L
INITIAL
17❑ STREET ❑', 510 SENECA AVE NW CITY RENTON ST WA ZIP 98057 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑
19 F] DRIVE # STATE SEX F MMD D.O.B.B. O6 _ 28 _ 194 3 39
INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE VIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
S.MORR/S 2613 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED35003
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1811
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) DANIEL KIRUBEL
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
507 SENECA AVE NW RENTON WA 98057 SEX M MMDOYyry 04 - 20 - 2009
PASSENGER I�I WITNESS[] UNIT# 1 SEAT 3 AIRBAG'y RESTR. 4 EJECT ? HELIVIET INJURY NATURE OF INJURIES
L�!1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
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 02-15-23 09:19 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 211712023 4:38:47 PM
BADGE OR ID# 2613 OR]# WA0171300 TIME POLICE DISPATCHED! 4:46 PM TIME POLICE ARRIVED',4:58 PM
PART I PAGE IT]OF 4]
REPORT NO. ED35003 CASE# 23-1811 OF COLLISION
02/13/23 16:40
OF CbLLI510N
NARRATIVE
On 02/13/23 at 1658 hours I arrived at a single vehicle accident at 510 Seneca Ave NW in Renton
Washington, King County.
Everyone was out of the vehicle and Renton Fire Authority had triaged the driver of U1 and did not
transport him. The driver was identified by Washington Drivers license. The driver seemed sore and
still kind of dazed. His possible injuries were not known and not specific. If U1 was to go to a DR he
was going to have a family member driver him. He remained on scene while I was there. The
passenger in U1 was not injured at all.
U1 lived directly across the street from the collision scene. U1 said he drove up to his house and set
up so he could reverse into his driveway. Instead of reversing though, he drove forward into the
neighbors yard at 510 Seneca Ave NW. The problem though is the elevation difference between the
road and 510 Seneca Ave NW which is down an embankment. Due to this the vehicle went into the
yard from above and crashed through trees, bushes, shrubs, and a decorative brick wall which stuck
the vehicle into a position where it was not on the ground and stuck on the wall and trees. There was
no real way to tow this vehicle out directly and a rotator truck had to respond to lift the vehicle out.
After the crash, both people in U1 were able to crawl out and climb up. There was a small dog in the
vehicle though that could not get out and had to wait in the vehicle until the tow could lift the vehicle
out.
I provided an exchange of info to the property owners.
I am not issuing any infractions in this crash however U1 is the proximate cause of this collision due
to driving directly into the property owners yard causing severe damage to landscape and brick.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Roadway Surface: TREES/BUSHES/YARD/BRICK WALL
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. ED35003 CASE# ' 23-1811 DATE AND TIME 02/13/23 16:40
OF COLLISION
U1
fr
41
r`
No
510 Seneca Ave NW
PAGE 4 OF 4