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Home My WebLink About23-7602 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED80065 170 27 COLLISION REP FIT 1591971 CASE 23-7602 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 07 - 1-- 2023 1340 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 3RD ST BLOCK NO. e✓ 1800 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ VV a MONTEREYDR NE 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2083010683 0 11 30 6� LAST NAME SEGEBARTT FIRSTNAME JARED MIDDLE A 1 2 31 INITIAL STREET ❑ 713 E F ST CITY MOSCOW ST ID 2jp, 83843 z NEW ADDRESS ]❑ 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 ICNLJAURY 1 NATURE OF INJURIES z❑ 3 ID 10❑ PI ATE 14 1L9669U STATE VIN#' 1FDXE4FS2DDA72960 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 5 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T E��/ y GOVT.VEHICLE 3 ] 34 13 8 2014 MH DAMAGE yES 0NO W&g YES❑ NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO STATEFARM 1141414CO212 3 4 IN EFFECT &POLICY# 9TOP vECALLv HICLe 1 5 36 res❑NO❑ CITATION# CHARGE 1 o BOTTOM 15❑ LE STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA. YES 1/ NO D:4252746821 16 a LAST NAME ADEM FIRST NAME FILLY MIDDLE M INITIAL 17 STREET❑ NEW ADOREss❑' 2914 NE 4TH ST CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK yEs I I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX M D.C.B. 11 25 _ 1977 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ ❑ILICENSE 21❑ PLA E# BPF1368 TATe 41 WA VIN# JTDK820U477645513 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' y GoI VEH D YEAR 200] MAKE TOYT MODEL PRIUS STYLE SD AMAGE TOWED✓ NOO BLIN NONE rowed B v HYES No%/ 44 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO GEIC04101884353IN I STOP 5 vE""LE ❑ N,J� CITATION# CHARGE LEG i o BOTTOM ALLY YES 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 BRETT WILLET 12257 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED80065 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7602 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SEGEBARTT SARA K (LAST FIRST, ADDRESS&PHONE# D.0 .B. 713 E F ST MOSCOW ID 83843 3602981146 SEX F MMDOYyry 10 - 08 - 1981 PASSENGER Z WITNESS E] UNIT# 1 SEAT 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET NJURY NATURE OF INJURIES USE CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) SEGEBARTT CAMERON A ADDRESS&PHONE# D O B 713 E F ST MOSCOW ID 83843 SEX: M MMDDYvvv 08 _ 16 _ 2013 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 1 POA 10 AIRBAG 2 RESTR. 2 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) SEGEBARTT HANNA K AooREss&PHONE# 713 E F ST MOSCOW/D 83843 SEX MMDDYYYY 01 15 _ 2015 . F D.O.B. _ PASSENGER WITNESS UNIT# ! 1 SEAT 10 AIRBAG 2 RESTR. 2 EJECT 1 HELMET INJURY 1 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. BRETT WILLET 07-04-23 03:08 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 711612023 2:33:30 PM BADGE OR ID# 12257 ORI#' WA0171300 TIME POLICE DISPATCHED! 1:44 PM TIME POLICE ARRIVED',1:56 PM PART Ei PAGE IT]OF STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED80065 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7602 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) FILLY HANAN A (LAST FIRST, ADDRESS&PHONE# D O.B. 2814 NE 4TH ST RENTON WA 98056 SEX F MMDDYyry 11 - 02 - 2013 PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑ 2 POS. 7 2 4 1 USE CLASS I1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B MMDDYYYY PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&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. BRETT WILLET 07-04-23 03:08 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 711612023 2:33:30 PM BADGE OR ID# 12257 ORI#' WA0171300 TIME POLICE DISPATCHED! 1:44 PM TIME POLICE ARRIVED',1:56 PM PART Ei PAGE 3�OF❑ REPORT NO. ED80065 CASE# 23-7602 OF COLLISION 07/04/23 13:40 OF CbLLI510N NARRATIVE Portions of this incident were captured on my Body-Worn Camera. Please See that for complete detail of witness statements and incident details. On 07.04.2023, 1 was working for the Renton Police Department as 1-Robert-22, fully uniformed and in a marked patrol vehicle. At approximately 1344 hours, I was dispatched to the 1800 block of NE 3rd St in the City of Renton, County of King, and the State of Washington to investigate a collision. VEHICLES INVOLVED: Unit# 01: 2014 Forest River Sunseeker Motorhome, ID LIC# 1 L9669U, Driven by: Jared A. Segebartt (DOB: 06.10.1984) Passenger: Sara K. Segebartt (DOB: 10.08.1981) Passenger: Cameron A. Segebartt (DOB: 08.16.2013) Passenger: Hanna K. Segebartt (DOB: 01.15.2015) Unit# 02: 2007 Toyota Prius, WA LIC# BPF1368, Driven by: Filly M. Adem (DOB: 11.25.1977) Passenger: Hannn A. Filly (DOB: 11.02.2013) INCIDENT: I arrived on the scene and determined the following: Unit# 01 was stopped in the left turn lane on NE 3rd St, waiting to turn north onto Bronson Way NE, but then decided to turn south (right) from the left turn lane onto Monterey Drive NE. Unit# 02 was traveling east on NE 3rd, approaching Monterey Drive NE's intersection. An uninvolved motor vehicle stopped and flashed its lights at Unit# 01, signaling that it was safe to proceed to turn. Unit# 01 made this right turn and collided with the driver's side of Unit# 02 as it was passing by. Unit# 01 said that he never saw Unit# 02 and that it was his fault. Unit# 01 had damage to the passenger front bumper and quarter panel. Unit# 02 had significant damage to the driver's side of his vehicle which included dents, scratches, and a broken window. No injuries were reported on the scene. I gathered all parties' information and then provided them with a case number and an information exchange sheet. Neither vehicle was towed and this ended my involvement with this incident. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. ELECTRONICALLY SIGNED Officer B. Willet# 12257 Renton, WA/ County of King State Of Washington 07.04.2023 1459 hours **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 1 Seat Position (Passenger CAMERON SEGEBARTT): BACK OF MOTERHOME Seat Position (Passenger HANNA SEGEBARTT): BACK OF MOTORHOME **** END OF AUTO-POPULATED SECTION **** PAGE 4 OF 5 REPORT NO. ED80065 CASE# ' 23-7602 DATE AND TIME 07/04/23 13:40 OF COLLISION er��s0 w CASE#23 7602 NOT TO SCALE Monterey Dr NE w z PAGE 5 OF 5