HomeMy WebLinkAbout23-5425 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-5425 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 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 dF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
ddwsloN 05 - 1-- 2023 1532 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2069303398 0 11
30
6� INITIAL
LAST NAME DELALIC FIRSTNAME MINELA MIDDLE 1 1 2 31
STREET ❑ 360 TAYLOR AVE NW APT 211 CITY RENTON ST I WA 2jp, 980575145 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LDRIVER # STATE WA SEX'F MID
.O B 11 1- 26 - 1982 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CDT9643 sTArI WAurN# 2HKRW2H57MH633184
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 5 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2021 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 4 HOND CR-V UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO MINELA DELALIC 360 TAYLOR AVE NWAPT 211 RENTON WA 98057 D:2069303398 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 927356614 3 4
IN EFFECT &POLICY# 9TOP
VEwcLe CHARGE 1 5 36
LEGALLY YES No CITATION# 3AO344732 FAIL YIELD PRIVATE RD MOTOR o eorrom
15❑ NDING 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2064461535
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME GITAU FIRST NAME PETER MIDDLE M
INITIAL
17❑ STREET ❑', 1218 133RD ST S CITY' TACOMA ST WA ZIP 984443569 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NoF,/
19 DRIVER'S STATE WA SEX M D.C.B. 03 _ 02 _ 1958 39
LICENSE# MMDDYY
El
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 1 RESTR 9 EJECT 1 USE CLASS ❑
21❑ LICENSE A4273C TAre I WA VIN1t 5FYH5YUOXDC041561
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2013 MAKE NEW MODEL BUS STYLE BU VEHICLETOWED TO BLIN TOWEDBY GOV H �44
24❑ DAMAGE YES NO�/ YES N.7
REGISTERED OWNER INFO KING DEPT OF TRANSPORTATION 5004TH AVE ROOM 620 SEATTLE WA 98104 D:2062632250 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&POLICY#E CO KING COUNTYIN 1 5--E ❑ ,J� CITATION# CHARGE25 GQ
LEGALLY YES N`L J
s � a
7SHA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61931
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5425
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ELLIS ERIC D
(I.P.ST FIRST,
ADDRESS&PHONE#
936 N 198TH ST#12 SHORELINE WA 98133 2069283435 SEX M MMDOYyry 10 - 12 - 1982
SEAT HELMET INJURY NATURE OF INJURIEs
PASSENGER�WITNESS[] UNIT# 2 SOS 10 AIRBAG 1 RESTR. 1 EJECT 1 USE CLASS 17 LOWER,CENTER BACK PAIN
NAME
(LAST,FIRST,MIDDLE INITIAL) i GLOVER MICHAEL L
ADDRESS&PHONE# D O B
3231 S 146TH ST SEA TAC WA 98168 2062553202 SEX' M MMnDuvvv 02 _ 03 _ 1996
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER �WITNESS� UNIT# 2 POS 10 AIRBAG'1 RESTR. 1 EJECT 1 USE CLASS 7 LOWER BACKPA(N
NAME
(LAST FIRST,MIDDLE INITIAL) GUTIERREZ MOISES
AooREss&PHONE# HOMELESS RENTON WA 98057 2067735165 SEX 02 _ 1961
. M M D.O.B. _
09MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
SHAWN CROW 05-17-23 02:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 512012023 11:32:05 AM
BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED! 3:33 PM TIME POLICE ARRIVED',3:43 PM
PART Ei PAGE IT]OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61931
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5425
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LOPEZ PAULA V
(LAST FIRST,
ADDRESS&PHONE#
HOMELESS RENTON WA 98057 7546105222 SEXi F MMDOYyry 08 - 17 - 1974
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEXI MMDDYYYY
PASSENGER [:]WITNESSO UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
SHAWN CROW 05-17-23 02:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 512012023 11:32:05 AM
BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED! 3:33 PM TIME POLICE ARRIVED',3:43 PM
PART Ei PAGE IT]OF
REPORT NO. ED61931 CASE# 23-5425 OF COLLISION
05/13/23 15:32
OF CbLLI510N
NARRATIVE
On 05/13/2023 at about 1538 hours I was working uniform marked patrol as 1 R15 when I was
dispatched to a motor vehicle collision in the 600 block of Rainier Ave S located within the city limits
of Renton, King County, Washington. A King County Metro Rapid Fire passenger bus facing
southbound was stopped in the right turn lane just north of SW 7th St. The other involved vehicle
(Honda CR-V) was parked in the nearby Starbucks parking lot. Two bus passengers complained of
pain, but no one was transported to the hospital. Both vehicles were able to be driven from the
scene.
Vehicle 1 (2021 Honda CR-V with Washington state license plate CDT9643) was driven by Minela
Delalic. Vehicle 2 (King County Metro Rapid Fire 2013 passenger bus with Washington state license
plate A4273C) was driven by Peter M. Gitau.
Minela Delalic was preparing to drive out of the Starbucks parking lot (641 Rainier Ave S), but came
to a stop before entering onto Rainier Ave S. Minela did not see any traffic coming and began to
make a right (south) turn onto Rainier Ave S. As Minela made the turn Vehicle 2 collided into the
front driver side of Vehicle 1. Minela's 3 year old child was seated in a car seat in the rear passenger
seat of her vehicle, but neither Minela or her child were injured. Minela drove her car into the
Starbucks parking lot after the collision.
Peter Gitau was traveling southbound on Rainier Ave S and was in the right turn lane when he saw
Vehicle 1 approach and stop at the end of the driveway of the Starbucks. Peter then saw Vehicle 1
turn right onto Rainier Ave S. Peter attempted to stop the bus, but unable to stop before colliding
into Vehicle 1. The front end of Vehicle 2 collided with the front driver side of Vehicle 1. Peter was
not injured, and the bus was able to be driven from the scene.
Two passengers inside Vehicle 2 complained of pain. Eric D. Ellis was seated in a center seat
towards the back of the bus when the collision occurred. Eric said the collision flung him against a
pole which caused pain in his middle/lower back. Eric said he would find his own transportation to the
hospital for further evaluation. Eric did not see how the collision happened. Michael L. Glover was
seated toward the rear of the bus when the collision occurred. Michael said he began to stand up as
he heard the bus sound its horn. The collision caused Michael to be tossed around inside the bus.
Michael complained of lower back pain. Michael was not transported to the hospital.
Moises Gutierrez and his wife Paula V. Lopez were both seated toward the front of the bus when the
collision occurred. They both saw Vehicle 1 start to exit the Starbucks parking lot onto Rainier Ave S,
but stop. They then saw Vehicle 1 turn right onto Rainier Ave S as the bus was traveling southbound
on Rainier Ave S, and then saw the bus collide into Vehicle 1. Moises and Paula did not report any
injuries.
Minela's actions appeared to contribute to the collision after she did not grant the right of way to
Vehicle 2 as she entered Rainier Ave S from the driveway of the Starbucks. 1 cited Minela for RCW
46.61.205.1, and I sent the infraction (3A0344732) to the court for maiing.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 2
Seat Position (Passenger ERIC ELLIS): CENTER SEAT TOWARD THE BACK OF THE
BUS
Seat Position (Passenger MICHAEL GLOVER): SEATED TOWARD THE REAR OF
THE BUS
**** END OF AUTO-POPULATED SECTION ****
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. ED61 931
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-5425
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT'# 2 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1
;TYPE
2 ❑ 1 28
CARRIER KING COUNTY METRO RAPID F
NAME
3 CARRIER
ADDRESS 500 4TH AVE#320
CITY SEATTLE ST WA ZIP'', 98104
4 ❑ NAME # PLACARD: :❑
02 GI1 NAME IF NO NUMBER
SOURCE 1 AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 g
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY 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 NFln+AnnRFs.� CITY'. ST SIP
CDL IGNITION REDUIREE7 IGNITION 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 3 4 4 AREA F 43
z
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.
SHAWN CROW 05-17-23 02:14 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID# 12618 O#I',WA0171300 SCOTT 5/20/2023 PAGE OF 6
3000-345-013(R 11118)
REPORT NO. ED61931 CASE# ' 23-5425 DATE AND TIME 05/13/23 15:32
OF COLLISION
Rainier Jive S
7C
IN
'Nat:drawn to scale
Vahscle:2 '. n
Vehscle:1 k. #
I
S[arhucks
PAGE 6 OF s