HomeMy WebLinkAbout23-1626 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED37011 170
27
COLLISION REP FIT 1591971
CASE 23-1626 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 - 08 - 2023 1656 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S GRADYWY BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FMILES EET e S ❑ E e RAINIER AVE S
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2016818169 0 11
30
6� LAST NAME MO FIRSTNAME DORIS MIDDLE L 1 1 2 31
INITIAL
STREET ❑✓ 17541 11OTH AVE E CITY PUYALLUP ST WA 2jp, 98374 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ vEs No�/
8❑ DRIVERS
# STATE WA SEX'F MIDI Y' 02 — 25 — 1955 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 ATNES# CFF3979 sTAr WAv N# 5YJSA1 E52NF473231
5 TRAILER STATE 7RAILEft STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR 2022 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T 1 Y GOVT.VEHICLE 3 ] 34
13 4 TESL MODEL 4D DAMAGE YES NO 4I� /�TE TOW 'Es❑ NO
REGISTERED OWNER INFO DORIS MO 17020 SE 14TH LN BELLEVUE WA 98008 D:2016818169 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO GEICO 4477385803
IN EFFECT &POLICY# STOP
❑ LEGALLYE LE CHARGE 1 5 36
15 2 YEs No clTAnoN# 3A0029769 IMPROPER LANE USAGE s 10 Borrow
MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD M PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ ET NO D.4 154040202
16 a
LAST NAME TANYA FIRST NAME GALBADRAKH MIDDLE
INITIAL
17❑ STREET ❑' 186 SAGAMORE ST CITY' SAN FRANCISCO ST' CA ZIP 94112 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES
t l NOF,/
19 DRIVER'S STATE CA SEX M I D.Q.B. 127_ 17 _ 1985 39
LICENSE# MMDDYY
HELMET I {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I YP44702 TAre CA vIN1t 1NPXLP9XXPD875175
❑ 41
pLATE# ❑
42
22❑ TRAILER B88235 STATE CA TRAILER STATE
PLATE# PLATE It
43
23❑ VINL# 1NPXLP9xxPD875175 IN
VEH YEAR 2023 MAKE PTRg MODEL 389 STYLE SE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO GALBADRAKH TANYA 186 SAGAMORE ST SAN FRANCISCO CA 94112 D:4154040202 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO LUBEMER INTERNATIONAL INSURANCE 17788470011 1 STOP 5
IN EFFECT
--E ❑ ,J� CITATION# CHARGE
25 io BOTTOM
LEGALLY YES N`L J
s � a
7SHA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED37011
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1626
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 02/08/2023 at about 1658 hours I was working uniform marked patrol as 1 R15 when I was
dispatched to a car versus semitruck motor vehicle collision in the 100 block of S Grady Wy within the
city limits of Renton, King County, Washington. The vehicles were partially blocking S Grady Wy at
one of the left (southbound) turn lanes. There were no reported injuries. The semitruck was
driveable, but the car had to be towed.
Vehicle 2 (Peterbilt semitruck with Washington license plate YP44702) was on S Grady Wy in the left
turn lane and stopped for traffic due to the red light at the upcoming intersection of S Grady
Wy/Rainier Ave S. Vehicle 2 was about 200 feet east of the intersection at the time. Vehicle 2
continued driving once the traffic in front of him began traveling through the green light intersection.
As Vehicle 2 moved forward Vehicle 1 (2022 Tesla Model S with Washington license plate CFF3979)
changed lanes from lane 2 (second lane in from the outer curb lane) into the turn lane directly in front
of Vehicle 2. The front passenger side of Vehicle 2 and the middle/rear section of Vehicle 1 collided.
Vehicle 2 had damage to the front passenger side fender well, and the front passenger wheel lug nut
covers were damaged. Vehicle 2 was able to be driven from the scene, and there were no reported
injuries.
Vehicle 1 had damage to the rear driver side door and the rear driver side tire. Vehicle 1 was unable
to be driven from the scene due to the tire damage, and it was towed (private tow). The driver of
Vehicle 1 did not report any injuries.
Doris Mo (driver of Vehicle 1) admitted the collision was her fault, but she also mentioned that Vehicle
2 purposely sped up as she entered the turn lane. It appeared that the actions of Doris Mo
contributed to the circumstances of the collision. I informed Doris that she would be receiving an
infraction in the mail. I cited Doris for Improper Lane Usage (RCW 46.61.140) and sent the infraction
to the court to be mailed.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
SHAWN CROW 02-17-23 10:02 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 2/24/2023 5:48:38 PM
BADGE OR ID# 12618 OR]#' WA0171300 TIME POLICE DISPATCHED; 4:88 Pry] TIME POLICE ARRIVED 5:02 PM
PART Ei PAGE IT]OF 4�
SUPPLEMENTAL REPORT NO. ED3701
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-1626
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 2 USDOT 3020587 ICC# VEHICLE TYPE 4 CARGO BODY 7
TYPE
2 ❑ 1 28
CARRIER NAME BZ TRANS,INC.
3 CARRIER
ADDRESS 5660 VAN GOGH WAY
CITY YORBA LINDA ST CA ZIP 92887
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 03 GI54600 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36
STREET
16 NFln+AnntxFs.� CITY'. ST SIP
CDL IGNITION REDUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE oF1NJURIEs 38
USE (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
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.
SHAWN CROW 02-17-23 10:02 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26F7 OI BADGE 12618 O#II,WA0171300 APPROVE
2%2E4/2023 PAGE OF F
3000-345-013(R 11118)
REPORT NO. EU37011 CASE# 23-1626 DATE AND TIME 02/08/2316:58