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Home My WebLink About23-5109 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED57950 170 27 COLLISION REP FIT 1591971 CASE 23-5109 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI 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# cowsloN 05 - 1-- 2023 0626 17 ❑-= S 8 IN e 1070 3 4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e✓ 000 ❑ 4a 9❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e RENTON AVE EXT 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:3608085840 0 4 30 6� LAST NAME PAIRADEE FIRSTNAME ALICIA MIDDLE R 1 1 2 31 INITIAL STREET ❑ 880 W SYLVESTER CT CITY SEQUIM ST WA Zjp, 98382 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑ 3 LICENSE C636492 STATE WA uN# 1N6AA07B57N210158 10 1❑ PI ATE� 11[-j- TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# IR.. ro TRLR. TRLR 5 7 33 12 3 5 VIN#j VIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34 13 8 2007 NISS TITAN DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO ALICIA PAIRADEE 880 WSYLVESTER CT SEQUIM WA 98382 D:3608085840 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO USAA 01373 09 54U 7101 8 4 IN EFFECT &POLICY# 9TOP VEH'CLE CHARGE 5 36 LECALLv YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:2536534736 16 a LAST NAME PO ON GUTIERREZ FIRST NAME JULIO MIDDLE R INITIAL 17❑ STREET ❑', 418 WASHINGTON BLVD CITY'ALGONA ST WA ZIP 980018501 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—TRANSPORTED ❑ 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NOF,/ 19[ DRIVER'S STATE WA SEX M D.C.B. 05 _ 26 _ 1973 0 39 LICENSE# MMDDYY HELMET {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE I C47010U TATe WA vIN1t 2XP3AJ7X9MM736929 ❑ 41 PLATE# ❑ 42 22❑ TRAILER 0744SQ STATE WA TRAILER STATE PLATE# PLATE# 43 23❑ �NL� 2MN01JAL361000503 i INL# YEAR 2021 MAKE PTRg MODEL 348 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 VEH 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO WESTERN COCA COLA BOTTLI 1150124TH AVE NE BELLEVUE WA 98005 D:4256256408 N:425 64 716 62 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO SAFETY NATIONAL CASUALTY CORP CA6675545 1 9TOP 5 IN EFFECT VEHICLE ❑ CE] CITATION# CHARGE 25 i o BOTTOM LEGALLY YES N s a 7Q"u,' S NAME(PRINT) OFFICER PHONE BADGE OR ID# [AGENCY 26 TIBEAU 07691 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED57950 COLLISION REPORT III III III III III 111 1591972 CASE# 23-5109 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 POS. 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' 23-5110 Narrative The following occurred in the City of Renton, County of King, State of Washington. On 05/06/2023 at about 0659 hours I was dispatched to Rainier Ave S and Renton Ave Ext. for a report of a collision. I contacted the drivers of both vehicles in the parking lot of the AM/PM on the corner. The driver of vehicle #2 stated that he was making a left turn from the outside turn lane of north bound Rainier Ave S onto Renton Ave Ext when vehicle #1 struck the side of his trailer. The driver of vehicle #1 stated that she was making a left turn from the inside turn lane of northbound Rainier Ave S onto Renton Ave Ext. She did not realize both lanes turned left and she drifted into the outside lane while making the turn, striking vehicle #2. This incident was captured on my Axon body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. Nothing further at this time. 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 Q. Tibeau 05/06/23 0956 hours, Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. QUINT TIBEAU 05-06-23 12:26 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT D.SKELTON 9139 51712023 3:33:14 PM BADGE OR ID# 07691 OR]# ! WA0171300 TIME POLICE DISPATCHED 6:59 AM TIME POLICE ARRIVED 7:07 AM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED57950 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-5109 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT# 2 USDOT 2965392 ICC# VEHICLE TYPE 6 CARGO BODY 2 TYPE 2 ❑ 1 28 CARRIER NAME WW COCA COLA BOTTLING ....... 3 CARRIER ADDRESS 1520 124TH AVE NE CITY BELLEVUE ST WA ZIP'', 98005 4 NAME # PLACARD: ❑ NAME IF NO NUMBER SOURCE 3 AXLES 04 GwvR 66000 + 4a ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO i MIDDLE'... 29 LAST NAME FIRST NAME INITIAL STREET 30 NFW AnnRFSP CITY ST ZIP 6 � CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No zERLOCK YES❑N0� vES N LLIICIENSE STATE I SEX M��DYRYY' 2 7 ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EHILLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36 STREET 16 NFln+AnnRFs.� CITY'. ST 21P CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs N. El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 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 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv 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. QUINT TIBEAU 05-06-23 12:26 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 07691 O#I',WA0171300 SKELTON 51712023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED57950 CASE# 23-5109 DATE AND TIME 05/06/23 06:26 OF COLLISION mmm No to Snk, NEW a � \ 0, ,r Rainier Ave S PAGE 4 OF 4