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HomeMy WebLinkAbout23-4366 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-4366 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OS STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# COLLISION.. 04 - 18 - 2023 1544 17 . N E IN� S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ LOGAN AVE N BLOCK NO. e✓ 500 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 6TH ST 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:4259237259 0 7 30 6� LAST NAME VERGE FIRSTNAME ZACHARY MIDDLE G 1 1 2 31 INITIAL STREET ❑ 18306 34TH AVE SE CITY BOTHELL ST WA ZIP 980128353 z 'NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO,/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� C73471 P sTArI WAurN# 1 FTNW21 F8YEC86066 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 5 1 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 4 2000 FORD F250 PK DAMAGE YESNo YYES[:] NO ❑ REGISTERED OWNER INFO ZA.RYVERGE 18814A IRIS CT ARLINGTON WA 98223 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 928638842 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES No CITATION# 3AO346426 FOLLOW VEHICLE TOO CLOSELY o eorrom 15❑ NDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2066175999 16 a LAST NAME MILLER FIRST NAME LINDSAY MIDDLE R INITIAL 17 STREET I❑ 6232 35TH AVE NE UNIT B CITY' SEATTLE ST WA ZIP 981157315 37 NEW ADOREss❑' 18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NoF,/ 19 LDIIVER # STATE WA ]SEX IF M .C.B. 09 _ 28 _ 1981 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑ILICENSE 21❑ PLA E# APK1217 TArE WA VIN# 41 JHMGD38677S068113 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2007 MAKE HOND MODEL FIT STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO DUANE RAMSEY 25003 N PERRY RD COLBERT WA 99005 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 912642860IN STOP VEHICLE CITATION# CHARGE 25❑ to BOTTOM LEGALLY YES N� J 7B- S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 MIN FLICK 12825 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED52569 COLLISION REPORT III III III III III 111 1591972 CASE# 23-4366 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' 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. BENJAMIN FLICK 04-18-23 06:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 4/19/2023 6:12:56 AM BADGE OR ID# 12825 ORI# WA0171300 TIME POLICE DISPATCHED! 3:46 PM TIME POLICE ARRIVED 3:46 PM PART I PAGE IT]OF REPORT NO. ED52569 CASE# 23-4366 OF COLLISION 04/18/23 15:44 OF CbLLI510N NARRATIVE 23-4366 On 3-17-23 at approximately 1203 hours I was working as a Renton Police Officer for the Renton Police Department on patrol in full uniform in the city of Renton, King County, Washington. I responded to a motor vehicle collision at the cross of N 6th ST and Logan AVE N. Upon arrival I made contact with all three vehicles involved. All three involved drivers agreed upon the circumstances that occurred which were as follows: All 3 involved units were northbound on Logan AVE N, approaching the traffic light on N 6th ST. Unit 3 (WA/BWS5721) driven by driver Mary L. Price (DOB: 03-18-1955 via WADOL) braked when the light at the cross of Logan AVE N and N 6th ST turned yellow and she knew she was not going to make the light. She braked and stopped at the intersection. Unit 2 (WA/APK1217) driven by Lindsey R. Miller (DOB: 09-28-1981 via WADOL) was behind unit 3, braked and was able to stop short of colliding with unit 3. Unit 1 (WA/C73471 P) driven by driver Zachary G. Verge (DOB: 05-27-1997 via WADOL) was behind unit 2, braked, but was not able to get his vehicle stopped in time. His vehicle collided with unit 2, which pushed unit 2 into unit 3. Driver Verge said that he braked, his brakes "locked up" and he steered to the left to attempt to avoid the collision, but still collided with unit 2. Driver Miller said that when she saw Verge braking, he was pretty far away and she thought he was going to be able to stop. Driver Price mentioned that she had lower back pain as a result of the collision. She was examined on scene by Renton Regional Fire Authority. I provided all three parties with an exchange of information via Sector which contained the case number. I observed that the damage to the vehicles was consistent with what all 3 parties had told me. At the conclusion of my investigation, I determined that driver Verge had been following too closely as he was not able to stop in time. I confirmed with driver Verge that his DOL address was current. I informed driver Verge that he would be receiving a citation for following too closely via mail. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by B. Flick 12825 on 04-18-23 in Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED52569 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-4366 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 DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO D:2066978324 0 8 29 LAST NAME PRICE FIRST NAME MARY MIDDLE'.. L INITIAL STREET 30 NEW AnDRFrtP 2361 31 ST AVE S CITY SEATTLE ST WA ZIP 981445523 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTE6 INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 03 - 18 - 1955 7 HELMET :INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG'' 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 BACK PAIN 8 ❑ 1 32 LICENSE BWS5721 TAr WA VIN# JN8AS5MT6FW673532 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2015 MAKE NISS MODELROGUE I STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1I' E FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFOMARY PRICE 236131ST AVE S SEATTLEWA98144 J 9 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE INSURANCE CO FARMERS 190431488 q"i"Olx IN EFFECT &POLICY# 1 EHICLE 34 13 4 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTUM STANDING } 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiR rD IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE rnr 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE 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. BENJAMIN FLICK 04-18-23 06:59 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 12825 O#II,WA0171300 APPROVED BY 41119/2023 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. ED52569 CASE# ' 23-4366 DATE AND TIME 04/18/23 15:44 OF COLLISION r Not to scale m z 1 T it 3 t2 t rrr PAGE 5 OF 5