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Home My WebLink About23-6997 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-6997 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OS 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 0704 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 3RD ST BLOCK NO. e✓ 2100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 200 00 FMILES EET e S ❑ W e BLAINEAVENE 0 1 29 UNIT MOTOR E Z CYVEHICCLE ElDDAMYESA✓NOESHOLD MET PHONE 0 1 30 6 LAST NAME REYES MENJIVAR FIRST NAME FLOR MIDDLE D 1 1 2 31 INITIAL STREET ❑, 2128 S 272ND ST APT C309 CITY KENT ST WA 2jp, 980327958 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ DRIVERS E# ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 H USEET ICNLJAUSSY 7 NAART�RE OF INJURIES 2❑ 3 10 9❑ P1 aT�S� CBR4116 sTArI WAVrN# 1FMFU18586LA31701 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 ] 34 13 2 2006 FORD EXPEDI DAMAGE YES NO MEYER YES[:] NO✓ REGISTERED OWNER INFO PEDRO ARIAS MENA 4801115TH STREET CT SWAPT 5 LAKEWOOD WA 98499 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO SAME. 3 IN EFFECT &POLICY# 9TOP vE—LL CHARGE 5 36 EGALLv re6 No CITATION# 3A0329681 SPEED TOO FAST FOR CONDITIONS o eorrom 15❑ STAIN.D'ING 7 6 UNIT VE IMOTOOR Z CYCLE ❑ PEDESTRIAN ❑ OWNER RTY ❑ DYES / H OLD MET PHONE 16 a LAST NAME ALI FIRST NAME IBRAHIM MIDDLE 1 O INITIAL 17❑ STREET ❑', 13748 42ND AVE S CITY' TUKWILA ST WA ZIP 981683216 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 LDIIVEW # STATE WA SEX M M .C.B. 10 _ 01 1990 39 WELMET INJURY6 NATURE OF INJURIES 40 20� ON DUTY STATUS' AIRBAG,6 RESTR 4 EJECT '1 USE CLASS LEG CHEST 21❑ LICENSE I BZP7024 TAre WA VIN# JTDEAMDEOMJ035301 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2021 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES NO (,ENE MEYER YES NO REGISTERED OWNER INFO ISHAQAL11374842NDAVES TUKWILAWA98168 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU POLICY#E CO SAME.IN 9TOP vE""Le ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED72244 COLLISION REPORT III III III III III 111 1591972 CASE# 23-6997 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) HASE CLAUDIA C (LAST FIRST, ADDRESS&PHONE# 201 UN/ON AVE SE UNIT 172 RENTON WA 980595167 SEXi F MMDovyry 12 - 11 - 1968 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑ 2 POS, 9 2 12 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) LANE ALEXIS D ADDRESS&PHONE# D O B 11100 59TH AVE S SEA TTLE WA 981782826 SEX IF MMDovvvv 02 _ 18 _ 2007 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑ UNIT# 5 POS. 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. 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. M.LEVERTON 06-20-23 08:35 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 612112023 10:36:44 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 7:04 AM TIME POLICE ARRIVED',7:05 AM PART I PAGE ❑OF 6❑ REPORT NO. ED72244 CASE# 23-6997 OF COLLISION 06/20/23 07:04 OF CbLLI510N NARRATIVE grn suv/1 eb crossed sil sedan/2 lane 2 wb brown wagon/3 lane 1 wb blk/4 sedan lane 1 sil/suv5 wb lane 1 CC Within the city limits of Renton/King/WA I responded to a 5 car blocking crash just west of Blaine Ave NE on NE 3rd St. I contacted the driver of unit 2 who was trapped inside his car. He told me he was west on NE 3rd St when a green SUV crossed the double yellow and crashed into the side of his car. He was forced partially off the roadway. His passenger did not complain of injury. The driver of unit 2 did complain of injury. He was cut out of his car by Renton Fire and transported to VMC-ER for further checks. His vehicle was towed for damages. The driver of unit 3 said she was west bound when the crash between unit 1 and 2 happened in front of her. Unit 1 spun out and crashed into the back of unit 3. She did not complain of injury and damages did require a tow truck. I contacted the driver of unit 4. He said a crash happened in front of him and as unit 5 was emergency braking he did too, but slid on the wet road and contacted the back of unit 5. He did not complain of injury and damage required a tow truck. I contacted the driver of unit 5 who was trying to avoid unit 3 and emergency braking when he was hit from behind by unit 4. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by her picture WADL. She spoke broken English. She was eastbound on NE 3rd St and lost control of her car up hill in the rain. She crossed over the double yellow crashing into the side of unit 2, spinning out and contacting unit 3. She did complain of injury and was transported by ambulance to VMC-ER for further checks. Her vehicle was towed for damages. I cited unit 1 ref RCW 46.61.400 Speeds too fast for conditions via complaint. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 6/20/2023 PAGE 3 OF 6 SUPPLEMENTAL REPORT NO. ED72244 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-6997 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 DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES� NO 29 LAST NAME SHAW FIRST NAME ROSEMARY MIDDLE 0 1 C INITIAL 0 1 30 STREET NFW AnDRIPISP 14721 SE 145TH PL CITY RENTON ST WA ZIP 980597336 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTEO 1 1 2 31 INTERLOCK YEs No zERLOCK YEs[:]NO[:] YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv', 03 - O6 - 1959 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE BNE5797 TAr WA VIN# 4S4BSAHC2K3219157 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR 91 VIN.#. VIN.#. 11 3 5 VEH.YEAR2019 MAKE SUBA MODELOUTBAC STYLE I VEHICLE TOWS ET SABLI W_-'•ER nVT VFHIGP FROM TO DAMAGE YES NO YES NO 33 SHADE IN DAMAGED REGISTERED OWNER INFOROSEMARY SHAW 14721 SE 145TH PL RENTON WA 98059 3 ]AREA 12 3 5 z 3 4 FROM To INSURANCE CO LIABILITY INSURANCE SAME. m 34 IN EFFECT &POLICY# 13 LEG VEHICLE ❑ ❑ CITATION# CHARGE 0 BOTTOM $ 7 LEGALLY YES NO STANDING } 7 6 14 UNIT Tr 4 VEO IOCRLE ❑ : CYCLE ❑ ❑ OWNER ❑ YES�DAM— ENOHRESHOLDMET PHONE ❑ 35 PEDESTRIAN ❑� GUEVARA EDSON MIDDLE /y 36 15 LAST NAME FIRST NAME INITIAL 2 STREET 16 ❑ ❑ 14048 144TH AVE SE CITY RENTON ST WA ZIP 980595530 NFn+AnntxFss CDL IGNITION REtIUiRED IGNITION PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YEs Nb INTERLOCK YEs NC7 YES No ❑ DRIVER'S STATE WA SEX M D.O.B 37 LICENSE# MMDDYYY` 08 - 22 - 2002 18 ❑ ❑ON DUTY� STATUS' AIRBAG 3 RESTR, 12 EJECT 1 HELMET INJURY'1 NATURE OF INJURIES 38 USE CLASS 19 ❑ LICENSE ❑ PLATE# BZF4116 TAr WA v+N# 5YFBU4EE9DP172239 39 20 ❑ TRAILER' STATE TRAILER ST ❑ 40 PLATE#< PLATE# ATE 21 ❑ TRLR TRLR 41❑ ViN# YIN#i 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 2013 TOYT COROL DAMAGE vEs ✓No GENE MEYER ves NOZI 23 ❑ REGISTERED OWNER INFOANTONIO GUEVARA PLASCENCIA 14048144TH AVE SE RENTON WA 98059 SHADE IN DAMAGED AREA 43 4 71 LIABILITY INSURANCE INSURANCE CO ❑ VEHICLE EFFECT �✓ &POLICY# SAME. 9 1'OP - 4 E:l 44 24 LE ALE LLY YES❑ NO❑ CITATION# CHARGE t0 Ei01"rOtvl .STANDING 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. X LEVERTON 06-20-23 08:35 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 2517 O#I',WA0171300 JACOBS 6121/2023 PAGE 4 �OF❑ 3000-345-013 fR 11t18) SUPPLEMENTAL REPORT NO. ED72244 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-6997 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 DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 5 VEHICLE t_"J � PEDESTRIAN YES� NO 0 6 29 LAST NAME BATES FIRST NAME TOMMY MIDDLE A INITIAL STREET 30 NEW AnnRFrtP 11100 59TH AVE S CITY SEATTLE ST WA ZIP 981782826 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 04 - 19 - 1967 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CEZ5642 TAr WA VIN# YV4A22PLXK1438609 PLATE# 9 [9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2019 MAKE VOLV MODELXC90 STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vFH1G P FROM TO DAMAGE YES ,E YES NO 12 REGISTERED OWNER INFO SHADE IN DAMAGED AREA. FROM T TOMMY BATES 1110059TH AVE S SEATTLEWA98178 $ ] 33 7 j LIABILITY INSURANCE INSURANCE CO O SAME. i"01 m 34 IN EFFECT &POLICY# 13 ❑ E LE L ❑ ❑ CITATION# CHARGE 0 BOTTOM LEGAGA LLY YES NO STANDING �} 8 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY 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 NTERLUCK YES No NTERLOCK YEs NO YEs NO El 17 37 LICENSE#RIVERS 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 LEwcLE 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. X LEVERTON 06-20-23 08:35 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 2517 O#I',WA0171300 JACOBS 6121/2023 PAGE 5 OF 6 3000-345-013 fR 11t18) REPORT NO. ED72244 CASE# 23-6997 DATE AND TIME 06/20/23 07:04 OF COLLISION uni nts PAGE 6 OF s