HomeMy WebLinkAbout23-13052 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-13052 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 02 STRUCK' BOULDER
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 1842 17 ❑-= S 8 IN 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 EAGLE RIDGE DRIVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2533504350 0 11
30
6� LAST NAME JOHNSON FIRSTNAME KEITH MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 26709 186TH AVE SE CITY COVINGTON ST I WA 21p 98042 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� 632015E sTArI WA VIN# 5TESM92N52Z113858
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR. 3 5 33
12 0 0 VIN# VIN#'
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34
13 4 2002 TOYT PICKUP PK DAMAGE vEsNo �LII� RS YES[:] No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14� LIABILITY INSURANCE INSURANCE CO STATE FARM 5087681-B14.47 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 1 5 36
LEGALLY YEs❑NO❑ CITATION# 3A0588151 INATTENTIVE DRIVING 1 o aorrom
15❑ NDING 8
MOTOR PEDAL-:. .PEDESTRIAN PROPERTY DAM THR PHONE
UNIT U2 VEHICLE ❑ ❑CYCLE ❑ OWNER ❑ YES 1/ NO OLD MET D:2062932247
16 a
LAST NAME LYNCH FIRST NAME ZAYD MIDDLE /
INITIAL
17 STREET I7TH ST E CITY PUYALLUP ST WA ZIP 98375 4❑ 37
NEW ADOREs�' 7249 17
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LICENSE# STATE WA SEX M M .C... 04 O6 _ 2006 39
20❑ ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 WEB SET 2 NJAU SY 7 COMPLAINT OF HEAD PAIN ❑F—NATURE OF INJURIES 40
❑LICENSE I 21❑ PLA E# CJN8029 TArE WA VIN# 2G4 WS52M9X1545531 41
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 1999 MAKE BUIC MODEL CENTURY STYLE SD VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44
24❑ DAMAGE YES�/ NO BANKERS YES NO
REGISTERED OWNER INFO MARIA CLOW 7249177TH STE PUYALLUP WA 98375 D:2062932247 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO BRISTOL WEST G013314604 00IN 9TOP 5
VE—LE ❑ ,J� CITATION# CHARGE
25 io BOTTOM
LEGALLY YES N J
' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MIR/AM LONG 7 12790 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE20503
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13052
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.
MIRIAM LONG 11-13-23 01:10 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1111712023 1:16:54 AM
BADGE OR ID# ( 12790 ORI# WA0171300 TIME POLICE DISPATCHED 6:47 PM TIME POLICE ARRIVED',7:04 PM
PART I PAGE IT]OF 4�
REPORT NO. EE20503 CASE# 23-13052 OF COLLISION
11/12/23 18:42
OF CbLLI510N
NARRATIVE
23-13052
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 11/12/2023 at approximately 1853 hours, while working as a commissioned police officer for the
City of Renton, I was dispatched to an accident that took place at Benson Rd S/Eagle Ridge Drive S.
Initial information was that the vehicles were not blocking and there were no injuries.
My involvement in this case was captured on my department-issued Axon body camera. This report is
a summary of events that occurred and is not an exact sequencing of events. Statements have been
paraphrased and summarized.
Upon arrival, I observed a white Toyota pickup halfway off the road on the west side of Benson Rd S
facing east towards Eagle Ridge Drive S. There was also a white Buick sedan off the roadway that
was up on the rocks on the northeast corner of Benson Rd S and Eagle Ridge Drive S near the stop
sign. There was debris on the east side of Benson Rd S near the stop sign at Eagle Ridge Drive S.
I contacted the driver of the Buick (WALIC/CJN8029), identified by WA DOL photo as Zayd I. Lynch
(DOB 04/06/2006). Zayd told me he was driving north on Benson Rd S when the Toyota, which was
at a complete stop at the stop sign on Eagle Ridge Drive S pulled out in front of him. He said he was
not able to stop but had swerved to try and avoid him and hit the back of the Toyota before he went
off the roadway. Zayd said he had hit his head and was feeling pain.
I spoke with the driver of the Toyota pickup (WALIC/B32015L), identified by WA DOL photo as Keith
L. Johnson Jr. (DOB 6/27/1956), who advised he was on Eagle Ridge Drive S stopped at the stop
sign. He said he saw the headlights of the Buick driving north on Benson Rd S and pulled out to turn
south on Benson Rd S when the Buick was approximately 30 feet south of Eagle Ridge Drive S. Keith
believed he had enough time to make the turn and tried to speed up to get out of their way but was
unable to make it and the Buick struck his truck on the rear driver side.
I looked at the damage to Keith's vehicle and observed significant damage to the left rear wheel and
truck bed.
I looked at the damage to Zayd's vehicle and observed the airbags had been deployed and there was
significant damage to the front end of the vehicle.
Renton Fire was called to the scene and medically evaluated Zayd. Keith said he was okay and
refused treatment.
Due to both vehicles being damaged and inoperable, Bankers Towing was called to the scene and
towed both vehicles.
Keith and Zayd provided me with their WA driver's licenses, vehicle registrations, and proof of
insurance.
I provided both drivers with my business card and the case number.
After hearing both driver's explanation of the incident, I believe Keith to be the at fault driver and
advised Keith that he would be receiving a citation in the mail for inattentive.
PAGE 3 OF 4
REPORT NO. EE20503 CASE# ' 23-13052 DATE AND TIME 11/12/23 18.42
OF COLLISION
Ve
Eagle �90
Unit 2
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PAGE 4 OF 4