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Home My WebLink About23-11285 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-11285 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 7100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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# ❑ COLLISION.. 10 - 1-— 2023 1714 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 2000 4a❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �.❑ FEET e S ❑ W e I-405 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLDHONE UNIT 01 VEHICLE ❑ CYCLE El MET P YES �/No D:4255950479 0 81 30 6� LAST NAME TIPANOVA FIRSTNAME EVELINA MIDDLE V 1 1 2 31 INITIAL STREET ❑, 4703 NE 24TH ST CITy RENTON ST WA Zjp, 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� CAA4113 sTAr� WAurN# KMHWF35H14A057215 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR 2004 HYUN SONATA SD MAKE MODEL STYLE VEHICLE TOWED fn TO VBLINJ TOWED By I GOVT.VEHICLE J 9 34 DAMAGE YES NO 13 4 YES[:] No REGISTERED OWNER INFO EVELINA TIPA10VA4703 NE 24TH ST RENTON WA 98059 D:4255950479 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE z INSURANCE CO STATE FARM 4825137F1947C 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:4258292411 16 a LAST NAME NELSON FIRST NAME JOSEPH MIDDLE O INITIAL 17 STREET I10TH PL,APT 2333 CITY' RENTON ST WA ZIP 37 NEW ADOREs�' 1204 N 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YES❑No� INTERLOCK yEs I I NOF YEs t l NOF,/ 19 DRIVER # ❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ 41 CLS 21❑ ILICENSE PLA E# B W4189 TArE WA VIN# JF2SJAHC9FH551212 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. TOWED eY Gov HI 44 VEH YEAR 2015 MAKE SUBA MODEL FORESTS STYLE UT EHICLETOWED TOO✓ BLIN YES NO 1/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU PORGY#E CO GEIC04306472839IN VEHICLe CITATION# CHARGE <E�00, LEGALLY YES N� 25❑ s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 PHILIP DAVIS 12018 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EE05614 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11285 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' 23-11285 On 10-2-23 around 1718 hours I dispatched to a blocking three vehicle collision in the 2000 block of NE Sunset Blvd, Renton, King Co, WA. Upon arrival I observed all three vehicles stopped in lane two of the 2000 block of NE Sunset Blvd. Unit 1 had heavy front-end damage, unit 2 had minor damage to the front and rear end, and unit 3 had minor rear end damage. All three drivers advised they were uninjured and were the only occupants of each vehicle. Each driver told a similar story. Unit 2 and 3 were stopped in the 2000 block of NE Sunset Blvd westbound at the light for the entrance to 1-405. As Unit 1 approached the stopped vehicles unit 1 was unable to stop colliding with unit2 causing unit 2 to collide with unit 3. All vehicles were drivable. All involved provided information. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by P Davis 12018 on October 2, 2023 at 18:30 hours in Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. PHILIP DAVIS 10-03-23 10:39 AM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1 101412023 1:48:18 PM BADGE OR ID# 12018 OR]#' [ WA0171300 TIME POLICE DISPATCHED 5:18 PM TIME POLICE ARRIVED 5:21 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EE05614 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-11285 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 t_"J CYCLE _) PEDESTRIAN � OWNER � YES NO D:4143917187 rOF 8 29 LAST NAME RIVERA FIRST NAME TATIANA MIDDLE' L INITIAL STREET 30 NEW AnDRFSP' 2319 W HOUSTON AVE CITY SPOKANE ST WA ZIP 6 ❑ 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 02 - 28 - 1998 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CJD3408 TAr WA VIN# 2C3CCABG7MH589221 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN It VIN.#. 11 0 0 VEH.YEAR2021 MAKE CHRY I MODEL300 STYLE SD I VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER J 9 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO COLUMBIA 71APR417349 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNER YE 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 ❑ 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 VEHICLE 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. PHILIP DAVIS 10-03-23 10:39 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED AI26OF FRD# O#II APPROVED BY � OI 12018 WA0171300 WOWA 1412023 3000-345-013(R 11118) REPORT NO. EE05814 CASE# 23-11285 DATE AND TIME 10/02/231714