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Home My WebLink About23-7893 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-7893 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AGENCI 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� TOTAL#OF OBJECT 1 1 8 2$ TRIBAL UNITS 04 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 07 - 10 - 2023 1837 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 2500 ❑ 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �,❑ FEET e S ❑ W e EDMONDS AVE NE 2 0 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El No ,/ I D:9706858135 0 11 30 6� LAST NAME HART FIRSTNAME AVALON MIDDLE C 1 1 2 31 INITIAL STREET ❑✓ 11400 MAIN ST RM 502 CITY BELLEVUE ST WA ZIP 98004 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ,/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ ❑ DRIVER'S' STATE CID SEX'F M".O B 01 1- 07 - 2003 2 32 8 LICENSE# 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 INJURY CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 ATE 14 5242977 STATE CO VN# JS2YB5A36C6302175 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# Rom To TRLR. TRLR 3 7 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34 13 4 2012 SUZ/ SX4 4D DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO STATE FARM 5640058-E15.06 3 4 IN EFFECT &POLICY# STOP VEHICLE CHARGE 1 5 36 LEGALLY YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 7 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:4252239779 16 a LAST NAME SOMSAK FIRST NAME BYRON MIDDLE W INITIAL 17 STREET❑ NEW ADDREss❑' 3816 NE 6TH STREET CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK yyEEsl I I NOF YES t l NO� 19 D IVEW # STATE WA SEX M M.O.B. 07 31 1986 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑21❑ PLA E# STRLORD TATE WA vIN# JF2(BPABC8G8279881 41 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR 'I GoI VEH YEAR 2016 MAKE $(JB�Q MODEL CROSS7- STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY v HyES NO,/ 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DAGED AREA 4 LIABILITY INSURANCE &POINSURGY#E CO STATE FARM 1066978-C20-47GIN STOP 5 'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM LEGALLY YES N 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JONATHAN SELBERT 12641 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED80063 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7893 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. JONATHAN SELBERT 07-10-23 09:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 711612023 2:32:53 PM BADGE OR ID# 12641 OR]# WA0171300 TIME POLICE DISPATCHED 6:40 PM TIME POLICE ARRIVED',6:46 PM PART Ei PAGE IT]OF REPORT NO. ED80063 CASE# 23-7893 OF COLLISION 07/10/23 18:37 OF CbLLI510N NARRATIVE On 7/10/2023, at 1840, 1 responded for an assignment for an Accident at the intersection of NE Sunset Boulevard and Edmonds Avenue NE, in the City of Renton, King County, Washington State. Call notes stated that four vehicles were involved and that a Subaru Crosstrek was blocking a lane of traffic. I arrived and observed a black Subaru Crosstrek (Vehicle 2) with stopped in the westbound left turn lane of NE Sunset Boulevard. I observed that it had significant front and driver's side damage and appeared disabled. On the west side of southbound Edmonds Avenue, I observed three other vehicles parked off of the roadway. These were a red Suzuiki (Vehicle 1), a silver Volvo (Vehicle 3), and a grey Honda (Vehicle 4). 1 met with the drivers of these vehicles on Edmonds. They informed me they had all exchanged insurance information. Each driver made the following statements: Driver 1 stated that she had been stopped behind a bus in the far-right lane of Sunset traveling westbound. She turned on her left turn signal and attempted to drive around the bus. She looked in her rear-view mirror before doing so and saw Vehicle 2 approaching, but believed she had ample space to maneuver her vehicle. She pulled into the center lane of Sunset and observed Vehicle 2 attempt to go around her on the left. At that time, Vehicle 2 struck Vehicles 3 and 4. Driver 2 stated that he was traveling westbound on Sunset when Vehicle 1 suddenly entered his lane. Vehicle 1 struck his vehicle on the passenger side, forcing his vehicle into the left turn lane where it collided with Vehicles and 4. Driver 3 stated that he was stopped behind Vehicle 4 in the left-hand turn lane of westbound Sunset when his vehicle was struck by Vehicle 2. He stated that the collision had enough force to push his vehicle over the small yellow concrete divider in the center of the roadway. He directed my attention to his rear driver-side tire and I observed yellow paint-similar to that of the curb's -on his tire. Driver 4 stated that he was stopped in the left-hand turn lane of westbound Sunset at the traffic light when a vehicle struck his from behind. He let his foot off of the brake as he was struck, and believes this is the reason why damage to his vehicle was minimal. All drivers stated they were uninjured. I observed minor damage to the driver's side wheel covers of Vehicle 1. I observed significant damage to the front and both sides of Vehicle 2. 1 observed damage to the passenger side of Vehicle 3. 1 noted that the doors opened and closed with difficulty. I observed yellow paint on the rear passenger tire. I observed minor damage to the rear of Vehicle 4. Vehicle 2 was able to be moved off of the roadway and a private tow was arranged. I photographed the vehicles and uploaded the photos via Axon Capture. PAGE 3 OF 6 REPORT NO. ED80063 CASE# 23-7893 OF COLLISION 07/10/23 18:37 OF CbLLI510N NARRATIVE My involvement in this incident was captured on my body-worn and in-car camera. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer J. Selbert (12641) in the City of Renton, King County, Washington State on 7/10/2023 at 2117. PAGE 4 OF 6 SUPPLEMENTAL REPORT NO. ED80063 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-7893 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 1 8 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:4253057056 0 8 29 LAST NAME : CHANG FIRST NAME ALEX MIDDLE'.. R INITIAL 0 8 30 STREET NFW AnnRFsP 3813 206TH PL NE CITY SAMMAMISH ST WA ZIP 1 98074 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YES N ✓ DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 03 - 15 - 2002 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE 348XMQ TAr WA VIN# YV4CZ982281452600 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR VIN.It VIN.#. 11 3 5 VEH.YEAR2008 MAKE VOLV MODELXC90 STYLE UT I VEHICLE TOWE E T SABLIN TOWED BY anvi vEH1C P FROM TO DAMAGE YES NO ✓ YES NO ✓ 33 12 SHADE IN DAMAGED AREA REGISTERED OWNER INFOOWNED BY DRIVER J 9 3 5 LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 912794585 FROM To IN EFFECT ✓ &POLICY# 5 4 TLSP S 9 9 VEHICLE 1060T1Y)M 9 34 13 ❑ LEGALLY YESZ NO❑ CITATION# CHARGE STANDING 8 7 6 DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAL ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:4257362295 ❑� JOHNSON COLIN MIDDLE '.A 36 15 LAST NAME FIRST NAME INITIAL 2 STREET 16 ❑ ❑; 4720 SOMMERSET AVE SE CITY', BELLEVUE ST WA ZIP 98006 NFln+AnntxFss CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YES Nb✓ INTERLOCK YEs NC7✓ YEs No�/ EDRIVER'S D.O.B 37 LICENSE# STATE WA SEX M MMDDyYY' 04 - 15 - 1997 18 ❑ ON DUTY❑ STATUS AIRBAG 2 RESTR, 4 EJECT 1 1 HELMET 2 INJURY 1 NATURE OF INJURIES 38 19 USE CLASS ❑ ❑ PLATE# 530XOY Tnr WA v+N# 5FNYF18378BO37601 3 39 20 ❑ TRAILER' STATE TRAILER ST 40 PLATE#< PLATE# ATE 21 ❑ ❑ 41 TRLR TRLR ViN# YIN#i 42 22 VEH.YEAR2008 MAKE HOND MODEL PILOT STYLE U7. VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1 DAMAGE YES NO ✓ YES NO ✓ 23 ❑ REGISTERED OWNER INFO OWNED BY DRIVER SHADE IN DAMAGED AREA 43 z s LIABILITY INSURANCE INSURANCE CO USAA 02838 63 04f 9'1'OP ❑ IN VEHICLE &POLICY# i " 44 24 LE E A tvi LE YESZ NO CITATION CHARGE iq BOTTOM LEGALLY STANDING 8 7 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JONATHAN SELBERT 07-10-23 09:18 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 12641 O#I',WA0171300 SCOTT 7/16/2023 PAGE❑OF❑ 3000-345-013(R 11118) REPORT NO. ED80063 CASE# ' 23-7893 DATE AND TIME 07/10/23 18:37 OF COLLISION a VA 7 W i 7 L^ "6 Q w W PAGE 6 OF s