HomeMy WebLinkAbout23-4980 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-4980 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 05 - 1-- 2023 1645 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAIN AVE S BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e S 3RD ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2534801542 0 3 30
6 LAST NAME BOSTEDER BARNES FIRST NAME DYLAN MIDDLE E 1 1 2 31
INITIAL
STREET ❑1 9910 S 248TH PL APT A305 CITY KENT ST I WA 2jp, 980305105 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R No�/
8❑ LICENS
DRIVER # STATE WA SEX'M MMDDYY 02 — 09 — 2001 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10❑ P1 aT�S� BZR4126 sTArI WAurN# KL7CJLSM9MB377140
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 3 34
13 2 2021 CHEV TRAX DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO AUTOZONE PARTS INC COM 23910104 AVE SE RENTON WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO AUTO ZONE INS UNK 3 4
IN EFFECT &POLICY# 9TOP
VE"'CLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067799988
16 a
LAST NAME ABRENICA FIRST NAME CESIL MIDDLE I C
INITIAL
17❑ STREET ❑', 6801 S 133RD ST APT D228 CITY' SEATTLE ST WA ZIP 981785136 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE I WA SEX M D.C... 08 _ O6 _ 1976 El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE RS11396 TAre WA vIN1i 1GAWGPFFXF1279849
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2015 MAKE CHEV MODEL EXPRESS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO KING METRO VANPOOL RIDESHARE 201 SJACKSON ST#KSC-TR-081 SEATTLEWA98104 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&POLICY#E CO KING COUNTYMETROIN 1GQ
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. ED57531
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4980
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.
CO.JOHNSON 05-03-23 02:15 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DIET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 51512023 6:36:24 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 5:20 PM TIME POLICE ARRIVED',5:29 PM
PART I PAGE IT]OF 4�
REPORT NO. ED57531 CASE# 23-4980 OF COLLISION
05/02/23 16:45
OF CbLLI510N
NARRATIVE
U1 NB LN#1 300 blk Main Ave S, U2 LN #2; both vehicles intend to turn right onto S 3rd St; U1 wide
right turn and collides with U2 in turn; U1 dvr fender/bumper into U2 pas quarter panel/bumper
On 05-02-2023 at about 1720 hours, I was dispatched to a collision in the area of 200 Mill Ave S in
the City of Renton, County of King, Washington. Both vehicles were in the parking lot and there were
no reported injuries. I arrived in the area at 1729 hours.
The driver of Unit 01 was identified by WA DL and admitted to driving the listed vehicle. The driver
initially had difficulty describing where the collision occurred but eventually described the intersection
on Main Ave S and S 3rd St. Unit 01 was northbound in the 300 block of Main Ave S in lane #1 (of 2).
The driver was following the navigation on his phone when he became confused at the intersection
due to a small street in the area (Houser Way S). The driver continued north into the intersection but
drifted to the left into lane #2 and collided with Unit 02.
The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. Unit 02 was
northbound in the 300 block of Main Ave S in lane #2 with the intent to turn right onto S 3rd St. The
driver of Unit 02 said Unit 01 came into his lane of travel and collided with his vehicle.
There was minor damage to the driver side front corner of Unit 01 and minor damage to the
passenger rear corner of Unit 02. The information provided by both drivers was consistent with the
information provided by both drivers. The 300 block of Main Ave S has two (2) lanes of travel for
north bound traffic. Lane #1 is a right turn only lane onto S 3rd St. Lane #2 is for both right turns onto
S 3rd St and traffic continuing north bound onto Main Ave S. The lane configuration allows for a
double right turn from Main Ave S and the lanes are separated by a dashed white line painted on the
roadway surface.
The proximate cause of the collision was Unit 01 failing to maintain its lane of travel while completing
the right turn. Were it not for the actions of the driver of Unit 01, The collision would not have
occurred.
No citations or infractions issued. Report for information and insurance.
PAGE 3 OF 4
REPORT NO. ED57531 CASE# ' 23-4980 DATE AND TIME 05/02/23 16:45
OF COLLISION
—Not to ScaW'
ate:
a 3rd St;
M
w
Unit 01
Unit 02;
Main Avg, -
PAGE 4 OF 4