HomeMy WebLinkAbout23-6438 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-6438 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4150 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#
cowsloN 06 - 1-- 2023 0807 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH BLOCK NO. e✓ 6100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e ROSAR/O
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2067870091 0 11
30
6� LAST NAME DANG FIRSTNAME LINDSEY MIDDLE M 1 1 2 31
INITIAL
STREET ❑, 328 ROSARIO PL NE CITY RENTON ST WA ZIP 980594542 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 6 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� AMN3383 sTArI WAvIN# 1FM5K7D80DGA79168
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 1 33
12 4 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 2O13 MAKE FORD MODEL EXPLOR STYLE
F1VEHICLE TOWED NOO pLSSBLIN T,QVyEq.BLRs yOS❑ENIC O✓ 3 7 34
DAMAGE ILJI tSA1Wl6
13 REGISTERED OWNER INFO WESLEYDANG726MARTINLUTHERKINGJRWAYSEATTLEINA98144 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCECO AMERICAN FAMILY CONNECT A104218501 <1�3 4
IN EFFECT &POLICY# TOPvENICLE CHARGE 36
LEGALLv YEs No clTAnoN# 3A0387730 FAIL TO YIELD MOTOR VEHICLE orrom
15❑ STANDING 6
MOTOR ✓ PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062515324
16 a
LAST NAME BENSON FIRST NAME DEBRA MIDDLE I,/
INITIAL
17❑ STREET ❑', 18566 SE 246TH PL CITY COVINGTON ST WA ZIP 980424827 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l No❑
19 DRIVER #
INJURY 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 USE CLASS LEG PAIN
21❑ LICENSE I BKJ9112 TAre WA VIN# 5XYPHDA51JG431175
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 201E MAKE KJA MODEL SORENT STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO DEBRA BENSON 18556 SE 246TH PL COVINGTON WA 98042 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO ALL STATE 987 914 297IN 1 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.M/TCHELL 10377 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED70712
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6438
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,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'
On 06/06/23 1 responded to a 2-vehicle injury/blocking collision at NE 4th and Rosario Ave NE.
I contacted the driver of unit 2 who told me they were traveling westbound in the #1 lane of NE 4th St
when unit 1 crashed into the driver side of her vehicle. The impact of the collision caused heavy
driver-side damage to unit 2. Renton Fire was called to the scene to observe the driver who
complained of left leg pain. Unit 2 was impounded by Bankers Towing.
I contacted the driver of unit 1, identified Lindsey Dang (dob 09/21/05) via her WA DL. Dang told me
she was stopped at the stop sign (northbound Rosario Ave NE) waiting to drive across NE 4th. Dang
says she did not see unit 2 approaching on westbound NE 4th. Dang entered NE 4th and collided
with unit 2. Dang did not complain of injury. Unit 1 sustained heavy front-end and side damage and
was impounded by Bankers towing.
But not for the action of UNIT 1 DRIVER the result would not have happened.
I cited Dang via SECTOR under RCW 46.61.180 -Failure to Yield
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.MITCHELL 06-06-23 12:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 6/16/2023 8:34:33 AM
BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED 8:07 AM TIME POLICE ARRIVED]8:15 AM
PART I PAGE IT]OF
REPORT NO. ED70712 CASE# 23-6438 DATE AND TIME 06/06/23 08:07
OF COLLISION
NE 4TH ST
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