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Home My WebLink About23-9146 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-9146 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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 CITY# ❑ cawsloN 08 - 09 - 2023 1500 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE CARR RD BLOCK NO. e✓ 200 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2069195351 0 6 30 6� LAST NAME VO FIRSTNAME LONG MIDDLE V 1 1 2 31 INITIAL STREET ❑, 13703 SE 188TH ST CITY RENTON ST WA ZIP 980588043 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 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10� PI ATFBit 018YKR sTATI WAvIN#' WDBNG84J85A459067 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 ZOOS MAKE MERZ MODEL 5004D STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 DAMAGE YES NO YES[:] NO✓ 13❑ REGISTERED OWNER INFO IONGV0631O.CYAVENERENTONWA98059 VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14❑ LIABILITY INSURANCE INSURANCE CO AMERICAN FAM INS BX01714234 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UN�T VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YEs NO 1/ D:2532937317 16 a LAST NAME SMITH FIRST NAME JAYLEN MIDDLE IN INITIAL 17❑ STREET ❑', 14027 SE 236TH PL CITY KENT ST WA ZIP 98042 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 LLIICENS# STATE SEX V MMDDYY 39 WELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE I CJL5619 TATe WA VIN# JN1CV6AR9DM352056 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2013 MAKE INFI MODEL G37 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO JAYLEN SMITH 14027 SE 236TH PL KENT WA 98042 D:2532937317 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE I PORGY#E CO STATE FARM INS 53938SOE15474 STOP IN EFFECT 'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM LEGALLY YES N J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 0( 26 J.M/TCHELL 10377 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED89739 COLLISION REPORT III III III III III 111 1591972 CASE# 23-9146 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' Within the City limits of Renton, King County, Washington. On 08-09-23 at approximately 1545 1 was dispatched to a three-car non-injury/non-blocking collision near the 200 block SE Carr RD. Upon arrival I contacted three drivers. I contacted the driver of unit#3 who told me they were stopped in traffic in the #1 lane of eastbound SE Carr Rd when they were rear-ended by unit 2. 1 observed some minor rear bumper damage. I contacted the driver of unit#2 who told me they were stopped for traffic in the #1 lane of eastbound SE Carr Rd when they were rear-ended by unit 1. The driver of unit 2 says the impact from being rear -ended by unit 1, pushed his vehicle into unit 3. 1 observed a good amount of rear bumper damage on unit 2 along with front bumper damage. I contacted the driver of unit#1 who told me they were traveling in the #1 lane of eastbound SE Carr Rd. Driver of unit 1 said unit 2 rear-ended unit 3. Driver of unit 1 says he rear-ended unit 2 after the first collision between 2 and 3. Driver of unit 1 denies that he pushed unit 2 into unit 3. 1 observed front bumper damage to unit 1. The driver of unit 3 told me that he only felt one jolt to his vehicle. But not for the action of UNIT 1, this incident would not have occurred. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.MITCHELL 08-14-23 01:42 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 8/16/2023 9:00:30 AM BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED 3:00 PM TIME POLICE ARRIVED 3:00 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED89739 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-9146 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:9495389865 0 6 29 LAST NAME MARDANDOLA FIRST NAME MATTHEW MIDDLE N INITIAL STREET 30 NEW AnDRFSP' 26862 WINDSOR DR CITY SAN JUAN ST CA ZIP 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N DRIVER'S D.O.B LICENSE STATE I CA SEX M MMDDYYv', 12 - 17 - 2002 7 ON DUTY STATUS AIRBAG 2 RESTR. Q EJECT 1 HELMET INJURY 1 NATURE OF INJURIES USE cLASS 8 ❑ 1 32 LICENSE 8XSX773 [TAT CA VIN# 4T1B11HK7JU137752 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 3 5 VEH.YEAR2018 MAKE TOYT MODEL CAMRY STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFO OWNED BY DRIVER ] 3 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO ((ABILITY INSURANCE INSURANCE CO FARMERS 182610702 gTOp IN EFFECT &POLICY# VEHICLE 1 o BarroM 34 13 IEcnuv YES N001 CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNERRTY 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 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 rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 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 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. J,MITCHELL 08-14-23 01:42 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 10377 O#IL WA0171300 JOHNSON 811612023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED89739 CASE# ' 23-9146 DATE AND TIME 08/09/23 15:00 OF COLLISION N SE CARR RD IMMM imi'llillimmillillillom PAGE 4 OF 4