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Home My WebLink About23-6403 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-6403 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 06 - 1-- 2023 1720 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ LOGAN AVE N BLOCK NO. e✓ 400 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2066433188 0 7 30 6� LAST NAME LETZKUS FIRSTNAME ERIK MIDDLE A 1 F 2 31 INITIAL STREET ❑ 4831 35TH AVE SW APT 423 CITY SEATTLE ST WA 2jp, 981262709 z= 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9� P1 ATE 14 AJ34999 STATE AZ VIN#' 1GDY7RFG1K1202488 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 5 1 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 9 9 34 13 2019 GMC SA VANA UT DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO UHAUL COMPANYOFARIZONA 2727 N CENTRAL AVE 3 SOUTH PHOENIXAZ 85004 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO UHAUL SELFINSURED 3 4 IN EFFECT &POLICY# 9TOP VEHICLE 5 36 LEGALLv Yes❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068833387 16 a LAST NAME LI FIRST NAME FENGYI MIDDLE N INITIAL 17❑ STREET ❑', 5822 32ND AVE S CITY SEATTLE ST WA ZIP 981182282 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YES❑NOR INTERLOCK YEs❑NOF YES❑NO❑ 19 DRIVER # INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY[:I] STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑ 21❑ LICENSE BWN3760 TATe WA VIN# 5TDZA23C15S378788 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2005 MAKE TOYT MODEL SIENNA STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO JINHONGL117236116THAVESE RENTONWA98058 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#ECO AMERICAN FAMILY INSURANCE 41072-58159-88 IN EFFECTVEHICLE CITATION# CHARGE25❑ LLY <E�00, LEGA YES[Z N� JAGENCY s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 26 JESSE VANDERHOEK 11631 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED67882 COLLISION REPORT III III III III III 111 1591972 CASE# 23-6403 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,FIRS 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' Vehicle #1 was traveling northbound in the 400 block of Logan Ave N. Vehicle #2 was stopped for traffic facing north in the 400 block of Logan Ave N. Vehicle #3 was stopped for traffic facing north in the 400 block block of Logan Ave N, directly in front of vehicle #2. The driver of vehicle #1 told me vehicle #2 stopped abruptly in front of him and he was unable to stop in time to avoid colliding with the rear end of vehicle #2. This caused vehicle #2 to be pushed foward, causing the front end of vehicle #2 to then collide with the rear end of vehicle #3. There were no reported injuries. Based on the totality of the circumstances, it appears the driver of vehicle #1 caused this collision. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JESSE VANDERHOEK 06-05-23 09:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 1 6/7/2023 9:44:07 AM BADGE OR ID# 11631 OR]#' > WA0171300 TIME POLICE DISPATCHED 5:22 Pry] TIME POLICE ARRIVED 5:22 PM FART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED67882 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-6403 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:4257530495 0 7 29 LAST NAME TINNEY FIRST NAME TRENT MIDDLE' L INITIAL STREET 30 NEW AnDRFSP. 11813 SE 91ST ST CITY NEWCASTLE ST WA ZIP 980562061 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES�NO� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 10 - 18 - 1988 7 ON DUTY� STATUS AIRBAG' 2 RESTR. g EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE W1561B TAr WA VIN# JTEBU5JR6H5459423 PLATE# 9 [9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2017 MAKE TOYT MODEL4RUNNER STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFO.TRENT TINNEY 11813 SE 91ST ST NEWCASTLE WA 98056 J 9 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO ((ABILITY INSURANCE INSURANCE CO STATE FARM 5076591-A26.47 gTOp IN EFFECT &POLICY# VEHICLE 1 o BarroM 34 13 IEcnuv YES NO 01 CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 36 15 LAST NAME FIRST NAME INITIALAL MDDLE ❑ ET 16 STRETRE "F-]' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK 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 ❑ 39 LICENSE vIN# PLATE# rnr 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 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 ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LecALLv 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. JESSE VANDERHOEK 06-05-23 09:59 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 11631 O#I',WA0171300 APPROVED BY 6n/2023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED67882 CASE# ' 23-6403 DATE AND TIME 06/055/23 17:20 OF COLLISION w L Not to scale \� Vehicle #3 Vehicle #2 -Vehicle #1 jffk t { 1 PAGE 4 OF 4