HomeMy WebLinkAbout23-12402 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-12402 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 28
0 5
RESERVATION
TRIBAL UNITS 02 STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 10 - 29 - 2023 1257 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARDIE AVE SW BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ MILE N�,❑ FEET e S ❑ E e RENTON CENTER WAY SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4156723999 0 4 30
6❑ LAST NAME SING FIRSTNAME MICHAEL MIDDLE J 1 2 31
INITIAL
STREET ❑ 12227 86TH CT S CITY SEATTLE ST WA 21P 981784548 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 05 1- 17 - 1984 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 2❑ I Pi ATNES# CDV7626 sTATe WAu N# SALVD2BG6HH236657
IT STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM ro
FT -R TPILFI 1 5 33
12 2 5 VIN#j VIN#'
FROM TO
❑ VEH.YEAR 2017 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34
13 4 LNDR RANGE UT DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO MICHAEL SING 1222786TH CTS SEATTLE WA 98178 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 031273104 3 4
IN EFFECT &POLICY# 9TOP
VE—L'
15❑ 1 5 36
LecA�ty YES❑NO❑ CITATION# CHARGE 10 BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:2533755768
16 2
LAST NAME CAVANAUGH FIRST NAME KAHLI MIDDLE ,I
INITIAL
17❑ STREET �' 8441 S 124TH ST CITY SEATTLE ST WA ZIP 98178 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19[-] D IVEW #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑
21❑ LICENSE I CHT0616 TATE WA VIN# 1FAHP3CN8AW155388
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE FORD MODEL FOCUS STYLE P2 VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KAHLI CAVANAUGH 8441 S 124TH ST SEATTLE WA 98178 D:2533755768 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
V LLE YEs Nc❑ CITATION# 3A0646339,3AO646339 CHARGE FAIL YIELD LEFT TURN MOTOR
25 o BOTTOM
GALLY
s � a
7SHA
NAME(PRINT) OFFICER PHONE BADGE ORID# AGENCY
26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE14819
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12402
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
PM 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'
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.
SHAWN CROW 10-29-23 05:35 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
DESIRES SCOTT 10272 1013112023 7:14:03 AM
BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED 4:04 PM TIME POLICE ARRIVED',1:12 PM
PART Ei PAGE IT]OF 4�
REPORT NO. EE14819 CASE# 23-12402 OF COLLISION
10/29/23 12:57
OF CbLLI510N
NARRATIVE
CC
On 10/29/2023 at about 1304 hours I was working uniform marked patrol as 1 R15 when I was
dispatched to the Fred Meyer parking lot (365 Renton Center Way SW) where two motorists were
awaiting to be contacted after being involved in a non-injury motor vehicle collision. I contacted both
drivers and discovered that the collision happened at the intersection of Hardie Ave SW/Renton
Center Way SW within the city limits of Renton, King County, Washington.
Driver 1 (Michael J. Sing) was the driver of Unit 1 (2017 Range Rover Evoque with Washington
license plate CDV7626).
Driver 2 (Kahli J. Cavanaugh) was the driver of Unit 2 (2010 Ford Focus with Washington license
plate CHT0616).
Unit 1 was traveling on Renton Center Way SW towards the Fred Meyer parking lot from the
intersection of Renton Center Way SW/SW Sunset Blvd when Unit 2 struck the front passenger
fender/wheel of Unit 1. Unit 2 was pointed northbound on Hardie Ave SW turning left onto Renton
Center Way SW when it struck Unit 1. Driver 2 said she stopped at the stop sign at the intersection of
Hardie Ave SW/Renton Center Way SW before turning left onto Renton Center Way SW. Driver 2
admitted she did not see Unit 1 as she made her turn.
No traffic control was posted in the direction that Driver 1 was traveling; however, a stop sign was
visibly posted for northbound traffic at the intersection where Driver 2 was traveling. Driver 2 did not
appear to yield to Driver 1 as she made her left turn after stopping at the stop sign, and her actions
appeared to contribute to the collision. Driver 2 also admitted she did not have motor vehicle
insurance on her car.
I completed a traffic infraction (3A0646339) against Kahli J. Cavanaugh (Driver 2) for failing to yield
as she made her left turn (RCW 46.61.185.1) and for operating a motor vehicle without insurance
(RCW 46.30.020). The infraction was sent to the court to be mailed.
PAGE 3 OF 4
REPORT NO.! EE14819 CASE# ' 23-12402 DATE AND TIME 10/29/23 12:57
OF COLLISION
6\, p
9� Rsntan Center Way SW I`J �w
rta " at drawn to scale
c a;
€ir
Unit 1 ,:
� 6�aara�?n �xrtew
r'
Unit2 =
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PAGE 4 OF 4