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HomeMy WebLinkAbout23-2563 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-2563 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT 8 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 - 1-- 2023 1413 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S GRADY WAY BLOCK NO. e✓ 700 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ MILE N❑ FEET e S ❑ E e TALBOT ROAD SOUTH 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4252757413 0 9 30 6� LAST NAME SMITH FIRSTNAME CINCINATI MIDDLE 1 1 2 31 INITIAL STREET ❑ 14037 SE 192ND ST CITY RENTON ST WA ZIP' 980589408 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10❑ Pi aT�S� C60484R sTATe WAurN# 1C6RR7TT4KS643056 -- TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR. TRLR 7 5 33 12 3 5 VIN#j VIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34 13 4 2019 RAM 1500 PK DAMAGE YES NO YES❑ ✓No REGISTERED OWNER INFO HONEYWELL INTERNATIONAL INC 16915 NE 28THWAY VANCOUVER WA 98682 D:3603385780 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO GREENWICH INSURANCE CO.RAC943764208 3 4 IN EFFECT &POLICY# 9TOP vEHICLE 5 36 E�ALLr re5 No CITATION# 3A0055504 CHARGE INATTENTIVE DRIVING o eorrom 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:7706244222 16 a LAST NAME STUTHERS FIRST NAME MICHELLE MIDDLE INITIAL 17❑ NEW ADDRE— 16890 1STREET 64TH WAY SE CITY' RENTON ST WA ZIP 98058 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NoF,/ 19 DRIVER'S STATE WA SEX F D.C... O6 _ 04 1992 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES ❑ 40 USE CLASS C/O ILICENSE ❑ 21❑ PLA E# BRG7888 TATE WA VIN# USE LOWER BACK PAIN 41 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2015 MAKE TOYT MODEL COROLL STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO MICHELLE GALVIS 16890164TH WAY SE RENTON WA 98058 D:7706244222 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE I PORGY#ECO GEIC04577929781IN 1GD vE""LE CITATION# CHARGE LEGALLY YES N(� 25❑ s a =UGENT (PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED40388 COLLISION REPORT III III III III III 111 1591972 CASE# 23-2563 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 04:34 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 31712023 3:26:21 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 2:97 Pry TIME POLICE ARRIVED',2:25 PM PART I PAGE IT]OF 4� REPORT NO. ED40388 CASE# 23-2563 OF COLLISION 03/02/23 14:13 OF CbLLI510N NARRATIVE 23-2563 On 03/02/2023 at approximately 1417 hours, I was dispatched to a non-injury and non-blocking vehicle collision at the intersection of South Grady Way and Talbot Road South, within the City Limits of Renton, County of King, State of Washington. Upon arrival, I confirmed there were no complaints of injury from either of the involved parties requiring immediate medical response at the time of report. The driver of Unit#2 did complain of lower back pain but declined Renton Fire/Ambulance response. I collected each of the involved parties driving documents and their independent recollection of the events leading up to the collision. The driver of Unit#1 said he was the sole occupant of his company vehicle and was traveling eastbound in about the 700 block of S Grady Way in lane 1 of 4 and was intending to turn right to proceed southbound onto Talbot Rd S. The driver of Unit#1 stated he was traveling directly behind Unit#2 and said that Unit#2 abruptly stopped in front of his work vehicle. The driver of Unit#1 stated that as a result, Unit#1 subsequently collided with the rear of Unit#2 causing moderate damage to the front of Unit#1. The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling eastbound in about the 700 block of S Grady Way in lane 1 of 4 and was intending to turn right to proceed southbound onto Talbot Rd S. The driver of Unit#2 stated that while stopped and preparing to make the right turn, Unit#1 collided with the rear of Unit#2 causing minor damage to the rear bumper of Unit#2. The driver of Unit#2 believed that Unit#1 was following too close. Based on the above statements, I determined that the Driver of Unit#1 (Smith) was the predominant factor for the cause of collision due to following too closely causing a collision. I cited Smith by mail for Following Too Close 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 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 4:30 PM 3/2/2023 Renton, King County, WA. PAGE 3 OF 4 REPORT NO. ED40388 CASE# ' 23-2563 DATE AND TIME 03/02/23 14:13 OF COLLISION Diagram not to scale e S Grady Way v 07 Unit#1 O �T Unit:#2 /u O v 12 PAGE 4 OF 4