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Home My WebLink About23-11286 ITFF' "POLCERA II I !�� I III I III I IIII III II I . S 27c COLLISION REP FIT 1591971 CASE 23-11286 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 28 TRIBAL UNITS 01 STRUCK' MAILBOX 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 1749 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 116TH AVE SE BLOCK NO. e✓ 16500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4255076583 30 6� LAST NAME BROWN FIRSTNAME ASHLEY MIDDLE M F 2 31 INITIAL STREET ❑ 17650 134TH AVE SE APT N302 CITY RENTON ST WA ZIP 98058 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NO 1/ I INTERLOCK YES NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 . EJECT 1 HELMETU E 2 CLASS'NJURY7 I HEAD PAIN JURIES z❑ 3 10� Pi aT�S� CER0310 sTATe WAurN# 1 D4GP24R056190606 F_ TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO rRLR. TRLR 1 5 33 12❑ VIN#' VIN# FROM 34 13� VEH.YEAR2OOS MAKE DODG MODEL GRAND STYLE VN VEHICLE TOWEDNOOpLSABLIN TOyED.BLRS yOES❑ENO DAMAGE IILLJJII ttSSAA1IVV/it�66 REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO eq�T3 4 IN EFFECT &POLICY# 9TOP VEH CHARGE o eorrom 5 36 LEGALLY res No clTAnoN# 3A0615643 OP MOT VEH W/OUT INSURANCE 15❑ 1ND'ING 8 7 6 MOTO PEDAL-UNIT a2 VE ICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER R,TY ❑ DYES NO OLD MET PHONE 16❑ LAST NAME FIRST NAME MIDDLE INITIAL STREET CITY' ST ZIP 4❑ 37 17❑ NEW ADDRES7 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l No❑ 19 LLIICENS # STATE SEX MMDDYY -�_ 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ TATE LICENSE vIN# 41 1 PLATE# 42 22❑ PR TRAILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN It IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY Gov HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO VEHICLE ❑ C[:] CITATION# CHARGEGQ LEGALLY YES N`LJ 25 s 7 6 7B- S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 MIN FLICK 12825 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE06440 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11286 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) BROWN JISELLE (I.P.ST FIRST, ADDRESS&PHONE# 17650 134TH AVE SE APT N302 RENTON WA 98058 SEXi F MSEAT MDovyry PASSENGER LVJ WITNESS UNIT# 1 POS. USE 2 CLASS 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET LASS NATURE OF INJURIES ' '1 NAME (LAST,FIRST,MIDDLE INITIAL) BROWN ISSAC ADDRESS&PHONE# DOB - 17650 134TH AVE SE APT N302 RENTON WA 98058 SEX M MMDDvvvv SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 1 POS 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 1 2 CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) BROWN JAYCELN AooREss&PHONE# 17650 134TH AVE SE N302 RENTON WA 98058 _ SEX M. D.O.B.M - MDDYYYY PASSENGER WITNESS UNIT# ! 1 SEAT 7 AIRBAG 2 RESTR. 10 EJECT 1 HELMET 2 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. BENJAMIN FLICK 10-02-23 08:10 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 101612023 12:36:05 PM BADGE OR ID# 12825 ORI# WA0171300 TIME POLICE DISPATCHED 5:51 PM TIME POLICE ARRIVED',5:55 PM PART Ei PAGE IT]OF REPORT NO. EE06440 CASE# 23-11286 OF COLLISION 10/02/23 17:49 OF CbLLI510N NARRATIVE 23-11286 On 10-02-2023 at approximately 1749 hours I was working a Renton Police Department patrol in full uniform in the city of Renton, King County, Washington. I responded to a motor vehicle collision in the 16500 block of 116th Ave SE. The RP was the driver and stated that she had a recent aneurism. Upon arrival I made contact with the vehicle involved. The involved vehicle and driver were identified as follows: Unit 1 (WA/CER0310) driver Ashley Marie Brown (DOB: 05-12-1990 via WADQ. Unit 01 was driving southbound on 116th AVE SE when it struck a mailbox on the side of the road, lost control and ended up in a grassy area near the collision site. The mailbox struck belonged to a Riley M. Richardson (10-05-1994 verbally) at 16543 116th AVE SE. It was a single-post mailbox serving only the one address. Driver Brown told me that she was driving back from Rainier AVE S and believed someone had possibly cut her brake lines. She also told me that earlier, she had driven from approximately the 17500 block of 134th AVE SE to get to Rainier AVE S and only felt spongy brakes once at Benson RD/Puget DR. Renton Fire evaluated Brown and she refused to be transported to the hospital. I did not believe it likely that brake problems were the cause of this accident. It appeared as though driver Brown had likely drifted off of the road momentarily due to an unknown distraction as she had 3 children in her vehicle from ages 4 to 16. 1 provided both parties with the case number. Driver Brown was unable to provide proof of insurance. She told me her insurance was "at home." I observed that the damage to the vehicle was consistent with striking the mailbox. The mailbox was destroyed. At the conclusion of my investigation, I determined that driver Brown had left the roadway and collided with the mailbox for an unknown reason or distraction. I confirmed with driver Brown that she would receive mail at the address listed on the Sector citation that I wrote. I informed her that she would be receiving a citation for not having insurance via mail. Driver Brown began complaining of her pre-existing aneurism issues. She seemed to be paranoid, convinced that someone had tampered with her vehicle, then explaining about her stays in Fairfax hospital and various medical malpractice incidents. I called Fire Department back to the scene and she was transported to a hospital via Trilled ambulance for head pain. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by B. Flick 12825 on 10-02-2023 in Renton, WA. PAGE 3 OF 5 REPORT NO. EE06440 CASE# 23-11286 OF COLLISION 10/02/23 17:49 OF CbLLI510N NARRATIVE PAGE 4 OF 5 REPORT NO. EE06440 CASE# ' 23-11286 DATE AND TIME 10/02/23 17:49 OF COLLISION Not to scale Cn C) Unit o 0- O O 1 Mailb m D C m m PAGE 5 OF 5