HomeMy WebLinkAbout23-2607 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-2607 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 N E IN CITY# ❑
cowsloN 03 - 1-- 2023 1941 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
19044108THAVESE BLOCK ST e✓
MILEPOST 1900
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e SE 192ND ST
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:2068537857 0 7 30
6❑ LAST NAME HALL FIRSTNAME VERNA MIDDLE L 1 0 1 31
INITIAL
STREET 01 731 5TH AVE S APT 31 CITY KENT ST WA Zjp, 98032 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
,/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8 LDRIVER # STATE WA SEX'F MID
.O B 09 1- 23 - 1961 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aTES� A6148996 sTArI WAurN# JHMGK5H54GX033363
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
FT -R TPILF1 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 4 2016 HOND FIT SD DAMAGE YES NO YES❑ ✓No
REGISTERED OWNER INFO VERNA HALL7315THAVE S APT 3I KENT WA 98032 D:2068537857 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICV# 9TOP
VEHICLE CHARGE 5 36
LEGALLY Yes❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068189635
16 a
LAST NAME DREKE FIRST NAME ELIZABETH MIDDLE I D
INITIAL
17 STREET ISPRING LAKE DR SE CITY RENTON ST WA ZIP 98058 37
NEW ADDREs�' 18515E
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CEM5501 TArE WA VIN# 41
JTMF83FVSND098333 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2022 MAKE TOYT MODEL RAV4 STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YESfj
NO,/ YES NO
REGISTERED OWNER INFO ELIZABETH DREKE 18515 E SPRING LAKE DR SE RENTON WA 98058 D:2068189635 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 817105018IN 1 9TOP
VE""LE ❑ ,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N
$ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
N AAH GIRELLO 12607 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED39648
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2607
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HOLLINGSWORTH MARTHA R
(IAST FIRST,
ADDRESS&PHONE# D O.B. '
26405 99TH PL S KENT WA 98030 SEXi F MMDOYyry 11 - 21 - 1963
PASSENGER L,WITNESS UNIT# 2 SEA 3 AIRBAG'2 RESTR. q EJECT ? HELMET INJURY NATURE OF INJURIES
USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
NOAH GIRELLO 03-04-23 05:02 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 31512023 5:47.05 PM
BADGE OR ID# 12607 OR]#' WA0171300 TIME POLICE DISPATCHED 7:46 PM TIME POLICE ARRIVED',7:54 PM
PART I PAGE IT]OF 4]
REPORT NO. ED39648 CASE# 23-2607 OF COLLISION
03/03/23 19:41
OF CbLLI510N
NARRATIVE
23-02607
At about 1946 hours on 03/03/2023 1 responded to a blocking accident report at, 19044 108th Ave
SE, in the city of Renton, King County, Washington. Dispatch advised me that this was a 2-car
collision with no injuries, and they were blocking south bound traffic.
Unit 1 -2016 silver Honda Fit (LIC/A6148996) (VIN/JHMGK5H54GX033363)
Driver/ RO -Verna L Hall (DOB 09/23/1961)
Unit 2 -2022 blue Toyota Rav4 Prime (LIC/CEM5501) (VIN/JTMFB3FV8ND098333)
Driver/ RO -Elizabeth D Dreke (DOB 03/07/1991)
Passenger- Martha R Hollingsworth (DOB 11/21/1963)
Upon my arrival, unit 2 had already pulled out of the roadway and into the 76-gas station parking lot
that was just to the east of the accident. Unit 1 was still in the roadway but was later also pushed out
of the roadway and into the same parking lot as unit 1.
I first contacted the driver of unit 1. Unit 1 said she did not have any injuries and did not need medical
attention. Unit 2 and the passenger advised me of the same.
The following is a summary of what unit 1 told me. Unit 1 said she was traveling south on 108th Ave
SE approaching an intersection at SE 192nd ST. Unit 1 said she did not see the traffic slowing in front
of her and did not have time to slow down. Unit 1 hit unit 2 from behind with the front bumper of her
vehicle. Unit 1 also noted that she thinks that her breaks were defective or just not working properly.
Unit 1 also mentioned several times that she can't see at night and shouldn't be driving at night. Its
important to note that at the time of the accident It was dark outside, and it was raining. Unit 1 had
damage to the front bumper and grill. From my observation the damaged looked to be only to the
body of the vehicle and the vehicle was still operable.
The following is a summary of what unit 2 told me. Unit 2 told me she was traveling south on 108th
Ave SE approaching an intersection at SE 192nd ST. Unit 2 said she was slowing for the traffic in
front of her that was coming to a stop at the intersection. Unit 2 said she was then struck from the rear
by unit 1. Unit 2 had minimal damage to the rear bumper of her vehicle however she said her sensors
and cameras in the rear of the vehicle were not working properly. With the damage to the sensors,
the estimated damage would be over $1,000. The passenger of unit 2 confirmed the story of the
driver and did not have anything to add.
Both vehicles were drivable and unit 2 was able to drive off safely. Unit 2's vehicle was drivable, but I
explained to the driver that it was not safe for her to drive her vehicle based on what she told me and
her actions. I could not articulate that the driver was under the influence of any intoxicating liquors but
based on her inability to see at night and the possible defect to her brakes I did not allow her to drive.
I parked the unit 2's vehicle in a parking spot at the gas station. Unit 2 asked me to take her to the
bus stop at the Fred Meyers downtown so she could take the bus home. I later dropped the driver of
unit 2 at the bus stop.
No one was cited in this accident.
This concludes my involvement with this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by N. GIRELLO #12607 on 03/03/2023 at 2300 Renton, WA
PAGE 3 OF 4
REPORT NO. EU39048 CASE# 23-2607 DATE AND TIME 03/03/2310:41