HomeMy WebLinkAbout23-10874 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-10874 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 09 - 1-- 2023 1525 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 7TH ST BLOCK NO. e✓ 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 170 00 FMILES N EET e S ❑ E e HARDIEAVESW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLDPHONE
UNIT 01 VEHICLE ❑ CYCLE El MET YES
�/No D:4439944181 0 11
30
6� LAST NAME BYRNE FIRSTNAME MARGARET MIDDLE I G 1 2 31
INITIAL
STREET ❑✓ 510 STEVENS AVE SW APT H302 CITY RENTON ST WA Zjp, 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO YEs No�/
8❑ LRIIVER #
[�] ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CCM2000 sTArI WAurN# JM3KFBCM3N0550986
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 3 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T/yj�)��p/ggY GOVT.VEHICLE 7 $ 34
13 2 2022 MAZD CX-5 DAMAGE YES NO �"-"--"TE YES❑ NO✓
REGISTERED OWNER INFO MARGARET BYRNE 1017 SW 154TH STAPT 10 BURIEN WA 98166 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO USAA 01328-44.07C 3 4
IN EFFECT &POLICY# 9TOP
LEwCLE CHARGE 1 5 36
15 2❑ srnNoiNG re8 No CITATION# 3A0701514 FL RENEW EXPIRED REG>2 MTHS, s I o aorrom
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER
❑ YES 1/ NO D:4252325570
16 a
LAST NAME Yl FIRST NAME EDDIE MIDDLE lK
INITIAL
17❑ STREET ❑', 4317 S 52ND ST CITY' TACOMA ST WA ZIP 984091800 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LICENSE# STATE WA SEX M M DDY
D.C.B.
06 _ 09 _ 1965 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE 5FYH7YU039C036316 TAre I WA vIN1 5FYH7YU039C036316
❑ 41
pLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2006 MAKE NEW MODEL BUS STYLE BU VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ AMAGE YES NO,/ YES NO
REGISTERED OWNER INFO KING COUNTY DOT TRANSIT 5004TH AVEAVE#650 SEATTLEWA98104 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO KC DOT TRANSIT SELFIN STOP 5
VEHICLE ❑ C[:] CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
0(
a
7.111CjEo-S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE01403
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10874
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) Z/GLER TAYLOR M
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
510 STEVENS AVE SW APT Q306 RENTON WA 98057 3609572061 SEXi F MMDOYyry 02 - 07 - 1998
PASSENGER Z WITNESS UNIT# 1 SEAT
i 3 AIRBAG 2 RESTR. 4 1 EJECT ? 1 HELMET USE CLASS LASS 11 NATURE OF INJURIES
'
NAME
(LAST,FIRST,MIDDLE INITIAL) NAZARENE JADA
ADDRESS&PHONE# DOB
323 PARK AVE N RENTON WA 2066027838 MMDDYv
SEX F vv 12 _ 04 _ 2006
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 11 AIRBAG 1 RESTR. 13 EJECT 1 USE CLASS 0
NAME
(LAST FIRST,MIDDLE INITIAL) ORTIVEZ MARIO S
AooREss PHONE# 2307 NE 4TH ST B207 RENTON WA 98056 4252695763 SEX M D.O•B. 08 _M 22 _ 1985
MDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT g AIRBAG 1 RESTR. 13 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES
pOS.❑ SEAT USE CLASS B�----�
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.
CO.JOHNSON 09-21-23 06:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 9/22/2023 4:09:19 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:36 PM TIME POLICE ARRIVED',3:42 PM
PART I PAGE IT]OF 7�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE01403
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10874
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WARREN GERALD D
(LAST FIRST,
ADDRESS&PHONE#
8325663144 SEX' m MMDDYYYY 03 - 12 - 2000
{� SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER ZWITNESS UNIT# 2 POS 9 AIRBAG 1 RESTR. 13 EJECT 1 USE CLASS 7 COMPLAINT OF PAIN
NAME
(LAST,FIRST,MIDDLE INITIAL) HEARN MICHAEL D
ADDRESS&PHONE# D O B
1812 I ST NE APT A AUBURN WA 98002 8132850629 SEX I M MMDDYvvv 04 _ 10 _ 2001
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGER Z WITNESS o UNIT# 2 POS 4 AIRBAG'1 RESTR. 13 EJECT 1 USE CLASS 7 COMPLAINT OF PA(N
NAME
(LAST FIRST,MIDDLE INITIAL) PABLO MARIE T
AooREss&PHONE# 7143942892 SEX MMDDYYYY _10 01 _ 1996
. F D.O.B.
PASSENGER WITNESS UNIT# ! 2 SEAT 7 AIRBAG 1 RESTR. 13 EJECT 1 HELMET NJURSY 1 NATURE OF INJURIES
❑ SEAT 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.
CO.JOHNSON 09-21-23 06:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 9/22/2023 4:09:19 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:36 PM TIME POLICE ARRIVED',3:42 PM
PART I PAGE IT]OF 7�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE01403
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10874
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WONG YUEN F
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3901 15TH AVE S APT 4 SEA TTLE WA 98108 SEXi F MMDOYyvv 10 - 07 - 1956
{� SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER ZWITNESS❑ UNIT 2 SEA 11 AIRBAG;1 RESTR. 13 EJECT 1 USE CLASS 16 LACERATION ABOVE LEFT EYE
NAME
(LAST,FIRST,MIDDLE INITIAL) LOCKETT DOUGLAS D
ADDRESS&PHONE# D O B
15640 21ST AVE SW BURIEN WA 98166 2064967025 SEX M MMaDYvvv 01 _ 31 _ 1965
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 1 RESTR. 13 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) JONES MAKEESHA M
AooREss PHONE# 12214 236TH AVENUE CT E BUCKLEY WA 98321 5642347774 SEX F D•O•B• 09 _ 26 _ 1985
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 3 AIRBAG 1 RESTR. 13 EJECT 1 HELMET INJURY 1 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.
CO.JOHNSON 09-21-23 06:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 9/22/2023 4:09:19 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:36 PM TIME POLICE ARRIVED',3:42 PM
PART I PAGE IT]OF 7�
TIME
REPORT NO. EE01403 CASE# 23-10874 OF COLLISION09/21/23 15:25
NARRATIVE
U2 EB SW 7th In2, U1 exit private drive from south
On 09-21-2023 at about 1544 hours, I was dispatched to a blocking injury collision near SW 7th St
and Hardie Ave SW in the City of Renton, County of King, Washington State. The collision involved a
bus and a car and one of the passengers on the bus had a laceration to their head. I arrived at about
1606 hours. Fire department personnel were already on scene and another officer had collected
information from the involved parties.
The driver of Unit 02 was identified by a commercial WA DL. The driver said he was wearing a
seatbelt and not injured as a result of the collision. Unit 02 was east bound in lane #2 (of 2) of the
100 block of SW 7th St. The driver said Unit 01 pulled out in front of his bus from a driveway to the
south of the roadway. The driver applied the bus brakes but was unable to avoid a collision.
The driver of Unit 01 was identified by WA DL. The driver said she was wearing a seatbelt and not
injured as a result of the collision. Unit 01 intended to turn left (west bound) from a private drive. The
driver said cars were stopped and backed up in the right lane (lane #1) because of a red light. There
was a gap between the line of cars in front of the private drive. A vehicle in the line of cars honked
and the driver motioned with their hand for Unit 01 to make the left turn. Unit 01 entered the roadway
and collided with Unit 02 in lane #2.
1 observed moderate damage to the front of Unit 02 and moderated damage to the driver side of Unit
01. The Unit 01 driver side curtain airbags were deployed. The information provided by both drivers
was consistent with damage to the vehicles. Although both vehicles were able to move off the
roadway after the collision under their own power, the airbag deployment of Unit 01 made the vehicle
undrivable.
Unit 02 is a Metro Transit articulated bus and eight passengers were identified. Nazarene was gone
from the area prior to may arrival. Ortivez did not complain of injury. Warren and Hearn made
indications they were possibly injured but did not appear to have any observable injuries. Pablo was
bit by a dog as she exited the bus after the collision. Jones and Lockett were the dog owners, they
did not appear to have any observable injuries. As I spoke with Jones and Lockett their dog
appeared calm and friendly. Wong had a laceration above her left eye and was transported to Valley
Medical Center for additional treatment. Fire department personnel were on scene to evaluate the
involved parties and returned a short time later to evaluate Pablo.
RCW 46.61.205 states the driver of a vehicle about to enter or cross a highway from a private road or
driveway shall yield the right-of-way to all vehicles lawfully approaching on said highway. The
proximate cause of the collision was Unit 01 entering the roadway and failing to yield the right of way
to Unit 02. Were it not for the actions of the driver of Unit 01, the collision would not have occurred.
Checks via DOL of Unit 01 returned expired on 03-27-2023.
Notice of Infraction for fail to yield from private drive and vehicle license expired more than 2 months
sent to the Renton Municipal Court to mail to the driver of Unit 01.
PAGE 5 OF 7
SUPPLEMENTAL REPORT NO. EE01403
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-1o874
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT'# 2 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1
;TYPE
2 ❑ 1 28
CARRIER KING COUNTY DOT TRANSIT
NAME
3 CARRIER
ADDRESS 500 4TH AVE
CITY SEATTLE ST WA ZIP'', 98104
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 03 GI65000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREETIAL
❑
16 NFln+AnnRFs.� CITY'. ST 21P
CDL IGNITION REDUIREE7 IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK 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 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
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 '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
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.
CO,JOHNSON 09-21-23 06:07 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID# 0505 O#I',WA0171300 JOHNSON 9/22/2023 PAGE F OF 7
3000-345-013(R 11118)
REPORT NO.! EE01403 CASE# ' 23-10874 DATE AND TIME 09/21/23 15:25
OF COLLISION
* Not to Scale"
SW 7tfl St
Unit 01
Jimmy Mac's
Unit 02: Hardie Ave SW
traffic'backup for signal
PAGE 7 OF 7