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Home My WebLink About23-449 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ 23-449 2 INTERSTATE CITY STREET RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4200 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# ❑ CowsloN 01 - 11 - 2023 1542 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ N LANDING WAY BLOCK NO. e✓ 1203 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 25 00 FEET MILES e S ❑ W e PARKAVEN 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4259883023 1 4 30 6� LAST NAME ADAMS FIRSTNAME KATHLEEN MIDDLE S 1 1 2 31 INITIAL STREET ❑ 16014 131 ST PL SE CITY RENTON ST WA ZIP' 98058 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITIt)N PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs No✓ INTERLOCKYEs NO✓ YEs No✓ 8❑ D RI VER # STATE WA SEX'F MMDDYY' 09 - 18 - 1947 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10� PI ATE 406YH1 sTAT1 WA VIN# 1 HGCP36848A087559 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM ro TRLR. TRLR 3 7 33 12 0 0 VIN#' VIN# 2008 HOND ACCOR SD V ❑ FROM 34 ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 13 A DAMAGE YES NO ✓ YES NO✓ REGISTERED.WNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14❑ UABILI INSURANCE U INSURANCE CO HARTFORD 55PHJ751040 <�3 4 IN EFFECT &POLICY#VEHICLE CHARGE36 LEGALLv YES❑NO CITATION# TTOM 15❑ STANDING 6 UNIT 02 VEHICCLE CYCLE ❑ PEDESTRIAN ❑ OWN RRTY ❑ DYES✓ NO OLD MET PHONE 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE INITIAL STREET CITY RENTON ST ZIP 4 17❑ NEW ADDRESS❑ ❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 LLIICENS RIVER# SEX U MMDDYY 39 WELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑ ❑ILICENSE 21❑ PLA E# BUX0740 TATE 41 WA VIN# KM8J3CA45KU921653 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 2019 MAKE HYUN MODEL TUCSON STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO KARINA COOK 12725 SE 312TH ST AUBURN WA 98092 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP VEHICLE ES[:] C[:] CITATION# CHARGE i o BOTTOM LEGALLY YN 25 $ ' 7HAL S NAME(PRINT) OFFICER PHONE BADGE OR ID# 771�NCY 26 Y BRUS 11663 0171300 PAGE 01 OF PART A 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED31199 COLLISION REPORT III III III III III 111 1591972 CASE# 23-449 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. HALLEYBRUS 01-11-23 07:06 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 1 2/4/2023 4:17.43 PM BADGE OR ID# ! 11663 ORI#' WA0171300 TIME POLICE DISPATCHED', 4:35 PM TIME POLICE ARRIVED',4:44 PM PART I PAGE IT]OF 6� TIME REPORT NO. ED31199 CASE# 23-449 OF COLLISION01/11/23 15:42 NARRATIVE Assignment: On 1-11-23, 1 was working uniformed patrol in a marked Renton PD unit. At approximately 1635 hours, I was dispatched to investigate a traffic collision that occurred in the Petsmart parking lot 1203 N Landing Way, in the City of Renton, County of King (WA). Arrival: Upon arrival, I saw a black Honda Accord (WALic#406YH1, Unit#1) with front end damage. There was a silver Hyundai Tucson (WALic#BUX0740, Unit#2) with rear end damage. There was a light green Hyundai Tucson (WALic#BW8013, Unit#3) with front end damage. There was also a silver BMW 328 (WALic #AKN8575, Unit#4). Additionally, the Petsmart shopping cart stall had been damaged and pushed into the passenger side of Unit#4. There was a destroyed shopping cart inside the metal frame of the stall as well. The driver and owners of Unit#1 and Unit#3 were on scene. Unit#2 and Unit#4 were unoccupied. Statement of Kathleen Adams: Adams (identified by WADL) was driving Unit#1. Adams was parked in a parking stall, facing westbound. Adams believes she was confused and either went forward when she thought she was in reverse of put her foot on the gas when she thought it was the brake. Adams admitted to causing the collision. Unit#1 went westbound into the rear of Unit#2, which was then pushed into the front of Unit#3. Unit#3 facing eastbound in a parking stall and was then pushed into the shopping cart stall rails. The metal rails were then pushed into the passenger side of Unit#4, which was parked unoccupied facing westbound in a parking stall. Adams appeared very frazzled by the incident but she stated she was not injured and there were no defects to the front of Unit#1 prior to this incident. Statement of Freda Emerson: Emerson (identified by WADL) was backing out of her parking stall when Unit#1 collided with Unit#2, then Unit#2 collided with the front of her vehicle (Unit#3). Unit#3 was pushed into the shopping cart stall railings, which then was pushed into the passenger side of Unit#4. Emerson complained of some back pain but stated it was sore from a pre-existing injury. Emerson declined aid. There were no defects to Unit#3 prior to this incident. Damage: The damage on all vehicles and property on scene matched both statements. Tow: No tows were requested. Summary: Due to this collision occurring on private property, I did not issue any traffic citations. I provided Petsmart employees with the case number and left my business card on Unit#2 and Unit#4. 1 certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by H.Brus/11663 at 1835 hours on 1-11-23, in the City of Renton, WA. PAGE 3 OF 6 SUPPLEMENTAL REPORT NO. ED31 1 99 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-449 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 DAMAGE THRESHOLD MET PHONE 5 UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES✓ NO D:2062146693 1 5 29 LAST NAME FIRST NAME MIDDLE EMERSON FREDA INITIAL, '' C 1 4 30 STREET NEW AnnRFsP 2200 NE 24TH ST CITY RENTON ST WA ZIP 98056 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO✓ zERLOCK YES�NOf YEs N ✓ DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 06 - 19 - 1958 7 HELMET INJURY' NATURE INJURIES ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 COMPLAINT NT OF BACK PAIN 8 ❑ 1 32 LICENSE BW8013 [TAT WA VIN# KM8JN72DX8U816261 PLATE# 9 TRAILER TRAILER 191 PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 0 0 VEH.YEAR2008 MAKE HYUN I MODEL TUCSON STYLE UT I VEHICLE TOME E T SABLIN TOWED BY anvi vFH.Ir P FROM TO DAMAGE YES NO ✓ YES NO ✓ REGISTERED OWNER INFO OWNED BY DRIVER Q Q 33 12 � SHADE IN DAMAGED AREA 4 FROM TO LIABILITY INSURANCE INSURANCE CO GENERAL 53-WA-4131391 q"i"Olx IN EFFECT &POLICY# vewcLE 10 6OTTUM 34 CITATION# CHARGE 13 LEGALLY YES NO STANDING �} 14 ❑ UNIT# 4 VEO IOCRLE CYDCLE � OWNER YES✓ENOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 36 15 � UNKNOWN 17 MIDDLE 71 LAST NAME FIRST NAME INITIAL 16 ❑ STREET CITY KENT ST ZIP N�n+AnnRESS CDL IGNITION REGUIREE7 IGNITtGN PRESENT MEDICAL TANSPORTED 17 ❑ INTERLOCK YES NO✓ INTERLOCK YE NO✓ YEs No.1 ❑DRIVER'S STATE SEX U D.O.B 4 37 18 ❑ LICENSE# MMDDYYY - - ON DUTY STATUS AIRBAG 9 RESTR, 9 EJECT 1 HELMET 9 INJURY Q NATURE OF INJURIES 38 USE CLASS 19 ❑ PLATE# AKN8575 TAr WA v!N# WBAVC73517KP30394 3 39 20 ❑ TRAILER' STATE TRAILER ST ❑ 40 PLATE#< PLATE# ATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR2007 MAKE BMW MODEL 328 STYLE SD VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 4 DAMAGE YES NO ✓ YES NO ✓ 23 REGISTERED OWNER INFO ROSAURO DIZON 2.21388TH WAYS#R102 KENT WA 98031 SHADE IN DAMAGED AREA F-1 43 LIABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# i 9 TOP 4 44 V 24 LEA LLY LE YES[:] NO CITATION# CHARGE tO SOTPOM .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. HALLEY BRUS 01-11-23 07:06 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 11663 O#I WA0171300 SUMMERS 2/4/2023 PAGE OF F 3000-345-013(R 11118) SUPPLEMENTAL REPORT NO. ED31 1 99 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-449 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 I_J CYCLE u PEDESTRIAN � OWNER � YEs� NO D:4252041759 MIDDLE 29 LAST NAME PETSMART FIRST NAME INITIAL STREET 30 NEW AnDRFSP' 1203 N LANDING WAY CITY RENTON ST WA ZIP 98056 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YEs No zERLOCK YES E]Na� YEs N DRIVER'S STATE I SEX U M��DYSYv' —� 2 LICENSE 7 F-I ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE cLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9F-I 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 vEHIG P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREETIAL ❑ 16 NEn+AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiREE7 IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK 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 ❑ 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE 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. HALLEY BRUS 01-11-23 07:06 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 11663 O#I,WA0171300 SUMMERS 2/4/2023 PAGE OF 6 3000-345-013(R 11118) REPORT NO. ED31199 CASE# 23-449 DATE AND TIME 01/11/2315:42 OF COLLISION P�et tiir CtPaft L o LJni WA ......................... , ...... ...... .... tlriit 2 .°' Unitr z Park Ave N PAGE 6 OF 6