HomeMy WebLinkAbout23-12185 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-12185 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 3 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 10 - 1-- 2023 1729 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ 500 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a LIND AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2064714049 0 11
30
6� LAST NAME VAN ALLEN FIRSTNAME GARY MIDDLE W 1 1 2 31
INITIAL
STREET ❑ 2425 SW WEBSTER ST APT E7 CITY SEATTLE ST WA 2jp, 981061785 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs 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❑ PI ATFBit BUE0193 sTATI WAvIN#' 2B7HB11YXYK156533
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 3 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 2000 DODG RAM VN DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO DA.BE.TH 11170 DES MOINES DR SOUTH A BURIEN WA 98168 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICV# 912P
VewcLE CHARGE 10BOTTOM 5 36
LEGALLv YES No CITATION# 3A0637861,3A0637861, NO VALID OPER LICENSE WITH
15❑ NDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4438567852
16 a
LAST NAME BRAGA FIRST NAME ELENA MIDDLE
INITIAL
17 STREET I❑ s❑' 1425 S PUGET DR APT J5 CITY' RENTON ST WA ZIP 980554321 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER #
—NATURE OF
20❑ JURI
ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 6 F/X WRIST,NTRAES
NSP TO VMC ❑ 40
LICENSE I ❑21❑ PLA E# BZM2196 TATE WA VIN# 41
BANKERS 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE TOYT MODEL PRIUS STYLE 4H I VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO ELENA BRAGA 1425 S PUGET DR APT J5 RENTON WA 98055 D:4438567852 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE� &POINSURGY#E CO STATE FARM 4827341-F23-47BIN STOP
VE""LE ❑ ,J� CITATION# CHARGE BOTTOM
05
LEGALLY YES N`L J
25 ' 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATT HEW NUGENT 11498 WA017771300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE15348
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12185
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WANZER DAVID M
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
19033 MAXWELL RD SE MAPLE VALLEY WA 98038 4252727668 SEX M MMDDYyry 06 - 28 - 1985
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
[:]WITNESS POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) 1 SILLER ARTHUR S
ADDREss a PHONE# 2012 17TH AVE NE ISSAQUAH WA 98029 3129192015 SEX: M D.O.B. 09 F_
MMDDYVYY - U5 1986
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.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.
MATTHEW NUGENT 10-26-23 11:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 11/1/2023 2:14:04 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 5:30 PM TIME POLICE ARRIVED',5:34 PM
PART I PAGE 2�OF❑
REPORT NO. EE15348 CASE# 23-12185 OF COLLISION
10/24/23 17:29
OF CbLLI510N
NARRATIVE
23-12185
On 10/24/2023 at approximately 1730 hours, I was dispatched to a vehicle collision with reports of
injury at the intersection of SW Grady Way and Lind Avenue SW, within the City Limits of Renton,
County of King, State of Washington.
Upon my arrival, 1 observed moderate mechanism to the involved vehicles with airbag deployment as
well as one of the involved parties complaining of a broken wrist. The Renton Regional Fire Authority
(RRFA) responded to the scene for evaluation. While on scene, I collected each of the involved
party's driving information and their independent recollection of the events leading up to the collision.
The driver of Unit#1 stated that he was the sole occupant of his vehicle and that prior to the collision
he was traveling eastbound in about the 500 block of SW Grady Way approaching the controlled
intersection of Lind Ave SW. The driver of Unit#1 had pulled into the left-turn lane and slowed to yield
to traffic for an upcoming left-turn at the intersection. The driver of Unit#1 stated he intended to turn
northbound onto Lind Ave SW. The driver of Unit#1 stated that he did not see Unit#2 traveling in the
westbound lanes of SW Grady Way which Unit#1 needed to traverse across. The driver of Unit#1
proceeded to make the left turn across the westbound lanes of travel. While Unit#1 was turning, he
noticed Unit#2 approach the same intersection. The driver of Unit#1 stated that both vehicles
collided in the intersection causing moderate damage to the front bumper and passenger side quarter
panel of Unit#1. Due to the initial impact, Unit#1 shifted direction and collided into a utility pole at the
intersection.
The driver of Unit#2 said she was the sole occupant of her vehicle and was traveling westbound in
about the 500 block of SW Grady Way approaching the controlled intersection of Lind Ave SW in lane
2 of 2. The driver of Unit#2 stated she was intending to continue west. The driver of Unit#2 stated as
she continued going straight ahead through the intersection, Unit#2 saw Unit#1 turn in front of her
vehicle. The driver of Unit#2 stated she was unable to avoid the collision and both vehicles collided
causing significant damage to the front of Unit#2. The driver of Unit#2's wrist was placed into a
brace by RRFA. 1 transported the driver of Unit#2 to Valley Medical Center (VMC) Emergency Room
for further evaluation.
Two witnesses remained at the scene and were identified as David Wanzer and Arthur Siller. Both
witnesses confirmed that Unit#1 turned across the intersection striking Unit#2.
Based on the above statements, 1 determined that the Driver of Unit#1 (Van Allen) was the
predominant factor for the collision due to not granting the right of way during a left turn causing a
collision. The driver of Unit#1 violated RCW 46.61.185(1) by being the driver of a vehicle intending to
turn to the left within an intersection and not yielding the right-of-way to any vehicle approaching from
the opposite direction which is within the intersection or so close thereto as to constitute an
immediate hazard. The driver of Unit#1 (Van Allen) did not grant the right of way to Unit#2 traveling
in the roadway which had the right of way and was already underway. Due to Unit#1 having to
traverse across oncoming traffic, the driver of Unit#1 must wait until the intersection is clear of
hazard prior to proceeding.
Upon a DOL records check, the driver of Unit#1 (Van Allen) was listed as `Not Licensed -Eligible.
Van Allen was also unable to provide proof of motor vehicle insurance. Van Allen was cited in-person
for No Valid Operator's License with Valid Identification, Operating a Motor Vehicle without Proof of
Insurance, and for Improper Left Turn.
Both involved vehicles had to be impounded due to extensive damage cause. An exchange of
PAGE 3 OF 5
REPORT NO. EE15348 CASE# 23-12185 OF COLLISION
10/24/23 17:29
OF CbLLI510N
NARRATIVE
information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 10/26/2023 10:56 AM Renton, King County,
WA.
PAGE 4 OF 5
REPORT NO.! EE15348 CASE# ' 23-12185 DATE AND TIME 10/24/23 17:29
OF COLLISION
*Diagram not to scale I
Unit#1 —0
J
a
8
SW Grady Way
Unit#2-
PAGE 5 OF 5