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Home My WebLink About23-14966 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 CASE 23-14966 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS OS STRUCK STREET LIGHT POLE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cawsloN 12 - 1-- 2023 1401 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S 43RD ST BLOCK NO. e✓ 100 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e SR 167 0 4 29 MOTU '�01 VEHtOR Z CLE CYCCLE. El �ESAGE NHORE✓LD MET PHONE p 1 30 6� LAST NAME ORAL FIRSTNAME YEVHEN MIDDLE 1 0 11 31 INITIAL STREET ❑ 2590 HORSEMANSHIP CT CITY COLORADO SPRINGS ST CO ZIP' 80922 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # STATE CO 02 SEX'M MI B Y' - 1 27 - 1986 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 I INJURY CLASS 1 NATURE OF INJURIES 2❑ 3 10 1❑ Pi ATNES# 251NPW sTATe OR vN# 3C63RRGLONG112993 [- TRAILER 511-7612 STATE ME TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro TRLR TRLR 5 7 33 12 3 5 vIN# 4FG8440376CO95446 VIN If ROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 3 ] 34 13 2 2022 DODG RAM PK DAMAGE YES NOBS YES[:] No✓ REGISTERED OWNER INFO KING LLC MOVING 1122 NE 122ND STSTEA205 PORTLAND OR 97230 D:3054074702 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 02592323 IN EFFECT &POLICY# 9TOP 15❑ LE vECALLv HIa.E 5 36 res❑NO❑ CITATION# CHARGE 10 BOTTOM STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE �NiT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:7325248221 16 a LAST NAME PARAM FIRST NAME VARUN MIDDLE R INITIAL 17❑ STREET ❑', 4850 156TH AVE NE APT 11 CITY REDMOND ST WA ZIP 98052 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19[-] DRIVERS {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE I CEZ8641 TATE WA vIN# WAUBBAF48NA013290 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE ILER# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I TOWED BY Gov HI 44 VEH YEAR 2022 MAKE /�(fDI MODEL�QQ STYLE 4D DAMAGE TOWED NOO✓ BLIN YES NO 1/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGED AREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO STATE FARM 526 8747-D18-47IN 1ULlliKOTlTlfll;0- MEvE""LE ❑ ,J� CITATION# CHARGELEGALYYES N`L J25 OFFICER'S NA (PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 C.STEED 8770 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EE35834 COLLISION REPORT III III III III III 111 1591972 CASE# 23-14966 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) TANG PANTING (LAST FIRST, ADDRESS&PHONE# D O.B. ' 5114 NE 11TH CT RENTON WA 98059 2069608789 SEXi F MMDDvyvv 08 - 20 - 1968 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET NJURY NATURE OF INJURIES ❑✓ ❑ 3 POS. 1 9 2 4 1 USE 2 CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) ZHU WANHUA ADDRESS&PHONE# D O B 5114 NE 11TH CT RENTON WA 98059 2067393737 SEX IF MMDDvvvv 12 _ 27 _ 1945 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER Z WITNESS❑ UNIT# 3 pOS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) SILVA CRISTINA M ADDREss&PHONE# 806 S 116TH ST SEATTLE WA 98168 2067792674 SEX' F D.O.B. 01 _ 31 _ 1966 MMDDYYYY PASSENGER WITNESS UNIT# ! 4 SEAT 3 AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES ❑ POS. USE CLASS --- ----� NARRATIVE' On 12/30/23 at about 1407 hrs I arrived at SW 43rd St at SR 167 for a vehicle that hit a light pole, in the City of Renton, County of King, and State of Washington. The driver of Unit#1 advised he was exiting from NB SR 167 and turning WB on SW 43rd St towing a trailer. He said his brakes failed as he was traveling WB on SW 43rd. To avoid a collision with the traffic in front of him, he drove over the sidewalk and struck a light pole knocking it down. Unit#2 was WB on SW 43rd St when the light pole struck the front passenger side of his vehicle. Unit#3 was EB on SW 43rd St when the light pole struck the front driver side of her vehicle. Unit#4 was traveling WB on SW 43rd St when the light pole broke the back window of his vehicle. There were no reported injuries from the collisions. This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. The video was uploaded to evidence.com. 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 Steed on 12/31/23 0506 hrs, Renton Washington Cassidy Steed/8770 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.STEED 12-31-23 05:07 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 12/31/2023 6:41:04 AM BADGE OR ID# 8770 OR]# WA0171300 TIME POLICE DISPATCHED Y:03 PM TIME POLICE ARRIVED',Y:07 PM FART I PAGE IT]OF 5� SUPPLEMENTAL REPORT No. EE35834 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-14966 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 tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO ✓ D:2069739808 0 1 Zg LAST NAME ZHAO FIRST NAME QINGMEI MIDDLE INITIAL 0 1 30 STREET NFW AnnRFSP' 5114 NE 11TH CT CITY RENTON ST WA ZIP 98059 6 [2 1 1 2 31 CDL IONITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YES N ✓ DRIVER'S LICENSE STATE I WA SEX U MMDDYYv', 08 - 20 - 1968 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE B►T2096 TAr WA VIN# 2T2BZMCAOHC134434 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE If STATE 10 TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2017 MAKE LEXS MODELRX 300 1 STYLE 4y I VEHICLE TOWE E T SABLIN TOWED BY anvi vEH1I' P FROM TO DAMAGE YES NO ✓ YES NO ✓ 33 REGISTERED OWNER INFO OWNED BY DRIVER ] 3 12 3 5 SHADE IN DAMAGED AREA 7 j 4 FROM TO LIABILITYT INSURANCE IN SURAN#E CO AMERICAN FAMILY 2344.8165.03.68-FPPA-WA �rOlx N EFFECPOCY 3 7 34 13 ❑ VEHICLE ❑ ❑ CITATION# CHARGE 0 BO OM VEHICLEGALLY YES NO STANDING 7 6 DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:2067792674 36 15 ❑ LAST NAME SILVA-ROSALES FIRST NAME FRANCISCO MIDDLE J ❑ INITIAL I 2 STREET 16 ❑ ❑; 806 S 116TH ST CITY SEATTLE ST WA Z!P 98168 NFW AnnRFSR CDL IGNITION RE'dUiRED IGNITION PRESENT MEDICAL TANSPORTED 17 ❑ INTERLOCK YE. NO✓ INTERLOCK YEs NO✓ YEs NO;./ ❑ DRIVER'S STATE WA SEX M D.O.B 37 LICENSE# MMDDYYY` 01 - 29 - 1966 18 ❑ NATURE OF INJURIES 38 ❑ON DUTY� STATUS AIRBAG 2 RESTR, 4 EJECT 1 HELMET 2 INJURY'1 USE CLASS 19 ❑ LICENSE ❑ PLATE# TAr BMH1344 WA VIN# 1HGCG2251XA006148 39 20 ❑ TRAILER' STATE TRAILER ST ❑ 40 PLATE#< PLATE If ATE 21 ❑ TRLR TRLR 41❑ ViN# YIN#i 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1999 HOND ACCOR 4D DAMAGE YES NO ✓ YES NO ✓ 23 ❑ REGISTERED OWNER INFO OWNED BYDRIVER SHADE IN DAMAGED AREA 43 s 4 71 LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 957193697 ❑ VEHICLE EFFECT ✓ &POLICY# iC�Q E:l 44 24 LE ALE LLY YES❑ NO CITATION# CHARGE .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. C.STEED 12-31-23 05:07 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OI BADGE 8770 O#I',WA0171300 APPROVED BY 12131/202 PAGE❑OF❑ 3000-345-013(R 11118) SUPPLEMENTAL REPORT No. EE35834 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-14966 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# 5 VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES� NO D:4254307500 MIDDLE.. 29 LAST NAME CITY OF FIRST NAME RENTON INITIAL STREET 30 NEW AnDRFSP' 1055 S GRADY WAY CITY RENTON ST WA ZIP 98055 6 II 1 31 CDL GNITItN REQUIRED GNITION PRESENT MEDEC INTERLOCK YEsNo zERLOCK YES❑N0� T DRIVER'S STATE I SEX U M��DYSYv' -� 2 LICENSE 7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE YES 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 IRE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NEn+AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiRED 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l 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. C.STEED 12-31-23 05:07 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APE D BY 226 � BADGE O#I'WA0171300 I 131 PAGE OF 3000-345-013(R 11118) REPORT NO. EE35834 CASE# ' 23-14966 DATE AND TIME 12/30/23 14:01 OF COLLISION w 4 PAGE 5 OF 5