HomeMy WebLinkAbout23-1687 ITFF' "POLCERA II I !�� I III I III I IIII III II I . B 27c
COLLISION REP FIT 1591971
CASE 23-1687 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
cowsloN 02 - 09 - 2023 1854 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARRINGTON AVE NE BLOCK NO. e✓ 1200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S B W e NE 12TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:3603938244 0 11
30
6� LAST NAME MANA FIRSTNAME KYLE MIDDLE A 1 2 31
INITIAL
STREET ❑, 1040 KINGSMILL ST CITY BELLINGHAM ST WA ZIP, 98229 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs 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 2❑ PI ATE 14 A 6003966 STATE WA u N# 2HGFE1 F95PH302561
----� TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM ro
TRLR. TRLR 3 7 33
12 2 5 VIN#j VIN#
:: FROM TO
VEH.YEAR 2023 HOND CIVIC P4 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO KYLE MANA 1040 KINGSMILL ST BELLINGHAM WA 98229 D:3603938244 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 530.2628-F17.47B 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2066432869
16 a
LAST NAME DECKER FIRST NAME DAVID MIDDLE E
INITIAL
17 STREET❑ NEW ADOREss❑' 14911 130TH AVE SE CITY RENTON ST WA ZIP 98058 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE I WA SEX M I D.C.B. 08 _ 30 _ 1968 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ 41
21❑ PLATE# 64352D TATE GOV vINIt 1GCGTBENXJ1204046 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE CHEV MODEL COLORA STYLE PK VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO CITY OF RENTON 1055 S GRADY WAY RENTON WA 98057 D:4254307500 VEHICLE NO.2
SHADE IN DAGED AREA
4
LIABILITY INSURANCE INSU&PORGY#ECO SELF INSURED CITY OF RENTON IGQ
5
IN EFFECT
VEwCLE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED35376
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1687
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'
On 2/9/2023 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a collision which had occurred in the intersection of NE
12th St and Harrington Ave NE Renton/King/WA. An involved driver was reporting a t-bone collision
with no injury in the intersection.
I located both involved vehicle in the intersection, Unit 1 was a black 2023 Honda Civic
(WA/A6003966) driven by Kyle A Mana (DOB: 9/6/1995). Kyle said that he was driving west on NE
12th and failed to see the stop sign at the four-way-stop intersection. He said that he continued
through and struck Unit 2 as it was driving through the intersection. The damage was to the front of
his vehicle.
Unit 2 was a City of Renton 2018 red Chevrolet Colorado (WA/XMT64352D) driven by David E
Decker (DOB: 8/30/1968). David said that he was driving northbound through the intersection after
stopping at the stop sign when he was struck on the passenger side door by Unit 1. There was
damage to the bottom of passenger side front door.
Neither driver reported any injuries.
Both vehicles were drivable and left the scene without issue.
I took photographs of both vehicle and uploaded them to Axon Evidence.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 02-09-23 07:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 2/19/2023 7:59:20 PM
BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED', 7:02 Pry TIME POLICE ARRIVED]7:12 PM
PART I PAGE IT]OF 3�
REPORT NO. ED35376 CASE# ' 23-1687 DATE AND TIME 02/09/23 18:54
OF COLLISION
W Harrington Ave NE
Unit 1
Unit -- NE 12th St
PAGE 3 OF 3