HomeMy WebLinkAbout23-5539 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-5539 2 0 7
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 05 - 1-- 2023 1801 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e✓ 3300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e MONROE AVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2535451914 0 3 30
6� LAST NAME PARSONS FIRSTNAME ANNE MIDDLE L 1 1 2 31
INITIAL
STREET ❑✓ 19104 113TH WAY SE CITY RENTON ST WA 71p 98055 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ P1aT�S� CDK9758 sTArr WAurN# JM1GL1U5XH1138507
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 3 1 34
13 2 2017 MAZE) 6 SO DAMAGE vE8 0NO agW�MEYER vEs❑ No
REGISTERED OWNER INFO ANNE PARSONS 25335109TH CT SE APT C304 KENT WA 98030 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILI INSURANCE INSURANCE CO USAA 0180722187101
IN EFFECT &POLICY# STOP
15❑ LE
vEGALLY HICLe 1 5 36
YES�No D CITATION# 3A0081176 CHARGE FOLLOW VEHICLE TOO CLOSELY )o sorrow
STANDING 8 7 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067591957
16 a
LAST NAME KHOZHIEV FIRST NAME DENIS MIDDLE
INITIAL
17❑ STREET NEW ADOREss❑' 1332 DUVALL AVE NE APT B323 CITY RENTON ST WA ZIP 980594354 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.O.B. 04 08 _ 1980 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 40
USE CLASS NECK PAIN
❑LICENSE I 21❑ PLA E# CFG0848 TArE 41
WA VIN# 1FAHP53266A245824 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2006 MAKE FORD MODEL TAURUS STYLE SO VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DENIS KHOZHIEV 1332 DUVALL AVE NE APT B323 RENTONWA98059 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 5288639-E23-47AIN 1 STOP
"'LE ❑ ,.I— CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
GREGORY BILLS 12495 WA0171300
1
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61930
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5539
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.
GREGORY BILLS 05-16-23 07:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 512012023 11:32:08 AM
BADGE OR ID# 12495 ORI# WA0171300 TIME POLICE DISPATCHED! 6:01 PM TIME POLICE ARRIVED',6:01 PM
PART Ei PAGE IT]OF 4�
REPORT NO. ED61930 CASE# 23-5539 OF COLLISION
05/16/23 18:01
OF CbLLI510N
NARRATIVE
On 05/16/2023 at 1801 hours I was on routine patrol at the intersection of NE 4th St/ Monroe Ave
NE, in the City of Renton, King County, Washington. I observed two vehicles stopped in the
intersection blocking traffic. Both vehicles were damaged and two people nearby were on the phone.
It appeared they had been involved in a recent collision. There were no pending 911 calls for the
collision yet, suggesting it just occurred.
In this report, Unit 1 refers to a red 2017 Mazda 6 (WA/CDK9758) driven by Anne Louise Parsons
(DOB 07/23/2001, WA DL). Unit 2 refers to a blue 2006 Ford Taurus (WA/CFG0848) driven by Denis
Khozhiev (DOB 04/08/1980, WA DL). There were no passengers in either vehicle.
I interviewed both drivers, who gave the same account of what happened. Unit 1 and Unit 2 were
driving westbound in lane 2 of 2 on NE 4th St. They had a green light for their westbound lane. Upon
reaching Monroe Ave NE, Unit 2 initiated a right turn. However, his path was blocked by a bicyclist in
the crosswalk. Unit 2 stopped to allow the bicyclist to cross the road and Unit 1 crashed into the back
of Unit 2. There was damage to the front passenger side corner of Unit 1 and matching damage on
the rear driver side bumper of Unit 2.
Anne told me she saw Unit 2 initiate the right turn, so she thought she was clear to continue
westbound. She did not notice Unit 2 stop for the bicyclist, and rear-ended Unit 2.
Denis complained of neck pain so I requested Renton Fire respond to evaluate him. They cleared him
medically. Anne did not complain of any injuries.
Unit 2 was drivable so I asked Denis to move it into a nearby parking lot, which he did. Unit 1 was not
drivable so I requested a tow truck respond to the scene. Gene Meyer towed Unit 1.
Based on the foregoing investigation, I established probable cause Anne committed the traffic
infraction of Following too Closely, RCW 46.61.145. Anne did not leave enough space to stop when
Unit 2 had to stop for the pedestrian. I informed Anne the ticket would be sent in the mail and she
confirmed her correct mailing address.
I provided both parties a SECTOR exchange of information form.
This concludes my involvement in this case.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. Gregory Bills #12495, 05/16/2023 at 1901 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. ED61930 CASE# ' 23-5539 DATE AND TIME 05/16/23 18:01
OF COLLISION
LNZ
Not to Scale
Bicyclist
Unit 2
Unit
NE 4th St
Impact
Monroe Ave NE
PAGE 4 OF 4