HomeMy WebLinkAbout23-3345 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-3345 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT 8 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# ❑
cowsloN 03 - 1-- 2023 1700 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 2400
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 130 00 FMILES EET e S ❑ E e EDMONDS AVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4065318339 0 7 30
6� LAST NAME STRIGHT FIRSTNAME KYLEAH MIDDLE R 1 1 2 31
INITIAL
STREET ❑✓ 200 SW 5TH CT#C202 CITY RENTON ST WA 21p 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITIt)N PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ NTERLOCKYEs NO Z YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 INJCLASSY 1 NATURE OF INJURIES 2❑
3
LICENSE 901DJU sTAT� ND vN# 1J4GR48K85C560334
10❑ PI ATE 14
— TRAILER STATE PL TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2005 JEEP GRAND UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# STOP
15❑ LE
vEGALLY Hla.e CHARGE 10BOTTOM 5 36
YES�No D CITATION# 3A0055590,3A0055590 INATTENTIVE DRIVING,OP MOT VEH
STANDING 8 7 6
MOTOR PEDAL-:. 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069627227
a
LAST NAME WHITE FIRST NAME MACKENZIE MIDDLE I L
INITIAL
17❑ NEW STREETR 17237 S
7 E 142ND ST CITY RENTON ST WA ZIP 980597635 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LICENSE# STATE WA ]SEX IF M .C... 09 _ 24 2002 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BU65242 rare 41
WA vIN# JTKDE167590277746 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
YEAR 2009 MAKE TOYT MODEL SCION TC STYLE CP VEHICLE TOWED ToffBLIN TOWED BY GOV HI 44
VEH
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SHAUN WHITE 17237 SE 142ND ST RENTON WA 98059 D:2069627227 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 817 262 860IN STOP
vE""LE CITATION# CHARGE
YES
25 i o BOTTOM
LEGALLY Nu
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW NUGENT 11498 WA017771300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED46970
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3345
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HARDCASTLE RYLEE M
(LAST FIRST,
ADDRESS&PHONE#
16919 SE 149TH ST RENTON WA 980598824 2069627227 SEXi F MMDOYyry 11 - 26 - 2002
PASSENGER Z WITNESS[] UNIT# 2 POS 'I 3 AIRBAG;2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE 2 CLASS
11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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 03-27-23 06:10 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
Co.JOHNSON 0505 313012023 3:25:22 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 5:03 PM TIME POLICE ARRIVED]5:22 PM
PART I PAGE IT]OF
REPORT NO. ED46970 CASE# 23-3345 OF COLLISION
03/23/23 17:00
OF CbLLI510N
NARRATIVE
23-3345
On 03/23/2023 at approximately 1703 hours, I was dispatched to a non-injury and non-blocking 3-
vehicle collision at the intersection of NE Sunset Boulevard and the Edmonds Ave NE, within the City
Limits of Renton, County of King, State of Washington.
Upon arrival, I contacted the involved parties and confirmed no injuries had occurred requiring
immediate medical response at the time of report. There, I collected the involved parties driving
documents and their independent recollection of events leading up to the collision.
The driver of Unit#1 said she was the sole occupant of her vehicle and was traveling westbound on
NE Sunset Blvd just west of the intersection of Edmonds Ave NE in lane 2 of 2. The driver of Unit#1
stated she was traveling directly behind Unit#2 and saw as Unit#2 was stopped or slowing for traffic.
The driver of Unit#1 stated that she attempted to stop her vehicle in time but was unable to and
subsequently collided with the rear of Unit#2 causing moderate damage to the front of Unit#1.
The driver of Unit#2 said she and her adult passenger were also traveling westbound on NE Sunset
Blvd just west of the intersection of Edmonds Ave NE in lane 2 of 2. The driver of Unit#2 stated she
was stopped for queued traffic at the upcoming intersection. While Unit#2 was stopped for traffic that
had backed up, Unit#1 collided with the rear of Unit#2 causing moderate damage to the rear of Unit
#2. The driver of Unit#2 stated that due to the initial impact, her vehicle was then pushed forward into
the rear of Unit#3 causing additional damage to the front of Unit#2.
The driver of Unit#3 said he was the sole occupant of his vehicle and was also traveling westbound
on NE Sunset Blvd just west of the intersection of Edmonds Ave NE in lane 2 of 2. The driver of Unit
#3 stated he was stopped for queued traffic at the upcoming intersection. While Unit#3 was stopped
for traffic that had backed up, Unit#2 collided with the rear of Unit#3 causing minor damage to the
rear of Unit#3.
Based on the above statements, I determined that the Driver of Unit#1 (Straight) was the
predominant factor for the collision due to inattention causing a collision. Straight should have been
paying closer attention to the movement of traffic in front of her. Additionally, Straight was unable to
provide proof of motor vehicle insurance.
I cited Straight in-person for inattention causing a collision as well as operating a motor vehicle
without insurance.
Both Unit#1 and Unit#3 were able to be driven away without further incident. Unit#2 had extensive
damage and was looking into options for a private impound. 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 3/27/2023 5:53 PM Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED46970
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-3345
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 DAMAGETHRESHOLD MET PHONE
UNIT# 3 �✓ � PEDESTRIAN YES NO
5 VEHICLE CYCLE OWNER ✓ D:2068591621
0 7 29
LAST NAME VALDOVINOS MARROQUIN FIRST NAME : IVAN MIDDLE
INITIAL
STREET 30
NEW AnnRFrtP 304 29TH ST SE APT 102 CITY AUBURN ST WA ZIP 980027510
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO✓ zERLOCK YES�NOf YES N ✓
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv', 03 - 25 - 1990
7
HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 C/O NECK PAIN
8 ❑ 1 32
LICENSE,BWW1038 TAr Wq VIN# 4S3BH896827647991
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 3 5 VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLIN TOWED BY anvi vEH1C E FROM TO
2002 SUBA LEGACY 4W DAMAGE YES NO ✓ YES NO ✓
REGISTERED OWNER INFO STEPHANIE VALDOVINOS 304 29TH ST SE APT 102 AUBURN WA 98002 D:2068591621 J 9 33
12 � SHADE IN DAMAGED AREA
34 FROM TO
LIABILITY INSURANCE INSURANCE CO VERN FONK 200531-4892 GQO
IN EFFECT &POLICY# 1VEHICLE 34
13LEGALLY YESZ NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME IDDL 36
❑
STREET
16Fl TEETEs.�' CITY ST ZIP
CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YES NO E
17 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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LECALLv
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 03-27-23 06:10 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26F7 ORID# 11498 O#IL WA0171300 JOHNSON 3/30/2023 PAGE F41 OFF
3000-345-013(R 11118)
REPORT NO. ED46970 CASE# ' 23-3345 DATE AND TIME 03/23/23 17:00
OF COLLISION
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PAGE 5 OF 5