HomeMy WebLinkAbout23-5488 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 23-5488 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# ❑
cowsloN 05 - 1-- 2023 1457 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
EAST VALLEYHWY BLOCK NO. e✓ 4200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 300 00 FMILES N EET e S B OF SW 43RD STREET
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068830664 0 11
30
6� LAST NAME WESTMILLER FIRSTNAME ADRIENNE MIDDLE N 1 2 31
INITIAL
STREET ❑✓ 1259 WEILAND STREET#A10 CITY KENT ST WA ZIP 98030 z
NEW ADDRESS
❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
7
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CG66476 sTArI WAvIN# KM8R2DGE8PU550670
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR. YRLR. 5 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2023 HYUN PALISA SV DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO ADRIENNE WESTMILLER 1259 WEILAND STREET#A10 KENT WA 98030 D:2068830664 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 4469132130 3 4
IN EFFECT &POLICY# STOP
VE—L' CHARGE 1 5 36
LEGALLY YES No CITATION# W23010254 PROHIBITED U TURN I o aorrom
15❑ STANDING 6
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068176019
16 a
LAST NAME BEN FIRST NAME VITALIY MIDDLE
INITIAL
17 STR❑ NEW EETADDREs7 11122 SE 316TH PL CITY AUBURN ST WA ZIP 980925307 37
18❑ CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NoF,/
19 DRIVER'S STATE WA SEX M D.O.B. 07 1 04 1989 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BRK7537 TArE 41
WA VIN# SALWR2PF8GA590712 1
42
22❑ PLATE# STATE PLATE ILER# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2016 MAKE LNDR MODEL RANGE STYLE SI/ VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VITALIY BEN 11122 SE 316TH PL AUBURN WA 98092 D:2068176019 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#ECO STATE FARM 4240244-D27-47AIN 1 STOP 5
'E"'LE ❑ N J
,J� CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED65535
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5488
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BLOCK JASON M
(LAST FIRST,
ADDRESS&PHONE# D.0.B.
1258 WEILAND ST APT B12 KENT WA 980304764 2068830664 SEX M MMDDYYYY 05 - 07 - 1977
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ [] 1 POS. 3 2 4 1 USE 2 CLASS ;1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
MATTHEW NUGENT 05-15-23 06:04 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 513112023 9:26:23 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 3:00 PM TIME POLICE ARRIVED i 3:21 PM
PART I PAGE IT]OF 4�
REPORT NO. ED65535 CASE# 23-5488 OF COLLISION
05/15/23 14:57
OF CbLLI510N
NARRATIVE
23-5488
On 05/15/2023 at approximately 1500 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of East Valley Highway and SW 43rd Street, within the City Limits
of Renton, County of King, State of Washington.
Upon arrival, I confirmed there were no complaints of injury requiring immediate medical response at
the time of report. There, I collected each of the involved parties driving documents and their
independent recollection of their involvement leading up to the collision.
The driver of Unit#1 stated that she and her adult passenger were traveling northbound in about the
4200 block of East Valley Hwy in lane 1 of 2. The driver of Unit#1 stated that she was intending to
make a U-turn to proceed back southbound on East Valley Hwy. The driver of Unit#1 stated she
slowed her vehicle and looked for other traffic. The driver of Unit#1 stated she did not see any traffic
before proceeding to make a U-turn. Unit#1 claims to not have seen Unit#2 also traveling
northbound on East Valley Hwy and occupying the adjacent lane next to Unit#1. As Unit#1
proceeded to make a U-turn, Unit#1 and Unit#2 collided. As a result, Unit#1 suffered moderate
damage to the front driver's side quarter panel, bumper, and headlight housing.
The driver of Unit#2 said he was the sole occupant of his vehicle and was also traveling northbound
in about the 4200 block of East Valley Hwy, but in lane 2 of 2. The driver of Unit#2 stated he saw Unit
#1 directly in front of him but in lane 1 of 2. The driver of Unit#2 stated that while traveling in his lane
of travel, he noticed as Unit#1 slowed down and began to turn to the left. The driver of Unit#2 was
unsure of what Unit#1 was doing and proceeded to go into the center-turn-lane to go around Unit#1,
not realizing Unit#1 was attempting a U-turn directly in front of Unit#2. The driver of Unit#2 stated
he tried to avoid the collision but subsequently both vehicles collided causing moderate damage to
the rear passenger side of Unit#2.
Based on the above statements, 1 determined that the Driver of Unit#1 (Westmiller) was the
predominant factor for the collision due to an improper U-turn causing a collision. The driver of Unit
#1 did not grant the right of way to Unit#2 traveling in the roadway which had the right of way. Per
RCW 46.61.295, the driver of any vehicle shall not turn such vehicle so as to proceed in the opposite
direction unless such movement can be made in safety and without interfering with other traffic.
I issued Westmiller a written warning for an improper U-turn.
Both Unit#1 and Unit#2 were able to be driven away without further incident. An exchange of
information was provided to all involved parties.
This incident was audio and video recorded via Axon BodyCam.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 6:02 PM 5/15/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED65535 CASE# ' 23-5488 DATE AND TIME 05/15/23 14:57
OF COLLISION
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