HomeMy WebLinkAbout23-4564 (2) IT ' " . 27POLCERAFFO 1 c 1I1llI 111I II REPORT NO ED61910
COLLISION REP FIT
1591971
CASE 23-4564 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cawsloN 04 - 1-- 2023 1031 17 ❑.= S 8 IN e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 100
4a 9❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FEET MILES e S B W e SW ICTOR/A ST
1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2066362274 0 11
30
6❑ LAST NAME FRANCO FIRSTNAME JULIAN MIDDLE 1 2 31
INITIAL
STREET 01 790149TH AVE S CITY SEATTLE ST WA ZIP 98118 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 12 1- 23 - 1971 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 I INJURY [NATURE OF INJURIES
CLASS 7 SORE RIGHT ELBOW z❑
3
10 9❑ P1 AT 14 C775831Z STATE WA VIN# 1FTFW1E62DFB93668
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
rRLR. TRLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34
13 2 2013 FORD F150 CW DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE
E 955826298 4
IN EFFECT &POLICY# 9TOP
vECALLv Hla.e 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4259316129
16 a
LAST NAME COSMAKOS FIRST NAME NICK MIDDLE
INITIAL
17❑ NEW STREETR 2742 83
7 RD AVE CT E CITY' EDGEWOOD ST WA ZIP 98371 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 F] LICENSE# STATE WA SEX M M D.C.B. 01 23 _ 1958 0 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
❑ILICENSE 21❑ PLA E# AHZ4228 TATe 41
WA vIN1t JTDKN3DU8C1493546 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
GI
VEH YEAR 2012 MAKE 7'Oy7' MODEL pRIUS STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 964128506IN STOP 5
vE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
D.LAMOTHE 11677 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61910
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4564
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
POS. 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.
D.LAMOTHE 04-23-23 11:51 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 512012023 10:03:06 AM
BADGE OR ID# 11677 ORI# WA0171300 TIME POLICE DISPATCHED! 10:37 AM TIME POLICE ARRIVED',10:41 AM
PART I PAGE IT]OF 4�
REPORT NO. ED61910 CASE# 23-4564 OF COLLISION
04/23/23 10:31
OF CbLLI510N
NARRATIVE
On 4/23/2023 at approximately 1037 hours, I was dispatched to the 100 block of Rainier Ave S, in the
City of Renton, County of King, State of Washington, reference a two vehicle collision.
I arrived on scene and I observed Vehicle #1 parked in the Autozone parking lot, while Vehicle #2
was pulled over on shoulder in the southbound lane on Rainier Ave S, just outside of Autozone.
I observed minor damage to the step rail on the passenger side of Vehicle #1 as well as white paint
transfer on the front passenger side tire of the vehicle.
Driver#1 stated that he had exited the Brown Bear parking lot, located at 77 Rainier Ave S, and had
pulled out onto Raineir Ave S to head south. He stated due to the size of his pickup truck, he was
unable to pull directly into lane #1 (closest to the curb), so he drifted out to lane #2. He stated he was
pulling into this lane as he was going to go to McClendon's, which is on the east/left side of the road.
He stated he then merged back into lane #1 as he decided he needed to go to Walmart, which is on
the west/right side of the road. While he was entering lane #1, he stated that Vehicle #2 struck the
passenger side of his vehicle. Driver#1 stated he believed Driver#2 was speeding. Driver#1 later
stated was only straddling both lanes and was not fully in either lane, so he believed Driver#2 should
have let him enter a lane.
Driver#1 stated that his right elbow was sore, however he declined medical attention.
I observed denting and paint transfer on the front and rear driver side of Vehicle #2.
Driver#2 stated he was traveling southbound on Rainier Ave S in lane #1. He stated that Vehicle #1
had pulled out from a parking lot or side street into lane #2, but then merged into lane #1 as Vehicle
#2, striking the driver side of his vehicle. Driver#2 stated he had been in lane #1 the entire time and
had not changed or merged lanes.
I issued Driver#1 a verbal warning for improper merging, as he merged from lane #2 to lane #1 when
it was not safe to do so.
I provided both parties with a business card and case number and emailed them a copy of the
exchange of information form.
This concludes my involvement in this case.
PAGE 3 OF 4
REPORT NO.! ED61910 CASE# ' 23-4564 DATE AND TIME 04/23/23 10:31
OF COLLISION
t`
'Brown Saar
Rainier Ave S,
Vehi
$1N victoria St
Diagram Not To Scale
PAGE 4 OF 4