HomeMy WebLinkAbout23-9529 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-9529 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 04 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 08 - 18 - 2023 1957 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 180 TH ST BLOCK NO. e✓ 8000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 500 00 FMILES N EET e S ❑ E e BOTH AVE S
0 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254637438 0 11
30
6� LAST NAME BATE FIRSTNAME RYAN MIDDLE A 1 2 31
INITIAL
STREET ❑ 10422 SE 186TH PL CITY RENTON ST WA ZIP 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO�/ INTERLOCK YES NO�/ YES R NO
$F-I LRIIVERCENS # STATE WA SEX'M MID
LOB 11 - 20 - 2004 1 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 9 EJECT 1 H USEET 7 CLASS VEHICLE[NATURE
OF INJURIES
FLIPPED 2❑
3
LICENSE CGT3552 STATE WA uN# JH4CL96856CO33331
10 9❑ Pr ATE�
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR ZOO6 ACUR TSX MAKE MODEL STYLE VEHICLE TOWED TO BLIN T VgyEWk R$ 3 7 GOVT.VEHICLE 34
13 DAMAGE YES NO """ YES[:] No
✓
REGISTERED OWNER INFO CHELSEYBA110422SE186THPL RENTONWA98055 D:4254637438 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 964258206
IN EFFECT &POLICY#
ve'CLE CHARGE ❑ 36
LECALLv res❑NO❑ CITATION# BOTTOM
15❑ MOTOR PEDAL- PEDESTRIAN PROPERTY DAM NO
OLD MET PHONE
U 1/NIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO D:2069460198
16 a
LAST NAME SINGH FIRST NAME JASPREET MIDDLE
INITIAL
17❑ STREET ❑', 17017 34TH AVE S CITY SEATAC ST WA ZIP 98188 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 D IVEW #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE CLASS ❑
21❑ LICENSE AWR2654 TATe I WA VIN# 4T1BF1FKOEU379275
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN 43
TIN##. IN RLR
' #.
VEH YEAR 2014 MAKE TOYT MODEL CAMRY STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO JASPREET SINGH 1701734TH AVE S SEATAC WA 98188 D:2069460198 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE I PORGY#E CO CONNECT A102103318IN 1GQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
LACY SMITH 12613 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED92176
COLLISION REPORT III III III III III 111
1591972 CASE# 23-9529
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WONG HENRYK
(LAST FIRST,
ADDRESS&PHONE#
14514 SE 188TH WAY RENTON WA 98058 8082332328 SEX M MMDOYyry 09 - 29 - 1971
PASSENGER I�I WITNESS❑ UNIT# 3 SEA ! 3 AIRBAG y RESTR. g EJECT ? 1 HELMET INJURY NATURE OF INJURIES
L�!1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) CHAPPEL ERWIN
ADDRESS&PHONE# D O B
4254292160 SEX U MMDDYYYv
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.
LACY SMITH 08-21-23 04:34 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1 8/23/2023 6:15:26 PM
BADGE OR ID# 12613 OR]# WA0171300 TIME POLICE DISPATCHED 7:88 PM TIME POLICE ARRIVED',8:03 PM
PART I PAGE 2�OF❑
REPORT NO. ED92176 CASE# 23-9529 OF COLLISION
08/18/23 19:57
OF CbLLI510N
NARRATIVE
The following report is a summary of the events that occurred while my AXON body-worn camera
was on and activated.
On 08/18/2023, 1 was assigned to District 13 as the, 31313. At approximately 1958 hours I was
dispatched to an unknown injury accident located at 8000 block of S 180TH ST . This is located in
the city of Renton, the county of King, and the state of Washington.
Per dispatch, "VEH HIT TWO OTHER VEHS, VEH THAT FLIPPED OVER IS BLK SEDAN, POSS
CIVIC....CAN HEAR SOMEONE CALLING OUT OF THE VEH".
I arrived on scene and observed vehicle WA/ CGT3552 flipped on its hood and stopped in oncoming
traffic.
All occupants were out of the vehicles and denied any major injuries at this time.
I contacted the driver of unit 1 and positively identified him as, Ryan Bates, by his Washington State
Drivers license. Bate stated something along the lines of, "I was being stupid, I was driving fast, not
caring about traffic." and "I was in the lane closest to the curb and I hit another car."
Unit 2- WA/AWR2654 had damage to the front passenger side. Unit 3- A6568167 had damage to the
rear drivers side. Unit 4 WA/BSS4788 had damage to the front passenger side.
Per witness, Erwin, unit 1 was traveling Westbound at a high rate of speed weaving in and out of
vehicles before it clipped units 2 and 3 and becoming airborne, flipping and hitting unit 4 which was
traveling Eastbound on S 180th ST.
Based on the evidence on scene and the statements made by the parties involved as well as
witnesses. It appears unit 1 was traveling Westbound on S 180th St and was driving with no regard
for other vehicles on the roadway when it attempted to cut between units 2 and 3. In the process of
cutting between units 2 and 3, unit 1 hit the front passenger side of unit 2 and bounced off into the
rear driver's side of unit 3. At this time unit 1 became air born into oncoming traffic which was heading
Westbound on S 180th. Unit 1 then landed on unit 4 upside down causing damage to the front
passenger side of the vehicle
Unit 1 was privately towed from the scene.
With the assistance of other Renton Officers, the others involved were positively identified and
provided this case number.
Renton Fire medically cleared the involved on scene.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer L. Smith 12613 on 08/21/2023 in Renton, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED921 76
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-9529
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 DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE ISJ CYCLE I_) PEDESTRIAN OWNER L_I YES✓ NO
D:8082232328
0 1 29
LAST NAME WONG FIRST NAME KERY MIDDLE
INITIAL
0 1 30
STREET
NFW AnDRFS CITY RENTON ST ZIP
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES[:]NO✓ zERLOCK YES❑NO❑✓ YEs N ✓
DRIVER'S STATE I SEX F M
7 ��DVSYv' -❑ 2
❑ LICENSE
ON DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET USE CLASS INJURY 1 NATURE OF INJURIES
8 ❑ 1 1 2 32
LICENSE A6568167 [TAT WA VIN# JN1BJ1AW7MW660878
PLATE#
9 TRAILER TRAILER
191 PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 0 0 VEH.YEAR2021 MAKE NISS MODELROGUE I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY anvi vEHlci F FROM TO
DAMAGE YES NO ✓ YES NO ✓
REGISTERED OWNER INFOHENRYWONG 14514 SE 188TH WAY RENTON WA 98058 D:8082332328 $ ] 33
12 � SHADE IN DAMAGED AREA
7 j 4 FROM TO
((ABILITY INSURANCE INSURANCE CO GEIC04576.12.55.63 gTOp
IN EFFECT &POLICY#
1 ------- 7 3 34
13 ❑ VEHICLE YES❑ NO❑ CITATION# CHARGE 0 BOTTUM
LEGALLY
STANDING 7
DAMAGE THRESHOLD MET PHONE ❑ 35
14 UNIT# 4 MOTOR ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO
VEHICLE CYCLE OWNER ✓ D:5179441776
15 � ABDI AHMED MIDDLE H
❑ 36
LAST NAME FIRST NAME INITIAL
2 STREET
16 ❑ ❑; 11808 SE 204TH ST CITY KENT ST WA ZIP 98031
NFn+AnnRFSS
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICAL TANSPORTED
17 ❑ INTERLOCK YES NO✓ INTERLOCK YES NO✓ rES NO;./ ❑
DRIVER'S STATE WA SEX M D.O.B 37
LICENSE# MMDDYYY` 01 - 01 - 1983
18 ❑ ❑ON DUTY� STATUS' AIRBAG 1 2 RESTR. g EJECT 1 HELMET INJURY'1 NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑
PLATE#
BSS4788 TAr WA vIN# 3C4PDCABOKT870969 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
2019 DODG JOURNE DAMAGE YES NO ✓ YES NO ✓
23 ❑ REGISTERED OWNER INFO OWNED BY DRIVER SHADE IN DAMAGED AREA 43
4 71
LIABILITY INSURANCE INSURANCE CO SAFECO H2150505 ❑
❑ IN EFFECT �✓ &POLICY# i 9 1'OP _ 4 44
24 VEHICLE YES[:] NO❑ CITATION# CHARGE 10 EiO1"rOtvl
LEGALLY
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.
LACY SMITH 08-21-23 04:34 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 F OI BADGE 12613 O#I',WA0171300 APBARFIELD 812312023 PAGE I OF❑
3000-345-013(R 11118)
REPORT NO. ED92176 CASE# ' 23-9529 DATE AND TIME 08/18/23 19:57
OF COLLISION
This diagram is not to sca[a
Unit Unl2 S 1861h ST
vi
i
a
PAGE 5 OF 5