HomeMy WebLinkAbout23-3198 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
CASE#r` 23-3198 2
RESULTED
1 STOLEN
STATE ROUTE � OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
CowsloN 03 - 19 - 2023 1849 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 2400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FMILES N EET e S ❑ E e BLAINEAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2533491757 0 11
30
6� LAST NAME KAPRIAN FIRSTNAME MICHAEL MIDDLE A 1 2 31
INITIAL
STREET 0113445 MARTIN LUTHER KING JR W UNIT R111 CITY SEATTLE ST WA ZIP, 98178 2
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
,/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8 LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ PI ATE
S� BXY9389 sTAr1 WAurN# WAUDG74FX5N054112
TRAILER STATE TRAILER STATE
11 4 5 PLATE# PLATE# ROM TO
TRLR 3 7. TRLR 33
12 4 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE ] 3 34
13 4 2005 AUDI A6 P4 DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO ALI.Pl?.11716W27THAVE SPOKANEWA99224 D:2533491757 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
VEH" CHARGE 36
LEGALLY YES❑NO❑ CITATION# 3AO063657 OP MOT VEH W/OUT INSURANCE 1 o eorrom
15❑ STANDING 8 7
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UN�T VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YEs NO ,/ D.2539515916
16 a
LAST NAME MUNENE FIRST NAME SAMUEL MIDDLE E
INITIAL
17❑ NEW STREETREs7 32792 SE COTTONWOOD ST CITY BLACK DIAMOND ST' WA ZIP 98010 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLATE# CDH7234 TArE WA vIN1 1GNSCAKC6HR231612 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2017 MAKE CHEV MODEL TAHOE STYLE P4 DAMAGE TOWED NOO✓ BLIN TOWED BY ov HYES NO,/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POLICY#E CO GE/CO 4145-19-56-42IN 970E 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED47510
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3198
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KAPR/AN ALEXA
(LAST FIRST,
ADDRESS&PHONE#
1716 W 27TH AVE SPOKANE WA 99224 2533491757 SEX M MMDOYyry 07 - 08 - 1983
PASSENGER Z WITNESS UNIT# 1 PEA 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE 2 CLASS i1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
D.NELSON 03-19-23 08:00 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 1 4/1/2023 4:34:42 PM
BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED 6:52 PM TIME POLICE ARRIVED',6:55 PM
PART I PAGE IT]OF 4�
REPORT NO. ED47510 CASE# 23-3198 OF COLLISION
03/19/23 18:49
OF CbLLI510N
NARRATIVE
23-3198 COLL
On 3/19/23 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City
of Renton. I was dispatched to a report of collision with unknown circumstance in the 2400 block of
Maple Valley Highway. An involved party was calling to report he had been in a collision and provided
the plates for both involved vehicles. I arrived on scene and confirmed with both parties there was no
injury.
I spoke with the driver if Unit 1, a black Audi A6 (WA/BXY9389), Michael A Kaprian (DOB:
8/16/2004). Michael told me that he was travelling eastbound on Maple Valley Highway and needed
to turn around so he made a U-turn to head back westbound. He said that he had to reverse to
complete the turn and as he was reversing in the middle of the highway, he was struck by Unit 2.
The Audi had damage to the driver side rear bumper, Michael said that he reversed all the way back
across the highway into the eastbound lanes. The Audi was drivable.
I then spoke with the driver of Unit 2, a black 2017 Chevrolet Tahoe (WA/CHD7234), Samuel M
Munene (DOB: 4/4/1974). Samuel told me that he was driving east on Maple Valley Highway when
the Audi reversed into his lanes while trying to make a U-turn. He struck the Audi and I saw damage
to the front diver side of the Tahoe. The Tahoe was drivable.
The damage was consistent both accounts given.
When I asked Michael for insurance on the vehicle, he advised there was no insurance on the
vehicle. The passenger and registered owner of the Audi Alex A Kaprian (DOB: 7/8/1983) confirmed
he did not carry any insurance on the vehicle.
I completed Sector Citation #3A0063657 for Operating a Motor Vehicle Without Valid Proof of
Insurance RCW 42.30.020 and advised a copy would be mailed to him.
Nothing further.
PAGE 3 OF 4
REPORT NO.! ED47510 CASE# 23-3198 DATE AND TIME 03/19/23 18:49
OF COLLISION
2400 Block Maple Valley Highway
Vehicle 1
PAGE 4 OF 4