HomeMy WebLinkAbout23-5083 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-5083 2 571
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OS STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 05 - 1-- 2023 1330 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 43RD ST BLOCK NO. e✓ p
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 40 00 FEET MILES e S ❑ W e E VALLEY RD
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065789034 0 81
30
6� LAST NAME ALFANASH FIRSTNAME MUHAMMAD MIDDLE K 1 1 2 31
INITIAL
STREET ❑✓ 20303 90TH PL S CITY KENT ST WA 7jp, 98031 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z YES Z NO
8❑ DRIVERS
E#
[NATURE OF INJURIES
9[�] ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 H U EET 2 CLASS 6 LACERATION TO HEAD 2❑
3
10 9❑ P1 AT 14 CFE9327 STATE WA VIN# WDBUF56X476077775
TRAILER STATE 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 T v GOVT.VEHICLE J 9 34
13 4 2007 MERZ E3504D SD DAMAGE vesNo � �MEYER YES❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
INSURANCE CO
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE
14 ❑ NO INSURANCE
IN EFFECT &POLICY# STOP
VEHicLe CHARGE to BOTTOM 5 36
LEGALLY YEs❑NO❑ CITATION# 3A0139746,3AO139746, SPEED TOO FAST FOR CONDITIONS, 5
15❑ STANDING 6
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V NO D:6263211137
16 a
LAST NAME DUAN FIRST NAME ZHICHAO MIDDLE
INITIAL
17❑ NEW STREETREs7 11063 SE CAUSEY CIR CITY HAPPY VALLEY ST OR ZIP 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NO/
19 LICENSE RS# STATE OR SEX M Mr D.C.B. 10 _ 10 _ 1993 39
20❑ ON DUTY STATUS I
AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# N/A TATE WA VIN 1t 5UXCR6CO2P9R80188 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
rowed By Gov HI 44
VEH YEAR 2023 MAKE BryI�rV MODEL XS STYLE UT —FEHICLE
TOWED✓ NOO BLIN GENEMEYER YES!TN-
REGISTERED 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEbAREA
s Cd
LIABILITY
INSURANCE INSU POLICY#E CO GEICO 6091046562IN STOP
VEwcLE CITATION# CHARGE
25 to BOTTOM
LEGALLY YES Nu
❑ 7NE
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
ON 12327 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED57949
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5083
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
PM 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.
T.NELSON 05-06-23 11:52 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 51712023 3:34:02 PM
BADGE OR ID# 12327 ORI# WA0171300 TIME POLICE DISPATCHED! 1:33 PM TIME POLICE ARRIVED',1:37 PM
PART I PAGE IT]OF 7�
REPORT NO. ED57949 CASE# 23-5083 OF COLLISION
05/05/23 13:30
OF CbLLI510N
NARRATIVE
23-5083
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 05-05-2023 at approximately 1335 hours I was dispatched to a multi vehicle injury collision at SW
43rd St and E Valley Rd.
Other officers and the fire department arrived before me. I arrived and observed the 5 involved units.
Some of the involved units had relocated off the roadway. Unit 1, unit 3, and unit 5 all had significant
damage and were inoperable. Unit 1 had significant passenger side damage and significant front-end
damage. Unit 2 had significant front and rear end damage. Unit 3 had significant front and rear end
damage. Unit 4 had minor rear end damage. Unit 5 had significant front-end damage.
The driver of unit 1, Alfanash, was being treated by fire and appeared to have a significant
laceration/injury to the right side of his head and was bleeding. Alfanash was transported to Valley
Medical Center (VMC) via ambulance for further evaluation. The driver of unit 2, Zhichao, complained
of neck pain. Zhichao was evaluated by the fire department on scene and was not medically
transported. The driver of unit 3, Kumar, advised she was not injured. The driver of unit 4, Kulybchuk,
advised she was not injured. The driver of unit 5, Baker, complained of chest pain. Baker was
evaluated by the fire department on scene and was not medically transported.
The following was gathered from Baker and other witnesses:
Unit 4 was facing west on SW 43rd St just east of E Valley Rd in the left turn lane. Unit 3 was behind
unit 4, and unit 2 was behind unit 3. Units 2,3, and 4 were stationary. Unit 5 was travelling east in lane
2 on SW 43rd St. Unit 1 was travelling west on SW 43rd St at a high rate of speed approaching traffic
that was stopped in the left turn lane. Unit 1 applied the brakes and went into a slide and rotated
approximately 90 degrees counterclockwise and the passenger side of unit 1 struck the rear of unit 2.
The force from unit 2 being struck by unit 1 caused unit 2 to strike unit 3 which then struck unit 4.
After unit 1 struck unit 2, unit 1 rotated approximately 90 degrees clockwise and travelled into
oncoming traffic and the front of unit 1 struck the front of unit 5.
My observations of the scene were consistent with what was relayed to me. Based on my
observations and the information relayed to me, I was led to believe the proximate cause of the
collision was unit 1's inattentive driving and speeds too fast for the conditions as the roadway was
wet.
Unit 1, unit 2, and unit 5 were all inoperable and were towed due to them blocking the roadway. Unit 3
and 4 appeared to be operable and were off the roadway. I completed an impound form for unit 1 due
to the driver being medically transported.
Each of the involved drivers was provided with the case number.
I later contacted Alfanash at VMC to obtain his contact number and insurance information. Alfanash
advised that he did not have insurance on the vehicle. Alfanash confirmed his mailing address and I
advised that he would be cited for speeds too fast for conditions, inattentive driving, and failing to
provide proof of insurance. Alfanash advised that he was not travelling too fast but that he lost control
of his vehicle and was unable to stop and that he did not mean to hit the other vehicles.
Alfanash was cited for violating the following:
RCW 46.61.400
PAGE 3 OF 7
REPORT NO. ED57949 CASE# 23-5083 OF COLLISION
05/05/23 13:30
OF CbLLI510N
NARRATIVE
RCW 46.30.020
RMC 10-12-25
PAGE 4 OF 7
SUPPLEMENTAL REPORT NO. ED557949
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-5083
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 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
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES✓ NO
D:2532557293
0 8 29
LAST NAME KUMAR FIRST NAME SANTOSHNI MIDDLE' ',, P
INITIAL
0 8 30
STREET
NFW AnDRFSP 27621 26TH AVE S CITY FEDERAL WAY _1ST WA ZIP 98003
6 [2 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YES N ✓
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv 04 - 04 - 1984
7 ❑ ON DUTY� STATUS AIRBAG' g RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 1 2 32
LICENSE C16356V TAr Wq VIN# 2C4RDGCG5KR696411
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 3 5 VEH.YEAR2019 MAKE DODG MODEL GRAND STYLE VN VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1O P FROM TO
DAMAGE YES NO ✓ YES NO ✓
33
REGISTERED OWNER INFO.NORCO INC 4140 LIND AVE SW RENTONWA98057 J 9
12 3 5 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE INSURANCE CO ZURICH AMERICAN BAP0381401.07 TOP
IN EFFECT &POLICY# 9 9
vewcLe 10 BOTTOM 34
4 CITATION# CHARGE
13 LEcnuv YES NO gg�@
STANDING ✓ a 7
DAMAGE P THRESHOLD MET HONE 35
14 UNIT# 4 MOTOR ❑✓ PEDAL- ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO
VEHICLE CYCLE OWNER ✓ D:2063345103
❑ 36
15 KULYBCHUK TETIANA MIDDLE'. 5
LAST NAME FIRST NAME INITIAL
2 STREET
16 ❑ ❑; 4305 FINNHORSE LN CITY PASCO ST WA ZIP 99301
NFln+AnnRFss
CDL IGNITION REOUIREE7 IGNITION PRESENT MEDICAL TANSPORTED
17 ❑ INTERLOCK YEs NO✓ INTERLOCK YEs NO✓ YEs NO;./ ❑
DRIVER'S D.O.B 4 37
LICENSE# STATE WA SEX F MMDDyYY' 02 — 16 — 1994
18 ❑
ON DUTY❑ STATUS' AIRBAG 2 RESTR, 4 EJECT 1 1 HELMET 2 INJURY 1 NATURE OF INJURIES 38
USE CLASS
19 ❑ ❑
PLATE# BZE8135 TAr WA v!N# SUXKROC39HOV78662 3 39
20 ❑ TRAILER' STATE TRAILER ST 3❑ 40
PLATE#< PLATE# ATE
21 ❑ ❑ 41
TRLR TRLR
ViN# YIN#i
42
22F-I VEH.YEAR2O17 MAKE BMW MODEL X5 STYLE U1. VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1
DAMAGE YES NO ✓ YES NO ✓
23 ❑ REGISTERED OWNER INFO OWNED BY DRIVER SHADE IN DAMAGED AREA 43
z s
LIABILITY INSURANCE INSURANCE CO GEIC06069-38-07-61 9'1'OP
❑ IN VEHICLE
&POLICY# i " 44
24 LE
E ALE YESZ NO❑ CITATION# CHARGE i060TiOtvi
LEGALLY
E:l
STANDING 8 7
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
T-NELSON 05-06-23 11:52 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
RD OI' APPROVED T DATE
12327 WA0171300 N /2 PAGE OF 26 ❑
3000-345-013(R 11118)
SUPPLEMENTAL REPORT NO. ED557949
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-5083
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# 5 VEHICLE tSJ CYCLE u PEDESTRIAN � OWNER � YEs� NO
D:2533434677
0 8 29
LAST NAME BAKER FIRST NAME : CASEY MIDDLE M
INITIAL
STREET 30
NEW AnDRFrtP 7844 NE 146TH ST CITY KENMORE ST WA ZIP 98028
6 ❑ 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO NTERLOCK YES❑N0� YES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 01 - 19 - 1982
7
HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 6 RESTR. 4 EJECT 1 USE 2 CLASS 7 COMPLAINT OF CHEST PAIN
8 ❑ 1 32
LICENSE C477698 TAT WA VIN# 1GCVKREC5EZ377238
PLATE#
9 TRAILER TRAILER
191 PLATE If STATE PLATE If STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2014 MAKE CHEV I MODELSILVERA STYLE PK I VEHICLE TOWS ET SABLI W,6'•ER nVT VFHIGP FROM TO
DAMAGE YES NO YES NO
33
REGISTERED OWNER INFO OWNED BY DRIVER J 9
12 SHADE IN DAMAGED AREA
4 j FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# R 701x
VEHICLE 10 6QTTUM 34
13 ❑ LEGALLY YESZ NO❑ CITATION# CHARGE gg�@
❑ STANDING dRD PROPERTY Y l:9 7 6
❑ 35GNHROE
VEHICLE CYCLE OWNER O14 UNITr
j PHONE
15 LAST NAME FIRST NAME INITIAL
36
MIDDLE ❑
STREET"[-]
16 NEW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK YEs NO YEs NO ❑
17 4 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 If
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 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
T.NELSON 05-06-23 11:52 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 ORID# 12327 O#I',WA0171300 APSKELTON 5n/2023 PAGE F OF 7
3000-345-013(R 11118)
REPORT NO. ED57949 CASE# ' 23-5083 DATE AND TIME 05/05/23 13:30
OF COLLISION
Qa \�
M1�
51'd3�Si
PAGE 7 OF 7