HomeMy WebLinkAbout23-7653 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-7653 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 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 07 - 1-- 2023 1255 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ 500 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ w a SENECA AVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4057062713 0 7 30
g� LAST NAME THATCHER FIRSTNAME ERIC MIDDLE A 1 1 2 31
INITIAL
STREET ❑✓ 11844 26TH AVE SOUTH#106 CITY SEATTLE ST WA ZIP' 98168 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER # STATE OK SEX'M MD.
I B Y' 02 - 11 1- 1998 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 CLASS 1 I INJURY NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 72684 STATE OK VIN#' 2HNYD18835H506457
TRAILER STATE TRAILER STATE
11 3 51 PLATE# PLATE# FROM TO
TRLR 7 3. TRLR 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34
13 2 ZOOS ACUR MDX SV DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 970100349 3 4
IN EFFECT &POLICY# STOP
VERGES CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# W23010266 INATTENTIVE DRIVING 1 o aorrom
15❑ STANDING 7 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO 0 2532223322
16 a
LAST NAME HUYNH FIRST NAME NGOC MIDDLE I T
INITIAL
17❑ STREET Is❑' 8057 YAKIMA AVE CITY' TACOMA ST WA ZIP 984084102 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. 03 _ 16 _ 1971 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# AXY3282 TATE 41
WA VIN# JF2SJAHC7GH463812 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2016 MAKE SUBA MODEL FORESTS STYLE 4W VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO THUYHUYNH 8057 YAKIMA AVE TACOMA WA 98408 D:2532223322 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO GEIC04615-57-59-19IN STOP
'E""LE CITATION# CHARGE
LEGAL
25 i o BOTTOM
LY YES Nu
❑ s a
=UGENT
PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED78175
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7653
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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 07-06-23 02:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 711012023 11:15:31 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 12:59 PM TIME POLICE ARRIVED',1:12 PM
PART I PAGE IT]OF 5�
REPORT NO. ED78175 CASE# 23-7653 OF COLLISION
07/05/23 12:55
OF CbLLI510N
NARRATIVE
23-7653
On 07/05/2023 at approximately 1259 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of Southwest Grady Way and Seneca Ave Southwest, within the
City Limits of Renton, County of King, State of Washington.
Upon arrival, I confirmed there were no complaints of injury from either of the involved parties. There,
I collected each of the involved parties driving documents and their independent recollection of the
events leading up to the collision.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling eastbound in
about the 500 block of SW Grady Way approaching the intersection of Seneca Ave SW in lane 2 of 2.
The driver of Unit#1 stated he was traveling directly behind Unit#2 and saw as Unit#2 had suddenly
stopped for traffic. The driver of Unit#1 was unable to stop in time subsequently colliding with the
rear of Unit#2 causing moderate damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling eastbound
in about the 500 block of SW Grady Way approaching the intersection of Seneca Ave SW in lane 2 of
2. The driver of Unit#2 came to a stop for queued traffic at the intersection ahead. The driver of Unit
#2 stated that while stopped, Unit#1 collided with the rear of Unit#2 causing moderate damage to
the rear of Unit#2. As a result of the initial collision, Unit#2 was pushed forward and collided into the
rear of Unit#3 causing additional damage to the front of Unit#2.
The driver of Unit#3 said he was the sole occupant of his vehicle and was traveling eastbound in
about the 500 block of SW Grady Way approaching the intersection of Seneca Ave SW in lane 2 of 2.
The driver of Unit#3 stated he was stopped for queued traffic at the intersection ahead. The driver of
Unit#3 stated that while stopped, Unit#2 collided with the rear of Unit#3 causing minor damage to
the rear of Unit#3.
Based on the above statements, 1 determined that the Driver of Unit#1 (Thatcher) was the
predominant factor for the cause of collision due to inattention causing a collision. I issued Thatcher a
written warning for Inattention.
All of the involved vehicles were able to be driven away without further incident. An exchange of
information was provided to all involved parties.
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 7/6/2023 2:31 PM Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED781 75
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-7653
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GI NAME 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:4252358037
OF 7 29
LAST NAME JOFUKU FIRST NAME : SCOTT MIDDLE M
INITIAL
STREET 30
NEW AnDRFrtP 7138 134TH CT SE CITY NEWCASTLE ST WA ZIP 980593003
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 06 TO]
- 1961
7
ON DUTYl STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE APR6340 [TAT WA VIN# 5FNYF4H28EB022190
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' E FROM TO
2014 HOND PILOT SV DAMAGE YES NO YES NO
REGISTERED OWNER INFO SCOTT JOFUKU 7138134TH CT SE NEWCASTLE WA 98059 D:4252358037 J 9 33
12 � SHADE IN DAMAGED AREA
34 FROM TO
((ABILITY INSURANCE INSURANCE CO pEMC0 CA 07804t0 GQO
IN EFFECT &POLICY#VEHICLE 34
13Lecnuv YES NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE INITIAL
TIAL
❑
ET
16 STRETRE "F ' CITY ST ZIP
NEW CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES No NTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE CLASS
19 ❑ LICENSE TAT VIN# 39
PLATE#
20 ❑ TRAILER TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
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 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
MATTHEW NUGENT 07-06-23 02:49 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 11498 O#IL..WA0171300 JACOBS 7/10/2023 PAGE 4 OF
F5
3000-345-013(R 11118)
REPORT NO. ED78175 CASE# ' 23-7653 DATE AND TIME 07/05/23 12:55
OF COLLISION
., j
a
c
J
f cn ,,`�SW Grady Way
w
a
v
v
PAGE 5 OF 5