HomeMy WebLinkAbout23-12905 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c
COLLISION REP FIT 1591971
CASE 23-12905 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC WA0171300 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TRIBAL 02
TOTAL#OF OBJECT 1 1 8 28
UNITS ❑
RESERVATION I I
STRUCK z
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
c us oN 11 - 09 - 2023 0550 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON RD S BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e BENSON DR S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066189390 0 4 30
6� LAST NAME LUTUI FIRSTNAME KATO MIDDLE 1 2 31
INITIAL
STREET ❑ 21123 119TH PL SE CITY KENT ST WA 2jp, 98031 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 H U EET 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ PI ATE 14 BNW8847 JBTATIJ WAvN# JM1GJ1U59G1471768
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM TO
TRLR. TRLR. $ 1 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 3 $ 34
13 A 2016 MAZD 6 SE SD DAMAGE YES NO YES[:] NO✓
REGISTEREDOWNERINFO JOSHUALUTUI24203104THAVESEKENTINA98030 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE U INSURANCE CO PROGRESSIVE 935460224
IN EFFECT &POLICY# 9TOP
ve EFFECT
CHARGE 1 5 36
LEGAL
IF" Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:7042647211
16 a
LAST NAME HAMRICK FIRST NAME MICHAEL MIDDLE D
INITIAL
17 STREET NEW ADOREsS❑' 1823 GRANT AVE S#2 CITY RENTON ST WA ZIP 98055 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 02 _ 26 _ 1985 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS PAIN TO HEAD
❑ 41
21❑ ILICENSE PLA E# BOL9488 TArE WA VIN# 19UUA56601A024447 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
Gov HI
VEH YEAR 2001 MAKE /a CUR MODEL 3 STYLE $D —FEHICLE
TOWED NOO✓ BLIN TOWED BY 44
fj
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 478-8617-D17-478IN STOP 5
VEHICLE YES[:] NC[:]I CITATION# CHARGE to BOTTOM
LEGALLY
25 N.HVCa
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
ROSEANNE HYNES 12612 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE21107
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12905
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'
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.
ROSEANNE HYNES 11-13-23 02:22 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 1111912023 7:25:02 AM
BADGE OR ID# ( 12612 OR]# WA0171300 TIME POLICE DISPATCHED; 5:52 AM TIME POLICE ARRIVED',5:53 AM
FART I PAGE IT]OF 4�
REPORT NO. EE21107 CASE# 23-12905 OF COLLISION
11/09/23 05:50
OF CbLLI510N
NARRATIVE
On 11/09/2023 at 0552 hours, I was in full patrol uniform and driving a marked Renton Police patrol
vehicle when I was dispatched to SE Petrovitsky RD & 108th AVE SE in the city of Renton, County of
King, State of Washington regarding a vehicle collision.
Upon arrival, I discovered the involved drivers and their vehicles were in the roadway on Benson DR
S, just south of Benson RD S. I asked the drivers to drive their vehicles to a nearby side street at SE
174th St for safety purposes and they did so.
I saw that V1-(WA LIC# BNW 8847) had sustained severe damage to the front right and right side of
the vehicle. It appeared the front right area took most of the impact and there were scrape marks
along the right side of the vehicle. 1 saw that V2 -(WA LIC# BOL9488) sustained major damage to the
front end. It appeared the front left area of the vehicle sustained most of the impact and then damage
continued throughout the front of the vehicle.
I spoke with D1 -Kato Lutui and she told me in summary: She was driving north on Benson DR S
approaching the light at Benson RD S. She saw that the light was red and she ran the light. V2 was
coming from Benson RD S and attempting to make a left turn onto Benson DR S when she collided
into V2. D1 said she did not know why she ran the red light. I did not see visible injury upon her. She
did not complain of injury and did not request medical assistance. Renton Fire arrived on scene and
asked D1 if she wanted medical treatment and she declined.
I spoke with D2 -Michael D. Hamrick and he told me in summary: He was driving west on Benson RD
S and approaching the intersection at Benson DR S. He had a green light and was making a left turn
through the intersection (attempting to go south on Benson DR S) when V1 struck him. He said V1
was traveling north on Benson DR S. D2 said he felt pain in his head. He said his head hit the inside
of the vehicle when the accident occurred. He requested to be evaluated by the fire department.
Renton Fire evaluated D2 and D2 declined medical transport.
Both V1 and V2 were pulled to the side of the roadway. Both drivers eventually removed their
vehicles from the roadway.
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.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: R. Hynes #12612 Date & Place: 11/13/2023 @ 1420 hrs Renton, WA
PAGE 3 OF 4
REPORT NO. EE21107 CASE# ' 23-12905 DATE AND TIME 11/09/23 05:50
OF COLLISION
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Benson R0
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PAGE 4 OF 4