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COLLISION REP FIT 1591971
CASE 23-2991 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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#
cawsloN 03 - 1-- 2023 2128 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
116TH AVE SE BLOCK NO. e✓ 1600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e SE 16TH ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:6267593620 0 11
30
6� LAST NAME YANG FIRSTNAME WEN MIDDLE Y 1 1 2 31
INITIAL
STREET ❑ 9355 53RD AVE S CITy SEATTLE WA
NEW ADDRESS ST 21p 981185513 z
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❑ P1 aTES� BXJ5022 sTATe WAvIN# 3W2B7AX9MM001384
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR 3 1 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2021 YOLK TIGUAN DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO KANG YANG 1331 LAKE YOUNGS WAY SE RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 955170609 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
E�ALLY YES❑NO❑ CITATION# 3AO133715 INATTENTIVE DRIVING o aorrom
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES�/ NO D:2064998120
16 a
LAST NAME COLLINS FIRST NAME STACIE777771 MIDDLE M
INITIAL
17 STREET NEW ADORE57 2111 SE 21 ST CT CITY RENTON ST WA ZIP 980554556 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX F D.C.B. O6 _ 07 1973 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# C62700W TATE 41
WA VIN# 1N6EDOEB5LN715994 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE NISS MODEL FRONTIE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO RICHARD KNOWLTON 2111 SE 21ST CT RENTON WA 98055 VEHICLE NO.2
SHADE DA GEbAREA
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 4570672BO147BIN 1 VE—LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s � e
OFFICERS NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
E.S/MS 12225 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED43357
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2991
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) STUCKLE SOPHIA K
(LAST FIRST,
ADDRESS&PHONE#
2111 SE 21ST CT RENTON WA 98055 4256155902 SEXi F MMDOYyry 03 - 29 - 2011
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ �' 2 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEXI MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY 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.
E.SIMS 03-13-23 11:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 311812023 2:37:48 AM
BADGE OR ID# ( 12225 ORI#' WA0171300 TIME POLICE DISPATCHED 9:35 PM TIME POLICE ARRIVED:9:35 PM
PART I PAGE IT]OF 4�
REPORT NO. ED43357 CASE# 23-2991 OF COLLISION
03/13/23 21:28
OF CbLLI510N
NARRATIVE
RPD CASE#: 23-2991
On 03/13/2023 at approximately 2131 hours, I was dispatched to 116th Ave SE and SE 16th ST, in
the City of Renton, King County, Washington, for a report of a blocking accident.
Upon arrival I identified Unit 1 as a black Volkswagen Tiguan bearing WA license plate #BXJ5022.
Unit 1 sustained damage to the front driver's side bumper area and was blocking the northbound
lanes of travel. I identified the driver of Unit 1 via his WADL as Wen Yuan Yang (DOB 04/02/1968).
Yang stated he did not speak English and I used my cellphone to contact language line for a Chinese
interpreter. Using an interpreter Chang stated he was not injured, and I asked him what happened.
Chang stated he was stopped at a stop sign on SE 16th ST facing westbound. Chang stated he
began to make a turn northbound onto 116th Ave SE when he was struck by unit 2. 1 asked Chang if
he had seen unit 2 and he initially stated he did not. Chang stated unit 2 was driving at a high rate of
speed prior to the collision.
I identified Unit 2 as a black Nissan Frontier, bearing WA license plate #C62700W. Unit 2 sustained
damage to the passenger side fender, and passenger side front and rear door. I identified the driver
of Unit 2 via her WADL as Stacie Marie Collins (DOB 06/07/1973). Collins stated she was not injured,
and I identified the front seat passenger as Sophia K Stuckle (DOB 03/29/2011). 1 asked Sophia if
she was injured and she stated she was not.
I asked Collins what happened and she stated she was driving northbound in the 1600 block of 116th
Ave SE when she observed unit 1 stopped at the stop sign on 16th Ave SE. Collins stated as she
began to drive past unit 1, he pulled onto the roadway striking the passenger side of her vehicle.
Due to the damage on both vehicles and the drivers statements I determined unit 1 was the at fault
party. I advised Yang he would receive a Citation in the mail for inattention. I provided both parties an
information exchange sheet and answered their questions.
Once all parties left the area, I cleared the scene.
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 E. Sims on 03/13/2023 at 2314 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO. EU43357 CASE# 23-2081 DATE AND TIME 03/ 3/2321:28