HomeMy WebLinkAbout23-3277 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-3277 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 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 N E IN CITY# ❑
cowsloN 03 - 1-- 2023 1508 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S PUGET DR BLOCK NO. e✓ 1900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 900 00 FEET MILES e S B W e BE ON RD S
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2063833363 0 7 30
6� LAST NAME SOLOMON FIRSTNAME NAHOM MIDDLE M 1 2 31
INITIAL
STREET ❑, 25401 32ND PL S CITY KENT ST WA 2jp, 980325648 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES z❑
3
,OF
P1 ATE 14 BPT8357 sTAr WAu N# JTDKN3DU5F0426705
IT STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2015 TOYT PRIUS 4H DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO .1...3010.0125401 32ND PL S KENT WA 98032 D:2063833363 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 987-812.507 3 4
IN EFFECT &POLICY# 9TOP
VEwcLe CHARGE 1 5 36
LEGALLY YES No CITATION# W23010243 FOLLOW VEHICLE TOO CLOSELY o aorrom
15❑ NDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064594130
LAST NAME MCKINLEY FIRSTNAME SHASTA MIDDLE H
INITIAL
17 STREET I❑ 17142 136TH PL SE CITY RENTON ST WA ZIP 980587045 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NO
19 LDI IVER # STATE WA ]SEX IF M D.C.B. 11 17 1969 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLATE# ATS8784 TArE WA vIN# 2TIBURHE6FC307625 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2015 MAKE TOYT MODEL COROLL STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SHASTA MCKINLEY 14201 SE PETROVITSKY RD APT A RENTONWA98058 D:2064594130 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 072 0583-FO6-47FIN I STOP 5
G
BOTTOM
LEGALLY YES Nu
25❑ s e
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED44640
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3277
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 03-22-23 01:03 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 312212023 4:38:26 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 3:29 Pry TIME POLICE ARRIVED',3:39 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. ED44640 CASE# 23-3277 OF COLLISIONO3/21/23 15:08
NARRATIVE
23-3277
On 03/21/2023 at approximately 1537 hours, I was dispatched to a non-injury and non-blocking
vehicle collision in the 1900 block of South Puget Drive, within the City Limits of Renton, County of
King, State of Washington.
Upon arrival, I located the two involved vehicles in a nearby parking lot and confirmed there were no
complaints of injury requiring immediate medical response at the time of report. There, I was able to
collect each involved party's information and independent summary of their involvement in the
collision.
The driver of Unit#1 said he and his passenger were traveling southeast in the 1900 block of S Puget
Dr in lane 2 of 2. The driver of Unit#1 stated he was traveling directly behind Unit#2. The driver of
Unit#1 stated that Unit#2 came to a sudden stop for traffic in the roadway. Unit#1 stated he tried to
abruptly change lanes into lane 1 of 2 to avoid the collision but that still collided with the rear of Unit
#2 causing moderate damage to the front driver's side quarter panel and bumper of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling southeast
in the 1900 block of S Puget Dr in lane 2 of 2. The driver of Unit#2 stated that she had come to a stop
for traffic as there was a vehicle in front of her waiting to make a left turn into a private property
parking lot. The driver of Unit#2 stated that while stopped, Unit#1 collided with the rear passenger
side quarter panel and bumper of Unit#2 causing moderate damage.
Based on the above statements, I determined that the Driver of Unit#1 (Solomon) was the
predominant factor for the cause of collision due to Solomon not paying attention to traffic in front of
him and was too close to the traffic directly in front of his vehicle causing a collision.
I issued Solomon a written warning for Following Too Closely 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 12:37 PM 3/22/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED44640 CASE# 23-3277 DATE AND TIME 03/21/2315:08
OF COLLISION
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unit.#t 1900 S Puget Or
unit#2 4
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PAGE 4 OF 4