HomeMy WebLinkAbout23-2748 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-2748 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 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 1405 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
EAST VALLEYROAD BLOCK NO. e✓ 4200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a SW 43RD STREET
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2532046128 0 81
30
6� LAST NAME LINE FIRSTNAME EMILY MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 10436 SE CARR RD APT B301 CITY RENTON ST WA 2jp, 980555971 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs 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 z❑
3
10❑ P1 aT�S� BDG5753 sTArI WAvIN# 1N4At3APXFC457520
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 4 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE g 9 34
13 2 2015 NISS ALTIMA 4D DAMAGE YES NO 14I� /�TE TOW 'Es❑ NO
REGISTERED OWNER INFO ELIZABETH GREEN 2150742ND AVE S#G4 SEATAC WA 98198 D:2532046128 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO STATE FARM 438 3667.614.478 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 3AO055516 INATTENTIVE DRIVING 1 o sorrow
15❑ NDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THRUNIT OLD MET PHONE
VEHICLE ❑ CYCLE El
OWNER ❑ YES 1/ No D:2064369755
16 a
LAST NAME CHUN FIRST NAME WUHYE MIDDLE
INITIAL
17 STREET Is❑' 205 SW 144TH ST CITY' BURIEN ST WA ZIP 981661541 4❑ 37
NEW ADOREs
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs❑NOF YEs❑NOF,/
19 LDI IVEW # STATE WA ]SEX IF M .C... 01 24 1988 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# AKL4697 TArE 41
WA vIN# 19XFA1F51AE032030 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE HOND MODEL CIVIC STYLE 4D VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES�/ NO PRIVATE TOW YES NO
REGISTERED OWNER INFO WUHYE CHUN 205 SW 144TH ST BURIEN WA 98166 D:2064369755 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 907484483IN 1 9TOP
VE""LE CITATION# CHARGE
YES N
25 BOTTOM
LEGALLY u
❑ s a
=UGENT
PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED43180
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2748
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 03-13-23 01:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 311712023 9:05:39 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 2:09 Pry TIME POLICE ARRIVED i 2:13 PM
PART I PAGE IT]OF
REPORT NO. ED43180 CASE# 23-2748 OF COLLISION
03/07/23 14:05
OF CbLLI510N
NARRATIVE
23-2748
On 03/07/2023 at approximately 1409 hours, I was dispatched to a non-injury and blocking vehicle
collision at the intersection of South 180th Street (aka SW 43rd Street) and East Valley Road, within
the City Limits of Renton, County of King, State of Washington.
While en route, Dispatch advised that the collision involved three vehicles and that the involved
parties were blocking the roadway. All vehicles were eventually able to be moved off the roadway and
into a nearby parking lot.
Upon arrival, I contacted all involved parties and confirmed no injuries had occurred requiring
immediate medical response at the time of report. I collected each of the involved parties driving
information and an independent summary of their involvement leading up to the collision.
The driver of Unit#1 said she was the sole occupant of her vehicle and was traveling southbound in
about the 4200 block of East Valley Road in lane 3 of 3 (left-turn lane). The driver of Unit#1 stated
she was traveling directly behind Unit#2 and said she had come to a stop behind queued traffic at
the intersection. The driver of Unit#1 admitted having fallen asleep from tiredness and her foot
slipped off the brake pedal. The driver of Unit#1 stated that her vehicle subsequently collided with
the rear of Unit#2 causing moderate damage to the front of Unit#1. As a result of the initial impact,
Unit#1 shifted direction and collided with Unit#3 which was stopped in the adjacent lane causing
additional 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
southbound in about the 4200 block of East Valley Road in lane 3 of 3 (left-turn lane). The driver of
Unit#2 stated she was stopped for the traffic light at the upcoming intersection. The driver of Unit#2
stated that while stopped, Unit#1 collided with the rear of Unit#2 causing moderate damage to the
rear passenger side quarter panel and bumper of Unit#2.
The driver of Unit#3 said he was the sole occupant of his vehicle and was also traveling southbound
in about the 4200 block of East Valley Road but was in lane 2 of 3 (left-turn lane). The driver of Unit
#2 stated he was stopped for the traffic light at the upcoming intersection. The driver of Unit#2 stated
that while stopped, Unit#1 collided with the rear of Unit#3 causing minor damage to the rear driver
side quarter panel and bumper of Unit#3.
Based on the above statements, I determined that the Driver of Unit#1 (Line) was the predominant
factor for the cause of collision due to inattention causing a collision. Line had allegedly fallen asleep
or was otherwise not paying attention to traffic when colliding with two other vehicles that had the
right of way. I cited Line by mail for Inattention causing a collision.
Both Unit#1 and Unit#2 had to be impounded due to extensive damage and had made arrangement
for a private impound. Unit#3 was 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 3/13/2023 12:52 PM Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED431 SO
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-2748
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO
D:2062097878
0 8 29
LAST NAME : THAI FIRST NAME QUOC MIDDLE M
INITIAL
STREET 30
NEW AnDRE.P 10105 201 ST AVENUE CT E CITY BONNEY LAKE ST WA ZIP 983915938
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO zERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 09 - 10 - 1977
7
ON DUTY� STATUS AIRBAG' 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BBU3793 TAr Wq VIN# 4T1BF1FK7FU047464
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 4 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLIN TOWED BY anvi vEH1C E FROM TO
2015 TOYT CAMRY 4D DAMAGE ves No �/ YES No
REGISTERED OWNER INFO QUOC THAI 10105201ST AVENUE CT E BONNEY LAKE WA 98391 D:2062097878 J 9 33
12 � SHADE IN DAMAGED AREA
3 4 FROM TO
((ABILITY INSURANCE INSURANCE CO PROGRESSIVE 911113062 RTOIx
IN EFFECT &POLICY# 1
EHICLE 34
13 ❑ LEGALLY YES NO❑ CITATION# CHARGE 0 BOTTOM
STANDING S} 8 7
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
RTY YES[—]AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME IDDL
❑ 36
AL
STREET
16F] NEW STRE "F-]' CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YES NO YES NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE CLASS
19 ❑ LICENSE TAr VIN# 39
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
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 AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
MATTHEW NUGENT 03-13-23 01:11 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26F7 OI BADGE 11498 O#I,WA0171300 JOHNSON 311712023 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. ED43180 CASE# ' 23-2748 DATE AND TIME 03/07/23 14:05
OF COLLISION
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PAGE 5 OF 5