HomeMy WebLinkAbout23-6066 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-6066 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 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 1107 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 5TH PL BLOCK NO. e✓ Y900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 00 FEET e MILES S ❑ W e INDEX AVE NE
2 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:4252899928 1 4 30
6� LAST NAME INTHASONE FIRSTNAME MONIQUE MIDDLE 1 2 31
INITIAL
STREET ❑ 5131NDEX AVE NE CITY RENTON ST WA ZIP 980564068 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ vEs No�/
8❑ LDRIVER # STATE WA SEX'F MMDDYY 12 - O6 - 1994 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES z❑
USE CLASS BRUISING/PAIN ON CHEST FROM SEA TBELT
3
10❑ LI QTNFS# BJS3039 STATE WA VIN#' 3CZRU6H54GM737380
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
FROM
34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE
13 4 2016 HOND HR-V SV DAMAGE YES NO �MEYERS YES❑ NO✓
REGISTERED OWNER INFO gOUNTIlENG INTHASONE 513 INDEX AVE NE RENTONWA98056 D:4252899928 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCE CO ALLSTATE 917092 750
IN EFFECT &POLICY#
VEwcLE ❑ 36
LEGALLY YES❑NO CITATION# 3AO431056 CHARGE INATTENTIVE DRIVING BOTTOM
15❑ STANDING
UNIT a2 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ DYES 1/ OLD M
MOTOR PEDAL- NO ET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME ' MIDDLE
INITIAL
STREET CITY BURIEN ST ZIP 4
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK vEs It I NOF YES
t l NOF,/
19 LLIICENS RIVEWS# STATE SEX U MMDDYY 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG g RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
LICENSE ❑21❑ PLA E# CBA4552 TATe 41
WA VIN# JHLRD78875CO28840 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2005 MAKE HOND MODEL CR-V EX STYLE SV VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SOVANNARITSON1214S138THST BURIENWA D:2068164971 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO UNOCCUPIED OWNER NOT PRESENTIN STOP
g
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 BOTTOM
ALLY YES $ '
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED65639
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6066
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.
MATTHEW NUGENT 05-30-23 12:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 513112023 12:39:43 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 11:08 AM TIME POLICE ARRIVED',11:12 AM
PART I PAGE IT]OF 5�
REPORT NO. ED65639 CASE# 23-6066 OF COLLISION
05/29/23 11:07
OF CbLLI510N
NARRATIVE
23-6066
On 05/29/2023 at approximately 1108 hours, I was dispatched to an unknown-if-injury vehicle
collision in front of 2912 NE 5th PL, within the City Limits of Renton, County of King, State of
Washington.
While en route, Dispatch advised that there was a single motor vehicle into a parked vehicle collision
and that the involved vehicle had rolled over onto its roof and was blocking the all lanes of travel of
NE 5th PL.
Upon arrival, I contacted the driver of Unit#1 who had already crawled out from the vehicle. Due to
heavy mechanism and airbag deployment on the involved vehicle, I requested Renton Fire respond
for a precautionary evaluation of the involved party. The driver of Unit#1 stated she did not sustain
any serious injuries but did have visible bruising near her chest where her seatbelt was secured.
Renton Fire later responded to the scene and evaluated the involved driver. The driver of Unit#1
declined further evaluation/transport to the hospital. Family members responded to the scene and
assisted in getting the driver of Unit#1 back home.
The driver of Unit#1 said she had just departed her residence on Index Ave NE. The driver of Unit#1
began traveling northbound on Index Ave NE before reaching the intersection of NE 5th PL. The
driver of Unit#1 made an eastbound turn and began traveling east on NE 5th PL. The driver of Unit
#1 stated that there was an uninvolved vehicle that was approaching from the opposite direction and
that she was had swerved to avoid contact with the other vehicle. The driver of Unit#1 stated that she
swerved into Unit#2, which was parked and unoccupied, and caused her vehicle to rollover and
come to a rest on the roof of the vehicle. As a result, Unit#1 suffered initial damage to the front
passenger corner of the vehicle but then sustained significant damage upon the vehicle rolling over.
A nearby resident showed me surveillance footage of the incident. The video shows another
uninvolved vehicle driving westbound on NE 5th PL but it does not appear to have been in the way or
cause any issues with Unit#1's lane of travel. A copy of the video was sent to me which has since
been uploaded to Axon Evidence.
Based on the above statements, 1 determined that the Driver of Unit#1 (Inthasone) was the
predominant factor for the cause of collision as Inthasone was not paying attention to the roadway
and appeared to unnecessarily swerve into a parked and unoccupied vehicle.
Inthason violated Renton Municipal Code (RMC) 10-12-25-Inattentive Driving is defined as any
person to drive a motor vehicle on any public highway, street, alley, or road in an inattentive manner
in the City of Renton. "Inattentive manner" in this section means a lack of: 1) attentiveness required to
safely operate the vehicle under the prevailing conditions, including, but not limited to, the nature and
condition of the roadway, the weather conditions, the presence of pedestrians, the presence of other
traffic, or by the driver focusing or directing the driver's attention to something other than driving the
motor vehicle; or 2) attentiveness that would permit the driver of a motor vehicle to observe anything
resting on, or traveling on, or entering the roadway in time to take appropriate action as
circumstances require. (Ord. 4462, 7-25-94, eff. retroactive to 7-1-94; Ord. 5635, 11-14-11). 1 cited
Inthasone via mail for Inattentive Driving.
Unit#1 had to be impounded due to extensive damage. An exchange of information was provided to
the driver of Unit#1 and the girlfriend to the owner of Unit#2. Unit#2 was off the roadway but would
likely require a tow truck due to extensive damage.
PAGE 3 OF 5
REPORT NO. ED65639 CASE# 23-6066 OF COLLISION
05/29/23 11:07
OF CbLLI510N
NARRATIVE
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 5/30/2023 12:11 PM Renton, King County, WA.
PAGE 4 OF 5
REPORT NO. ED65639 CASE# ' 23-6066 DATE AND TIME 05/29/23 11:07
OF COLLISION
LU
z .
> aI
'Diagram rant to sC.le- Q .1
C a
Unit#1
NE 5th PL
aa61112
PAGE 5 OF 5