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Home My WebLink About23-7570 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-7570 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;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 1643 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW 43RD ST BLOCK NO. e✓ 1000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �,❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:2533477676 0 7 30 6� LAST NAME POWELL FIRSTNAME QUANDRELL MIDDLE R 1 1 2 31 INITIAL STREET ❑ 20357105TH CT SE CITY KENT ST WA 21p 980315569 z NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R No�/ 8❑ LRIIVERS STATE WA SEX'M MM DAY' 04 1- 16 - 1994 2 32 CENSE 9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H USEET 2 CLASS 7 [NATURE OF HAND INJURYRIEs z❑ 3 ,OF] P1 aTS AZN0435 sTAr WA u N# 5N1A22MH3FN235246 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# Rom To TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE J 9 34 13 2 2015 NISS MURAN DAMAGE vEs 0NO f �AWkkRS vEs❑ No REGISTERED OWNER INFO QUANDRELL POWELL 2LI357105TH CT SE KENT WA 98031 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 2 INSURANCE CO 3 4 14 LIABILITY INSURANCE STATE FARM UNK IN EFFECT &POLICY# 9TOP VEwcLE CHARGE 10BOTTOM 5 36 -ALLv YES No CITATION# 3A0492513,3AO492514 INATTENTIVE DRIVING,OP MOT VEH 15❑ STANDING 8 7 6 MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:5039532099 16 a LAST NAME SMITH FIRST NAME TIA IN DOLE M IN MIDDLE 17❑ STREET ❑', 24617 36TH AVE S CITY' KENT ST WA ZIP 980324104 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOF INTERLOCK YEs It I NOF YES t l NOF%/ 19 F] DRIVER'S STATE WA SEX F D.C.B. 10 _ 07 1975 El 39 LICENSE# MMDDYY WELMET {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑ 21❑ LICENSE AMU2984 TAre WA VIN# USE ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2007 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBv GOV HI 44 24❑ DAMAGE YES'/ NO BANKERS YES 11 REGISTERED OWNER INFO TIA SMITH 2461736TH AVE S KENTWA98032 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE 8POINSURGY#ECO STATE FARM 3807811-1314-47AIN VEwGLE CHARGE <E�� LEGALLY YESZ N� CITATION# 25❑ J s a 7KLANE S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 10008 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED82453 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7570 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' Unit 3 was stopped for traffic on westbound SW 43rd ST in the 1000 blk backed up from a red light at Oakesdale AVE SW in the left lane. Unit 2 slowed and stopped behind Unit 3 also on westbound SW 43rd ST. Unit 1 was approaching Unit 2 and Unit 3 on westbound SW 43rd ST. Driver 1 states that Unit 2 came to a quick stop and he did not have time to stop in time. The front end of Unit 1 struck the rear end of Unit 2 causing moderate and disabling damage. The force of this collision sent Unit 2 forward and the front end of Unit 2 struck the rear end of Unit 3 causing minor damage. Driver 1 was cited for inattentive driving for not driving with due care and caution to realize traffic was stopped in front of him which was the proximate cause of the collision. At the time of the collision, Driver 1 stated he had insurance and his mother attempted to bring it up. left him a card with instructions to email me proof of insurance. As of 07/12/2023 1 have not received proof and attempts to call him went straight to voicemail. Driver 1 cited for operating a motor vehicle without insurance. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 07-12-23 10:06 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 7/24/2023 11:28:31 AM BADGE OR ID# 10008 ORI# WA0171300 TIME POLICE DISPATCHED 4:46 PM TIME POLICE ARRIVED',4:50 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED82453 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-7570 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 t_"J CYCLE _) PEDESTRIAN � OWNER � YES NO D:7146532272 OF 7 29 LAST NAME MORALES FIRST NAME EDDIE MIDDLE INI r:�j TIAL STREET 30 NFW Anr)RFS9+ 4739 44TH AVE S W#203 CITY SEATTLE ST WA ZIP 98116 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 05 - 13 - 1993 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BTH6791 TAr Wq VIN# 4S3GKAB62K3613593 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 3 5 VEH.YEAR2019 MAKE SUBA MODELIMPREZA STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOEDDIE MORALES 6216 S 242ND PL APT 303 KENT WA 98032 J 9 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 937980783 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNER YE 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 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 VEHICLE 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. K.LANE 07-12-23 10:06 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 10008 O#IL WA0171300 JACOBS 712412023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED82453 CASE# ' 23-7570 DATE AND TIME 07/03/23 16:43 OF COLLISION CS 0 > I ME x m ***NOT TO SCALE*** m C m PAGE 4 OF 4