HomeMy WebLinkAbout23-5380 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 23-5380 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT 8 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 05 - 1-- 2023 1554 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MONSTER RD SW BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FMILES EET e S B W e OAKESDALE AVE SE
1 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063878883 0 4 30
LAST NAME FERNANDEZ DE LA TORRE FIRST NAME DANIEL MIDDLE
6 INITIAL 1 2 31
STREET ❑, 307 S 302ND PL CITY FEDERAL WAY ST WA Zjp, 980034078 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NOWINTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 2❑ I Pi ATNES# CFW0180 sTAr WAvN# 1N46t4CV8LC187740
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 0 33
12 0 1
VIN#' VIN#'
FROM TO
VEH.YEAR 2020 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 1 TOWED BY GOVT.VEHICLE 34
13 4 NISS ALTIMA DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO DANIEL FERNANDEZ DE LA TORRE 307 S 302ND PL FEDERAL WAY WA 98003 VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3
14 IN EFFECT INSURANCE STATE FARM 5327013 A2047
IN EFFECT &POLICY# � 9TOP
VEwcLE CHARGE BOTTOM 36
LECALLv res❑NO❑ CITATION# 5
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064602463
a
LAST NAME TIDWELL FIRST NAME KELLIE MIDDLE L
INITIAL
17 NEW STREETRE57 11102 SE 214TH ST CITY KENT ST WA ZIP 980311328 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLA E# CAS1369 TArE 41
WA vIN# 2HNYD18673H514590 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2003 MAKE ACUR MODEL MDX STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES NO (,ENE MEYER YES NO
REGISTERED OWNER INFO KELLIE TIDWELL 339 BURNETT AVE S APT 205 RENTONWA98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE I PORGY#E CO PERMANENT GENERAL 53 WA 5810875 5Q,
IN EFFECTVE"LE ❑ ,J� CITATION# CHARGEYES N`L J25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
RYAN KARLO RIVERA 1
12649 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED65883
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5380
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.
RYAN KARLO R/VERA 05-13-23 06:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
D.MOYNIHAN 11288 513112023 9:16:47 AM
BADGE OR ID# 112649 ORI#' WA0171300 TIME POLICE DISPATCHED; 4:05 PM TIME POLICE ARRIVED 4:07 pry
PART I PAGE IT]OF 4�
REPORT NO. ED65883 CASE# 23-5380 OF COLLISION
05/12/23 15:54
OF CbLLI510N
NARRATIVE
On 05/13/2023 1 was working uniformed patrol in a marked police car as 1 R26. At approximately
1605 hours, I was dispatched to a blocking accident at the intersection of Monster Rd SW/Oakesdale
Ave SW, which is within the city limits of Renton, county of King, Washington. The accident occurred
just south of that intersection above. Dispatch advised that there was a two-vehicle accident with no
injuries. Dispatch also advised that one of the vehicles was blocked and could not move the vehicle.
When I arrived on the scene, I found Unit 2 just south of the intersection perpendicular to Monster Rd
SW. I later found Unit 1 parked in the adjacent parking lot.
I located Unit 2's driver in the adjacent lot as well as Unit 1's driver. My conversation with Unit 2 is
summarized as follows:
Unit 2 stated she was exiting the adjacent parking lot after getting off work. Unit 2 stated she was
driving eastbound about to exit the lot. When she got to the end of the lot, she began to signal left to
turn northbound onto Monster Rd SW. When Unit 2's driver began her turn, she remembers being
struck on the driver's side by Unit 1.
After speaking with Unit 2's driver, I then interviewed Unit 1's driver. My conversation with Unit 1 is
summarized as follows:
Unit 1 stated he was already on Monster Rd SW and was facing northbound at the stop line just
before Oakesdale Ave SW. Unit 1's driver said he was preparing to turn left to head westbound onto
Oakesdale Ave SW. Unit 1 then said something to the effect that he wanted to turn around to head
southbound on Monster Rd SW. Unit 1 then placed his car in reverse to try and turn his vehicle
around. Unit 1 then remembers colliding the rear end of his vehicle with Unit 2.
Unit 1 sustained damage to the rear passenger side of his vehicle. There were visible dents to the
rear and a broken passenger taillight as a result. Unit 1's vehicle was driveable and he was able to
move out of the roadway.
Unit 2 sustained damage to the front driver's side of her vehicle. There were visible dents to the front
end of her car and what appeared to be a broken bar that connected to the driver's wheel. Her vehicle
was undrivable. I requested a tow to tow her vehicle. Gene Meyers's tow arrived shortly after and
coordinated with Unit 2's driver on where her vehicle would go.
Based on the circumstances, it appears that Unit 1 is the cause of the accident.
This concludes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signature: Ryan Rivera (#12649) Date and Place: 05/13/2023 @ Renton, WA
PAGE 3 OF 4
REPORT NO. ED65883 CASE# ' 23-5380 DATE AND TIME 05/12/23 15:54
OF COLLISION
RPD Case #23-5380
*Not Drawn to Scale*
Oakesdale Ave SW
Point of Impact
Parking Lot/Business c
rY
L
0
CC
C
PAGE 4 OF 4