HomeMy WebLinkAbout23-4467 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c
COLLISION REP FIT 1591971
CASE 23-4467 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
COLLISION.. 04 - 1-— 2023 1525 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE CARR RD BLOCK NO. e✓ 10300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FEET MILES e S B W e 103RD AVE SE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2533208880 0 6 30
6� LAST NAME STOKES FIRSTNAME SHERRI MIDDLE I K 1 1 2 31
INITIAL
STREET El 706 SWEETBRIAR RD CITy MANDAN ST NO ZIP 585540000 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO YES No�/
❑ DRIVER'S' STATE ND SEX'F MM DAY' 10 - 02 - 1967 1 2 32
8 LICENSE#
9[ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 . EJECT 1 HELMETU E CLASSY'7 NATURE OF INJURIES
COMPLAINT PAIN RT ANKLE z❑
3
10� P1 ATE 14 895CNK STATE ND VIN# WMWSS7C55DWN51432
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 2 6 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO 2 6 34
13 2 2013 MNN/ COOPS YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO USAA 0045691017111 3 4
IN EFFECT &POLICY# 9TOP
vECEHA"LE 5 36
Ltty Yes❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063349924
16 a
LAST NAME HAMADA FIRST NAME MINNAT MIDDLE A
INITIAL
17❑ STREET ❑', 24446 SE 46TH PL CITY ISSAQUAH ST WA ZIP 980296326 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX F D.C... 11 � 1977 22 _ El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CBL9244 TATe WA VIN# 7SAYGAEE6NF358126
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2022 MAKE TESL MODEL MODEL Y STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO MINNAT HAMADA 24446 SE 46TH PL ISSAQUAH WA 98029 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ALL STATE 964 154 999IN 1GD
VEHICLe ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`LJ
25 s � e
7.111CjEo-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED55443
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4467
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HAMADA ALY
(LAST FIRST,
ADDRESS&PHONE# D O.B.
1SSAQUAH 2O63697160 SEX' U MMDDYYYY - -
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET CLASS NATURE OF INJURIES
❑✓ ❑ 2 PCs. 3 2 4 1 USE CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D Q 8
SEX MMDDYYYT
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.MMDD -❑
YYYY.
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.
CO.JOHNSON 04-26-23 02:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 412812023 7:41:49 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:32 PM TIME POLICE ARRIVED',3:40 PM
PART I PAGE IT]OF 4❑
REPORT NO. ED55443 CASE# 23-4467 OF COLLISION
04/20/23 15:25
OF CbLLI510N
NARRATIVE
U2 WB 10300 blk SE Carr Rd In #1; U1 also WB Carr In #1; unidentified vehicle stopped in In #2 to
make illegal left turn into nearby school; a truck (behind stopped vehicle) unexpectedly veers into In
#1 to avoid collision; U2 emergency brakes to avoid colliding with truck; front of U1 collided with rear
U2; raining and roadway wet
On 04-20-23 at about 1532 hours I was dispatched to a blocking collision in the vicinity of SE Carr Rd
and 103rd Ave SE in the City of Renton, County of King, Washington. The collision involved two (2)
vehicles and were blocking a west bound lane. I arrived in the area at about 1540 hours. The
vehicles had moved onto 103rd Ave SE and were no longer blocking the roadway.
The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. The driver
was wearing a seatbelt during the collision and did not complain of any injuries. The driver verbally
identified the passenger.
Unit 02 was westbound in the 10300 block of SE Carr Rd in lane #1 (of 2). A vehicle stopped in west
bound lane #2 to make a left turn. A truck following behind in lane #2 made an abrupt lane change
into lane #1 to avoid colliding with the stopped vehicle. The truck failed to yield the right of way when
changing lanes. Unit 02 quickly applied full brakes to avoid colliding with the truck and was struck
from behind by Unit 01.
The driver of Unit 01 was identified by ND DL and admitted to driving the listed vehicle. The driver
was wearing a seatbelt during the collision and complained of pain to her right ankle but declined
response from fire department personnel.
Unit 01 was west bound on SE Carr Rd in lane #1 and behind Unit 02. The driver of Unit 01 saw Unit
02 stopping and applied full brakes to avoid a collision. The driver said her vehicle slid due to the wet
roadway. The front of Unit 01 impacted the rear of Unit 02.
The damage to both vehicles was consistent with the information provided by both drivers. The
10300 block of SE Carr Rd contains four (4) lanes of travel with two (2) in each direction. The
opposing lanes of travel are separated by a solid double yellow line. The west bound lanes are a
downhill grade in a curve. I observed the roadway was wet as it had recently rained in the area.
The proximate cause of the collision was Unit 01 following too closely to avoid colliding with Unit 02.
Per RCW 46.61.145 the driver of a motor vehicle shall not follow another vehicle more closely than is
reasonable and prudent, having due regard for the speed of such vehicle and the traffic upon and the
condition of the highway. A contributing factor to the collision was the unidentified truck that made an
abrupt lane change into lane #1 causing Unit 02 to apply their brakes.
No infractions or citations issued. Report for information purposes.
PAGE 3 OF 4
REPORT NO. ED55443 CASE# ' 23-4467 DATE AND TIME 04/20/23 15:25
OF COLLISION
I�n�ti71
1 3w Ave F:
U nit 0_2
AF
—Not to Scala"
SE Carr Rd
oil. y
°.err i m
at'
truck
tt `" toppod vehicto
PAGE 4 OF 4