HomeMy WebLinkAbout23-7298 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-7298 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4900 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 06 - 1-- 2023 1133 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MONSTER RD SW BLOCK NO. e✓ 500 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a 68TH AVE SOUTH
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2062475914 0 9 30
6� LAST NAME SOLLENDER FIRSTNAME KYLE MIDDLE J 1 2 31
INITIAL
STREET ❑ 16403 22ND AVE E CITY TACOMA ST WA ZIP 984454517 z
NEW ADDRESS
7❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NOWINTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 12 1- 11 - 1974 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 9AKJ455 sTArI CA urN#' 1G1ZD5ST9NF131795
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM ro
TRLR. TRLR 5 1 33
12 2 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE g 9 34
13 2 2022 CHEV MALIBU 4D DAMAGE vEs 0NO f �LAWkkRS vEs❑ No
REGISTERED OWNER INFO I VHOLDING CORP 5721 W96TH ST LOS ANGELES CA 90045 D:2062475914 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO C�3
4
14LIABILITY INSURANCE CALIFORNIA SELF-INSURANCE 77IN EFFECTPOLICY#VEHCLE CHARGE 36
EHCLv res No clTAnoN# 3AO431077 FOLLOW VEHICLE TOO CLOSELY orroM
15❑ STANDING 7 6
MOTOR PEDAL- '.PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2526390939
LAST NAME THOMAS FIRST NAME TIFFANY MIDDLE I L
INITIAL
17❑ STREETNEW ADOREss❑I 922 STATELY PINES RD CITY NEW BERN ST' NC ZIP 285608464 4❑ 37
18❑ CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES
t l NOF,/
19[ DCENSE# STATE NC SEX F MMo D.O.B.DY 027_ 22 _ 1983 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS C/O NECK PAIN
LICENSE ❑21❑ PLA E# CGU3254 TArE WA VIN 1 41
KNDJ23AUXP7882796 1
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE KJA MODEL SOUL STYLE SV VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO PV HOLDING CORP 158201NTERNATIONAL BLVD TUKWILAWA98188 D:2526390939 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU POLICY#E CO A WS SELF-INSURANCE UNK.#IN I STOP
vE"'LE CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N�
❑ s
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED76155
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7298
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.
MATTHEW NUGENT 06-27-23 02:51 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 7/3/2023 3:23:36 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 11:38 AM TIME POLICE ARRIVED',11:45 AM
PART I PAGE IT]OF 5�
REPORT NO. ED76155 CASE# 23_7298 O COLLOTINIE
OFF CbLLI510N 06/27/23 11:33
NARRATIVE
23-7298
On 06/27/2023 at approximately 1138 hours, I was dispatched to a blocking vehicle collision at the
intersection of Monster Road SW and Beacon Coal Mine Road South, within the City Limits of
Renton, County of King, State of Washington.
While en route, Dispatch advised that there was a 3-vehicle collision at the intersection and that one
of the involved vehicles was heavily damaged and unable to move off the roadway.
Upon arrival, I confirmed that the driver of Unit#2 was complaining of neck pain and had requested
the Renton Fire Department respond for evaluation. The drivers of Unit#1 and Unit#3 did not
complain of injury. There, I collected the driving documents and independent recollection from each
of the involved parties leading up to the incident. The driver of Unit#2 was later treated by Renton
Fire at the scene and released.
The driver of Unit#1 said he was the sole occupant of his rental vehicle and was traveling northbound
in about the 500 block of Monster Road SW approaching the intersection of 68th Ave S/Beacon Coal
Mine Road, which is a "Y' shaped intersection. The driver of Unit#1 stated he was traveling directly
behind Unit#2 and saw that Unit#2 stopped at the "Y". The driver of Unit#1 said that he was unable
to stop his vehicle in time and subsequently collided with the rear of Unit#2 causing significant
damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her rental vehicle and was also traveling
northbound in about the 500 block of Monster Road SW and had reached the "Y" intersection of 68th
Ave S/Beacon Coal Mine Road. The driver of Unit#2 stated she had come to a stop with the intent to
turn left (west) at the intersection. 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.
The driver of Unit#3 said he was the sole occupant of his vehicle and was also traveling northbound
in about the 500 block of Monster Road SW and approaching the "Y" intersection of 68th Ave
S/Beacon Coal Mine Road. The driver of Unit#3 stated he has traveling directly behind Unit#1 and
observed as Unit#1 and Unit#2 collided. The driver of Unit#3 stated that he attempted to stop his
vehicle in time, but that Unit#3 collided into the rear of Unit#1 causing moderate damage to the front
of Unit#3. Additional damage to the rear of Unit#1 was caused as a result of the collision.
Based on the above statements, 1 determined that the Driver of Unit#1 (Sollender) violated RCW
46.61.145(1) as any driver of a motor vehicle shall not follow another vehicle more closely than is
reasonable and prudent, having due regard for the speed of such vehicles and the traffic upon and
the condition of the highway. Sollender was the predominant factor for the collision due to Following
too closely causing a collision.
Unit#1 had to be impounded due to extensive damage. Unit#2 was able to be driven away without
further incident. An exchange of information was provided to all involved parties.
I cited the driver of Unit#1 (Sollender) in-person for Following Too Closely causing a collision.
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 2:32 PM 6/27/2023 Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED761 55
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-7298
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:2062900540
0 1 29
LAST NAME HEYDARINIA FIRST NAME : VAHID MIDDLE
INITIAL
STREET 30
NEW AnDRFrtP 13025 64TH AVE SOUTH#3 CITY SEATTLE ST WA ZIP 98178
5 ❑ 1 1 2 31
CDL GNITION REQUIRED GNITION PRESENT MEDICAL TAN5PORTED
INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 09 TV]
- 1986
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BMG0562 TAr Wq VIN# 19XFB2F89DE206590
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 2 5 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' E FROM TO
2013 HOND CIVIC 4D DAMAGE YES NO YES NO
REGISTERED OWNER INFO.VAHID HEYDARINIA 13025 64TH AVE SOUTH#3 SEATTLE WA 98178 D:2062900540 $ 1 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
LIABILITY INSURANCE INSURANCE CO GEIC04563.71.60.10 q"i"Olx
IN EFFECT &POLICY#
VEHICLE 10 6QTTUM 34
13 ❑ Lecnuv YES❑ NO❑ CITATION# CHARGE gg�@
STANDING S} l:9 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNER YE
YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME NIITIA 35
L
❑
STRE
16 NEW ETETnnR"F] CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK 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 TAr 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 AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LERICLE 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 06-27-23 02:51 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
25 OI BADGE 11498 O#I',WA0171300 JACOBS 7/3/2023 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. ED76155 CASE# ' 23-7298 DATE AND TIME 06/27/23 11:33
OF COLLISION
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PAGE 5 OF 5