HomeMy WebLinkAbout23-3026 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-3026 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 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 03 - 1-- 2023 1704 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a MAPLE AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:4258641181 0 11
30
6� LAST NAME SCHENCK FIRSTNAME GARY MIDDLE J 1 2 31
INITIAL
STREET ❑ 13689 199TH AVE SE CITY[MO
ST WA ZIP 982728511 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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aTES� /a6223744 sTArI WAvIN# 3GCUDGET6NG676764
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 7 $ 34
13 8 2022 CHEV SILVER PK DAMAGE vEs ONO agW�MEYERS ves❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO AARP 55PHB460169 4
IN EFFECT &POLICY# TOPVEHCLE CHARGE 36
LEGALLYYES NO CITATION# W23010242 FAIL YIELD LEFT TURN MOTOR <1�3
orrow
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD HONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YE MET P
S 1/ NO D:6014548498
16 a
LAST NAME ARMSTRONG FIRST NAME JESSICA MIDDLE I L
INITIAL
17❑ NEW STREETREs7 13618 SE 192ND ST CITY RENTON ST WA ZIP 980587709 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK vEs It I NOF YES
t l NOF,/
19� LDI IVERS STATE WA SEX F M D.C.B. 12 02 _ 1979 39
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAU SY 6 C/O L�SHOULDER AND R.FOREARM PAIN ❑OF INJURIES 40
❑21❑ PLATE# A6143718 TArE 41
WA VIN# KNDRMDLHOP5164642 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED ev G.. HI 44
VEH YEAR 2023 MAKE I(I/� MODEL SORREN STYLE UT DAMAGE TOWED✓ NOO BLIN GENE MEYERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 523582COI-47AOOIIN STOP 5
IE"ICLE ❑ CITATION# CHARGE
LEG
25 to BOTTOM
ALLY YES Nu
a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED43181
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3026
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 03-16-23 01:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 311712023 9:10:37 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 5:16 PM TIME POLICE ARRIVED 5:25 PM
PART I PAGE IT]OF
REPORT NO. ED43181 CASE# 23-3026 OF COLLISION
03/14/23 17:04
OF CbLLI510N
NARRATIVE
23-3026
On 03/14/2023 at approximately 1716 hours, I was dispatched to a blocking vehicle collision at the
intersection of SW Grady Way and Maple Avenue SW, within the City Limits of Renton, County of
King, State of Washington.
Upon my arrival, I observed moderate mechanism to the involved vehicles with airbag deployment as
well as one of the involved parties complaining of left shoulder and right forearm pain. I requested
Renton Regional Fire Authority respond to the scene for evaluation. While on scene, I collected each
of the involved party's driving information and their independent recollection of the events leading up
to the collision.
The driver of Unit#1 stated that he was the sole occupant of his vehicle and was traveling westbound
in about the 300 block of SW Grady Way approaching the intersection of Maple Ave SW. The driver
of Unit#1 had pulled into the left-turn lane and stopped to yield to backed up traffic for an upcoming
left-turn at the intersection. The driver of Unit#1 stated he intended to turn southbound onto Maple
Ave SW. I verified the intersection that Unit#1 was approaching was uncontrolled. The driver of Unit
#1 stated that lanes 2 of 3 and 3 of 3 of eastbound SW Grady Way had created a gap in traffic to
allow for Unit#1 to proceed. The driver of Unit#1 proceeded to make the left turn across the
eastbound lanes of travel. While Unit#1 was doing so, he noticed Unit#2 approaching eastbound on
SW Grady Way but in lane 1 of 3. The driver of Unit#1 stated that both vehicles collided in lane 1 of 3
of the eastbound lanes of SW Grady Way causing significant damage to the front bumper and
passenger side quarter panel of Unit#1. Due to the initial impact, Unit#1 shifted direction and
collided with Unit#3 causing additional damage to the front driver's side of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was traveling eastbound in
about the 300 block of SW Grady Way approaching the intersection of Maple Ave SW in lane 1 of 3.
The driver of Unit#2 stated she was intending to continue east. The driver of Unit#2 stated as she
continued going straight ahead through the uncontrolled intersection, Unit#2 saw Unit#1 turn in front
of her vehicle. The driver of Unit#2 stated she was unable to avoid the collision and struck Unit#1
causing significant damage to the front of Unit#2. The driver of Unit#2 was evaluated for injuries and
released at the scene regarding the above-mentioned complaints of pain.
The driver of Unit#3 said he was the sole occupant of his vehicle and was traveling northbound in
about the 1100 block of Maple Ave SW approaching the intersection of SW Grady Way. The driver of
Unit#3 stated he was intending to turn right at the intersection and was stopped waiting for an
opening in traffic. The driver of Unit#3 stated that while stopped, he noticed Unit#1 make the turn
from the center-turn-lane and across traffic. The driver of Unit#3 stated the collision between Unit#1
and Unit#2 occurred just in front of his vehicle and that Unit#1 then made secondary impact with the
front driver's side of Unit#3 causing significant damage.
Based on the above statements, I determined that the Driver of Unit#1 (Schenck) was the
predominant factor for the collision due to not granting the right of way during a left-turn causing a
collision. The driver of Unit#1 did not grant the right of way to Unit#2 traveling in the roadway which
had the right of way and was already underway. Due to Unit#1 having to traverse across oncoming
traffic, the driver of Unit#1 must wait until the intersection is clear of hazard prior to proceeding. A
written warning was issued for Schenck due to not granting right of way during a left turn.
All involved vehicles (Unit#1, #2 & #3) had to be impounded due to extensive damage cause. An
exchange of information was provided to all involved parties.
PAGE 3 OF 6
REPORT NO. ED43181 CASE# 23-3026 OF COLLISION
03/14/23 17:04
OF CbLLI510N
NARRATIVE
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 1:06 PM 3/16/2023 Renton, King County, WA.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. ED431 81
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-3026
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:2536389217
] OF 8 29
LAST NAME JOHNSON FIRST NAME ROBERT MIDDLE E r:j INITIAL
STREET 30
NEW AnDRFrtP 21800 121ST PL SE CITY KENT ST WA ZIP 980312379
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv', 10 - 24 - 1959
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE AWJ5196 [TAT WA VIN# 2HKRM4H51DH612607
PLATE#
9 2] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2013 MAKE HOND MODELCR-V STYLE UT I VEHICLE TOVVE E T SABLI T�'W_-''ERS G VT VFHIG P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFOROBERT JOHNSON 21800121ST PL SE KENT WA 98031 D:2536389217 J 9 33
12 SHADE IN DAMAGED AREA
2 3 4 FROM TO
LIABILITY INSURANCE INSURANCE CO FARMERS 188447081 gl"OI'
IN EFFECT &POLICY# 1 _
13 ❑ LG VEHICLE ❑ CITATION# CHARGE
BarroM m 34
LEG YES NO
STANDING
❑ dRD PROPERTY NOHRHOLD MET
❑ 35
VEHICLE CYCLE OWNER YESG
PHONE
14 UNIT�
15 LAST NAME FIRST NAME N!I IAL
MIDDLE ❑ 36
STRE
16 NEW ETETnnR"� CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK YEs NO YES NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY -� II
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE CLASS
19 ❑ LICENSE TAr VIN# 39
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
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 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeG E
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 03-16-23 01:25 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 11498 O#IL WA0171300 JOHNSON 311712023 PAGE F51OF 6
3000-345-013(R 11118)
REPORT NO. ED43181 CASE# ' 23-3026 DATE AND TIME 03/14/23 17:04
OF COLLISION
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SW Grady Way
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PAGE 6 OF s