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Home My WebLink About23-12827 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE20367 170 27 COLLISION REP FIT 1591971 CASE 23-12827 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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 11 - 1-- 2023 1204 17 ❑.= S 8 E IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RENTON AVE EXT. BLOCK NO. e✓ 100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 2 0 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El No ,/ I D:2069484135 0 11 30 6� LAST NAME ASENCE FIRSTNAME JOSELITO MIDDLE A 1 2 31 INITIAL STREET ❑, 17813 31ST DR SE CITY BOTHELL ST WA ZIP 980128554 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 9� Pi AT 14 98435C STATE WA VIN# 1 VHHH3V2286707399 TRAILER STATE TRAILER STATE 11 3 51 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34 13 2 2010 ONTR BUS BU DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO KING COUNTYDOT TRANSIT5004THAVE#653 SEATTLE WA 98104 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14LIABILITY INSURANCE INSURANCE CO KING COUNTY SELF 3 IN EFFECT &POLICY# 9TOP vewcLE CHARGE 5 36 LECALLv Yes❑NO❑ CITATION# 10 BOTTOM 15❑ NDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE iT 02 VEHICLE ❑ CYCLE ❑ ❑ : OWNER , ❑ YES,� No PHONE 2533593155 16 a LAST NAME JONES FIRST NAME JAILYNNE MIDDLE I/ INITIAL 17❑ STREET ❑', 4047 E E ST CITY' TACOMA ST WA ZIP 984041448 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER # STATE WA SEX F M .C... 04 05 _ 1995 El 39 HELMET {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE I C6G1535 TATe WA VIN# 1V2KP2CA1NC509992 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2022 MAKE VOLK MODEL ATLAS STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES,� NO GENE MEYER YES NO REGISTERED OWNER INFO JAILYNNE JONES 4047 E E ST TACOMA WA 98404 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSURANCE #E CO GEICO 6120300469IN I STOP 5 VEHICLE ❑ — CITATION# CHARGE to BOTTOM LEGALLY YES NC[:] 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 K.LANE 10008 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE20367 COLLISION REPORT III III III III III 111 1591972 CASE# 23-12827 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' Unit 2 was traveling in the far-right (north) lane of westbound Renton AVE EXT in the 100 blk. Unit 1 (a metro bus) was in the lane to the left of Unit 2 also traveling westbound in the 100 blk of Renton AVE EXT. Unit 2 was adjacent to but slightly towards the rear of Unit 1 on the passenger side of Unit 1. Driver 1 stated that a rider exclaimed to him that he needed him to stop at a bus stop on the north side of the roadway just west of Hardie AVE NW, so he attempted to move over to the right (north) to make the bus stop. When Unit 1 attempted this lane change to the right curb, the middle/rear passenger side of Unit 1 impacted the driver's side of Unit 2. The force of this collision caused Unit 2 to be pushed to the north curb and the front passenger wheel of Unit 2 struck the curb causing it to go flat. Unit 1 sustained minor damage while Unit 2 sustained moderate but disabling damage. Unit 2 towed by Gene Meyer. This report is to document the circumstances of the collision. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 11-07-23 01:30 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 11/18/2023 3:54:48 PM BADGE OR ID# 10008 ORI# WA0171300 TIME POLICE DISPATCHED 12:15 PM TIME POLICE ARRIVED',12:25 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EE20367 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-12827 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT'# 1 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1 ;TYPE 2 ❑ 1 28 CARRIER KING COUNTY METRO TRANSIT NAME 3 CARRIER ADDRESS 500 4TH AVE #653 CITY SEATTLE ST WA ZIP'', 98104 4 ❑ NAME # PLACARD: :❑ 02 GI1 NAME IF NO NUMBER SOURCE 1 AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO i MIDDLE'... 29 LAST NAME FIRST NAME INITIAL STREET 30 NFW AnnRFrtP. CITY ST ZIP 6 2 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No NTERLOCK YES E]NO� vES N LLIICIENSE STATE I SEX M��DYRYY' 2 7 F-1 ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE Y EES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# t 9 1"01? VEHICLE 1 o BarroM 34 13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1 RE O CYCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 El PEDESTRIAN 15 LAST NAME FIRST NAME INITIALMIDDLE TIAL ❑ STR 16 NFlEETEET"F-] CITY ST ZIP AnnRCDL IGNITION REQUIRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES NO NTERLOCK 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 TRR 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 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LeGALLv STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 11-07-23 01:30 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 10008 O#I,WA0171300 JOHNSON 11/16/202 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EE20367 CASE# ' 23-12827 DATE AND TIME 11/07/23 12:04 OF COLLISION a it S 4 I�) S ii AA9 +a� i {y V I l �I 3 1 � 3 { A ox ( t Y V Y 9y I Ir f � PAGE 4 OF 4