HomeMy WebLinkAbout23-2522 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-2522 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 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 N E IN CITY#
cowsloN 03 - 01 - 2023 1309 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N 4TH ST BLOCK e✓ 600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e LOGAN AVE NORTH
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2538864913 0 81
30
g� LAST NAME CHANDLER FIRSTNAME VALERIE MIDDLE C 1 2 31
INITIAL
STREET ❑ 25623 27TH PL S APT J104 CITY KENT ST WA 2jp, 980326331 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10[1P1 ATE 14 BXH4743 sTAr WAu N# 5FNRL38886B087814
0 TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 7 33
12 3 0 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34
13 1 2006 HOND ODYSSE VN DAMAGE YES NO YES❑ No✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCECO GEICO4601.93.84.28 3 4
IN EFFECT &POLICY# 9TOP
LEGA LE CHARGE 5 35
LEGALLY YES❑No CITATION# W23010237 FOLLOW VEHICLE TOO CLOSELY o eorrom
15❑ STANDING 8 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065816221
LAST NAME SAELEE FIRST NAME NGING MIDDLE L
INITIAL
17 NEW ADDRE— 15533 1STREET 56TH CT SE CITY RENTON ST WA Zip 98058 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER # STATE WA SEX F M D.C.B. 04 14 1971 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES ❑ 40
USE CLASS C/O DIZZINESS
❑21❑ PLATE# CAX5502 TArE WA VIN# 41
2HKRW2H85MH660149 1
42
22❑ PLATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE HOND MODEL CR-V STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO NGING SAELEE 15533156TH CTSE RENTON WA 98058 D:206581622f VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#ECO STATE FARM 4005723-1322-47AIN I GD
VE""LE CITATION# CHARGE LEGAL
25
LY YES N�
❑ s a
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED40383
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2522
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
PM 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 NUGENT 03-02-23 01:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 31712023 3:21:24 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 1:10 PM TIME POLICE ARRIVED',1:12 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. ED40383 CASE# 23-2522 OF COLLISIONO3/01/23 13:09
NARRATIVE
23-2522
On 03/01/2023 at approximately 1310 hours, I was dispatched to an injury and non-blocking vehicle
collision at the intersection of Logan Avenue North and North 4th Street, within the City Limits of
Renton, County of King, State of Washington.
Prior to my arrival, Sergeant E. Gordon and Officer K. Lane had arrived on scene and confirmed no
injuries had occurred from any of the involved parties requiring immediate medical response at the
time of report. Upon my arrival, I obtained the incident summary from Officer Lane and collected each
party's driving documents.
Per Officer Lane, the driver of Unit#1 said she was the sole occupant of her vehicle and was
traveling westbound in about the 600 block of N 4th Street in lane 1 of 3. The driver of Unit#1 stated
she was traveling directly behind Unit#2 and saw as Unit#2 had stopped at the controlled
intersection of Logan Ave N. The driver of Unit#1 stated that Unit#2 was setting up to make a
northbound turn onto Logan Ave N and that Unit#2 had initially started to make the turn but then
suddenly stopped again. The driver of Unit#1 was looking towards traffic to find an opening and did
not realize Unit#2 had stopped again. Unit#1 subsequently collided with the rear of Unit#2 causing
minor damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was traveling westbound in
about the 600 block of N 4th Street in lane 1 of 3. The driver of Unit#2 stated she was stopped and
waiting for an opening in traffic at the controlled intersection of Logan Ave N. The driver of Unit#2
stated that while stopped, Unit#1 collided with the rear of Unit#2 causing minor damage to the rear
of Unit#2. The driver of Unit#2 later complained of dizziness but felt comfortable driving herself to
urgent care for medical follow-up.
Based on the above statements, 1 determined that the Driver of Unit#1 (Chandler) was the
predominant factor for the collision due to inattention causing a collision. Both Unit#1 and Unit#2
were able to be driven away without further incident. An exchange of information was provided to all
involved parties.
I issued the driver of Unit#1 (Chandler) a written warning for following too closely.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 1:07 PM 3/2/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED40383 CASE# 23-2522 DATE AND TIME 03/01/2313:09
OF COLLISION
'Diagram not to scale
Unit#2 Unit#1
s,
MN 4th St
Q
co
CM
0
PAGE 4 OF 4