HomeMy WebLinkAbout23-2843 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-2843 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I 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# ❑
cawsloN 03 - 09 - 2023 1648 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e✓ 4600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
6❑ 30 00 FEET e S ❑ W V DUVAL!AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2068325291 0 11
30
6� LAST NAME BAREM FIRSTNAME ISMAEL MIDDLE M 1 2 31
INITIAL
STREET ❑ 7205 38TH AVE S CITY SEATTLE ST WA 2jp, 98118 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10� P1 aT�S� CFV5105 sTArI WAvIN# WAUAFAFtOBN002764
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2011 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 AUDI A4 SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO ISMAEL SAREM 720538TH AVE S SEATTLE WA 98118 D:2068325291 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO <53 4
LIABILITY INSURANCEIN EFFECT &POLICV# TOPVEIF" CHARGE OTTOM 5 36
LEGALLY YEs❑NO CITATION# 3A0175195,3AO175195 OP MOT VEH W/OUT INSURANCE, $
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:4257705154
LAST NAME REESER FIRST NAME SARAH MIDDLE L
INITIAL
17 STREET❑ NEW ADOREss❑' 608 QUINCYAVE NE CITY RENTON ST WA ZIP 98059 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[—] LDI IVER # STATE WA ]SEX IF MMDDW 12 _ 25 _ 1970 39
20❑ ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BEC5733 TArE 41
WA VIN# JM3T638A280154203 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
Gov HI
VEH YEAR 2018 MAKE IlggZp MODEL CX9 STYLE UT DAMAGE TOWED NOO✓ BLIN TOWED BY 44
ES YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DA GEbAREA
z Cdd
LIABILITY
INSURANCE INSURANCE
#E CO PEMCO CA 1545972IN 1GQ
VEHICLE ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`LJ
25 s � e
7HAL
S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
Y BRUS 11663 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED41396
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2843
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.
HALLEY BRUS 03-09-23 06:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 311112023 12:22:43 AM
BADGE OR ID# 11663 ORI# WA0171300 TIME POLICE DISPATCHED 5:03 PM TIME POLICE ARRIVED',5:12 PM
PART I PAGE IT]OF 4�
REPORT NO. ED41396 CASE# 23-2843 OF COLLISION
03/09/23 16:48
OF CbLLI510N
NARRATIVE
Assignment:
On 3-9-23, 1 was working uniformed patrol in a marked Renton PD unit. At approximately 1703 hours,
I was dispatched to investigate a traffic collision that occurred in the 4600 block of NE 4th St, in the
City of Renton, County of King (WA).
Scene:
The 4600 block of NE 4th St is a two-way east-west bound street with a double center left turn lane
and two lanes of travel in each direction. There is a small commercial plaza, parking lot, and
driveway on the south side of NE 4th St. There is a right turn only sign at the intersection of the
driveway, indicating only right turns onto NE 4th St from the driveway shall be made.
Arriva I:
Upon arrival, I saw a black Audi sedan (WALic #CFV5105, Unit#1) with front end damage parked in
a parking lot to the north of the location. There was also a black Mazda SUV (WALic#BEC5733, Unit
#2) with rear passenger side damage and side air bag deployment, parked in a lot just southeast of
the location. Both drivers were on scene.
Statement of Ismael Barem:
Barem (identified by WA permit) was driving Unit#1 northbound from a private driveway and parking
lot just south of NE 4th St (Carl's Jr). Barem believed the roadway was clear and drove out of the
parking lot with the intention of turning left, westbound, onto NE 4th St. Barem collided with the rear
passenger side of Unit#2.
Barem stated he was not injured and there was no airbag deployment in Unit#1. Barem stated there
were no defects to Unit#1 prior to the collision. Barem stated he did not have insurance on the
vehicle and was unable to provide any proof of insurance.
Statement of Sarah Reeser:
Reeser (identified by WADL) was going straight ahead, eastbound, in the inside eastbound lane in
the 4600 block of NE 4th St. Unit#2 collided with the side of her vehicle.
Reeser stated she was not injured but Fire arrived on scene for an evaluation due to airbag
deployment in Unit#2. Reeser did not need medical aid and was not injured. Reeser stated there
were no defects to Unit#2 prior to the collision.
Damage:
The damage on both vehicles on scene matched both statements.
Tow:
No tows were requested.
Summary:
Based on statements provided and the supporting physical evidence, I determined Barem caused the
collision when he failed to yield the right of way to any/all oncoming traffic while entering a highway
from a private driveway. I issued Barem RPD Citation #3A0175195 for operating a motor vehicle
without liability insurance and failing to yield right of way when entering a highway from a private
drive.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by H.Brus/11663 at 1823 hours on 3-9-23, in the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. ED41396 CASE# ' 23-2843 DATE AND TIME 03/09/23 16:48
OF COLLISION
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2?
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NE 4th St m
Cares Jr Parking Lot
PAGE 4 OF 4