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Home My WebLink About23-5204 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CASE# 23-$204 2 0 7 INTERSTATE CITY STREET RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AGENCI 4250 3❑HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cawsloN 05 - 08 - 2023 2040 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 68TH AVE S BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e BEACON COAL MINE RD 0 1 29 UNIT 01 VEHICLE MOTZ PEDAL-ORCYCLE ElDESA✓NHORESHOLDMET PHONE O 7 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY ST ZIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/ $❑ LICIENSE# STA fE I SEX u MMDOBYY '❑- 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES 2❑ 3 10 9❑ Pi AT 14 CGJ0457 STATE WA VIN# 1FMFU18L8VLC25321 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FR.. ro TRLR. TRLR 5 1 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 9 9 34 13 2 1997 FORD EXPEDI DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO DASHAWN CLAIBGRNE 2343261STAVE S APT V303 KENTWA 98032 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 912P VEHICLE CHARGE 5 36 LEGALLv YEs❑NO❑ CITATION# 10 BOTTOM 15❑ NDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069629168 16 a LAST NAME HANG FIRST NAME ANNA MIDDLE INITIAL 17 STREET IS❑' 11813 AMBAUM BLVD SW UNIT 3 CITY BURIEN ST WA ZIP 98146 37 NEW ADDRES 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICALt—T�RANSFORTED ❑ 38 INTERLOCK YES�NO INTERLOCK YEs I I NOF YES t l ND� 19 LDI IVEW # STATE WA ]SEX IF M D.C.B. O6 _ 26 _ 1994 El 39 HELMET I {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 6 RESTR 9 EJECT ''1 USE CLASS 1 ❑ LICENSE ❑21❑ PLA E# BSU3007 TATe WA VIN 1 41 2HKYF18776H521592 4 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 2006 MAKE HOND MODEL PILOT EX STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO ANNA HANG 11813 AMBAUM BLVD SW UNIT 3 BURIEN WA 98146 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE &POINSURGY#ECO STATE FARM 4618607 E2247AIN STOP VE""LE CITATION# CHARGE YES 25 to BOTTOM LEGALLY � ❑ OFFICER'S NAME(NPRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 LACY SMITH 12613 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED61937 COLLISION REPORT III III III III III 111 1591972 CASE# 23-5204 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY) NAME MIDDLE INITIAL) RATH SOMMA (LAST FIRST, ADDRESS&PHONE# BURIEN 2066831547 SEXi F MMDOYyry 03 - 11 - 1994 PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑, 2 POS. 3 6 9 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) HOANG PHI ADDRESS&PHONE# D O B 2062912353 SEX' U MMDDY',Y PASSENGER ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.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. LACY SMITH 05-11-23 05:17 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 512012023 11:32:21 AM BADGE OR ID# 12613 ORI#' WA0171300 TIME POLICE DISPATCHED 8:49 Pry] TIME POLICE ARRIVED',8:56 PM PART Ei PAGE 2�OF❑ REPORT NO. ED61937 CASE# 23-5204 OF COLLISION 05/08/23 20:40 OF CbLLI510N NARRATIVE On 05/08/2023, 1 was assigned to District 13 as the, 3R13. At approximately 2049 hours I was dispatched to BEACON COAL MINE RD S/68TH AVE S for a hit and run collision. This is located in the city of Renton, the county of King, and the state of Washington. Per dispatch, 10 MIN AGO, HIT AND RUN, RP DECLINING AID, VEH CONTIUNED ON BEACON COAL MINE RD, RP IS PARTIALLY BLKING THE ROADWAY ". Unit 1-WA/CGJ0457 Unit 2-WA/BSU3007 Driver of unit 2- ANNA HANG Unit 3-WA/B70305N Driver of Unit 3- BRUCE WARD Witness- Phi Hoang I arrived on scene and contacted the Driver of Unit 2 and positively identified her as, Anna Hang, by her Washington state driver's license. Hang stated Unit 3 abruptly stopped so she stopped and that was when she was rear-ended into Unit 3 by Unit 1. I contacted the driver of Unit 3 and positively identified him as, Bruce Ward by his Washington state driver's license. Ward stated he stopped at the fork in the road and was rear ended by Unit 2 when she was rear ended by Unit 1. Unit 1 was gone upon my arrival. Bruce stated Hoang witnessed the event, and they were able to locate Unit 1 down the street and that was how he was able to provide the plate for Unit 1. Renton Fire was called to the scene due to airbag deployment. Renton Fire Medically cleared the people on scene. Unit 2 was privately towed from the scene. I did an area check for Unit 1 and was unable to locate it at this time. Based on the statements made and the evidence on scene, it appears Unit 3 stopped at the fork in the road to his turn. Unit 2 was able to stop without incident. However, Unit 1 did not stop due to unknown reasons and hit Unit 2 causing Unit 2 to collide with Unit 1. Unit 1 left the scene immediately and did not exchange information with the other Units. Unit 1 is outstanding. 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 Officer L.Smith 12613 on 05/11/2023 in Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED61 937 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-5204 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L 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:2067722342 0 9 29 LAST NAME : WARD FIRST NAME BRUCE MIDDLE M INITIAL STREET 30 NEW AnoRFsP- 12034 70TH AVE S CITY SEATTLE ST WA ZIP 98178 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 05 - 14 - 1954 7 ON DUTY� STATUS AIRBAG' 2 RESTR. g EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE B70305N [TAT WA VIN# JT4RN63R3HO111613 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR1987 MAKE TOYT MODEL 112 TON STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOBRUCE WARD 1203470TH AVE S SEATTLE WA 98178 D:2067722342 J 9 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE[] INSURANCE CO IN EFFECT &POLICY# t 9 101? EHICLE o BarroM 34 13 LEGALLY YES NO 01 CITATION# CHARGE STANDING �}� 8 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 REdUiRED IGNITION PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER El40 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 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 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. LACY SMITH 05-11-23 05:17 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26F7 OI BADGE 12613 O#I',WA0171300 SCOTT 512012023 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. ED61937 CASE# 23-5204 DATE AND TIME 05/08/23 20:40 OF COLLISION j i Rt In Q� w C? phis diagram is not to scale � Unit 3 Points of impact -Unit2 Point of impact1 Unit 1 I i PAGE 5 OF 5